Health check: Hypertension

THREE out of ten adults in the Philippines are hypertensive while cases of hypertension among young adults and adolescent are already rising.

Hypertension, according to doctor Neal Rana, specialist on Occupational Medicine and Pathology and the chairman of the Office of Documents and Records Control of Northern Mindanao Medical Center, is a “silent killer.” It is included in the top 10 leading causes of death and disease in the country.

“When we say hypertension, it is the abnormal persistent elevation of blood pressure, bisaya pa ‘high blood’ or ‘alta presyon,’” Rana said.

According to the World Health Organization, hypertension exists for around 40 percent globally among adults age 25 years and above. It is estimated to have caused approximately 7.5 million or 12 percent annual deaths.

“For the Joint National Committee, a normal blood pressure is defined as a systolic, kanang taas nga una litokon (that’s in the upper part where we mention it first), pressure lower than 120 and diastolic, kanang ubos nga ikaduhang litokon (lower part to mention), nga 80 mmHg. Meaning below 120/80. Kung mo tongtong nakas (if you reached) 120 paingon sa 139 over 80 paingon 89 (120-139 mmHg/80-89 mmHg), (you are already in) pre hypertension na kana,” Rana said.

“Meaning dako kayo ang tsansa (there’s a big chance) that you will develop hypertension. Stage 1 hypertension kun ang imong BP (if you have a blood pressure) 140-159/90-99 mmHg and Stage 2, last nga stage, kun more than 160/100 mmHg,” he added.

In other organizations such as the American Heart Association, Rana said that their cut off is lower for stage 1 hypertension which is 130-139/80-89 mmHg.

Hypertension has two types, according to Rana: Primary or Essential Hypertension, the most common type that develops over the years with no identifiable cause but a product of multiple factors; and the Secondary Hypertension which often appears abruptly and can be caused by kidney problems, thyroid diseases, illegal drugs and inborn defects of blood vessels.

“Daghan factors i-consider before mo diagnose ang doctor nga high blood ang pasyente kay usahay mosaka jud normally ang BP labi na ug gikan ka nagdagan, alsa or doing strenuous activities,” Rana said.

(There are many factors to consider before you get diagnosed by the doctor that the patient has high blood, because the BP sometimes jacks up, especially if you came from running, lifting or doing strenuous activities)

“Diagnosis does not only require the taking of blood pressure. History, physical examination and even laboratory testing maybe required to support the diagnosis. So better jud ka magpakonsulta sa imong (consult a) doctor,” he added.

The risks of developing hypertension increases with age. Men are more likely to develop earlier and women later in early 60s.

Other factors that increase risk for hypertension are family history, stress, cigarette smoking, eating too much salt and fatty foods, not physically active, too much alcohol, presence of diabetes, and being overweight.

Mild to moderate manifestations of hypertension includes: headache, nape discomfort, dizziness, vomiting, and occasionally being irritable.

“The manifestations ranges from asymptomatic or no symptoms to severe complications like stroke or organ damages,” he said.

“Oftentimes, wala itong (it has no) manifestations since naka-tolerate na yung patient (was able to tolerate it). Ito ang (this is the) usual na dahilan kung bakit mag-stop na ng gamot ang patient kasi ok na yung feeling niya (reason why the patient stops taking medicines because they thought they already feel well) which is wrong,” Rana said.

There are also the “very important manifestations” that should not be ignored, according to Rana. First is the Hypertensive Emergency, the most common rapid rise of blood pressure for persons who have long been diagnosed with the disease.

“Ang BP (the blood pressure) umaabot lampas (that reaches above) 180 or more, would up having organ damage like stroke, congestive heart failure, pagkaroon ng tubig sa baga (water in the lungs (like the case of comedian Chocoleit (pulmonary edema), pagkabulag (blindness) and kidney damage,” Rana said.

The second one is the Hypertensive Urgency, which the blood pressure reaches above 220/120 mmHg but with no end organ damage.

The aforementioned manifestations, Rana said, warrants immediate treatment in a hospital.

“Since this disease is multi-factorial, we have a lot of factors to consider in terms of management. First dito tayo sa lifestyle modifications kasi kahit gaano ka ka compliant in taking your medicines pero you have a bad lifestyle, most likely failure ang treatment mo,” Rana said.

To avoid developing hypertension, he said, you should control your cholesterol levels, special the bad cholesterol. It can be controlled through avoidance of fatty and salty foods and taking medicines.

Dietary modifications like lowering your salt intake, exercise and weight loss if overweight are vital.

However, for those who are already hypertensive and their blood pressure levels are fluctuating despite medications, they should consult their doctor for appropriate exercises.

“Baka mag (if they) over exercise sila and mag-trigger ng (it can also trigger) hypertensive emergencies,” Rana said.

“Another very important prevention is avoid stress and get enough sleep. If really you can’t avoid stress, then learn to manage anger or do things that divert your weariness,” he added.

In terms of medicine, Rana said antihypertensive medicines are core to your management. Only stop the medications if you feel well.

“Consult your doctor first. Second, learn to communicate freely to your doctor and have a good follow up. If you think you did not respond, tell your doctor. If you think you responded well, tell also your doctor for proper revision of your medications. We avoid asking non doctors for treatment kasi (because) not all medications are applicable to all patients,” Rana said.

“Put in mind however, that the management of this disease is holistic that includes yourself your environment. Help yourself and pray,” he added.


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