So You Already Suffer from High Blood Pressure...Pt I

Over the last few months we've looked at the way the heart works and factors that contribute to the appearance of hypertension in our lives, and Dr. Smith in her post enlightened us about steps that can be used for preventative purposes...but what about those of you who have already past the risk factor stage, and are now living and suffering from the disease?

Well in today's post I'd like you to learn a bit about how medications you may be taking for your hypertension works. Many people are delinquent in the treatment of this disease sometimes for lack of understanding of how the treatment works. 

Its IMPORTANT  for me to say, that the treatment for hypertension like most other diseases is INDIVIDUALIZED, that means... 

courtesy theexecutiveconsultant.com

...that just because Susie down the road is using a particular medication for her pressure, and you're not using it DOES NOT mean that Susie's treatment is better. Not just because Susie has it, it is good for you to have. 

Why?

1. She might be at a different stage of hypertension than you are, (To see the Stages of Hypertension click here)  
2. You might have a particular allergy to certain types of medication that Susie does not have. 
3. Susie may suffer from Hypertension and other diseases that make her medication better suited for her use.

I just listed 3 but to tell the truth, the factors are endless. 
The bottom line is your treatment should cater to your body and circumstance, not someone else's.

Having said that, here's my version of an explanation. 

Anti-hypertensive drugs can be grouped or classified in scores of different ways. For easier reference I've decided to use the following:

1. Diuretics
2. Calcium Channel Blockers
3. ACE Inhibitors
4. Angiotensin II Receptor Antagonists
5. Beta-Adrenoreceptor Antagonists.

Don't worry. I'll make it as simple as I can, In this post, Part I mind you, we'll tackle the first two. 

Diuretics and Calcium Channel Blockers.

• DIURETICS

Generally speaking, this group of medication lowers blood pressure and water retention by increasing the amount of urine you produce. 

Diuretics primarily reduce the amount of salt (principally sodium) in the body, causing the overall amount of blood or blood volume to be reduced, if there is less volume of blood in the arteries this means the blood pressure is reduced, and the heart can pump blood to the rest of the body more effectively.

Here are some examples of diuretics that you may use. I have bolded those which some of my family members use.

Brand Name                                           Scientific Name                    

Diuril                                                                  Chlorothiazide                         
Esidrex, Microzide, Oretic                                     Hydrochlorothizide               
Lasix                                                                   Furosemide                             
Lozol                                                                   Indapamide
Thalitone, Hygroton                                              Clorthalidone

The large diuretic group has sub-classifications dependent on how each drug acts specifically, if interested you can read a general overview here, or get into the details here.

• CALCIUM CHANNEL BLOCKERS

Let me give you a bit of background first.

Calcium is the element that is linked to the heart contracting, think of it as an activator. Our heart has electrical impulses flowing through it, and these impulses allow calcium to enter the muscle cells of the heart and release calcium stores that are already present inside them.

Now, if there is calcium coming from the outside in, and on top of that releasing more calcium on the inside, of course the amount of overall calcium will increase, and when it has reached a certain level it activates the heart muscles to contract, causing the heart to pump blood.

courtesy alessiodevecchi

The higher the amount of calcium the greater the contraction, and the harder the heart pumps blood. The electrical impulse will eventually pass and when it does calcium can no longer enter the heart cells. This means that it can no longer release the calcium stores inside it. So, its levels are reduced and the muscles of the heart relax. 

All this happens in less than a second, believe it or not.

Now. How does this anti-hypertensive drug group reduce blood pressure? 
Read on.

Calcium Channels Blockers prevents calcium from entering the heart, this means that the forceful contraction of the heart is reduced, this means that the heart will not pump as forcefully, reducing the heart rate, also calcium channel blockers help to open up blood vessels that are narrow, which means the pressure of the blood will be reduced.

Brand Name                                           Scientific Name              

Adalat, Procardia                                                     Nifedipine
Cardene                                                                   Nicardipine
Norvasc                                                                  Amlodipine
Cereleen, Isoptin, Covera                                         Verapamil
Diltia, Dilacor, Cardizem                                           Diltiazem


Read more about the general mechanism of calcium channel blockers here.

Your homework?
Revise this post again, and when you are finished, check to see if you take any medications from these first two groups we've discussed.  (Google it if you're not sure) and look up the side effects.

These are my ABCD's for taking medication:

Always ask your doctor about the side effects of any and every drug you take. 
Be interested in what you put into your body. 
Crave information.
Do a little digging, inform your self. Self-education is always necessary to maintain health.

In the next post we'll have a look at ACE Inhibitors, Angiotensin II Receptor Antagonists and Beta-Adrenoreceptor Antagonists.

Stay #wadadlianstrong. 
Blessings to you and yours,

© March 2014

Preventing High Blood Pressure...Guest Post by Dr. Tadia Smith

Since I've started the Wadadlian Health blog, other Antiguan Cuban-trained doctors who also want to make a difference in our Community Health have become interested in participating and have decided to lend a hand in ensuring our islands become #wadadlianstrong.

Today's post summarizes different measures that we all can use in our lives to live healthier and decrease the risk of the "silent-killer" hypertension. It is contributed by fellow colleague, Doctor Tadia S. S. Smith, currently training in our CARICOM neighbour, St. Lucia.

Enjoy...

                     

PREVENTING HIGH BLOOD PRESSURE   

  

Factors that can be managed in order to avoid the presence of hypertension, fit easily under the topic of lifestyle, specifically when it comes to diet and exercise. The following measures, if implemented can not only contribute to a healthier you, but reduce the risk of hypertension.

A high fiber diet is very important (whole grains, beans, fruits and vegetables). Eat lots of fresh fruits, fresh vegetables (raw if possible) rich in potassium, calcium and magnesium, and limit products containing saturated animal fats (margarine etc.). 

courtesy www.fodors.com

The DASH Diet– Dietary Approaches to Stop Hypertension has been reported to substantially lower Blood Pressure (BP).

The DASH diet-eating plan is a diet rich in fruits, vegetables, low fat or nonfat dairy. It also includes grains, especially whole grains; lean meats, fish and poultry; nuts and beans. It is high fiber and low to moderate in fat. Since the DASH diet is a healthy way of eating, it offers health benefits besides just lowering blood pressure. The DASH diet is also in line with dietary recommendations to prevent osteoporosis, cancer, heart disease, stroke and diabetes.

It is a plan that follows US guidelines for sodium content. In addition to lowering blood pressure, the DASH eating plan lowers cholesterol and makes it easy to lose weight. It is a healthy way of eating, designed to be flexible enough to meet the lifestyle and food preferences of most people; and, it contains all the healthy foods from the Mediterranean diet. (Read more here.)

The DASH eating plan used along with other lifestyle changes can help you prevent and control blood pressure. This eating plan also has other benefits, such as lowering LDL (“bad”) cholesterol, which, along with lowering blood pressure, can reduce your risk for getting heart disease.

Other dietary suggestions include limiting the amounts of red meats such as beef, liver, kidneys in the diet, and instead increasing the amounts of white meats such as chicken and fish that are rich in Omega-3.

The use of Onions, garlic and cloves are also helpful, as these natural herbs contain compounds that lower Blood Pressure (BP) and cholesterol levels. Of notable use is parsley which is a natural diuretic and also high in potassium.

It is important to try to reduce the amount of salt in your diet. Salt contains sodium that causes the blood to retain fluid, and as a result, increases the Blood Pressure (BP).

Reduce your intake of caffeinated products, and limit the consumption of alcohol. Moderation is key in life.

Keep active; do not lead a sedentary or inactive life. 

Exercise regularly and systematically for 30-45 minutes daily or walking at least 2-3 blocks. The type of exercise must be individualized depending on your age and condition. Aerobic exercises are recommended. 

Losing excess weight and trying to maintain an ideal body weight influences blood pressure values. Here's an easy to calculate what is ideal for you:

                Ideal Body weight in Kg = (Body Height in cm – 100) Non diabetics

                Ideal Body weight in Kg = (Body Height in cm - 105) Diabetics

Quit smoking and avoid secondhand smoke since nicotine causes the blood vessels to constrict, thus increasing Blood Pressure (BP). 

Remember that when your Mind, Body and Spirit are in total equilibrium, there is no room for DISEASE!!!! 

The risk of high blood pressure can be lessened by making intelligent lifestyle choices that include a healthy, nutritionally complete diet, daily exercise and avoidance of stress.

An ounce of Prevention is better than a pound of Cure – So eat healthy, exercise regularly and maintain a positive attitude towards life.

Periodic Blood Pressure Checks are advised, particularly if you are over 30 years, so that you can begin treatment early in the event that you develop hypertension.

Hypertension is a chronic and non-transmissible disease that poses as a threat to life if not treated adequately. Find the cause and treat it!

© March 2014

Lawd ma Pressha! Part II

Let's start off with a refresher...can you tell me the definition of blood pressure?

In my last post Lawd ma Pressha! Part I,  a simple definition of hypertension/ high blood pressure was given, by first defining what blood pressure was:

"Blood pressure is the physical force of the blood flowing against the walls of our arteries"

From that concept we defined hypertension as "the sustained elevation of this physical force of the blood flow (in our arteries) above its normal value, that being below 120/80 millimetres of mercury(mmHg)."

That last bit though, about the normal value... is it understood?
When your mama comes back from the health centre and they tell her her pressure is 170/110 mmHg, does she understand what that number means?

This post will help you to put any confusion about blood pressure readings to rest, and offer an explanation to mama the next time around.

Let's begin....

Blood pressure is measured based on two values, the systolic reading and the diastolic reading, usually its written in a "systolic reading/diastolic reading" style. 

                                       

                                   

The systolic reading is symbolized the top number of the full blood pressure reading, for example "110/80", and it represents the pressure of the blood flow against the arteries when the heart in contracting, whereas the diastolic reading which would be symbolized by the bottom number of the reading "110/80", represents the pressure of the blood flow against the arteries when the heart is relaxing and refilling itself with blood.

You may have noticed that my definition ended with 'normal range'. This is simply because for pressure to be considered abnormal it will be above a certain range. Check out the table below which marks the ideal range in green...

      Please click the chart above to read more about each range.

If we apply the ranges in this chart into the context above, if your mama comes from the clinic and tells you that her pressure is 170/110 mmHg, what can you interpret this value as meaning?

Understanding the values taken at a hospital or clinic are important in self-evaluating the steps you may have to take in order to prevent hypertension or maintain your already healthy lifestyle, or helping mama who might lambase your cooking because she can't taste the salt, or Daddy Joe who only takes his pressure medications when he feels bad.

It must be mentioned for those who already suffer from this disease a further sub-classification is used for the Hypertensive/High blood pressure Category, which is above 140/90 mmHG.

                                                        courtesy www.socalmds.com

As you can see High Blood Pressure is further divided into Stages 1, 2 & 3.  Consistent high readings in one of these three categories can classify you into a certain "hypertensive type".

Now that you are acquainted in a little more than general sense, to how blood pressure readings are classified. Use this theoretical understanding and apply it to your life, and enrich the lives of those loved ones who may not understand their readings. 

Many people in Antigua and Barbuda, now invest in home blood pressure kits, which are electronic devices used to monitor blood pressure. 

If you or an immediate family suffers from high blood and are without one, I would strongly suggest you make the investment, especially if you are in one of the upper stages of the disease.In the mean time, visit your local health clinic and get your blood pressure taken at regular intervals. 

For those of you who are not screened, I encourage you to do so, at your local health clinic, especially if you have risk factors, that were mentioned in Lawd ma Pressha! Part I.

Make and take time to educate yourself about your health, in the end you will always win.

Play your part in making your famiiy #wadadlianstrong.

Quote for today?

Wise Words.

                                     

Blessings to you and yours,

© February 2014

Lawd mah Pressha! Part I

In my last post Understanding Your Heart we touched on blood circulation, and the structures that make this possible. Do you you remember the names of the blood vessels? What about the parts of the heart?

Wah you know bout pressha?

Hypertension is one of those topics that has been discussed, re-discussed and then some in ANU, but really and truly how much does the average person know? While we've been hearing all the talks on the radio, at our health clinics, and on the television, how many of us can say we've actually been listening?

I'll ask you a simple question to begin this educational tidbit.
What is High blood pressure?
Don't scroll, stay right here.
Take your time and think, and try to formulate a response. Can you?

...........................................................................

If you were able to, good for you, and congrats; but if you fumbled or just shrugged a 'no' we've got some work to do.

Well, blood pressure is literally the physical force of the blood flowing against the walls of our arteries.

High blood pressure or hypertension therefore, can be considered as a sustained high level of this physical force of the blood flow above its normal value (which in figures is generally equal to 120/80 millimeters of mercury).

In medical terms the definition gets a bit technical, but for the average person this one gives you a practical understanding of what it simply is.

Now you have a definition to start with, it's important that you understand that hypertension can be classified as primary or secondary.

Primary hypertension (also known as essential hypertension) makes up for 90% of cases of high blood pressure, the specific cause is unknown but generally it is related to lifestyle and genetic influences.

Secondary hypertension makes up the 10% of cases that are left, and it manifests due to a specific cause that is already present in the person's life, examples of which could be kidney disease, use of cocaine, or narrowing of the arteries by cholesterol fragments.

The risk factors about to be mentioned are related to Primary Hypertension.
Maybe you have a general idea of some of them already...

                                                            



(For an easier way to remember I've divided them into those risks that cannot be changed and those risks that you can change)

RISK FACTORS THAT CANNOT BE CHANGED

• Heredity: there are different clinical studies that corroborate that there is an important genetic factor in the origin of hypertension, and persons who generally are descendants of hypertensive folk have a higher risk of becoming hypertensive themselves. 

Notice that the word risk is in bold. This does not mean that you will suffer from hypertension.
Nothing is written in stone.

Well...you know what I mean....

 [Click on the picture directly above and those following for further reading...]

• Race: There has been a correlation made between the appearance of hypertension and its tendency to appear in people of African descent in comparison to their counterparts of European descent. Generally speaking, black people tend to suffer more from hypertension, and of course the complications of the disease.

• Age: With age pressure values tend to increase progressively. Older folks are more likely to be at risk for hypertension.

• Sex: Hypertension was highly associated with men in previous years, however the relationship between sex and high blood pressure is modified by age. After the age of 60 women become more predisposed to becoming hypertensive; among other factors, it is now known that women are protected by oestrogen before menopause.

                                

Now, let's consider the risk factors that you have control over...

RISK FACTORS THAT CAN BE CHANGED

The following modifiable risk factors come under a general heading known as LIFESTYLE. 

• Diet: There is a direct link between the amount of salt ingested in the diet and the elevation of blood pressure, and vice versa, there is also a direct relationship between the reduction of salt ingested in the diet and the reduction of blood pressure. Lower your salt intake, lower your pressure.

Click on the picture above to read on...

In Antigua and Barbuda, diet can be a touchy subject. As soon as diet is mentioned, the air becomes thick with unease, persons set their jaw, and tense their shoulders...you know me a talk truth.

Thoughts of expensive, alternative changes come to mind, and calculations begin to be made about the cost of the diet, and right there in there and then, the idea of the diet is shut down, without even being attempted.

I would like to propose however, a diet is not a two week long crash remedy before the impending release of the carnival costumes, it's not four month affair you take on to fit that outfit you bought to go to your daughter's wedding , but a diet is rather the way you eat for the rest of life, day in and day out.

This is what needs to be changed, not just three months out of your life. Your meals don't have to cost an arm and a leg to be healthy and satisfying, the trick is being creative with what you have at hand, and what you can afford. You don't have to push your head where your body can't pass.

                                

Photo courtesy eatyourworld.com

It must be mentioned that not only is it the abuse of salt in the diet that serves as a risk to your health but also the lack of other important elements such as potassium and vitamin D, and others such as iron and zinc.

• Obesity: This goes hand in hand with diet for most people, and is a well-known risk factor for hypertension. Hypertension is twice as possible in the obese. The Framingham Heart Study (one of the most popular and long running investigations into cardiovascular health) demonstrated that excess body weight was related to the appearance of high blood pressure in both men and women. 

• Stress: maintained, or reiterated emotional tension is a contributing risk factor to the appearance of hypertension. This stress can come from the environment in which we live, or work, or just from the type of personality we have. In psychology there are different classifications. Do a Google search about the Type A personality.

• Other factors: Smoking is a risk factor for multiple diseases, it should come as no surprise that hypertension is included in the onslaught. The label says, smoking kills, believe them. Drinking is also a risk factor, drinking excessively can lead to a temporary rise in blood pressure but doing so over a long period of time can lead to permanent consequences.

I want you to think of how many persons in your family that suffer from hypertension. If you're like me, you can probably think of more than two.

So many persons suffer from high blood pressure in Antigua and Barbuda that it has become commonplace amongst us, despite this being so, we ought not to ever feel comfortable about this disease.

There is a reason why this sickness is known as the silent killer; its not uncommon that persons live undiagnosed for years, not knowing that all the while the excessive force of the blood has begun to cause damage to their most vital organs.

Courtesy nintendojo.com

Hypertension is what I like to refer to as a gateway illness, when the door is opened and not closed in time, it leads to other diseases that lead to dire circumstances.

The sad thing about hypertension is the fact that ... (and I'm quoting the World Health Organization here) "it has been identified as one of the world's most prevalent preventable disease, which can largely be counteracted by relatively simple measures related to maintaining a healthy lifestyle."

For further reading see the article here.

Now you've read it all,  I want you to consider the risk factors that could be present right now in your life, or that of a loved one/s. You could be standing on a border that with only one fateful step could take you over into the realm of being hypertensive.

Utilize the services available to you, swing by your local health centre, or clinic, remember prevention is much better than the cure.

#becomewadadlianstrong.

Blessings to you and yours,

©February 2014