Opinions of Thursday, 20 February 2014

Columnist: Ussif, Aminu

Nothing gives you a high blood pressure than ....

measuring your blood pressure.

This article is motivated by the recent statistics that were reported by Prof. Kwabena Frimpong Boateng that 40 per cent of Ghanaians above 40 years of age has HT but about 30 per cent is unaware of it. These statistics mirror some figures among Afro-Americans according to the Centers for Disease Control and Prevention. The main goal of this article is twofold. First to share with and remind people about the emerging people’s disease in Ghana; second to encourage people to seek help from qualified professionals when checking or when treating properly diagnosed high blood pressure (HBP).

There is a general consensus that many patients’ blood pressure (BP) rises only by the fact that they are visiting a doctor, by being examined by a doctor or by seeing a doctor in their white coat. In addition, there are several sources of error associated with measuring BP for example, instrumental error, precision error, the use of inappropriate cuff and many more. Another source of error is the use of results based on a single measurement value which often together with incorrect measurements can lead to unwarranted worries and bewilderment on the part of the patient.

Hypertension (HT) or HBP can be classified as either primary (essential) or secondary. The primary type of HT also known as idiopathic HBP is of unknown cause while the secondary type is seen in patients with ailments such as kidney, endocrine and heart conditions as the underlying cause. Another form of HT is seen during pregnancy and when using certain medications or birth control pills.

When is your blood pressure high? BP is recorded as two numbers systolic/diastolic. I will employ this notation throughout the remainder of the article. According to the WHO classifications an ideal BP is when accurate readings are less than 120/80 mm Hg and it is considered normal if the BP is less than 130/85 mm Hg. When BP readings lie between 130-139/85-89 mm Hg it is considered normal high and this does not usually require medication. A person has mild HT if the readings are between 140-159/90-99 mm Hg and it is called Grade I HT. If the levels are between 160-179/100-109 mm Hg it is considered moderate HT whence Grade II. In severe HT the levels are equal or above 180/110 that is Grade III. These dangerously high levels of HT are referred to as hypertensive crisis. Severe HT is described as hypertensive urgency if the diastolic pressure lies above 120 barring any affection of an organ. Hypertensive crisis usually occurs at diastolic pressure above 130 mm Hg with a sign of organ affection and is usually diagnosed by an eye test called ophthalmoscopy.

Does hypertension have symptoms? According to the American Heart Association it is a misconception that HT causes symptoms such as nervousness, sweating and difficulty sleeping. In fact HT does not normally give any symptoms except in the severe case where emergency treatment is required. Owing to the fact that HBP does not give any warning signs it is named the “silent killer” thus majority of people with HT are not aware of the condition.

Treatment of HT is not discussed here because it is important that qualified professional are consulted since a total evaluation of the patient with regard to cardiovascular and other risk factors has to be considered. The best advice is to see the doctor which in my view is an investment that is worthwhile. One thing I and other non-specialists can do without making serious error is to encourage lifestyle modifications such as physical activities, managing stress and dietary measures.


Here are some of the complications of hypertension but these occur normally in the severe case and over time. Headache, cramps, stroke, heart failure/attack, kidney failure, changes in the retina and other eye symptoms.
Caution:

Be wary of who measures your BP and the circumstances under which the measurement is taken. Proper technique of measuring BP, using appropriate kit and the circumstances under which this is carried out are of critical importance in diagnosing HBP.

If you told that you have HT ask the doctor or the nurse how high the readings are and if possible let them write it down for you.

Do not allow unqualified people to diagnose your high blood pressure, it can lead to unnecessary fears and anxiety.

Seek help from qualified professionals when diagnosed with HT and do not allow anybody at all to treat your HT. Notice that all medications have some form of side effects, antihypertensive drugs included but most of them are mild. The side effects depend on different factors for example the type of drug you are using and the dose. Talk to your doctor if you are experiencing any symptoms after being put on a BP medication and do not stop taking the medication without talking to your doctor.

Ask the professional the name of the medication you are prescribed and about the possible side effects of the said drug.

When diagnosed with HBP follow your doctor’s advice and recommendations it is a worthwhile invest in the long run. It is certainly better to live healthy than to die wealthy.

If you are on treatment for diabetes inform your doctor about it when you are diagnosed with HT.

If you are on BP medication and planning to be pregnant inform your doctor.
Pregnant women with BP above 140/90 mm Hg ought to be referred to a specialist. So if you happen to hear about or know a pregnant woman that has a BP in this range you may advise her to seek help. It may save lives.

Any errors are mine.

Aminu Ussif.