HYPERTENSION
Hypertension is a cardiovascular disease characterized by a persistently elevated arterial blood pressure beyond 140/90mmHg.
Cardiovascular diseases affect the heart, and the blood vessels. Some cardiovascular diseases affect the arteries (arterial disease) and some affect the veins (venous disease).
Hypertension is an arterial disease.
Hypertension can be a disease on its own, or it can be caused by another medical condition.
Hypertension occurring on its own is known as Primary Hypertension. Hypertension occurring as a result of some other disease (like kidney disease) is Secondary Hypertension.
Hypertension in the Gambia
According to a study car
ried out using a 1% population sample over 15 years of age (van der Sande et al, 1997), 24.2% subjects were found to be hypertensive. In this case, being hypertensive was defined as one having a persistently elevated blood pressure beyond 140/90mmHg.
Causes of Primary Hypertension
The cause of primary hypertension is unknown, but it is unlikely to be a single cause.
Heredity and environmental factors play a part in its occurrence.
A family history of hypertension is significant, but does not mean that one will ultimately end up with the condition.
Thus, individuals who have a parent or sibling with hypertension need to proceed with a little caution and be weary of the symptoms of the condition. Having said this, there is no need for excessive worry since they may not have the condition at all.
Environmental factors also play a role. Obesity, a high salt diet and stress are key environmental factors in the occurrence of primary hypertension.
Causes of Secondary Hypertension
Hypertension due to other medical conditions is secondary. The causes include:
• Kidney disease
• Adrenal gland disorders
• Diseases of the arteries (e.g. Atherosclerosis)
• Hyperthyroidism (excessive secretion of hormones from the thyroid gland).
• Excessive alcohol intake
• Excessive use of corticosteroids
• Oral contraceptives
Symptoms of Hypertension
It is important that hypertension can present without symptoms (asymptomatic) until complications arise.
The disease can affect a host of organs, most notably the Central Nervous System (CNS), the heart and kidneys.
Common symptoms with respect to the disease in the central Nervous System (CNS) include:
• Onset of frequent headaches
• Dizziness
• Blurred vision
Symptoms due to complications in the heart include:
• Fatigue
• Frequent palpitations
• Swollen feet
Symptoms due to complications in the kidneys include:
• Excessive urination (polyuria)
• Frequent urination at night (nocturia)
• Blood in the urine (haematuria)
Diagnosing Hypertension
Hypertension cannot be diagnosed with a single blood pressure recording (BP), and it cannot be diagnosed by multiple BP recordings in a single day.
At least two BP recordings a few hours apart on each of three days should be used to diagnose the condition.
When recording blood pressure, one should have rested a bit after arriving at the health facility before the recordings are done.
Stress and anxiety can also raise blood pressure.
Complications of Hypertension
• Stroke
• Heart Failure
• Chronic Kidney Disease
Managing Hypertension
After hypertension is diagnosed in an individual, the doctor will order some investigations to determine the level to which the disease has affected the heart, CNS and kidneys amongst others.
These tests may include:
• Kidney function tests (to check Urea and Creatinine levels)
• A chest X-ray (the heart may become enlarged in long-standing hypertension)
• A blood lipid profile
• An electrocardiogram (EGG)
A combination of diet, drugs and moderate exercise is used to control hypertension.
A diet low in salt, fatty foods and high in fibre is ideal.
There are various drugs which can be used to control hypertension. A combination of the different drugs can also be used to control the disease. Your doctor will decide which drug/combination of drugs best controls your condition. The drug combinations vary from one person to another.
Regular, tolerable exercise can stop the progression of the disease and even reverse some complications in some instances.
A very important feature of the management of the condition is the regular visits to the doctor. Taking medication alone is not enough to prevent the complications. The doctor needs to re-assess the response to treatment on a regular basis and adjust the treatment if necessary.
If you have any comments, contributions or if you require more information on hypertension, please contact us on:
mcham@medgambia.com
|
