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High Blood Pressure, The Silent Killer

If you have moderately raised blood pressure the risk of stroke is four times greater and the risk of a heart attack is twice as high compared with normal blood pressure. This risk increases as the level of a person’s blood pressure gets even higher.

Hypertension is very common indeed and hence a major public health issue. The prevalence is expected to increase considerably in the coming years. In 2000, the estimated number of adults living with high blood pressure globally was 972 million. This is expected to increase to 1.56 billion by 2025! Lifestyle factors, such as physical inactivity, a diet with high processed and fatty foods, and alcohol and tobacco use, are reasons for this increased disease burden, which is spreading at an alarming rate from developed countries to emerging economies, such as India, China and African nations.

Adequate treatment of high blood pressure with lifestyle changes or with prescribed drugs lowers this cardiovascular risk towards normal levels. However, the biggest problem for controlling hypertension is compliance with treatment. Despite very effective and cost-effective treatments, target blood pressure levels are very rarely reached, even in countries where cost of medication is not an issue. Sadly, many patients still believe that hypertension is a disease that can be “cured”, and they stop or reduce medication when their blood pressure levels fall to normal levels. Despite the availability of effective and safe antihypertensive drugs, hypertension and its related risk factors (obesity, high blood lipids, and diabetes mellitus) remain uncontrolled in many patients. One often talks about “the rule of the halves”: Only one half of the patients with high blood pressure in a population have been diagnosed, only half of those detected have been treated, and only half of those treated have been adequately treated to a normal blood pressure (International Society of Hypertension).

Despite what many authorities may say, your blood pressure should not inevitably get worse with age. Primary Hypertension is only age related because the cause is cumulative.

To find out whether we have a problem, we need to establish what our resting heart rate is. We measure the pressure of blood in the arteries, the only part of the circulation where flow is controlled by the heart, and we measure it in two ways: the rate when the heart is actually contracting, called systolic pressure, and the rate when the heart is resting between pumps, called diastolic pressure. This is shown as a number like 125/80 mmHg and the pulse, the number of times that the heart pumps each minute, is shown as a single number, 60. Good health is indicated by a pressure around 120/70 mmHg or lower and a systolic rate of 125 mmHg or more is a sign of hypertension. At 140 mmHg systolic, you should be taking action to reduce your blood pressure. The abbreviation mmHg means millimetres of mercury, from when the pressure in barometers was measured in units based on the fluid pressure exerted by one millimetre of mercury in a tube.

Many authorities believe that self measurement of blood pressure at home with an approved automatic machine gives a better indication of blood pressure than a visit to a clinic. Such machines are readily available at a reasonable price. If your blood pressure can fall below 120 over 70 this is a good indication that the arteries remain flexible. The time when normal blood pressure is lowest is overnight. So if the reading is taken when you are still lying in bed after sleeping you may achieve a reading as low as 110 over 60. If so it is likely that you have good flexible arteries, and it will not matter if your blood pressure rises a bit during the day because of physical exercise or stress.

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