High blood pressure – Know your numbers!

A few days back, on May 17, World Hypertension Day was celebrated. The World Hypertension Day was first inaugurated in May 2005 and has become an annual event ever since. The purpose of the WHD is to promote public awareness of hypertension and to encourage citizens of all countries to prevent and control this silent killer, the modern epidemic.

The theme for World Hypertension Day is “Know Your Numbers”. This is a recurring theme with a goal of increasing high blood pressure (BP) awareness in all populations around the world. One in every four adults – some 50 million people in the USA alone – have high blood pressure. But many people are unaware that they have the condition.

Untreated hypertension increases the risk of heart disease and stroke. Hypertension can also damage the kidneys and increase the risk of blindness and dementia. That is why hypertension is referred to as a “silent killer”.

Everyone is at risk from high blood pressure. However, the elderly tend to have a different hypertension profile compared with younger people, according to the National Heart, Lung, and Blood Institute (NHLBI), which is part of the National Institutes of Health (NIH).

It is important to raise our collective consciousness of a particular type of high blood pressure, known as Isolated Systolic Hypertension (ISH). Systolic pressure is the first number in a blood pressure reading and is an indicator of blood pressure when the heart contracts. The second number, the diastolic pressure, reflects pressure when the heart relaxes between beats.

In the past, many doctors diagnosed high blood pressure based on diastolic pressure, the smaller number. However, new research suggests that systolic pressure is a much better indicator of hypertension, particularly in the elderly.

Diastolic pressure increases up to age 55 and then tends to decline, according to the NHLBI. On the other hand, systolic pressure continues to increase with age and is an important determinant of elevated blood pressure in middle-aged and older adults. While any pressure above 140/90 is considered elevated, about 65 per cent of people with hypertension who are over age 60 have ISH.

High blood pressure interacts with other major risk factors, such as diabetes and high levels of cholesterol, to amplify the risk of heart attack and stroke. Changes in lifestyle can therefore help us achieve blood pressure goals. Remember the only way you can take control of your pressure is by knowing your numbers.

Dr Rosmond Adams, MD is a medical doctor and a public health specialist with training in bioethics and ethical issues in medicine, the life sciences and research. He is the head of Health Information, Communicable Disease and Emergency Response at the Caribbean Public Health Agency (CARPHA). He is also a member of the World Health Organization Global Coordination Mechanism on the Prevention and Control of NCDs.

(The views expressed here are not written on behalf of CARPHA nor the WHO).

Dr Rosmond Adams is a medical doctor and a public health specialist. He may be emailed at:adamsrosmond@gmail.com