1. Hypertension is a disease of the elderly.

Due to numerous lifestyle changes that have come with the 21^st century, hypertension is now more common among the younger population. The triggers of this are those that we looked at in our last article [link here]. Even in the presence of a worrying family history, lifestyle still plays a critical role in the development of hypertension. Myth: False!

• If I feel fine, my blood pressure is normal.

Hypertension is not painful. A subset of the population will experience some dizziness, without heaviness in the shoulders or a headache, but for the majority. The condition is purely symptomless. As such, period checking is advised, especially in a proper healthcare setting. Myth: False!

• Salt causes high blood pressure.

Rev. Dr. Chris Oyakhilome went to great lengths to debunk this myth for us during [insert name of program and link]. The body has the capacity to regulate its salt levels without elevating blood pressure. In fact, sugar and other corn-based products are associated with damage to blood vessels and a subsequent elevation in blood pressure. Myth: False!

• Checking Bp too often will cause it to rise.

Now this is the big one. Whilst repeat Bp checks in one setting involving the same arm are associated with a mild increase in blood pressure, frequent checking (up to twice a week) has not been associated with any consistent elevation in blood pressure. This, however, has a caveat, which we will address in the next myth. Myth: False!

• Bp checks in a medical facility tend to be higher than those at home.

There is the concept of white-coat hypertension, which is a consistent elevation in blood pressure when measured in a medical setting compared to a home setting. This is because many people find medical settings stressful, and this will, in turn, lead to the body activating its fight or flight response. This physiologic response is associated with an elevation in blood pressure. (This physiologic response may also lead to an elevation in the blood pressure during repeat testing in the same sitting.) Myth: True!

These are some of the more common myths that tend to be encountered in society. But how do I deal with hypertension? Is there safe treatment? Is there a cure? When can I stop the medication?

We’ll address these in our next article.

Until then, yours in healthcare and service

-Dr T Kamuzonde

At one point in time, these were the Bp guidelines.

The idea, particularly in the elderly population was that studies had already shown several key considerations.

1. With aging, the blood vessels stiffen, making the heart have to pump harder. In turn, the systolic ( upper) value would higher when checking; but still normal. This was the body’s natural response to the stiffer vessels.

1. The higher risk of dizziness with subsequent falls was more common, with aggressive Iowering of the BP.

Then the world changed, the guidelines changed, but the vessels the falls remained. The guidelines changed, but humans, humans haven’t.

So what is hypertension? Let’s talk about the one of the leading clinical diagnoses of the 21st century.

Several drivers have been considered for this condition, today, we look into them at length.

1. Chronic stress.

The body’s response whether physical or paraphysical is to release stress hormones to help respond to the insult. These include adrenaline and cortisol. However, these hormones tighten blood vessels and increase the heart rate. This forces the heart to work harder, with a subsequent increase in pressures. When stress becomes a lifestyle, High Blood pressure is not far off.

2. Physical inactivity.

Adam was always on the go. His sons, farmers and hunters, constantly moving. The modern man, “works” sitting behind a desk, “moves” sitting in a four-wheel contraption and ‘hunts for food’ on an app on his phone. We have become static, slow and lethargic. This weakens the body’s muscles, weakens blood vessels, promotes weight gain and worsens insulin resistance, a cocktail for elevated pressures.

3. Increased body weight.

We eat and sit, eat and sleep and wonder who has been tightening our clothes around the waist. Extra body fat increases the workload on the heart and disrupts the bodys hormone systems. This in turn leads to disregulation of the systems that control the blood pressures

4. Poor sleep

Long day, dark room, sound sleep. At that point in time, the body is awash with melatonin, a hormone that is only released when sleeping. It’s primary function, a reset and repair mechanism for the body. When people don’t sleep as well as they should, or for as long as they should, you produce less melatonin. Subsequently, the body doesn’t get to reset and repair as efficiently as it should, this in turn keeps the stress hormones high.

Hypertension does not appear overnight. The blood vessels which at first where elastic and flexible, stiffen and narrow due the stressors above. The heart then has to work harder to pump the same amount of blood through. The end result, the pressures in the vessels are higher and the readings on that little machine, will stress your doctor.

So how to manage and prevent all this.

See you on the next post.Dr. Tadiwa Kamuzonde MBChB (UZ) (Hons) is a Loveworld SOM in the Southern Africa Region and a medical doctor. He is a General Practitioner and a Fellow in Diabetology Fellowship at University of Zimbabwe