Hypertension: How to tame the silent killer (3)
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Disorders of hormones such as thyroid disease for example hyperthyroidism (overacting thyroid) may lead to raised blood pressure in individual sufferers.
High blood pressure very often coexists or be part of the disease of diabetes mellitus.
High Blood Pressure in a Peculiar Situation (Pregnancy and in Children):
As a junior doctor decades ago, I was witnessing a young lady in labour in a government hospital.
She had become unconscious of her environment although she could still respond to conversations with her carers. Suddenly she started telling those of us who were present that she wanted to “fly” and that she should be allowed to fly away in the midst of labour.
She got to this stage because of a deadly, brutal form of blood pressure that affects pregnant women.
In her case, she was suffering from preeclampsia- a vicious killer of pregnant women.
Depending on the origin, hypertension in pregnant women may be pregnancy-induced hypertension, hypertension-in-pregnancy and both can lead to preeclampsia or eclampsia. The latter two constitute extreme medical emergency. Therefore, all pregnant women should have their blood pressure measured as soon as possible and same should be kept in check in each antenatal attendance.
High Blood Pressure in Children: Blood pressure in children is not expected to be raised except in rare circumstances.
Thus, a notice of high blood pressure in children is an indication of an underlying disease. The attending doctor is likely to raise an alarm on this finding and parents should take any raise blood pressure in children extremely seriously.
Symptoms and signs of High Blood Pressure: Very frequently, there may be no symptom at all until late in the disease. Finding that a person has a raised blood pressure may be an accidental discovery by a doctor or a nurse who is checking for something else or it may be a discovery as part of routine monitoring.
There is no blood test or imaging test that will say a person has high blood pressure other than clinical findings, although investigations may follow discovery of raised blood pressure as a step to finding the cause of the hypertension.
Therefore, in most cases, the blood pressure is slow crawling and silent hence the name, silent killer.
When the pressure has been raised to a certain level that the body, kidney and heart or brain can no longer tolerate, symptoms may begin to appear. If the symptoms were to appear, it comes in form of headache, visual impairment, dizziness, nausea, shortness of breath, awareness of the beating of the heart or palpitation and vomiting, nose bleed as well as chest pain. In some complex situations, the legs may be swollen especially if the heart is starting to fail.
Dangers and complications of High Blood Pressure: The higher the blood pressure, the greater the risk of injury to the heart and blood vessels in major organs of the body such as the heart, the brain and kidneys. Overall, raised blood pressure is the most important preventable cause of heart disease and stroke in the entire world.
If left untreated, high BP (Blood Pressure) can lead to a heart attack, an enlargement of the heart and ultimately can cause a stroke (blood in the brain or absence of enough blood/oxygen) supply to the brain. Hypertension is also known to cause kidney failure, blindness, and cognitive impairment.
Treatment of High Blood Pressure: In a lot of cases, notwithstanding the age, raised blood pressure is treatable especially if it is detected early.
The challenging part of managing blood pressure especially in Nigeria is the denial of the illness by the patient. This is complicated by religious indoctrination that denies evidence of existence of the disease.
The second problem is compliance with treatment. I have been asked to see a young patient who was brought to me listless and unconscious at the verge of death due to high blood pressure. The fundamental problem is not the fact that she has high blood pressure but of the fact that she denied the illness and refused to comply with the prescribed medications. After her near-death ordeal however, she learnt her lesson to comply with medications, in a hard way.
That said, there are various medications that exist and are available to treat high blood pressure. Such treatment will be individualised depending on the person’s tolerance and acceptability of the therapy.
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