By Michael Kanaabi Dollar
Complaints of High Blood pressure plus it’s signs and symptoms are on the rise in Uganda and Medical experts say it is a significant public concern if not an emergency already that needs to be addressed urgently to ensure the country maintains a healthy populace on the whole and a productive work force specifically.
Research figures available show that the prevalence of Hypertension in Uganda’s adult population stands at about 25% making it a threat to public health and a significant health concern.
Medical Professional Julius Habumugisha who is also the CEO of Teamwork Homecare Services observes, a a homebased medical services provider notes that men are more likely to develop Hypertension than women before the age of 55 years while women are very likely to suffer from this ailment after Menopause.
“The risk of one getting Hypertension after the age of 45 years significantly increases becoming even much more likely after 65 years. However even young adults in the age group 20-39 years can catch the disease if they have a family history of Hypertension or indulge continuously in a life style with high risk factors such as alcoholism , chain smoking and sedentary lifestyles” he says.
What is Hypertension?
Hypertension which is also known as high blood pressure, is a chronic medical condition where the blood pressure in the arteries is persistently elevated (above normal).
What Causes Hypertension?
Hypertension is caused by a number of factors some closely related and others unrelated. Key among the causes according to Senior Consultant Dr. Robert Kalyesubula attached to Teamwork Homecare Services is family history and genetic disposition as it plays a vital role in one acquiring Hypertension.
Obesity exacerbated by lack of exercise and specifically excess weight around the waist is a leading cause of Hypertension too.
Chronic stress when it becomes a mainstay in one’s life, this person is likely to develop High Blood pressure.
Adrenal gland disorders manifesting with diseases like Cushing’s syndrome can cause Hypertension.
Thyroid disorders that is both hypothyroidism and hyperthyroidism can lead to High Blood pressure.
Pregnancy too can be a precursor to Hypertension according to Dr. Kalyesubula especially when a pregnant woman is suffering from one or more underlying conditions.
He adds that medications like birth control pills and antidepressants when used continuously overtime can lead to High Blood pressure as well.
Hormonal changes for example in women undergoing menopause can also be a catalyst for High Blood pressure.
Lack of calcium and low Vitamin D levels in the body, a polluted environment with high noise levels and other environmental stressors can lead to Hypertension.
What are the signs and symptoms of Hypertension?
Unfortunately High Blood Pressure or Hypertension may not show any signs and symptoms in some cases with patients only realising they have the disease after it has caused significant damage to the body, Teamwork Homecare’s Dr. Richard Lukandwa points out.
But that is not the case with all patients as some may experience frequent or severe headaches as a sign of the disease, dizziness or lightheadedness may occur due to reduced blood flow to the brain.
Patients may also experience Nose Bleeding after High Blood Pressure has caused fragility to the blood vessels in the nose.
Others may experience consistent fatigue because the heart is forced to work extra hard to pump blood as a result of High Blood Pressure.
Shortness of breath too can occur because the Hypertension pushes the heart and lungs to work harder.
In more serious cases Dr. Lukandwa says patients will experience irregular heartbeats or palpitations in addition to chest pain and discomfort which may also be a sign of further heart complications.
Some patients do manifest with swollen legs and feet due to fluid build up in the legs caused by High Blood Pressure.
Patients may also experience vision challenges such as blurred vision or double vision plus intense coughing and wheezing if the sickness leads to Heart Failure.
Blood in urine, protein in urine and vision loss are danger signs too when it comes to Hypertension.
Severe signs and symptoms that call for emergency medical attention include very severe headaches, confusion or disorientation, seizures, Heart attack and transient ischemic attack or stroke these immediately call for quick life saving intervention according to Dr. Lukandwa.
What underlying sicknesses can lead to Hypertension?
There are a number of underlying conditions or sicknesses in the body that may lead to Hypertension. And these conditions require immediate and consistent medical attention according Medical Professional Habumugisha the CEO of Teamwork Homecare Services if Hypertension is to be averted.
Kidney disease and damage, Sleep Apnea, Diabetes, Obesity, Heart disease, Adrenal gland disorders, thyroid disorders, preeclampsia and polycystic kidney disease which manifests with cysts on the Kidney can all lead to significant increases in blood pressure.
Other underlying conditions that may be a precursor for Hypertension according to Habumugisha are Glomerulonephritis an inflammation of the kidneys’ filtering units, Rheumatoid arthritis, Lupus, Scleroderma and Pulmonary Embolism.
What factors increase one’s chances of suffering Hypertension?
Dr. Robert Kalyesubula a Senior Consultant with Teamwork Homecare Services notes that there are a number of factors that may increase the body Pressure many of them being lifestyle and diet related for example for example high stress levels, inadequate sleep, a sedentary lifestyle with very low physical activity and obesity characterised by a lot of fat around the waist.
When it comes to feeding high, sodium intake with low potassium intake which is supposed to balance and counter the excess sodium in the body, smoking, taking excessive alcohol, saturated fats in excess, refined sugars and cholesterol rich foods can all increase one’s chances of getting High blood pressure according to Dr. Kalyesubula.
There are a number of factors that do increase the risk of getting hypertension which are non life style or diet related for example one’s ethnicity.
“ African Americans are known to be more prone to High blood pressure than other ethnicities” he says.
One’s family history may also make them predisposed to catching the disease, age also increases the chances of one catching the disease as they grow older, in terms of gender men have been discovered to have higher chances of getting Hypertension before the age of 55 years.
Environmental factors, hormonal issues, and medications such as birth control pills and anti depressants can also make one susceptible to Hypertension.
Hypertension is also common among pregnant women especially those with underlying conditions which according to Dr. Kalyesubula, the underlying conditions may include include Sleep Apnea, Diabetes, Kidney diseases, Adrenal gland disorders and disorders of the thyroid gland.
Complications that result from Hypertension
Julius Habumugisha a Medical Professional and CEO of Teamwork Homecare Services notes that the complications which may arise from one having Hypertension are quite many and these include Heart diseases like Coronary Artery disease, Heart Failure and Cardiomyopathy.
Strokes both Ischemic and Hemorrhagic can result from Hypertension, Kidney disease which results in kidney damage and chronic Kidney disease may also arise.
Atrial Fibrillation, Peripheral artery disease which is the narrowing of blood vessels in the legs, Vision loss due to damaged blood vessels in the eyes, cognitive impairment and Dementia, Gout and Osteoporosis along with bone fractures may also affect the body as a result of Hypertension according to Habumugisha.
Other diseases that may arise from chronic Hypertension include Kidney stones, Pulmonary embolism, Chronic Obstructive Pulmonary Disease, Rheumatoid arthritis, Lupus, scleroderma plus depression and anxiety.
How is Hypertension managed and treated?
Teamwork Homecare’s Senior Consultant Dr. Robert Kalyesubula notes that High Blood Pressure being a chronic condition makes it necessary for patients to undergo on going treatment and monitoring.
“This is the most effective way to maintain healthy blood pressure levels and prevent other complications such as Kidney damage, Heart disease and Stroke that may result from High Blood Pressure” he says.
Change in diet with emphasis put on consumption of whole grains, fruits, vegetables and lean protein will help bring down the disease.
Indulging in physical exercises such as walking, jogging, cycling or swimming for at least 30 minutes daily will also bring Blood Pressure under control.
Dr. Kalyesubula notes that having adequate sleep, reducing on stress and weight management will help bring down Hypertension as well.
The recommended medications for managing this ailment include Diuretics to remove excess fluid and sodium in the body, Beta Blockers to reduce heart rate and blood pressure, Angiotensin-Converting Enzyme (ACE) Inhibitors, Angiotensin receptor Blockers which both relax blood vessels and reduce blood pressure plus Calcium Channel Blockers that do the same as ACE inhibitors.
Alternative therapies which include acupuncture, herbal supplements like hawthorn and coleus, yoga plus other forms of meditation also reduce stress and lower blood pressure.
Follow up is also key when it comes to treatment of High Blood Pressure and Dr. Kalyesubula recommends regular monitoring of Blood Pressure to ensure treatment is effective and achieving the desired health goals plus follow up appointments with one’s Doctor to adjust treatment and make it more effective where need arises.
How can Hypertension (High blood pressure) be prevented?
According to Dr. Richard Lukandwa of Teamwork Homecare Services preventing High blood pressure combines a number of interventions which include dietary modifications, managing underlying conditions and lifestyle changes among others.
“Regular exercise which includes physical activity for at least 30 minutes 5 days a week, maintaining a healthy weight through a good balance of healthy diet and exercise and keeping stress levels down by practising yoga, deep breathing and other forms of meditation can greatly reduce one’s chances of getting the disease” Dr. Lukandwa says.
Having adequate sleep which is about 7-8 hours per night plus staying away from smoking will also reduce one’s chances of getting High blood pressure.
In regards to one’s diet Dr. Lukandwa says consuming less sodium in food that is less than 2300 milligrams per day will reduce your chances of acquiring Hypertension.
Increasing potassium intake through foods like bananas, leafy greens and sweet potatoes will keep the sickness away.
Taking healthy unsaturated fats from nuts, seeds and avocado is also recommended alongside whole grains while keeping off refined carbohydrates and ensuring you have at least 5 servings of fruits a day Dr. Lukandwa advises.
Proper management of underlying conditions like Diabetes through monitoring blood sugar and medication, regular exercise and keeping other conditions like Kidney disease, sleep Apnea will also help keep Hypertension away.
Avoiding excessive caffeine that is consuming not more than 200 mgs per day, keeping alcohol consumption to two bottles for men and one bottle for women a day, getting regular checkups and pressure monitoring plus staying hydrated will also help prevent the disease.
Finally Dr. Lukandwa recommends the consumption of good quality nutritional supplements that include Omega 3 fatty acids, calcium and Vitamin D to keep one’s blood pressure at bay however he advises consultation with one’s Doctor before embarking on this.
What policies can government put in place to reduce the prevalence of Hypertension?
On the side of government intervention Medical Professional and Teamwork Homecare Services CEO Julius Habumugisha suggests the promotion of more healthy lifestyles which include more physical activity, eating a healthy balanced diet and better stress management with in our communities. All this he says can be done through mass public awareness and education campaigns.
Pushing for reduction of sodium in proceed foods and also encouraging individuals and families to cut down on their consumption of salt as it’s excessive consumption increases one’s chances of getting hypertension.
Increasing access to health care services by bringing them closer to the general populace and making them more affordable can cut down prevalence too with more check ups and quicker intervention.
Adding interventions such as pressure monitoring and testing plus education about Hypertension and physical activity into school and workplace wellness programs will also bring down prevalence Habumugisha advises.
Putting in place stricter alcohol and tobacco control measures as all these contribute greatly to higher Hypertension prevalence when not checked.
Investing more funding in research and surveillance systems targeting Hypertension specifically, providing more training to health care professionals on diagnosis, treatment and management of Hypertension Habumugisha says can also bring down cases of the disease.
Working at putting in place a more green, less stressful environment in the community with public parks for rest, infrastructure that is bike and walking friendly to encourage more physical activity will also help.
Finally inter-sectorial collaboration with in government that provides more holistic solutions geared towards bringing down Hypertension prevalence through joint initiatives between the Health, Education, Agricultural, Environmental and Infrastructure sectors will curb the disease greatly.
Email: michaelkanaabi@gmail.com
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