JOIN USIt is very important for the middle-aged to keep a tab on their blood pressure, as nearly 90 per cent of those aged 50 years and above develop prehypertension, which can lead to hypertension, warns Dr Suresh G Vijan.
Simply put, blood pressure is the force exerted by blood, on the walls of the arteries and veins, as it courses through the body. Like the ocean tide, it is normal for blood pressure to rise and fall throughout the day. Blood pressure is lowest when you are asleep, and rises when you awaken. But when the pressure stays elevated over time, it causes the heart to pump harder and work overtime, possibly leading to serious health problems, ranging from hardening of the arteries, stroke and brain hemorrhage, to kidney malfunction and blindness.
Detecting it
High blood pressure affects 1.2 billion people worldwide. Its prevalence is estimated to increase by more than 29 per cent by 2029. This condition is associated with increasing obesity and an ageing population. It has become a major public health challenge.
Hypertension rarely causes any specific symptoms. Therefore, it is detected only when doctors check your blood pressure for a specific complication such as stroke or heart attack. The primary goal of therapy is to reduce blood pressure to normal levels by a combination of lifestyle changes and drugs.
Measuring it
Blood pressure is recorded as two numbers, the systolic (pressure during a heartbeat) over the diastolic (pressure between heartbeats). For example, a measurement of 120/80 millimeters of mercury (mmHg) is expressed as “120 over 80.” Normal blood pressure is less than 120/80. People with pressures between 120/80 and 139/89 are considered to have prehypertension and are likely to develop high blood pressure, in the absence of any preventive measures.
At risk
Today, clinical guidelines recommend that doctors work with patients to keep their blood pressures below 140/90 mmHg, and even lower for people with diabetes or kidney ailments. In all cases, patients are encouraged to lose excess weight, exercise regularly, not smoke, limit intake of alcoholic beverages, and follow heart-healthy diet, including cutting back on salt and other forms of sodium. While many develop high blood pressure as they get older, it is not a hallmark of healthy ageing. While an individual’s blood pressure may be normal now, 90 per cent of people over 50 years of age have a lifetime risk of high blood pressure.Preventing itn Because blood pressure rises as body weight increases (and obesity is a known risk factor for developing high cholesterol and diabetes, which in turn can lead to heart disease), a loss of as little as five kgs can help lower blood pressure.
n The Dietary Approaches to Stop Hypertension (DASH) clinical study tested the effects of food nutrients on blood pressure. It emphasizes and recommends consumption of fruits, vegetables, and low-fat dairy foods, whole grains, poultry, fish and nuts, and stresses reduction of fats, red meats, sweets and sugared beverages.
n The DASH-sodium study demonstrates the importance of lowering sodium (salt) intake. Most patients consume far more than the current, daily recommendation of 2,400 milligrams (mg) of sodium - about a teaspoon of table salt or less. This includes all salt and sodium consumed, not just at the table, but also in cooking and consumption of sodium-rich foods such as pickles, papad, preserved foods. For those with high blood pressure, consuming even lesser amount of sodium may be advisable, since the DASH-sodium study revealed that diets containing no more than 1,500 mg of sodium per day had greater pressure-lowering effects.
n Regular physical activity is another good step toward controlling high blood pressure.
(The writer is a cardiologist at Lilavati Hospital & Fortis Hospital, Mumbai)