Good advice by Dr. Harold-Why do most people neglect to check their blood pressure regularly?

Strokes, cardiovascular events, peripheral vascular disease among others, are quite prevalent among our people, as they age.

One question to be asked is,” Do you check your blood pressure regularly?” and the answer would be in the negative, in most cases.

Preventable diseases lead to death due to ignorance and being not health conscious.

Investing in a digital blood pressure monitor should be the responsibility of every household.

Most people would say there were no symptoms to see the doctor. That is quite right, because high blood pressure does not occur overnight to give symptoms. The onset is insidious, and the body gets used to the higher pressures until one day a shocking complication occurs, as described above.

High blood pressure is called the silent killer, because, as mentioned, gives no warning signs or symptoms until a stroke or heart attack occurs. I have repeated this to emphasise the importance of knowing what blood pressure is and take precautionary measures to prevent illnesses, caused from hypertension: the simplest action would be to check your BP regularly with your own monitor in home surroundings.

How does one get high blood pressure? When you are young, your peripheral arteries are tender and elastic and not resilient to the pressure from the contractions of the heart (left ventricle). Their inner lining is smooth so the blood flows with no friction.

As one gets older the peripheral arteries become thickened and we name that condition, “arteriosclerosis”. In addition, plaques tend to build up in most vessels atjunctions, bifurcations and curves where the pressure of the blood turbulence is maximum. This condition we call, “atherosclerosis”, or simply plaques.

Both these conditions develop as one gets older, and the blood vessels become more resilient to the pressure from the contractions of the heart.  More forceful contractions of the left ventricle will result to distribute the oxygenated blood to the periphery. These resulting forceful contractions cause the high blood pressure.

Increased persistent blood pressure can cause aneurysms- a bulge at some weak point of the arteries. They can rupture and cause life-threatening internal bleeding.

One could easily assess the thickness of coronary arteries due to high blood pressure and other causes, by palpating the radial artery at the wrist joint. When you roll two fingers over your radial artery you could feel whether the artery is soft, more elastic, or thickened and feels firm. The latter findings reflect the situation of the coronary arteries, indirectly.

Taking fish oil capsules daily seem to keep your peripheral vessels more elastic. Lifestyle changes, such as less alcohol consumption, eating a low fat and low carb diets, regular exercise, meditation and less stressful life all contribute to keeping your blood vessels more elastic.

Medications could cause high blood pressure

Certain medications can cause high blood pressure. For instance, certain pain and anti-inflammatory medications can cause retention of water, resulting in kidney problems and increasing your blood pressure. Examples are non-steroid anti-inflammatory drugs (NSAIDs),

Certain antidepressants may cause your blood pressure to raise. These antidepressants work by changing your body’s response to brain chemicals, including serotonin, norepinephrine, dopamine and others. The chemicals in these drugs can increase your blood pressure.

Birth control pills and other hormonal birth control devices containing hormones may increase your blood pressure by narrowing smaller blood vessels.

Those who drink coffee, many cups a day can increase their blood pressure caused from caffeine. 200 to 300 milligrams of caffeine can temporarily raise your blood pressure.Medicine taken for colds such as decongestants seems to narrow your blood vessels, increasing your blood pressure. Good examples are Sudafed and neo-synephrine.

Be aware that most herbal supplements can increase your blood pressure. Good examples are Arnica, bitter orange, gingko, ginseng, liquorice, Senna, St. John’s wort and so on.

Certain immunosuppressants can raise your blood pressure, possibly because of the ways immunosuppressants affecting your kidneys.

Taking long term cortisone tablets orally, like prednisone can increase your blood pressure due to water retention.

There are in total about 22 medications that can give you high blood pressure. If you are on any of the above and other medications (not mentioned), it is advisable to record your blood pressure, weekly. Any changes, please contact your doctor.

Uncontrolled high blood pressure can weaken your blood vessels of the brain. Then, they can get narrowed, or rupture with a slow leak. High blood pressure can cause blood clots in the arteries and lead to a stroke, and dementia.

With uncontrolled high blood pressure, your left ventricle muscles of your heart can increase in size (hypertrophy), leading to an enlarged heart seen on plain x-rays of the chest (cardiomegaly).

With further uncontrolled blood pressure, the strain causes your hypertrophied heart muscles to weaken and work less efficiently. Eventually, the muscles weaken and leads to irreversible heart failure.

Just by checking your blood pressure regularly you could avoid life threatening heart failure.

Damage to the brain caused by high blood pressure

Atherosclerosis, a condition that thickens your blood vessels, as described earlier can cause a mini-stroke called Transient ischaemic attack (TIA). It is caused by the release of a blood clot from an atheromatous plaque in the inner lining of the carotid arteries in the neck. TIA is a warning that you are at risk of a full- blown stroke.

The symptoms of TIA are the same with a full-blown stroke, but it can be reversed by prompt medication. You need to be admitted to your local hospital without delay and the clots in the brain can be dissolved with blood thinners (heparin).

Stroke.

This is the most frequent illness caused by neglecting to check your blood pressure regularly. It occurs when part of your brain is deprived of oxygen and nutrients, causing brain cells to die.

Dementia.

In this situation one finds it difficult to think, speak, reasoning, memory loss, vision problems and unstable movements. This occurs due to narrowing and blockage of arteries due to uncontrolled high blood pressure.

Classification

Doctors classify high blood pressure as primary (essential) and secondary causes due to other pathological situations. What has been discussed so far is the primary situations where underlying causes cannot be found, other than the factors mentioned earlier.

Among the causes of secondary high blood pressure, kidney disease ranks highest. It can be triggered by tumours of the adrenal glands (glands sitting on each kidney like caps). These tumours secrete hormones that elevates the blood pressure.

Renal artery stenosis

When doctors cannot find a cause for the underlying high blood pressure, narrowing of the renal arteries needs to be ruled out. Stenosis is the word we use for narrowing of blood vessels, and the commonest cause is atherosclerosis, a process in which plaques made up of cholesterol and other material builds up on the inner lining of the blood vessels. If you suffer from primary hypertension, your doctor should investigate and rule out renal artery stenosis.

Abdominal scan studies are done to rule out renal artery stenosis.

Normal blood pressure

If you are diagnosed having high blood pressure you need to bring down the pressures to normal range – less than 120 (systolic) and 80 (diastolic).

In stage 1 hypertension the BP may be 130-139 (systolic) and 80-89 (diastolic)

In stage 2 the systolic is above 140 and diastolic above 90.

In a crisis your systolic pressure could be over 180 and diastolic higher than 120.

If you are diagnosed that you have high blood pressure, it would be your responsibility to take measures to reduce it.

Remedial actions

Walk regularly- Do 20,000 steps a day.

Reduce your sodium intake. Eating tasty restaurant foods are full of salt. Avoid them as much as possible until your p is controlled.

Drink less alcohol

Eat foods containing potassium

Reduce your coffee drinks

Learn to manage your stress

Lose weight

Eat veggies that brings down your BP, such as beetroot, and a variety of other foods and fruits.

Bottom line

Controlling your blood pressure is simple.  Purchase your own BP monitor and check your BP regularly.

Checking your BP regularly can avoid other chronic illness mentioned before.

The author’s personal experience is that walking 30,000 steps at intervals daily, would dilate your blood vessels to reduce your high blood pressure, without medication. Further, that would be the quickest way to get rid of your accumulated ‘triglyceride’ stores in your fat cells to reduce weight. The best way to wash off your unhealthy visceral fat that cause heart disease, would be that way.

Hope this article was of value from a health-point.

About the author: Dr Gunatillake-Health editor is a member of the Academy of Medicine, Singapore. Member of the Australian Association of Cosmetic Surgery. Fellow of the Royal College of Surgeons (UK), Corresponding Fellow of the American Academy of Cosmetic Surgery, Member of the International Societies of Cosmetic surgery, Fellow of the International College of Surgery (US), Australian diplomat for the International Society of Plastic, Aesthetic & Reconstructive Surgery, Board member of the International Society of Aesthetic Surgery, Member of the American Academy of Aesthetic & restorative Surgery, Life Member of the College of Surgeons, Sri Lanka, Batchelor of Medicine & Surgery (Cey). Government scholar to UK for higher studies