Have you checked your BP?

Having your blood pressure checked regularly could save you from trouble later, says DR. GEORGE THOMAS.

THE simplest test in a health checkup is measuring blood pressure (BP), which can detect the commonest cardiovascular disorder - hypertension.

Hypertension, or "high BP", is also known as "the silent killer", because it is usually without symptoms. But, it would be better to say that the measurement of BP has saved many lives.

There has been a growing prevalence of hypertension in the country in the past 50 years. The Cardiological Society of India, the Hypertension Society of India, the Indian College of Physicians and the Association of Physicians of India have jointly issued guidelines to control hypertension, which take into account our geographical, ethnic and economic factors.

When a nurse or doctor measures a person's BP, they record two numbers: your systolic pressure and your diastolic pressure. If the two measurements are 120 and 80, they would be written as 120/80. Your systolic pressure (the first and higher number) is the pressure or force the heart exerts on the walls of the blood vessels with each beat. Diastolic pressure (the second and lower number) is the lowest pressure placed on the walls of the blood vessels when the heart relaxes between beats. Electronic and dialtype gadgets should be periodically crosschecked with a mercury apparatus. Electronic gadgets used on the wrist could be unreliable.

Contrary to belief, both the systolic and diastolic values are important. High readings of both are responsible for cardiovascular problems. Any increase in BP should be taken seriously.

Ramachandran, an executive in his forties, consulted his doctor for cough. When recorded, his BP was 160/100, which he said was a "variation" due to anxietyand the fact that he had met with a minor accident that day.

The doctor advised him to measure his BP after a week. It was still high and he was put on treatment. Although anxiety can cause hypertension, it is imprudent to dismiss a high reading. Similarly, there is a belief that a visit to the doctor can increase a person's BP, the so-called "white coat hypertension". But research has shown that such a response need not be normal as it can increase after exercise. Abnormal increases could point to hypertension.

A cuff is tied around the arm and inflated. A manometer records the pressure in the cuff. A stethoscope is used to take the upper and lower readings. Usually two or three readings over a span of two or three weeks are required before diagnosing high BP. A reading of 120/80 is considered optimal. However, in a normal individual, a low reading could signify good health.

An elevation of the systolic and/or diastolic blood pressure increases the risk of developing heart and kidney diseases, clogging of the arteries, eye damage and stroke. A World Health Organisation (WHO) report categorically states that the term mild hypertension does not imply freedom from long-term complications. On the other hand, high BP readings need not create panic.

Most people dread a check-up fearing that they will be subject to unnecessary investigations and treatments. This is not true as treatment need not always be with drugs. Milder grades of hypertension can be controlled by modifying a person's lifestyle.

Sudha consulted a doctor when she discovered a white patch on her face. When her BP was taken on two occasions, the readings suggested hypertension. But the doctor did not prescribe any medicine. He only taught her "lifestyle management". Two months later, Sudha felt better and her BP was normal. "Lifestyle management" consists of weight reduction, exercise, relaxation and proper diet.

Obesity (being overweight) is a common problem among hypertensives, as it is a risk factor for increased mortality. It can also cause a person's BP to rise. When a person is obese, the heart has to increase its output. It also causes salt retention. Excessive snoring by obese individuals causes decreased intake of oxygen. All these factors lead to hypertension. It has been estimated that BP can be reduced by a third of a unit for every kilogram weight loss. Maintenance of the ideal body weight would also reduce the incidence of diabetes and heart disease.

Exercise is important in reducing a person's BP, but there is no need to make a fetish of this. Just use your common sense. For example, when watching TV, do not use the remote control. Get up and adjust the controls. Parking your car at a distance will make you walk back. Do household chores. Use the stairs instead of the lift. But consult your doctor if you would like to embark on a vigorous exercise programme or indulge in competitive sports.

Another aspect is a person's diet. A Dietary Approach to Stop Hypertension diet (DASH) prescribed by the American Heart Association is ideal. Basically, it consists of foods low in fats and rich in fruit and vegetables. It is low in cholesterol and saturated fat, high in dietary fibre, potassium, calcium and magnesium and moderately high in protein. It includes many servings of fruit and vegetables. These include tomatoes, potatoes, carrots, green peas, broccoli, green leaves, green beans and sweet potatoes, apricots, bananas, dates, grapes, oranges, grapefruit, mangoes, melons, peaches, pineapples, raisins, strawberries and sweet lime. Two or three servings of low fat dairy products a day contribute the required calcium and protein. Whole grain from cereals, breads and biscuits contribute fibre and energy. To provide more potassium and protein, a moderate intake of lean meat, poultry and fish is recommended. To maximise potassium, fibre, protein, and energy intake, DASH recommends nuts and seeds. Some foods like banana flower, banana stem and drumstick leaves are excellent sources of fibre.

A low intake of salt is very important. Cut down on processed and fast food. Take the salt cellar off the table - do not add salt to food after it is cooked. Cut down on pickles, pappads and bakery items. Avoid salted food like dried fish, chips, salted biscuits and nuts. Hotel food has a lot of salt.

Hotel food is mouth watering because of an increased salt and ajinomoto content. What is harmful is the sodium content. So salt (sodium chloride), baking powder (sodium bicarbonate) and ajinomoto (monosodium glutamate) are all bad. A high level of homocysteine (a protein constituent) appears to increase the risk of heart disease, stroke and disease of the blood vessels. Avoid alcohol and excessive consumption of coffee.

Lung cancer, bronchitis and stomach ulcers are the other freebies that come with smoking. A word of caution though. Patients suffering from diabetes and kidney diseases should consult a doctor before embarking on dietary regimens. There are some medications that can increase BP. Tell your doctor about all the medicines you use - even nasal drops.

Meditation yoga, massage, controlling anger and breathing exercises are good. These are stressed in the Indian guidelines to control hypertension. If necessary, seek professional help. A study has found that surges of anger cause increases in systolic BP, while suppressing anger affects diastolic pressure. Transcendental meditation and formalised anger management programmes have been found to reduce blood pressure levels.

After these measures, if your BP is still high, then drug treatment should be initiated. There is a wide range of available drugs. So if you have not yet checked your BP, please do it now. It could save you from trouble.

The writer is a senior consultant in the department of cardiology, Indira Gandhi Co-operative Hospital and the Siloam Clinic, Kochi.

Send this article to Friends by E-Mail

Section  : Features
Previous : Pure as milk
Next     : Take help from nature