DR. CORY: High blood pressure – the silent killer

World Health Day is celebrated on 7 April and highlights a priority area of public health concern in the world. The theme for 2013 is high blood pressure. One in three adults are known to have high blood pressure, are you one of them?

Many people do not know they have high blood pressure because it does not always cause noticeable symptoms. As a result, the silent condition contributes to more than 9 million deaths every year, including about half of all deaths due to heart disease and stroke.

The rates increase with age, from 1 in 10 people in their 20s and 30s to 5 in 10 people in their 50s. The prevalence of high blood pressure is the highest among the African decent, with over 40 percent of adults thought to be affected. However, raised blood pressure is among many factors that contribute to cardiovascular disease.

Cardiovascular diseases (CVDs) have a broad meaning. It’s not a single condition or disorder in itself. Rather, it’s a collection of diseases and conditions. In fact, some types of cardiovascular disease can cause other types of cardiovascular disease. It’s normally seen as chain reaction.

CVDs are the number one cause of death globally: more people die from CVDs than from any other cause. An estimated 17.3 million people died from CVDs in 2008, representing 30 percent of all global deaths. Of these deaths, an estimated 7.3 million were due to heart disease and 6.2 million were due to stroke.

Over 80 percent of CVD deaths take place in low- and middle-income countries and occur almost equally between men and women. The number of people who die from CVDs, mainly from heart disease and stroke, is projected to increase to 23.3 million by 2030.

Addressing risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity, high blood pressure, diabetes and raised cholesterol can prevent the most common causes of cardiovascular disease.

Preventing heart attack and stroke

Coronary artery disease (CAD) is a disease of the arteries that supply the heart muscle with blood. CAD means that blood flow through the arteries has become impaired and is no longer reaching the muscle. The most common way that an obstruction develops is through a condition called atherosclerosis, a largely preventable form of cardiovascular disease.

Cerebrovascular disease occurs when obstruction occurs in the blood vessels that supply the brain with oxygen. Strokes can occur due to bleeding from a blood vessel in the brain or from blood clots that obstruct the flow of blood. The most common obstruction is a build-up of fatty deposits on the inner walls of the blood vessels that supply the brain.

Not all heart disease preventable

Although one may hear a lot about preventing cardiovascular disease, sometimes they’re not preventable as well. That’s because some types of cardiovascular disease are congenital or one is born with them. Congenital heart diseases are faults in the structure of the heart that exist from early development.

Rheumatic heart disease is a condition that impacts a lot of children.  It’s known to cause damage to the heart muscle and valves.  The condition is caused by bacteria that can produce what’s called rheumatic fever.  Once rheumatic valve disease begins, it tends to progressively worsen over time. Repeated episodes of rheumatic fever can accelerate the deterioration of the heart valves.

Rheumatic heart disease ends up affecting about half the people who have rheumatic fever with carditis or inflammation of the heart. Most of the time, rheumatic heart disease is diagnosed 10 to 20 years after being triggered by acute rheumatic fever.

The silent killer

Often, there are no symptoms of the underlying disease of the blood vessels. A heart attack or stroke may be the first warning of an underlying problem. The symptoms of a heart attack often include pain and discomfort directly over one’s heart or in the center of the chest.

Symptoms can often be confusing and one of the most common areas of pain is in the arms, the left shoulder, elbows, jaw or back. In addition a person may experience difficulty in breathing, shortness of breath, light-headedness, cold sweats, nausea and vomiting. Men are more likely to experience chest pain while women often demonstrate shortness of breath, nausea, vomiting, and back or jaw pain.

The chance of having a stroke approximately doubles for each decade after age 55. While strokes are common among the elderly, a lot of people under 65 also have strokes. One’s risk of stroke is greater if a parent, grandparent, sister or brother has had a stroke.

The most common symptom of a stroke is sudden weakness in one’s face, arm, or leg. Symptoms are most often seen on one side of the body. One can experience visual changes, dizziness, loss of balance and confusion as well.  A stroke victim often characterizes having the worst headache of their life with no known cause.

Choices more important than genetics

Behavioral risk factors are responsible for about 80 percent of heart disease and cerebrovascular disease. Ceasing tobacco use, reducing salt in the diet, consuming fruits and vegetables, maintaining a healthy body weight, engaging in regular physical activity and avoiding harmful use of alcohol have been shown to reduce the risk of cardiovascular disease

The effects of unhealthy diet and physical inactivity may show up in individuals as raised blood pressure, raised blood sugar, raised cholesterol, and overweight and obesity. This is the mechanism that cardiovascular disease can produce other cardiovascular disease.

It’s important to be physically active every day. Research has shown that getting at least 30 minutes of physical activity on 5 or more days of the week can help lower blood pressure, lower cholesterol and keep one’s weight at a healthy level.

Something is always better than nothing. If you’re doing nothing now, start out slow. Even 10 minutes at a time can offer health benefits. Studies show that people who have achieved even a moderate level of fitness are much less likely to die early than those with low levels.

Control one’s dietary portion size. How much one eats is just as important as what you eat. Overloading the plate, taking seconds and eating until one feels stuffed can lead to eating more calories, fat and cholesterol than is recommended.

Eat more of low-calorie, nutrient-rich foods, such as fruits and vegetables, and less high-calorie, high-sodium foods, such as refined, processed or takeaway foods. Eating this way can shape up one’s heart and waistline.

Fruits and vegetables are also a good source of vitamins, minerals and dietary fiber. Vegetables and fruits contain substances found in plants that are known to help prevent cardiovascular disease, high blood pressure and inflammation. Eating more fruits and vegetables is also one of the best ways to reduce high-fat foods such as processed meats, crisps and other junk foods.

Dr Cory Couillard is an international healthcare speaker and columnist for numerous newspapers, magazines, websites and publications throughout the world. He works in collaboration with the World Health Organization’s goals of disease prevention and global healthcare education. Views do not necessarily reflect endorsement.

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