Hypertension is one of the most preventable causes of early death in this part of the world. It is the fifth leading cause of death. It is called the silent killer because people with hypertension usually have no symptoms. This disease is only detected by measuring the blood pressure. The presence of consistently high blood pressure in excess of 140/90 mmHg leads to a diagnosis of hypertension also called 'pressure'. Unchecked high blood pressure results in stroke, heart failure and heart disease which are the primary causes of death in the Caribbean.
Causes of hypertension
Hypertension is found in a quarter of adults over 25 years of age, and in 55 per cent of persons over 40 years of age. This high prevalence is due to genetic and environmental factors. Most people with hypertension have family members with the disease. The factors which contribute to hypertension are similar to those which result in obesity and diabetes. The environmental factors are high salt intake, diets with excessive calories (especially from animal foods), insufficient physical activity, stress, smoking and excessive use of alcohol.
Screening for hypertension
In view of the high prevalence of hypertension in our population, men should check their blood pressures regularly to screen for the disease. Persons with blood pressures of 120-139 over 80-89 are suffering from pre-hypertension and should start lifestyle changes immediately along with blood pressure checks every six months. Once hypertension is diagnosed, the physician will assess other factors such as blood sugar, cholesterol levels, and the presence of protein in the urine. Other tests will include an electrocardiogram (ECG), and examination of the eyes.
Dietary treatment
Dietary management of hypertension includes no addition of salt in cooking or at the table and avoiding salted or canned foods. Men with hypertension should restrict fat intake, particularly saturated fats and trans-fatty acids found in foods from animals. Regular fish (especially mackerel and herring) intake lowers blood pressure. People with hypertension should ensure high intake of fibre by eating ground provisions, whole grains, vegetables, fruits, nuts and legumes. They should eat foods with high levels of potassium such as bananas, tomatoes, oranges and coconut water.
Physical activity
Physical exercise can be used to prevent as well as treat hypertension. Men should engage in physical activity for at least 30 minutes every day. Walking briskly, gardening, cycling, dancing and climbing stairs are activities that should be included in the daily routine. Progressive resistance exercise also lowers blood pressure.
Tobacco and alcohol
Tobacco causes an increase in blood pressure which lasts 15 to 30 minutes after each cigarette. So men should quit smoking. Excessive alcohol will increase the blood pressure so men should restrict themselves to two ounces of white rum, 16 ounces of beer or 8 ounces of wine per day.
Education
Many men are unaware of this disease until struck by a heart attack, stroke or kidney failure. Every opportunity should be taken to check the blood pressure and implement a healthy lifestyle.
Dr Pauline Williams-Green is a family physician and president of the Caribbean College of Family Physicians; email: yourhealth@gleanerjm.com.
It is the fifth leading cause of death. It is called the silent killer because people with hypertension usually have no symptoms. This disease is only detected by measuring the blood pressure.
