By Dr Joel Akande
I have had several patients whose blood pressure may be “normal” at home but rose at the care centre. The presence of an authoritative figure such as a doctor or a nurse may cause a blood pressure to be raised. In all these situations that I have mentioned, the blood pressure may be temporarily raised. It does not mean that the individual has a raised blood pressure as an illness. However, if the pressure is raised to a certain level even on the same day within 60mins, the doctor may decide to offer treatment. I had a client in recent times. He had lost a very close and loving relative. When I was asked to see him because of his distress, amongst other things, I took his blood pressure. To my greatest surprise, it was the highest blood pressure readings that I have ever seen. Of, course; I had to start treatment immediately.
Therefore, normal blood pressure is a matter of relative degree, individualised, age and circumstances that are influencing the pressure reading. Raised blood pressure is a matter of persistence.
Types of Blood Pressure: Blood pressure can be divided into two. The first is called essential or primary hypertension. In this case, there is no knowing specific cause for the raised blood pressure although there are certain features that can be identified as contributing to the high blood pressure. It’s by far the commoner form. The other type is called secondary hypertension. In this case, there is a reason, an identifiable cause for the abnormal blood pressure. Now let us deal with each category of the raised blood pressure.
Essential Hypertension: 90% of raised blood pressure belongs in this category. This is the more common form of blood pressure and sadly a deadly disease that is extremely common amongst people of Black African descent wherever they may be on earth. There are certain factors that had been identified as contributing to essential hypertension. These factors include unreasonable consumption of table salt (sodium chloride). I once had a 30year old patient who came with his wife to see me by reason of infertility. As soon as I measured the blood pressure of the husband, I noticed that for his age, he was reading a pressure as if he was 70year old: very high for his age. Upon discussion, the wife said, he likes to “lick salt” for no apparent reason. He will ask for extra salt be put in his food. It was therefore not surprising that my patient was having abnormal blood pressure readings. Another common association with high blood pressure is obesity. Being fat may compress the blood vessels and cause the heart to pump blood around the body with extra effort. High cholesterol that tends to block the passage of blood may also contribute to essential hypertension. On the other hand, being Black-African is a factor. Hypertension may run in the family. Father, son, daughter, and grandchildren may inherit essential hypertension.
Persistent anxiety whatever the cause, depression and sleeplessness may be the unseen cause of high blood pressure in an individual. Gender plays a part too. Men appear to suffer high blood pressure that women.
Obviously, just along with obesity and high blood cholesterol, lack of regular, voluntary, physical exercise is a well known association with rising blood pressure.
Causes of Secondary Hypertension: As I mentioned earlier, secondarily raised blood pressure is often due to something else. That is, 10% of hypertension is due to another illness. Amongst the chief and well known causes of secondarily raised blood pressures are: Chronic kidney disease. A long standing impairment of one or both kidneys may lead to increased blood pressure whatever the age and gender or race of the individual. Therefore, kidney disease should be treated with the urgency that it requires. Persistent sleep apnea associated with obesity, difficulty in breathing during sleep may lead to blood pressure disorders. Abnormal growth of the adrenal gland and diseases of the adrenal gland such as Cushing’s disease may cause high blood pressure.
Coarctation of the aorta — A narrowing of the aorta (the large blood vessel from the heart) that you are born with that can cause high blood pressure in the arms. Pregnancy: (See hypertension in peculiar situations). Medications: Some medications such as oral contraceptive pills, antidepressants and antipsychotics may cause high blood pressure as part of their side effects. Alcohol addiction: In individuals that consume some amount of alcohol over long time may suffer from liver cirrhosis and high blood pressure.
Treatment: At all times high blood pressure must be controlled and brought to normal level for suitable for the individual. Failing, blood pressure is deadly and a silent killer. The doctor will conduct appropriate investigations and prescribe suitable treatment.
Exercise is the free, sure-bet that could help bring the blood pressure low. Before commencing exercise, you should inform your doctor to assess your suitability. Exercise may not be for everyone but may be for most. Exercise will help expel salts from the body, make the blood vessels and heart relax, clear fats from the vessels and body store. To be effective, exercise must be planned, structured and regular involving aerobic, stretching and anaerobic forms of exercises.
Further, decrease salt intake and eat as much of natural foods and fruits as possible. If unsure of your status, talk to your doctor or have your blood pressure checked at least every 6 months.