Hypertension, also known as High Blood Pressure, is a serious public health condition that affects over one billion people (out of 7,8 billion people in the world).The number of people living with hypertension doubled between 1990 and 2019 (WHO, 2023) There is a higher prevalence in low -and middle- income countries.
Global burden
Hypertension is a leading cause of death and disability in the world. An estimated 7,6 million people die annually from hypertension, representing 13.5% of all deaths. Hypertension is a major risk factor for stroke and coronary heart disease.
Medical conundrum
Despite millions succumbing to hypertension every year, the following estimates are worrisome:
Only about 54% of adults with hypertension are diagnosed
Only about 42% of adults with hypertension receive treatment
Only about 21% of adults with hypertension have their hypertension controlled.
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Are there reasons known?
Researchers have identified numerous factors contributing to high default rate with Mundagowa (2024) putting religious beliefs, lack of health education, fear of side effects, co-morbidities as key factors contributing to hypertension treatment defaulting.
Diagnosis of Hypertension
Hypertension is diagnosed by measuring blood pressure with a BP machine. So many of these machines are available in the country. Normal Blood pressure should be around 120/80.
There are stages of blood pressure which are reported as follows:
Elevated blood pressure — the top number (systolic pressure) ranges from 120 to 129mmHg and the bottom one (diastolic) is not above 80mmHg.
Stage 1 hypertension—the top number ranges from 130 to 139 and the diastolic is between 80 and 89mmHg
Stage 2 hypertension—the systolic is higher than 140 and the diastolic is higher than 90.
NB* Blood pressure higher than 180/120 is considered a hypertensive emergency or crisis. You have to seek emergency medical help from anyone possible if you have such alarming readings.
Symptoms and signs of hypertension
Many people with hypertension have no symptoms even if they have terribly high blood pressure, hence the reason why it is a silent killer. However, for those with symptoms, the following may be present:
-Headache
-Joint weakness
-Poor eye sight
-Poor sexual power
-Shortness of breath
Epistaxis (mututu)
There are patients who may present with complications of hypertension which may include signs and symptoms of stroke already, signs of heart failure, kidney failure, eye complications. This may be late stage disease and may show long-standing hypertension.
Causes of hypertension
Blood pressure is determined by two things: the amount of blood the heart pumps and how hard it is for the blood to move through arteries. The more blood the heart pumps and the narrower the arteries, the higher the blood pressure. There are two main types of hypertension which are:
Primary hypertension
Here there are no identifiable causes of hypertension. Familiar predisposition plays a significant role. The blood pressure can develop over a long time. Plaque build-up in the arteries increases the risk of high blood pressure.
Secondary hypertension
This type of blood pressure is caused by an underlying condition. There is potential that the hypertension can appear suddenly. Conditions and medicines that can cause secondary hypertension include:
-Thyroid problems like hyperthyroidism
-Kidney disease
-Adrenal gland tumours
-Blood vessel problems present at birth also called congenital heart defects
-Obstructive sleep apnea
-Illegal drugs such as cocaine, crystal meth etc
-Pregnancy
-Some cough and cold medicines, birth control pills, steroids etc
Risk factors
There are many factors which may worsen or propagate blood pressure. These include:
Age — the risk of high blood pressure increases with age. Until about 64 years, blood pressure is more common in men than women who are at higher risk after 65 years of age.
Race — Particularly more common among the black people, even developing at an earlier age in black people than in white people.
Family history—you are more likely to develop high blood pressure if you have a parent or sibling with this condition.
Obesity — excess weight causes changes in blood vessels, the kidneys and other parts of the body. Remember being overweight or being obese raises the risk of heart disease and its risk factors such as high cholesterol.
Lack of exercise — This can cause weight gain with high risk on hypertension
Too much salt — the body can retain fluid with resultant increase in blood pressure
Too much alcohol — alcohol is quickly absorbed hence can increase blood pressure
Stress — high levels of stress can lead to temporary increase in blood pressure
Complications
Be wary of the complications of hypertension. These complications can be life-threatening hence the need to observe your blood pressure. The following are complications:
Heart attack or stroke—hardening of arteries due to hypertension can lead to heart attack, stroke and other complications
Heart failure
Kidney failure
Eye problems with even vision loss
Changes with memory or understanding
Dementia
Treatment
Get a proper diagnosis done by making sure you have your blood pressure measurements. There are many drugs that are used to control hypertension even in Zimbabwe. Please note hypertension is a chronic condition that requires you to take medication over a long time. Do not be fooled into defaulting medication because of religious beliefs, herbs, faith etc. Drugs used include nifedipine, amlodipine, atenolol, urazide, Indapamide, losartan, captopril, lisinopril, Hydrochlorothiazide.
