Controlling the risks
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.
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Dr Sudarwin Tjanaka.