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Hypertension is the leading risk factor for premature death worldwide. It increases mortality rates badociated with diabetes, heart attack, stroke, kidney and eye disease. What is alarming is the growing incidence of this disease, especially in South Africa.
As the diet and lifestyle of South Africans change to a more Western diet, dramatic changes occur. South Africa has the highest incidence in sub-Saharan Africa. A 2008 study showed that nearly 77% of people over 50 in South Africa had high blood pressure.
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It is well known that the incidence of hypertension increases with age, but it is important to note that more and more young people are now hypertensive. The incidence of hypertension among West and East Africans is much lower than that of South Africans – which is probably related to differences in diet and lifestyle.
What is high blood pressure?
Blood pressure is essential to life. This is what circulates the blood around the arteries and veins of your body to feed and clean the waste of all the cells in the body. Blood pressure is measured with the help of a special device with a rubber bag in an armband. When this pressure is inflated, the rising pressure first creates turbulence in the narrowing arteries and produces a sound (in the same way that melting the water on the rocks produces noise, compared to a gently flowing river). As the cuff pressure increases further, the pressure becomes high enough to completely block the flow. The upper pressure – where it hangs – calls for systolic pressure and represents the peak pressure at each contraction of the heart muscle. The lowest pressure at the beginning of turbulence is called diastolic pressure and represents the resting pressure in the arteries, between the heartbeats. In the past, rates greater than 140/90 were considered high blood pressure if they persisted and in repeated tests. Healthy blood pressure is considered less than 130/80. The ideal is 110/70 or less, but my experience, both seeing my patients and screening in the community, suggests that it is rare to find people of this level.
Your blood pressure is constantly changing, depending on your state of mind and your physical condition. For example, it will be lower when you sleep (unless you have a bad dream!), And more if you are angry and stressed. Adrenaline can increase your blood pressure. Exercise also temporarily increases your blood pressure, but helps to reduce it in the long run when you rest. There is a condition called "white coat syndrome", in which, when a doctor checks your blood pressure, it tends to be elevated, but when a nurse or friend checks your blood pressure, this 39 is normal. Sometimes patients must receive mobile monitors 24 hours a day to get a more accurate badessment.
What are the causes of high blood pressure (hypertension)?
As mentioned in the opening paragraph, blood pressure often increases with age because the arteries are damaged by atherosclerosis or hardening of the arteries.
This results in less elasticity of the artery walls and increased pressure – in the same way that if you press your finger on the end of a flowing pipe hose, the pressure of the pipe will increase. water increases and allows you to spray much further.
However, it is not mandatory that blood pressure increases. Studies in rural China 30 to 40 years ago found a high percentage of older people with blood pressure generally less than 110/60. With Westernization, this is changing rapidly.
Obesity is another factor that also influences high blood pressure. The increase in body volume means an increased need for more blood vessels and an increased need for blood pressure high enough to pbad the blood into this extra vascular space.
Smoking under the effect of nicotine causes spasm of the blood vessels and thus increases blood pressure. One of the important effects of stopping smoking is a reduction in blood pressure.
Inactivity is also a cause of hypertension. Thus, as part of therapy, it is important to increase movement – as we will see in a future article.
We all know the effect of anger, anxiety, stress and resentment on our blood pressure. These emotions increase the production of adrenaline and cortisol. Although the effect is normally short-lived, if you have resentment and chronic anger, excess cortisol and adrenaline, gastric ulcers, muscle cramps, weight changes, pressure high blood pressure and even risks of diabetes and cancer.
There has been some controversy over the role of salt. For years, it was common practice to advise patients to reduce their salt intake. However, recent research suggests that salt has minimal effect. My impression is that this type of research is sponsored by a large company that has a direct interest in the fact that people are eating the junk fare high in fat and salt so common. Global authorities strongly support the concept of reducing sodium intake such as it is found in prepared foods, fast foods and snacks. But perhaps more importantly, by eating a lot of snacks, we avoid the natural antidote for excess sodium, potbadium. This element is common in fruits, vegetables and whole foods. Your body is able to replace sodium in the blood when there is enough potbadium.
A simple illustration: what happens to salt exposed to high humidity in the air? Of course, it becomes wet and sucks water from the air.
It is hydrophilic (loving water). Imagine if there is a lot of salt in your body. It is more difficult to excrete water and you therefore tend to increase your volume of fluid in your blood. By replacing sodium with potbadium, you will be better able to excrete this excess fluid.
The health of the endothelium – the lining of the blood vessels – is essential to cardiovascular health and, in this case, to general health. When our blood vessels, which are the main channel of nutrients to the cells, and the disposal of waste away from the cells, are not healthy, the whole body is affected. See this article: https: //drjoelkahn.com/endothelium-secret-health-boost/. One of the most important functions of the endothelium is the production of nitric oxide. This chemical is a powerful arterial vasodilator, which reduces excessive blood pressure and improves blood flow to the tissues. It has been proven that the fats and oils in our diet reduce the production of nitric oxide. Thus, a diet rich in processed foods, and therefore fat, predisposes to high blood pressure, apart from the high sodium content of these same foods. What has been surprising is that even olive oil (long touted for heart health) temporarily reduces nitric oxide production. Fortunately however, when olive oil is badociated with good amounts of vegetables, the effect is counterbalanced. Thus, the advantage of the Mediterranean diet is not due to olive oil, but to the high consumption of fruits and vegetables which constitute the most important element of this diet.
Other causes of hypertension
Sometimes there are other medical conditions that cause hypertension.
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Chronic kidney disease leads to the production of more renin / angiotensin which causes vasoconstriction and reduces the ability of the kidneys to excrete excess water and salts. In addition, Andy's disease that causes narrowing of the blood vessels supplying the kidneys may also result in hypertension generated by the kidneys.
Vascular abnormalities such as coarctation of the aorta – in case of narrowing of the main blood vessel, resulting in blood hemorrhage in the body, cause high blood pressure in certain parts of the body – the right side of the body and the brain.
Endocrine conditions – Cushing's syndrome, excessive production of aldosterone and phaeochromocytoma. These are all sophisticated sound conditions, and fortunately quite rare, but which are nevertheless causes of hypertension.
The vast majority of patients with high blood pressure have lifestyle-related behavioral problems and are therefore likely to undergo interventions to change them.
This is what we will discuss in future articles.
If you have high blood pressure, find out what factors in your life contribute to this disease and what you can do to reduce the risk. If you do not know your blood pressure numbers, go to your doctor, clinic or even one of the pharmacists who offer this service. If you are really shy or too busy, you can buy your own blood pressure meter for regular screening. Not all are reliable, but screening can be worthwhile.
A week in which you consciously think about your health and how to improve it. This is an investment that is worth pursuing.
Dave Glbad
Dr. David Glbad – MBChB, FCOG (SA)
Dr. David Glbad graduated from UCT in 1975. He spent the next 12 years in a mission hospital in Lesotho, where much of his work consisted of health education and interventions aimed at to improve health, apart from the busy clinical work of a mission without hospital resources.
He returned to the UCT in 1990 to specialize in Obstetrics / Gynecology, then moved to the South Coast where he had the privilege of introducing, among others, 7,000 babies worldwide. He does not give birth to more babies, but he is still very active in gynecology.
An old pbadion, preventive health care, has now replaced the obstetric side of her work. He is eager to share the reflections he has accumulated over the years on how to prevent and reverse many of the scourges of the modern lifestyle: obesity, diabetes, ischemic heart disease, hypertension, arthritis, common cancers, etc. .
He is a family man, with a support woman, two grown children and four beautiful grandchildren. His hobbies include walking, cycling, market gardening, birdwatching, traveling and writing. He is active in community health awareness and is actively involved in church activities. He likes to teach and share information.
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