HYPERTENSION:A CHALLENGE FOR DEVELOPING COUNTRIES

Hypertension simply means high blood pressure.Persistent high blood pressure leads to stroke,heart attacks,problems with vision and occasionally a vicious cycle of kidney damage sets in with high BP.The worst case of encephalopathy that I saw was in a young Caucasian woman of 40 when I worked as a medical registrar in a hospital in the UK. This is another dreaded complication of hypertension.So,why hypertension is detected more often than before.One is an increase in the awareness of getting the BP checked more often and the other is the lifestyle that we lead in cities and towns across the world.

Hypertension is a silent killer because it does not give rise to any specific symptom. It may present with a major catastrophe such as a stroke or a heart attack. A visit to a dcotor’s clinic or a healthcare facility should prompt the measurement of BP(Blood Pressure) in any individual case.People with renal,endocrinal and strong family history must be regularly checked for high BP. Primary Hypertension where the cause is unknown is the commonest form of hypertension.In any person below the age of forty with hypertension must  be investigated for an underlying cause specially either a kidney problem or endocrinal problem.At the same time some baseline cardiac investigation must be initiated to see the presence of any damage to the heart.

The normal range of BP is a slightly controversial issue. Based on population studies in the Western world anyone having a BP above 140/95 on three different occasions can be labeled as hypertensive and requires to be checked also for Blood Glucose,Serum Lipids apart from any evidence of cardiac or renal damage.A basic screening for endocrinal disorder is also essential.Recently both European and American Hypertension Societies have recommended a test called 24-hour ambulatory BP monitoring by a special device  which is now available in most of the healthcare facilities.This test is similar to the Holter monitoring for cardiac rhythm abnormalities.

Reduction of BMI(body mass index),Contorol of Blood Glucose,Stopping smoking cigarettes,Controlling lipids,Daily regular exercise.Low salt intake must take precedence before writing a prescription for BP lowering medicine.Because once started the treatment of hypertension is a lifelong undertaking.The person with hypertension must attend a clinic dedicated to treat hypertension.

Hypertension is the precursor of most dreadful diseases causing extensive comorbidites and mortalities and hence special expertise may be required at times to treat it.

 

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