Hypertension – or elevated blood pressure, is a serious medical condition, and according to the World Health Organization (WHO), 1.13 billion people worldwide have hypertension, it is estimated that between 10 to 20 million may have hypertension in low- and middle-income Sub Saharan Africa.

While the WHOs target is to reduce the prevalence of hypertension by 25% by 2025 globally, the COVID-19 pandemic is the unpredictable barrier to achieving this target.

There is increasing evidence across the globe that people living with non-communicable diseases (NCDs) such as hypertension, are more likely to suffer severe cases of COVID-19 and die, report by the WHO. In Ghana, Hypertension accounted for 3/4 all cases and deaths and the possibly resulting in strokes. It is estimated that ,more than 61% of the COVID-19 patients in hospitals had hypertension, 52% had diabetes, and 45% of people aged 60 – 69 who died from COVID-19 also had hypertension according the WHO article on “Non Communicable diseases increase risk of dying from COVID-19 in Africa,” 2020.

The Stroke Association Supportnetwork-Ghana (SASNET-GHANA) a members of the WHL aligns with the World Hypertension League’s (WHL) expanded theme for World Hypertension Day 2020: “Measure your blood pressure, control it, and live longer”. The key messages conveyed with this theme are to increase the awareness about the dangers of high blood pressure, emphasize the importance of measuring your blood pressure regularly, and adhering to the treatment plan as prescribed by your doctor.  World Hypertension Day is normally celebrated annually on the 17th May although in 2020 the WHL postponed this date to 17^th October due to the COVID-19 pandemic.

According to a WHO preliminary analysis (September, 2020) for 14 countries in the African region, hypertension, diabetes, cardiovascular disease and asthma were the co-morbidities most associated with COVID-19 patients.  These chronic conditions require continuous treatment, but as governments address the ongoing pandemic, health services for NCDs have been severely disrupted.  Moreover, individuals who should be accessing health care are reluctant to do so for fear of becoming infected with COVID-19.

The high rate of increased blood pressure is a great concern , more than 50% of Ghanaian  adult are  living with hypertension, a key driver for cardio-vascular disease, are unaware of their condition and of those who are aware, half  do not take any action to control their blood pressure either through lifestyle modification or medication. Approximately 4 in 10 adults older than 25 years have hypertension and this means 75% of the world’s hypertension population are at risk and are potential candidates for heart disease, strokes, kidney disease or even sudden death”.  SASNET-GHANA makes the point that, simple health-seeking behavior change can help to prevent hypertension and keep those who are hypertensive in good health. “The importance of knowing your blood pressure status and taking your medication if you are hypertensive is of paramount importance.

What is high blood pressure (hypertension)?

Blood pressure is the force exerted by circulating blood against the walls of the body’s arteries, the major blood vessels in the body.  Hypertension, also known as high blood pressure, is when the blood pressure is too high.

 

Measured blood pressure is written as two numbers (fraction).  Systolic (the top/ numerator) number represents the pressure in the blood vessels when the heart contracts or beats – called systolic pressure.   Then the diastolic (bottom/ denominator) number represents the pressure in the vessels when the heart relaxes or rests between beats – called diastolic pressure

 

Hypertension is diagnosed if, when it is measured on different sites, positions or days, the systolic blood pressure readings on the days is > 140mmHg and the diastolic blood pressure readings is > 90 mmHg.

Oftentimes when a person has hypertension will feel no signs/ symptoms.  But at certain times: during hypertension Stage 1 a person might feel slight headaches, dizziness, vision problems irregular heartbeat or difficulty in breathing which might even worsen with stage 2 going to hypertensive crisis.

 The Drivers of Hypertension

Hypertension can be familial or it can be associated with other medical conditions. The likelihood of blood pressure also increases with age. More than 60% of adult Ghanaians over the age of 55 years are known to have high blood pressure. In addition, other contributory risk factors may contribute to high blood pressure, heart disease, strokes and other circulatory diseases such as:

• an unhealthy diet (consisting of too much salt, sugar and unhealthy fats)
• consumption of excessive alcohol
• tobacco smoking
• being overweight
• Being physically inactive

Age being a risk factor for hypertension, as one grows/ ages the likelihood of developing hypertension increases. Thus, increasing the number of times, a person can have their blood pressure measurements taken, including visits to the doctor. The American Heart Association recommends that adults with normal blood pressure should get blood pressure checked each year at routine health visits. If you are between ages 40-59, it should be checked and monitored once to twice according to the findings/ readings/ family history. Then at 60 and above as the risk is higher, at least have it checked twice/ more annually, depending on the readings/ findings/ family history.

 Prevention, Management and Control of   Hypertension

Making small lifestyle changes can make steady improvements in blood pressure. Together, these changes can make a big difference!

●      Eat a healthy, balanced diet. Dietary Approaches to Stop Hypertension, also known as the DASH diet emphasizes fruits, vegetables, low-fat dairy products, whole grains, poultry, fish and nuts; and limits sugary drinks, sweets and red meat.

●      Cut down on salt. A high salt intake is linked to high blood pressure. Reduce the salt added to food during cooking and at the table. Make use of fresh and dried herbs, spices, garlic, ginger, chili and lemon juice to add flavor to food, without adding too much salt or salty ingredients like chicken or BBQ spice. Foods like packet soups, stock cubes, gravies, cheese, many breakfast cereals, breads, salty snacks, processed meats and fast foods are very high in salt, so should be used sparingly too.

 

●      Get active. Moderate- to vigorous-intensity aerobic physical activity can effectively reduce systolic blood pressure over several months by an average of 10 mmHg.

●      Be smoke-free. After each cigarette blood pressure will temporarily increase for 30 minutes! Chronic smoking increases the stiffness of blood vessel walls, making the damage caused by high blood pressure even worse.

 

●      Achieve and maintain a healthy weight. If overweight, losing even 2 to 5 kg of weight can already help to reduce blood pressure, and even greater reductions can be achieved with further weight loss towards a healthy weight.

●      Manage stress. Stress and anxiety can directly increase blood pressure and indirectly lead to unhealthy habits such as poor dietary choices, not enough exercise, and tobacco or alcohol use.

●      Limit alcohol. People with very high blood pressure should ideally avoid alcohol completely or discuss their alcohol intake with their doctor first.

●      Take medication regularly. Not taking blood pressure medications correctly is one of the most common causes of uncontrolled high blood pressure. Prescribed medication for hypertension should be taken regularly as instructed by a doctor or nurse.

Complications of uncontrolled hypertension

High blood pressure causes damage to the blood vessels, including the blood vessels inside some of the organs such as the eyes, the kidneys and the brain. Uncontrolled high blood pressure can lead to a heart attack, stroke, kidney failure and blindness. The increased workload can also weaken the heart and lead to heart failure. Tiredness, shortness of breath and swollen ankles are often experienced. Blood pressure medication should always be taken exactly as prescribed and should not be stopped or changed unless advised to do so by a medical doctor.

 Importance of getting health professional advice:

Blood pressure medication should always be taken exactly as prescribed and should not be stopped or changed unless advised to do so by a medical doctor.

Know your numbers. Even when taking blood pressure medication, blood pressure may remain too high or increase again over time. Blood pressure should be checked regularly, or as recommended by a doctor or nurse. “Measure your blood pressure, Control it, Live Longer”

 For more information

Ad Adams Ebenezer

Website:care.sasnetghana.org

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