A simple blood pressure test could save your life

World Hypertension Day is being observed on 17 May to raise awareness of this common chronic illness.

"According to the Southern African Hypertension Society, high blood pressure, medically known as hypertension, is the major risk factor for heart diseases, strokes, kidney disease and even eye diseases," says Dr Noluthando Nematswerani, Head of the Centre for Clinical Excellence at Discovery Health. "When blood pressure goes above a certain limit, we call it high blood pressure."

What causes high blood pressure?

High blood pressure is when the force of circulating blood against your artery walls is continually high - and high enough to eventually cause health problems, such as heart disease.

The Mayo Clinic explains that high blood pressure is also determined by the amount of blood your heart pumps: "The more blood your heart pumps and the narrower your arteries, the higher your blood pressure."

Why hypertension is silent - and dangerous

The Heart and Stroke Foundation of South Africa found that more than a third of adults in South Africa live with high blood pressure. Hypertension is responsible for half of all strokes and 40% of heart attacks.

Hypertension is also a major cause of premature death across the world, says the World Health Organization. "About four in 10 adults older than 25 have hypertension. This means that nearly one billion people have hypertension. Unfortunately, around 50% of these people are unaware of their condition," says Dr Nematswerani.

Understanding the numbers

Blood pressure can be checked quickly and easily by a nurse at a pharmacy or clinic, or by your GP. A device called a sphygmomanometer will be used to do this - and it's much easier to use than it is to pronounce! It's simply a cuff that's placed around the upper arm. The cuff gets tighter as it's inflated to give the blood pressure reading.

Blood pressure is measured in millimetres of mercury (mm Hg). The measurement is recorded as two numbers, one "over" another - for example 140/90 mm Hg. The top number refers to systolic pressure, which is the pressure in your arteries when your heart contracts. The bottom number refers to diastolic pressure, which is the pressure when your heart is resting between beats (this is when pressure is at its lowest). So, a measurement of 140/90 mm Hg is read as systolic over diastolic pressure.

"A normal blood pressure reading is below 120/80 mm Hg," explains Dr Nematswerani. "Hypertension is usually defined as when either number (or both numbers) are equal to or above 140/90 mm Hg, when measured on two different days. You will need emergency medical care if your blood pressure measurement is 180/120 mm Hg or higher."

Hypertension is easy to manage if picked up early enough

"If hypertension is picked up early enough, it is relatively easy to manage," says Dr Nematswerani. "This is why we encourage all our members to go for health screenings, such as the Vitality Health Check, at least once a year, where blood pressure readings and other important health checks will be done."

Toni feels that many of the healthcare providers that deal with moms and their babies are not always equipped to pick up on and support mothers with postpartum mental health issues. She says she was brushed off by healthcare providers who she had told she was having a tough time. "One doctor said to me that she knew I'd be fine because she'd seen women with postpartum depression and that I didn't look like they did."

Johannesburg-based GP, Dr Lize-Maré Steenkamp, echoes this: "One's body is a beautiful, well-functioning machine that wants to keep you alive. It's your responsibility to look after it as well as you possibly can."

Book your Vitality Health Check today

• Find out your blood pressure, blood glucose levels, cholesterol and body mass index (BMI) by doing your Health Check at an accredited Vitality Wellness Centre, Vitality Wellness Network pharmacy or Discovery Store, or on a Discovery Wellness Day. You can also book an appointment online.
• You can also earn Vitality points for doing other important screening checks, such as a mammogram, Pap smear and HIV test.
• We pay for the Health Check from your Screening and Prevention Benefit. This means it won't affect your day-to-day benefits. If you are a Vitality member, you can also get points for doing your Health Check.

"Her kidneys failed because of long-term, untreated hypertension."

Dr Steenkamp has voiced her concern about patients who don't get screened regularly. "The vast majority of patients are completely unaware that they are hypertensive. They don't understand that hypertension may not present with symptoms, and that when hypertension is left untreated for a long time it can cause severe complications later on," she says.

When she started as a GP, Dr Steenkamp treated an elderly patient who was very sick when Dr Steenkamp met her for the first time. "When I tested her blood, she was in kidney failure. It turned out that her kidneys failed because of long-term, untreated hypertension. Unfortunately, she didn't live for much longer, and her husband helped her with dialysis at home before she passed away," she says.

Dr Steenkamp says this case opened her eyes to the importance of catching hypertension early and taking it seriously.

Symptoms and causes of hypertension

Most people with hypertension don't have any symptoms. Those who do have symptoms may experience headaches, shortness of breath, dizziness, chest pain, heart palpitations and nose bleeds.

Primary hypertension (also called essential hypertension) is when no cause for the high blood pressure can be found. Primary hypertension is thought to run in families and is affected by our lifestyle choices (for example, what we eat and how much exercise we get). Secondary hypertension is caused by an underlying condition such as kidney disease, vascular disease or a tumour.

According to the Mayo Clinic, the biggest risk factors for hypertension are:

• Age: The risk of high blood pressure increases as you age. Until about age 64, high blood pressure is more common in men. In women, the risk increases significantly after age 65.
• Race: High blood pressure is particularly common among people of African heritage, often developing at an earlier age than it does in Caucasian people. Serious complications, such as stroke, heart attack and kidney failure, also are more common in people of African heritage.
• Being overweight or obese: The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls.
• Family history: High blood pressure tends to run in families, with a genetic predisposition putting certain people at higher risk.
• Physical inactivity: People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction, which means there's more force on your arteries. Lack of physical activity also increases the risk of being overweight.
• High stress levels: High levels of stress can lead to a temporary increase in blood pressure. If you try to relax by eating more, using tobacco or drinking alcohol, you may increase your risk factors for high blood pressure.
• Smoking: Not only does smoking or chewing tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls. This can cause your arteries to narrow and increase your risk of heart disease. Second-hand smoke can also increase your risk of heart disease.
• Excessive alcohol intake: Over time, heavy drinking can damage your heart. Having more than one drink a day for women and more than two drinks a day for men may affect your blood pressure.
• Making unhealthy food choices: This includes eating too much salt, as too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.
• Certain chronic conditions: Conditions such as kidney disease, diabetes and sleep apnoea may increase your risk of high blood pressure.

"Don't wait for symptoms to appear. High blood pressure becomes more likely with older age, but anyone, no matter their age, gender, fitness level or lifestyle, can develop high blood pressure," says Dr Nematswerani.

A healthy lifestyle for healthy blood pressure

"Making lifestyle changes can help you to control and prevent high blood pressure," says Dr Nematswerani. She suggests living by the following principles:

• Eat healthy foods
• Decrease the salt in your diet
• Maintain a healthy weight
• Increase your physical activity
• Don't smoke
• Manage your stress
• Limit your alcohol intake
• Know your blood pressure numbers.