SA’s blood pres­sure rate is ris­ing

To­day is World Hy­per­ten­sion Day, which aims to raise aware­ness about the ‘silent killer’

The Mercury - - FRONT PAGE - Mer­cury Cor­re­spon­dents

SOUTH Africa has seen an ex­po­nen­tial growth in hy­per­ten­sion or high blood pres­sure (BP) over the past 20 years.

This is ac­cord­ing to Pro­fes­sor Bryan Rayner, nephrol­o­gist and di­rec­tor of the Hy­per­ten­sion In­sti­tute at the Univer­sity of Cape Town.

“In a sense we are fac­ing a na­tional health emer­gency, but be­cause the links be­tween high BP and death, heart dis­ease and stroke are in­di­rect, pub­lic aware­ness is poor,” Rayner says.

His com­ments come as to­day marks World Hy­per­ten­sion Day which seeks to raise aware­ness about the “silent killer”.

“Risk fac­tors for hy­per­ten­sion are a fam­ily his­tory of hy­per­ten­sion, di­a­betes or stroke, obe­sity, African eth­nic­ity, seden­tary life­style, di­a­betes, high BP in preg­nancy, and a poor diet with ex­cess al­co­hol, sugar and salt,” says Rayner.

“High BP gen­er­ally causes

no symp­toms be­fore it strikes un­ex­pect­edly. But the very good news is that med­i­ca­tion, com­bined with a healthy life­style, can pre­vent com­pli­ca­tions.”

In 2017, an es­ti­mated 42% to 54% of peo­ple were suf­fer­ing from hy­per­ten­sion in South Africa and this fig­ure is ex­pected to in­crease.

Hy­per­ten­sion is also the lead­ing risk fac­tor for heart dis­ease and stroke. Other com­pli­ca­tions can in­clude heart fail­ure, pe­riph­eral vas­cu­lar dis­ease, re­nal im­pair­ment, retinal haem­or­rhage and vis­ual im­pair­ment.

Hy­per­ten­sion is the lead­ing cause of mor­tal­ity, with an es­ti­mated 1.2 bil­lion suf­fer­ers glob­ally. In South Africa, more than 1 in 3 adults live with high blood pres­sure and it is re­spon­si­ble for one in ev­ery two strokes and two in ev­ery five heart at­tacks.

A study by Wits Univer­sity sci­en­tists and peers has re­vealed that South Africa also has the high­est preva­lence of hy­per­ten­sion in south­ern Africa, as well as the largest num­ber of peo­ple whose blood pres­sure is not con­trolled, even while on treat­ment.

Ac­cord­ing to Dr Stuart Ali, project man­ager and re­searcher at the Syd­ney Brenner In­sti­tute for Molec­u­lar Bio­science at Wits Univer­sity, peo­ple may be com­pletely un­aware that they have hy­per­ten­sion.

“For men, only 40% were aware of their hy­per­ten­sion con­di­tion. Of those who knew and were be­ing treated, only 39% had con­trolled blood pres­sure. For women, the pic­ture was bet­ter with 54% be­ing aware of their hy­per­ten­sion con­di­tion, and of those un­der­go­ing treat­ment, 51% had con­trolled blood pres­sure.

“No one is im­mune to hy­per­ten­sion – black or white, male or fe­male, rich or poor, old or young, over­weight or thin, fit or un­fit – and it is es­sen­tial that ev­ery­one has their BP screened reg­u­larly es­pe­cially if you have risk fac­tors for hy­per­ten­sion,” says Rayner. “If your BP is greater than 140/90, fur­ther eval­u­a­tion is re­quired by a health pro­fes­sional. If your BP is be­tween 130-140/80-90, im­ple­ment life­style changes as you are at risk for hy­per­ten­sion.”

A blood pres­sure test is the only way to find out if your blood pres­sure is too high. In light of these facts, and in col­lab­o­ra­tion with the May Mea­sure­ment Month (MMM) cam­paign run by the In­ter­na­tional So­ci­ety of Hy­per­ten­sion (ISH), phar­ma­ceu­ti­cal group Servier is launch­ing #Be­causeIsayso – a new world­wide cam­paign to raise pub­lic aware­ness about the im­por­tance of reg­u­lar blood pres­sure screen­ing.

In South Africa, the South­ern African Hy­per­ten­sion So­ci­ety (SAHS), linked to the ISH screen­ing ini­tia­tive, will be run­ning screen­ing days and rais­ing aware­ness of hy­per­ten­sion in May.

One of those who was un­aware of his con­di­tion was 28-year-old Nhlanhla Phillips who was di­ag­nosed in 2010.

“I went to the doc­tor be­cause there was some­thing wrong with my heart. They found that my heart was fine but my blood pres­sure was very high. I was then put on chronic treat­ment.”

Phillips ad­mits it has been hard mak­ing life­style changes like ex­er­cis­ing, re­duc­ing his drink­ing and bad eat­ing habits. “I have not had heart prob­lems since I’ve been on the med­i­ca­tion. I try to con­trol my stress lev­els be­cause that shoots it up,” Phillips.

Soweto nurse Tlalane Nd­lala’s fam­ily had a long his­tory of hy­per­ten­sion.

But Nd­lala only re­alised she had the con­di­tion when she fell preg­nant. “When I was 22 and preg­nant, I went for an­te­na­tal classes and it was found I had high blood pres­sure. It was mon­i­tored and I was placed on treat­ment,” she said.

While Nd­lala has man­aged to live well with the con­di­tion for over three decades, this has not been the case for some of her rel­a­tives.

“There is a his­tory of high blood pres­sure in my fam­ily and one of my brothers had a stroke be­cause of it. He can­not walk, he can­not talk or do any­thing for him­self. My other brother died in 2016 be­cause the con­di­tion led to kid­ney fail­ure. He was on dial­y­sis but that didn’t help. Be­fore my brother died, my mother also died of kid­ney fail­ure which was a side-effect of high blood pres­sure,” Nd­lala said.

Be­ing acutely aware of what hy­per­ten­sion can lead to, she has al­ways been dili­gent about car­ing for her health. “I man­age my health with pills. I also eat a low sodium diet and take walks,” she said.

TO­DAY is World Hy­per­ten­sion Day, an ex­cel­lent op­por­tu­nity to raise aware­ness about a most se­ri­ous health chal­lenge which has grown enor­mously in this coun­try.

Hy­per­ten­sion, com­monly known as high blood pres­sure (BP), is the lead­ing risk fac­tor for heart at­tacks and strokes. The Heart and Stroke Foun­da­tion SA says an es­ti­mated 11 mil­lion South Africans live with it.

Un­con­trolled high blood pres­sure is re­spon­si­ble for 65% of kid­ney dis­ease in South Africa, which in turn in­creases the risk of heart dis­ease five to eight-fold.

One in three South Africans 15 years and older have hy­per­ten­sion. A fright­en­ing fact is that a large por­tion of the pop­u­la­tion have no idea they have high blood pres­sure. As one ex­pert puts it, it gen­er­ally causes no symp­toms and strikes un­ex­pect­edly.

World­wide, around 1.8 bil­lion peo­ple have it.

A wor­ry­ing trend is the num­ber of young peo­ple who de­velop it. A study in­volv­ing data from 2008 from 14 000 men and women aged 24 to 32, found that of these peo­ple, 19% had high blood pres­sure – a read­ing of 140/90 or more. Re­searchers found that men were more likely than women to have high blood pres­sure – 27% of men had hy­per­ten­sion, 11% of women.

To keep blood pres­sure un­der con­trol, med­i­cal author­i­ties rec­om­mend eat­ing a bal­anced and healthy diet high in fruits and veg­eta­bles. Also, re­duce in­take of salt to less than 2 300 mil­ligrams a day, cut back on al­co­hol, and be sure to get reg­u­lar ex­er­cise – at least 150 min­utes of mod­er­ate to vig­or­ous ac­tiv­ity a week.

Hy­per­ten­sion has been de­scribed by Pro­fes­sor Bryan Rayner, di­rec­tor of the Hy­per­ten­sion In­sti­tute at the Univer­sity of Cape Town, as a na­tional health emer­gency.

The theme of World Hy­per­ten­sion Day is “Know Your Num­bers”, and the heart­en­ing thing to know is that the con­di­tion is largely man­age­able.

It starts with reg­u­lar checks, and ac­quaint­ing one­self with one’s blood pres­sure read­ings.

“The very good news,” said Rayner, “is that med­i­ca­tion, com­bined with a healthy life­style, can pre­vent com­pli­ca­tions.”

Get to it, then. Know your num­bers.

A blood pres­sure test is the only way to find out if your blood pres­sure is too high.

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