Blood pressure is a silent killer – Know your numbers
Hypertension, or high blood pressure, is the leading cause of heart attacks and strokes in South Africa yet three out of four people do not even know they have it… With World Hypertension Day (WHD) being held this month, ER24 is urging people to have their blood pressure measured. It is an easy and pain-free test, but could potentially save thousands of lives. ER24 is also urging people who know they have hypertension to also measure their blood pressure to ensure it is adequately lowered. Many people using blood pressure medication still have very high blood pressures and assume it is controlled. The World Hypertension League (WHL), in partnership with the International Society of Hypertension (ISH), and other organisations, annually promote WHD. The theme of WHD for 2013-2018 is “Know Your Numbers” with the goal of increasing high blood pressure awareness in all populations around the world. According to Professor Alta Schutte, President of the Southern African Hypertension Society and Executive Council Member of ISH, one of the most important aspects of high blood pressure is that in most individuals there are no clear symptoms. Individuals may feel normal and healthy and as a result, are not aware they are at a very high risk for stroke or heart attack – which is why hypertension is called the silent killer. “This is why all individuals are strongly encouraged to get their blood pressure tested and know their numbers,” said Prof Schutte. Dr Mark Niebylski, the Chief Executive Officer of the WHL, said, “This decision was based on global statistics, indicating that only 50% of those with hypertension were aware they had high blood pressure, that only a few populations have an awareness rate of more than 75% and the critical fact that high blood pressure substantively increases the risk for stroke, heart attack, heart failure and kidney disease.” Dr Niebylski said awareness in some populations is lower than 10%. To increase awareness of hypertension diagnosis, there are two critical components: one is to establish high capacity community screening programmes for blood pressure in those at risk and two, to promote routine measurement of blood pressure by healthcare professionals at all clinical encounters. Moreover, an important initial step to control hypertension and help achieve the United Nations 2025 goal of a 25% reduction in uncontrolled hypertension is to improve hypertension diagnosis,” he said. Jessica Byrne, a dietitian at The Heart and Stroke Foundation South Africa, said an estimated 11 million South Africans live with hypertension. “South Africa has one of the highest hypertension rates worldwide. A recent international survey found eight in 10 adults over the age of 50 in South Africa have high blood pressure. This was the highest of the six countries measured and the highest prevalence ever measured worldwide,” she said. She added that heart disease and strokes are the second leading cause of death in South Africa, responsible for one in six deaths, or 220 deaths per day. Byrne attributed the high prevalence of hypertension in South Africa to a combination of unhealthy lifestyles, a genetic link between blood pressure and salt intake and lack of awareness about the condition. “Most South Africans are only vaguely aware of the risk factors which contribute to hypertension and therefore cannot identify whether they are at risk. There are a few risk factors beyond our control such as age, family history of hypertension and being diabetic. However, our unhealthy lifestyles are largely to blame. What we eat, being overweight or obese, smoking, drinking too much alcohol and stress are some of the contributing factors,” she said. Salt Too much salt is a key driver of hypertension. “Many South Africans eat too much salt. More than half of the salt we eat, is added by manufacturers during the processing of foods. Often these foods don’t look or taste salty. The rest of the salt we eat comes from salt we add during cooking and salt sprinkled on at the table,” said Byrne. She said bread is the biggest contributor to South Africans’ salt intake. Other foods with a lot of hidden salt include breakfast cereals, processed meat, flavouring, savoury snacks, margarine and butter. Byrne urged people to read the ingredients list and nutritional information table on the food packaging. “If you see ‘salt’, ‘MSG’ or any ingredient with the word ‘sodium’ listed as one of the first three ingredients, the product is likely to be high in salt,” she said. According to Prof Schutte one way of lowering salt intake includes removing salt shakers from the table. “Many people have the habit of adding salt to their food even before tasting. Also, when preparing food at home, gradually lower the amount of salt added,” she said. Children According to Byrne, at least one in 10 children in South Africa are already diagnosed with high blood pressure. She said this is worrying especially as these children stand a greater risk of developing severe health problems as young adults. Steps to beat hypertension Byrne said about 80% of heart attacks and strokes can be prevented with a healthy lifestyle. There are three important steps to beating hypertension: diagnosis, starting treatment and achieving hypertension control. “Sadly, a recent review shows that South Africans fare dismally in all three of these steps. Not only are South Africans not aware of their blood pressure but most of those diagnosed are not on the appropriate treatment and only 7% of hypertensive patients are controlling their blood pressure adequately. This means that 93% of sufferers are at risk of having a heart attack, stroke or developing severe heart disease,” said Byrne. Prof Schutte added, “Everyone should get their blood pressure tested. Those that have a family member who suffered from hypertension, a stroke, a heart attack or kidney disease, are especially encouraged to check their blood pressure annually,” she said.