Con­trol­ling the risks

The Star Malaysia - Star2 - - World Diabetes Day -

HY­PER­TEN­SION or high blood pres­sure is a ma­jor risk fac­tor for many life-threat­en­ing con­di­tions, in­clud­ing car­dio­vas­cu­lar dis­eases and stroke.

Dr Su­dar­win Tjanaka, con­sul­tant in­ter­nal medicine physi­cian at Columbia Asia Hos­pi­tal – Se­ta­pak, shares that hy­per­ten­sion is com­mon among di­a­betes pa­tients and vice versa.

“Di­a­betes and high blood pres­sure are core­lated be­cause they share the same risk fac­tors – obe­sity, smok­ing, un­con­trolled al­co­hol con­sump­tion, lack of ex­er­cise, age and fam­ily his­tory,” he ex­plains.

He adds that the risk of get­ting car­dio­vas­cu­lar dis­eases and stroke in­creases if a pa­tient has both di­a­betes and hy­per­ten­sion.

“It is im­per­a­tive to con­trol the risk fac­tors for hy­per­ten­sion, and more so if one has di­a­betes,” warns Dr Su­dar­win. A per­son is di­ag­nosed with hy­per­ten­sion when his blood pres­sure is higher than 140/90.

“Di­ag­no­sis of hy­per­ten­sion usu­ally takes more than one visit to the clinic be­cause a one-time spike in blood pres­sure might be caused by other fac­tors such as pain and anx­i­ety.

“How­ever, if the blood pres­sure read­ing is very high – for ex­am­ple, around 180/100 dur­ing the first visit – doc­tors would con­sider it hy­per­ten­sion and ad­vise pa­tients to start treat­ment im­me­di­ately.”

Ac­cord­ing to him, peo­ple need to be aware of not just hy­per­ten­sion but pre­hy­per­ten­sion as well and take the nec­es­sary pre­cau­tions to avoid fu­ture health com­pli­ca­tions.

“Even if a pa­tient has a blood pres­sure read­ing of 135/85, which is within the nor­mal range, doc­tors con­sider it pre­hy­per­ten­sion. The pa­tient would not need any med­i­ca­tion yet, but con­trol­ling risk fac­tors is es­sen­tial at this stage,” says Dr Su­dar­win.

Treat­ment de­pends on the pa­tient’s stage of hy­per­ten­sion. He elab­o­rates, “The sys­tolic range of 140 to 160 is con­sid­ered stage 1 of hy­per­ten­sion, 160 to 180 is stage 2 and any­thing above 180 is stage 3.

“When a pa­tient comes in with stage 1 hy­per­ten­sion, non-phar­ma­co­log­i­cal treat­ment such as life­style al­ter­ation might work, but for pa­tients with stage 2 hy­per­ten­sion or higher, medic­i­nal treat­ment is es­sen­tial.”

What makes hy­per­ten­sion dan­ger­ous is that it shows no typ­i­cal symp­toms – earn­ing it its rep­u­ta­tion as a silent killer. Of­ten­times, it is di­ag­nosed when a pa­tient un­der­goes a check-up for some other prob­lems.

Dr Su­dar­win says that it is pos­si­ble for ev­ery­one, even peo­ple with un­mod­i­fi­able risk fac­tors such as fam­ily his­tory of hy­per­ten­sion and type 2 di­a­betes, to prevent the oc­cur­rence of th­ese dis­eases by mak­ing sim­ple life­style changes.

“Sit­ting for long hours and lack of phys­i­cal ac­tiv­ity can in­crease the chances of get­ting di­a­betes and hy­per­ten­sion. For peo­ple who pro­vide the ex­cuse of hav­ing no time to ex­er­cise, the min­i­mum they can do is walk more. It is cru­cial to walk at least 8,000 steps daily to stay away from th­ese dis­eases.

“Weight re­duc­tion is also es­sen­tial for peo­ple who are obese. As lit­tle as 5% weight loss may re­duce blood pres­sure and make di­a­betes eas­ier to con­trol.

“Ad­di­tion­ally, it is im­por­tant to be care­ful with one’s diet be­cause too much salty food is one of the lead­ing causes of hy­per­ten­sion. In­take of fruits and veg­eta­bles must be in­creased to keep hy­per­ten­sion and di­a­betes in check.”

Among Dr Su­dar­win’s con­cerns is that there are peo­ple who stop tak­ing their hy­per­ten­sion and di­a­betes med­i­ca­tions once they be­lieve they have their dis­eases un­der con­trol.

He ad­vises, “The im­por­tance of con­tin­u­ing with med­i­ca­tions and lead­ing a healthy life­style can­not be em­pha­sised more, es­pe­cially for in­di­vid­u­als who have both hy­per­ten­sion and di­a­betes.

“Peo­ple need to un­der­stand that although th­ese are not cur­able dis­eases, they can be suc­cess­fully con­trolled with life­style al­ter­ations and med­i­ca­tion. Hence, con­tin­ual treat­ment and fol­low-ups are vi­tal.”

With proper aware­ness, preva­lence of di­a­betes and hy­per­ten­sion can be mit­i­gated, equat­ing to lives be­ing saved from the clutches of car­dio­vas­cu­lar dis­eases and stroke.

Take the pledge to em­power your­self and oth­ers with knowl­edge about pre­vent­ing and treat­ing th­ese dis­eases.

For more in­for­ma­tion, call 03-4145 9999.

Dr Su­dar­win Tjanaka.

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