The best pill to control high blood pressure
a year ago
BY Dr. Chamara Dalugama High blood pressure also known as hypertension is one of the major modifiable risk factors for heart disease and a leading cause of disability and death worldwide. High blood pressure is diagnosed based on multiple readings of elevated systolic (the top number which measures the force one’s heart exerts on the walls of one’s arteries each time that it beats) blood pressure above 140 millimetres of mercury (mmHg) and diastolic (the bottom number, which is the pressure in the arteries when the heart rests between beats) blood pressure above 90 mmHg. Hypertension is considered a “killer in disguise” as it is largely asymptomatic and may be diagnosed for the first time with a related complication such as a heart attack or a stroke. The healthcare system is under tremendous pressure with the ever increasing burden of non-communicable diseases such as hypertension and in a recent islandwide survey in Sri Lanka, one third of the adult population was found to be hypertensive. Screening for largely asymptomatic hypertension, diagnosing early, looking for hypertension-related complications and acting fast to control the hypertension to meet desired treatment targets should be the way forward. The management of hypertension has two main aspects which include lifestyle modifications and anti-hypertensive medications. Both of these are equally important and complementary to each other. Mild, uncomplicated hypertension can be managed with lifestyle modification alone. The article on guidance for prevention, detection, evaluation and management of high blood pressure in adults in the American College of Cardiology in 2017 highlights the importance of lifestyle modifications over the “pressure pills”. It states that dietary changes (Dietary Approaches to Stop Hypertension diet) alone can bring down the blood pressure by 11 mmHg. Reduction in alcohol consumption and physical exercise can improve blood pressure by four mmHg and four to eight mmHg, respectively. According to the article, every kilogramme you lose can reduce the blood pressure by one mmHg.
- Quitting smoking
- Limiting ethanol intake
- Stress reducing strategies
- Self-monitoring of blood pressure