High blood pressure on the rise -  experts

High blood pressure or hypertension is one of the non-communicable diseases that is ravaging lives globally.

In commemoration of the May 17 World Hypertension Day, Uganda Heart Association (UHA) seeks to create awareness of the high rate at which high blood pressure is gaining ground in Africa and Uganda.

Dr Emmanuel Okello, the president of UHA, says whereas the condition is more prevalent in western countries, Ugandans are also at high risk.

This year’s celebrations were under the theme:  “Measure Your Blood Pressure Accurately, Control It, Live Longer”.

Dr Okello says: “According to the World Health Organisation, an estimated 1.28 billion adults between 30 and 79 years worldwide have hypertension, with two-thirds living in low and middle-income countries.”

Dr Elijah Rutahaba, a cardiovascular physician, and an executive member of UHA, describes hypertension using a water pipe analogy.  “Imagine a water pipe with a certain pressure force of water moving in the pipe. This is the same with our blood vessels as blood flows through them at a certain pressure. However, when one has hypertension, the pressure in their blood vessels increases,” he says.

Dr Rutahaba says hypertension is caused due to reduction in blood vessel diameter thus blood squeezes through narrow blood vessels.

“The other is that the amount of blood passing through the blood vessels increases yet it must squeeze through normal sized blood vessels. However, the heart continues to pump hard to force blood against such pressure which can damage the blood vessels...”

Dr Charles Musoke (UHA) reports that surveys in Uganda conducted by Makerere University and Ministry of Health have shown that one in four Ugandan adults have hypertension.  Of these, men are more at risk ‘‘because they do not take care of their health well.”

Only a small fraction of men seek medical attention, according to Dr Isaac Ssinabulya from Mulago hospital.

Signs of hypertension

Dr Judith Namuyonga Twesime (UHA) says high blood pressure is largely a painless disease and the most effective method of early diagnosis is routine medical checks.

“Patients with a sudden, acute or slow rise in the high blood pressure, ...have complaints such as morning headache, strong or irregular heartbeats, nosebleeds, changes in vision, and buzzing in the ears. Those with severe hypertension may have fatigue, nausea, vomiting, confusion, anxiety, chest pain, and even muscle tremors,” she says.

She adds that somebody organs may be damaged with a late diagnosis.

 “Oftentimes, patients come to the healthcare facilities when they already have symptoms due to the complications of the advanced stage of the disease,” Dr Elias Sebatta (UHA) says.

Causes

It is common that patients would like to know what could have caused the high blood pressure so as to work on it.

However, Dr Peter Lwabi (UHA) says: “The risk of developing hypertension increases with advancing age, obesity, high salt intake in food, including that in processed foods and fast foods. Genetics also play a role, African ethnicity, excessive alcohol consumption and physical inactivity.”

Dr Lwabi adds that patients with kidney disease, diabetes mellitus, thyroid disease, adrenal gland disease, and congenital coarctation (obstruction) of the aorta also have hypertension.

However, the cause in more than 95 percent of these patients is unknown.

Dr Twalib Aliku (UHA) says underweight babies, premature babies, and babies born to malnourished mothers are also at higher risk of hypertension.

Diagnosis

Dr Asad Muyinda (UHA) reports that diagnosing hypertension is a simple, quick and painless process.

“It starts with a medical personnel placing a cuff around your arm, which is either manually or automatically inflated. The normal upper readings (systolic blood pressure) should be less than 140 mmHg, and normal lower reading (diastolic blood pressure) should be less than 90 mmHg. They will then review the results and advise on the next step,” he says.

Today, due to fear of mercury, manual devices have become less popular.

Dr Barbara Kakande, the UHA vice president, says high blood pressure strains the heart muscle and blood vessels.  “The heart initially tries to compensate by becoming bigger, so as to forcefully pump blood through the blood vessels. This complication is called left ventricular hypertrophy.”

Dr Rutahaba found a high prevalence of left ventricular hypertrophy among hypertensive patients in rural western Uganda.

Other heart complications include heart dilation, heart attacks, heart stiffening, heart weakening, abnormal heart rhythms, and even sudden death.

Dr Suleiman Lubega (UHA) reports that high blood pressure also causes strokes, kidney diseases and failure, retinopathy (and visual impairment), and poor flow to limbs; which may even result in amputation.

Hypertension is a chronic disease and individuals should monitor their blood pressure regularly and to do assessment of the integrity of high risk body organs periodically.

Prevention

Dr Tom Mwambu (UHA) emphasises the importance of a healthy lifestyle. “A healthy lifestyle encompasses diet, exercise and mental well-being. The growing trend in consumption of fast foods as evidenced with growing number of fast food businesses in Uganda is among the key causes of unhealthy diets,” he says.

Dr Mwambu adds that individuals must limit the total daily salt intake to 2.5 grams of salt.

Dr Tony Hasashya (UHA) also calls for eating of more fruits and vegetables, avoidance of use of tobacco (including shisha), reduce alcohol consumption, limit eating foods high in saturated fats and reduce trans-fats in diet.

 Dr Muhoozi Rwakaryebe, the General Secretary of UHA, says: “Medication is very effective and widely available on the market. However, only use prescribed medicines to avoid complications.”

Dr Zhang Mondo (UHA) advise patients to take their medication daily, and adhere to the personalised treatment plan.

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