<p><span style="font-family: helvetica;"><img src="/nairobi/PublishingImages/HBP%20body.jpg" alt="" style="margin: 5px;"/></span> </p><p><span style="font-family: helvetica;">In Kenya, the silent killer known as hypertension is tightening its grip, with alarming statistics revealing a nation at risk. The latest STEP survey conducted in 2015 showed that 28.6% of Kenyan adults have hypertension, out of which only 29.4% were aware of their hypertension, and only 6.5% of them were using any medication. Only 12.5% had their BPs &lt;140/90mmHg. These grim statistics remain to date, leaving many vulnerable to the deadly consequences of hypertension. Understanding the gravity of this health crisis is crucial in combatting its effects and saving lives.
</span></p><p><strong style="font-family: helvetica;">What is Hypertension?</strong></p><p><span style="font-family: helvetica;">High blood pressure, or hypertension, is a medical condition characterized by increased blood pressure levels. According to most hypertension guidelines, it is diagnosed when the blood pressure rises above 130/80 mmHg or more on several occasions. Hypertension should not be diagnosed with one reading but multiple readings, preferably at home or outside the hospital. Hypertension is diagnosed if the mean of the readings is consistently above 130/80 mmHg.</span></p><p><strong style="font-family: helvetica;">How common is hypertension?</strong></p><p><span style="font-family: helvetica;">According to the latest data from the Kenya Ministry of Health, hypertension affects nearly 1 in 4 adults, with approximately 7 out of 10 Kenyans remaining unaware of their condition. This number rises sharply as the prevalence increases to 58.3% in those 60-69. This staggering figure underscores the urgent need for heightened awareness and proactive measures to address this growing public health concern.</span></p><p><span style="font-family: helvetica;">Hypertension in the young is increasingly common. It also commonly affects pregnant women where it requires utmost attention as the blood pressure surges rapidly and can endanger the health of the mother and baby.
</span></p><p><strong style="font-family: helvetica;">What causes hypertension?</strong></p><p><span style="font-family: helvetica;">No single factor contributes to hypertension. Instead, a conglomerate of factors contributes to the development of hypertension. These include genetic predisposition, unhealthy dietary habits, exceptionally high salt intake, sedentary lifestyles, and excessive alcohol consumption.   </span></p><p><strong style="font-family: helvetica;">How do you know you have hypertension?</strong></p><p><span style="font-family: helvetica;">Blood pressure is notoriously described as the silent killer. This is because most people have no symptoms even with very high blood pressure, such as 200/100mmHg. The best way is to have routine screening at least once a year and more frequently for those at risk, for example, if there is a family history of hypertension. Early diagnosis is paramount in identifying hypertension and preventing its potentially devastating consequences.
</span></p><p><span style="font-family: helvetica;">The Kenya Ministry of Health recommends that all adults undergo blood pressure screenings at least once every two years, with more frequent checks for individuals at higher risk or with preexisting health conditions.
</span></p><p><strong style="font-family: helvetica;">Is hypertension treatable?</strong></p><p><span style="font-family: helvetica;">For those diagnosed with hypertension, timely intervention is crucial. Treatment often involves lifestyle modifications such as adopting a balanced diet, engaging in regular physical activity, limiting alcohol and tobacco consumption, and managing stress. In addition, a health practitioner can prescribe various medications to control blood pressure. After that, follow-up is paramount to ensure adequate blood pressure targets, as hypertension guidelines recommend. Patients should measure their BP regularly to ensure it remains at the &lt;140/90mmHg target.
</span></p><p><strong style="font-family: helvetica;">How long is hypertension treated?</strong></p><p><span style="font-family: helvetica;">Once someone has been diagnosed with hypertension, the treatment is life-long, which is essential to keep the patient safe from the hypertension-related devastating consequences.
</span></p><p><strong style="font-family: helvetica;">Are there consequences of untreated hypertension?</strong></p><p><span style="font-family: helvetica;">Failure to address hypertension can lead to severe health complications, including heart disease (heart attack and heart failure), stroke, kidney damage, and vision impairment. These complications are more expensive than treating hypertension itself. In addition, these complications jeopardize individuals&#39; overall well-being and strain the healthcare system.
</span></p><p><strong style="font-family: helvetica;">Can you protect yourself from hypertension?</strong></p><p><span style="font-family: helvetica;">You can protect yourself and your loved ones from hypertension and its complications. Individual efforts include increasing physical activity to 30-45 minutes a day for at least five days a week, reducing salt intake, changing diet to one that is rich in fruits and vegetables, and legumes and reducing intake of carbohydrates, and reducing weight to aim for BMI of 20-24. Get your BP checked at least once a year and more frequently if there is someone in the family with elevated blood pressure. Individuals are also advised to seek health care quickly if their blood pressure is consistently above 130/80mmHg.</span></p><p><strong style="font-family: helvetica;">Who are the best doctors to treat hypertension?</strong></p><p><span style="font-family: helvetica;">Specialists such as cardiologists, nephrologists, and internal medicine and family medicine physicians often possess the expertise necessary to navigate the complexities of hypertension treatment effectively. Their comprehensive understanding of cardiovascular health allows them to tailor treatment plans to suit individual patient needs, incorporating lifestyle modifications and medication management strategies.
</span></p><p><strong style="font-family: helvetica;">Is the medication for hypertension harmful?</strong></p><p><span style="font-family: helvetica;">While medications are commonly prescribed to control hypertension, questions arise regarding their potential harm. While all medicines carry some degree of risk, particularly when misused or improperly monitored, the benefits of effectively managing hypertension generally outweigh the risks. All antihypertensive medication used to treat hypertension have been tested comprehensively and found to be safe for the patient and indeed effective in lowering blood pressure. Furthermore, patients are typically evaluated for drug-related side effects during follow-up visits. However, patients should remain vigilant for potential side effects and adhere closely to their prescribed regimen, consulting their healthcare provider promptly with any concerns.</span></p><p><strong style="font-family: helvetica;">Are there alternatives to pills to treat hypertension?</strong></p><p><span style="font-family: helvetica;">Daily pills remain the cornerstone for the control of blood pressure. However, adopting a healthy lifestyle involving a Mediterranean diet, regular exercise, and medical treatment improves blood pressure control. Pills and lifestyle measures have both been shown to prevent cardiovascular complications of hypertension such as heart failure, heart attack, kidney failure, and stroke.
</span></p><p><span style="font-family: helvetica;">When patients get admitted with very high blood pressures in hospital and with complications suh as heart failure or stroke, intravenous medication is administered to lower the blood pressure immediately.
</span></p><p><span style="font-family: helvetica;">Lately, there are non-pill options for hypertension. One of them is renal denervation therapy which can be offered to patients with resistant hypertension and may reduce pill burden.
</span></p><p><strong style="font-family: helvetica;">What makes blood pressure that is well controlled suddenly become difficult to control?</strong></p><p><span style="font-family: helvetica;">Alterations in medication, stress levels from work or personal life, poor diet, lack of exercise, and weight gain can cause fluctuations. Health issues like kidney disease or hormonal changes, such as during menopause, may also play a role. Missing doses, ignoring lifestyle advice, or skipping check-ups can worsen control.
</span></p><p><span style="font-family: helvetica;">Commonly blood pressure goes up with a bad flu, when taking pain medication such as diclofenac, cough medication with pseudoephedrine, steroids etc. Consulting a healthcare provider is crucial for managing blood pressure effectively amidst these factors.
</span></p><p><strong style="font-family: helvetica;">Have you ever heard of May Measurement Month (MMM)?</strong></p><p><span style="font-family: helvetica;">The month of May is dedicated to public awareness of hypertension. If you get to many hospitals, you will find free blood pressure checks. Take advantage of these to know your blood pressure and that of your loved ones.
</span></p><p><em style="font-family: helvetica;"><strong>By Dr Mzee Ngunga, Consultant Interventional Cardiologist and Dr Salim Abdalla, Cardiology Fellow, Aga Khan University Hospital​</strong></em></p>