High blood pressure: the condition you cannot feel

High blood pressure, also called hypertension, is one of the most common long-term conditions we see at Almadina Hospital. It is also one of the most dangerous, because it usually causes no symptoms at all. Many people discover it only after a stroke, a heart attack or kidney damage. The good news is that it is easy to measure, and with the right care most people can keep it under control for life.

What blood pressure means

Every time your heart beats, it pushes blood through your arteries. Blood pressure is the force of that blood against the artery walls. It is written as two numbers, for example 120/80:

• The first number is the pressure when the heart beats.
• The second is the pressure when the heart rests between beats.

When the pressure stays high for a long time, it slowly damages the arteries, the heart, the brain, the kidneys and the eyes.

When is blood pressure high?

A single reading does not make a diagnosis. Blood pressure rises with stress, exercise, pain or a long walk to the clinic. Your doctor will usually check it on more than one occasion, after you have rested. As a general guide, readings that stay at or above 140/90 point to high blood pressure, and readings below 120/80 are considered healthy. Readings in between deserve attention and lifestyle changes.

Why it matters

Untreated high blood pressure is a leading cause of:

• Stroke, which can cause weakness, loss of speech or death.
• Heart attack and heart failure.
• Kidney disease, which may eventually need dialysis.
• Damage to the eyes and loss of vision.
• Problems in pregnancy, including pre-eclampsia.

These complications build up quietly over years. Treating high blood pressure early prevents most of them.

Who should be checked

Every adult should have their blood pressure measured at least once a year, and more often if they have any of these:

• A parent, brother or sister with high blood pressure or a stroke.
• Diabetes or kidney disease.
• Overweight, especially around the waist.
• A diet high in salt.
• Little physical activity.
• Smoking or regular alcohol use.
• Pregnancy.
• Age over 40.

You can ask for a blood pressure check at any visit to our outpatient clinic, even if you came for something else.

Lifestyle changes that work

For many people, lifestyle changes lower blood pressure noticeably. They also help the medicines work better.

Cut down on salt. In Nigerian cooking, much of our salt comes from seasoning cubes, not only from the salt shaker. Use fewer cubes, add less salt at the table, and go easy on salty snacks and processed foods. Your taste adjusts within a few weeks.

Eat more vegetables, fruit, beans and whole grains. Leafy greens such as zogale and alayyahu, tomatoes, garden eggs, okra, beans and millet are good choices that are easy to find in Zaria markets.

Move every day. Brisk walking for 30 minutes on most days helps. So does any activity that makes you breathe a little faster.

Keep a healthy weight. Losing even a few kilograms can lower blood pressure.

Stop smoking and limit alcohol. Both raise the risk of stroke and heart disease.

Sleep well and manage stress. Long-term stress and poor sleep both push blood pressure up.

Medicines

Many people also need medicine. Several kinds are available, and your doctor will choose what suits you, sometimes combining two or more. A few points are important:

• Take your medicine every day, at the same time, even when you feel well. Feeling well does not mean your blood pressure is normal.
• Do not stop suddenly or change the dose without speaking to your doctor.
• Tell your doctor about side effects such as dizziness, swollen ankles or a cough. There is usually another option.
• Keep your appointments so the doctor can check that treatment is working.
• Bring all your medicines, including herbal remedies, to each visit.

If you are covered by NHIA, many blood pressure medicines are included in the scheme. Our NHIA desk can tell you what your plan covers.

Stroke warning signs: act fast

A stroke is an emergency. Come to the hospital immediately if someone suddenly has:

• Face drooping on one side.
• Arm or leg weakness or numbness, especially on one side.
• Speech that is slurred, confused or lost.
• Time matters: every minute counts.

Also come straight away for a sudden, severe headache, chest pain, difficulty breathing, or sudden loss of vision.

Measuring your blood pressure at home

If your doctor asks you to check your blood pressure at home, a digital upper-arm monitor is the most reliable kind. Wrist monitors are less accurate. To get a true reading:

• Sit quietly for five minutes first, with your back supported and feet flat on the floor.
• Rest your arm on a table at the level of your heart.
• Do not smoke, drink tea or coffee, or exercise in the 30 minutes before.
• Take two readings a minute apart, and write both down with the date and time.
• Measure at the same times each day, for example morning and evening.

Bring your record and your monitor to your next visit. Our nurses can check that your machine reads correctly and that you are using the right cuff size, since a cuff that is too small gives falsely high readings.

Common myths

"I would feel it if my blood pressure was high." Most people feel nothing until damage is done.

"Only older people get it." It is becoming more common in younger adults, especially with weight gain and high-salt diets.

"Herbal remedies can replace my tablets." Some remedies interact with medicines or raise blood pressure. Always ask your doctor first.

When to come to the hospital

Come to our outpatient clinic for a blood pressure check if you have not had one in the past year, or if you have any of the risk factors above. If you already have high blood pressure, come for regular reviews and whenever your readings at home stay high. Come to the emergency department immediately, day or night, for any stroke warning sign or chest pain. Almadina Hospital is at 1-4 Chikaji Road, Sabon Gari, Zaria. Call 0806 083 9148.