Association of Cameroonian Physicians in the Americas


    Hypertension- what you should know


    American Heart Association

    Hypertension is defined as a chronic elevation of blood pressure in the arteries. It is basically a condition where the pressure within your arteries is too high. Several physician groups have different guidelines and classifications of hypertension. For the purpose of this article, I will focus on the ACC/AHA (American college of Cardiologists/American Heart association) classifications of hypertension. The systolic blood pressure (top number) measures the pressure in your blood vessels when your heart beats. It should be no higher than 120 mmHg. The diastolic blood pressure is the pressure in your blood vessels in between heart beats when your heart is resting. It should be no higher than 80 mmHg. Uncontrolled high blood pressure can lead to severe health problems.

    Symptoms of hypertension

    Hypertension can be a silent killer and as such will have no symptoms at all. When symptoms are present, they can be sometimes vague and can present as headaches, difficulty sleeping, nosebleeds or anxiety.

    Types of hypertension

    Hypertension may be primary which is caused by stress, lack of exercise and imbalance in the hormones regulating blood volume and pressure. Secondary hypertension occurs as a result of other diseases e.g. diabetes, obesity, pregnancy, sleep apnea, hyperthyroidism or chronic kidney disease

    Stages of hypertension

    Elevated blood pressure is a systolic blood pressure (SBP) of 120-129 mmHg and a diastolic blood pressure (DBP) less than 80mmHg

    Stage 1 hypertension is SBP 130-139 mmHg and a DBP 80-89 mmHg

    Stage 2 hypertension is SBP greater than 140 mmHg and a DBP greater than 90 mmHg

    Hypertensive crisis is SBP greater than 180 mmHg and DBP greater than 120 mmHg

     Risk factors for hypertension

    • Age: Hypertension is more common in people aged over 60 years. With age, blood pressure can increase steadily as the arteries become stiffer and narrower due to plaque build-up.
    • Ethnicity: Some ethnic groups are more prone to hypertension.
    • Size and weight: Being overweight or obese.
    • Alcohol and tobacco use: Consuming large amounts of alcohol regularly can increase a person's blood pressure, as can smoking tobacco and using nicotine products.
    • Sex: The lifetime risk is the same for males and females, but men are more prone to hypertension at a younger age. The prevalence tends to be higher in older women.
    • Existing health conditions: Other heart diseases, diabetes, chronic kidney disease, and high cholesterol levels can lead to hypertension, especially as people get older.

     Other contributing factors to hypertension include:

    • Lack of exercise
    • A diet with excessive salty foods and a diet high in fatty foods
    • Low potassium diet
    • Certain medications
    • Stress
    • Family history of hypertension

     Treatment of hypertension

    Several medications are available to treat hypertension. The choice of medication depends on the other medical problems that you may have. Some classes of blood pressure lowering medications and their examples include:

    • Diuretics, e.g. thiazides (Chlorthalidone, Hydrochlorothiazide)
    • Beta-blockers (Metoprolol)
    • Calcium-channel blockers (Diltiazem, Nifedipine)
    • Central agonists (Clonidine)
    • Vasodilators (Hydralazine)
    • Angiotensin-converting enzyme (ACE) inhibitors (Lisinopril)
    • Angiotensin receptor blockers (Losartan)

    Lifestyle modifications to reduce hypertension include

    • Exercising at least 30 minutes a day, at least 5 days a week is recommended. It can be something as simple as dancing to West African music for 30 minutes a day. If you have to do it, you might as well make it fun!
    • Eating a well-balanced diet that is low in saturated fats, salts, preservatives and high in fiber is important. Physicians encourage the DASH (Dietary Approaches to Stop Hypertension) diet. Resources for the DASH diet are found online. Our African recipes can be easily adjusted/modified to fit these recommendations.
    • Limiting your alcohol intake (no more than 2 drinks a day for men or 1 drink a day for women e.g. 12 oz of beer or 1-1.5 oz of liquor.
    • Weight loss
    • Getting at least 8 hours of sleep nightly
    • Avoiding stress (exercising and pursuing your hobbies can actually help with stress)
    • Limiting caffeine and other stimulant use

    Poorly controlled or untreated hypertension can lead to atherosclerosis which is when there is the formation of plaque that leads to the narrowing of blood vessels. This makes hypertension worse, as the heart must pump harder to deliver blood to the body. Atherosclerosis leads to complications like heart failure, kidney failure, strokes, blindness, and aneurysms (an abnormal bulge in the wall of an artery that can burst, causing severe bleeding or even death)

    What to do if you have hypertension

    • Buy a blood pressure cuff and take your blood pressure twice daily and record it. Take these records to your doctor for your next checkup.
    • Exercise often. Walk, dance, play soccer. Anything to get your heart rate up.Just move. Get a pedometer and aim for 10,000 steps a day, download the Couch to 5K app and start jogging
    • Eat a balanced diet
    • Avoid alcohol, nicotine and other stimulants
    • Avoid stressful situations
    • Get a good night's rest
    • Take your medications as prescribed
    • See your doctor as scheduled and get your eyesight and kidney function monitored.
    • If you are over 60 years old, get an abdominal ultrasound or Cat scan (CT scan) done to see if you have an abdominal aneurysm

    Author: Shirley Ayuk-Takem, DO


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