Healthy Living examines the symptoms of hypertension
Available information indicates that hypertension is affecting a large segment of the population and most of time the causes are unknown. Healthy Living this week looks at the symptoms of this health problem.
Marleni Cuellar, Reporting
Hypertension or high blood pressure is an all too common condition in Belize. In fact, hypertension has been one of the leading causes of death for Belizeans for several years. Cardiologist Dr John Gough explains the importance of looking at hypertension in three specific steps.
Dr. John Gough, Cardiologist
“The important thing about hypertension, you need to classify. We need to find out if you have it, secondly what stage you’re in and thirdly what is it you need to do.”
Most doctor visits include a blood pressure check. This is because for most persons, hypertension has no symptoms at all.
Dr. John Gough
“Most patients, if not all are asymptomatic they have no symptoms unless you are the very few that will complain about headache dizziness some chest compression, chest pain, shortness of breath and problems with vision, well you’d be of the big group that doesn’t have any kind of symptoms and sometimes it might be possible that you find out that you’re hypertensive when you go for your annual check up or you happen to be somewhere you requested to test your blood pressure and they tell you your pressure is high.”
Blood pressure is measured in milligrams of mercury. For example the normal blood pressure would be defined as one-twenty and eighty milligrams of mercury. Both numbers measure two different components of blood pressure.
Dr. John Gough
“You have the top number which is the contraction pressure, you have a bottom number; diastolic pressure which is when the heart and blood vessel relax. That’s the difference between the two. Basically, the systemic pressure or the top number is the high pressure—is the pressure when the vessels around the body and the heart are contracting to circulate blood around the body and the bottom number basically would be when the blood vessels and the heart would relax at least momentarily between heart beats or the next heart beat.”
Hypertension then is when the blood pressure exceeds this normal range. As of 2003, the classification of hypertension has been simplified. Persons are now diagnosed as pre-hypertensive, stage one hypertension and stage two hypertension.
Dr. John Gough
“We should keep our contraction pressure, the top number, between one-twenty, ideally one-thirty, and the bottom number just around the eighty’s. Why do we want to keep it in that range is that the minute we go over this range, we classify people as pre-hypertensive and basically means that in a couple months or years they will begin to have problems because of chronic elevated blood pressure. Stage one basically we want to get up or allow a patient to get up to at least a one-fifty and the systolic, or the contraction or the top number and ninety or eighty-nine to ninety the bottom number which is relaxation of the vessels and the heart pressure. And anything above that would be considered stage two.”
The stage as well as type of hypertension plays a major role in treatment. As Dr. Gough points out for the majority of patients, the cause of the condition is more difficult to trace.
Dr. John Gough
“Almost ninety-seven percent of the time we don’t know why we have hypertension. We say that it’s a multi factorial problem it could be because we live in Belize, it could be because you’re overweight, it could be because of race, it could be because you smoke, it could be because cholesterol, triglycerides, diabetes, some thyroid problems some kidney problems some endocrinological problem could be contributing to a high blood pressure.”
This form of hypertension without an identifiable cause is primary hypertension. Secondary hypertension is usually the result of an underlying identifiable cause, which most times is correctable through some form of invasive surgery. However, this is not the most common diagnosis for hypertensive patients.
For Belizeans, with hypertension and other lifestyle diseases so prevalent, understanding our risk factors and how to control them are of utmost importance.
Dr. John Gough
“The three-four hundred thousand people we have. We’re in problems when you look around and you don’t see that average seventy kilogram human being or the sixty/sixty-five kilogram young lady, forget it. We eat bad the type of food we have we won’t call it a culture thing but we could be conscious of all of this but we’re not doing anything to control these problems. I think it’s just about education. We need to remember that we need to come out of that sedentarysm, we need to get ourselves out there eat the right type of food. We have to get at all the daily requirements when it comes to supplements which are important to us to try to help the body in controlling or trying to auto-regulate the normal limits of blood pressure”
Untreated hypertension can cause severe damage to the blood vessels in the body affecting the kidneys, heart, brain and eyes. Fortunately, once diagnosed, it can be controlled through lifestyle changes and medication.
Dr John Gough
“Why wait until we have an infer, why wait until we need to put in a pacemaker, why wait until you have the first stroke and half of the body doesn’t work? We need to re-stratify or classify, see where we are stage one stage two. Modify the lifestyle; that’s always step one. Most of the times it’s not enough and you need to add medications to control the blood pressure. Of the medications, we have a whole bunch of them now. We have expensive, we have cheap. The expensive ones basically are the ones that have less side effects, the cheaper ones have a whole bunch of those and depending on the stages, we know if we’re gonna use one or two or three or four or five different anti-hypertism medication or keep you within that range. The body doesn’t care how you do it. That’s something we have to learn to live with and if we have to live with it, let’s learn to take care of ourselves. Your doctor can’t do that for you; he can only orientate you. You’ll have the last say there.”
The onus remains on you. If you are hypertensive, stick to the regime as set out by your doctor. Be sure to schedule follow up consultations yearly to ensure that your blood pressure is under control.
