Found at: http://www.anguillaguide.com/article/articleprint/2653/-1/133/
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ASK YOUR DOCTOR: Hypertension - The Silent Killer by Dr. Brett Hodge
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Hypertension is the most common chronic condition seen in general practice in Anguilla and is a common cause of sickness and death. Many individuals in Anguilla are hypertensive and do not know because this condition seldom has any symptoms until complications develop.
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Dr. Brett Hodge
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What is hypertension?
Hypertension can be defined as a systolic blood pressure of 140 mmHg or a diastolic blood pressure of 90 mmHg or the use of antihypertensive medications. Hypertension is one of the major risk factors for kidney and cardiovascular sickness in Anguilla.
What are the symptoms of hypertension?
Unfortunately, many individuals with hypertension have no symptoms and signs. They only know they are hypertensive when they have their blood pressure checked. This is why it is called the silent killer.
Contrary to a widely held belief, headaches are not a common symptom of high blood pressure.
Individuals with a strong family history of high blood pressure should have regular medical check ups by a well trained health care provider and others, without a family history of high blood pressure, should have at least one yearly medical check-up.
What are some complications of hypertension?
The most common complications of hypertension in Anguilla are stroke, kidney disease, and congestive heart failure.
Stroke is 2.5 times more common in people of African decent than whites, which is reflected in the high incidence of stroke in the Caribbean. Studies have shown that even treatment of mild hypertension can reduce stroke incidence by 42%.
Kidney failure secondary to hypertension is common in the Caribbean.
Treatment of hypertension
The goal of treatment is to reduce the risk of complications of high blood pressure.
Lifestyle changes
All individuals with a raised blood pressure must be given advice about lifestyle changes which have been shown in clinical studies to lower blood pressure.
Individuals should be encouraged to restrict salt intake to less than 6 g/day (less than 100 mmol/day). Current evidence suggests that salt reduction from a daily average of 10 g to 5 g lowers the blood pressure by about 5/2 mmHg.
Increasing fruit and vegetable consumption from two to seven portions/day lowers the blood pressure by around 7/3 mmHg.
Individuals with hypertension should try to achieve a reduction of fat, particularly saturated fats and increase intake of fibre and potassium.
Weight reduction for overweight or obese individuals is vital.
Regular aerobic physical activity (at least 30 min/day on at least 3 days/week) can lead to improve cardiovascular fitness.
There is no doubt that lifestyle interventions reduce the need for drug therapy in some patients and in other patients they enhance the antihypertensive effects of various antihypertensive drugs.
Drug therapy
A number of medications are available for treating hypertension in Anguilla. The use of one drug rarely achieves blood pressure control, except in mild hypertension. Drug combinations allow lower doses to be used with minimal or no side effects. Some drugs are less effective in black people compared to whites. Example Beta-blockers, while others are more effective in blacks like methyldopa.
Conclusion
Hypertension is a major health condition in Anguilla. Unfortunately this condition has few or no symptoms and many individuals can develop complications and die suddenly. Effective treatment not only prevents strokes and heart conditions. It also prevents kidney failure and dementia. Lifestyle changes are important in individuals with hypertension and these should be encouraged as much as possible. Individuals requiring antihypertensive drugs need to take the drugs as prescribed and if they are having difficulties should discuss with their doctor an alternative combination so that adequate control of their blood pressure can be achieved. Complications from uncontrolled hypertension are a common cause of death in Anguilla every year.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.