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World Health Day : 7th April 2013 : Theme - "High Blood Pressure"

"Hypertension is a silent killer"
"Most common chronic illness" 

This year the World Health Day is Celebrated on 7th April to mark the anniversary of the founding of WHO (World Health Organisation) in 1948. Each year a theme is selected for World Health Day that highlights a priority area of Public health Concern in the world. 

The theme for 2013 is "HIGH BLOOD PRESSURE" also known as hypertension. We call it "SILENT KILLER". 

What is high blood Pressure or Hypertension? 

Blood Pressure is merely the Pressure that the Blood exerts on the blood vessels, while circulating. It is measured with an instrument called Sphygmomanometer. The normal Blood Pressure is 119/79 mmHg. If it is 120-139/80-89 mmHg, it is Prehypertension. When it reaches 140/90 mmHg, it is called Stage 1 Hypertension. 

There are two types of hypertension, Essential (Primary) & Secondary. The exact etiology of Primary is unknown and there are definitely causes in Secondary hypertension. Many factors are responsible for the Primary Cause. They are. 

Hereditary :- Most experts believe that hereditary does play a role in causing high blood pressure. 

Excess intake of Salt :- That an excessive intake of common salt (Sodium Chloride) elevates the blood pressure is an indisputable. 

Mental tension and approach :- All researchers accept the role of mental tension and negative thinking in the development of blood Pressure. 

Obesity (Excessive Weight):- The incidence of high blood Pressure is 2 ½ times more in obese than in normal personal. 

Sedentary life :- The incidence of high blood pressure is much higher in sedentary persons than in Physical laborers. 

Smoking :- The incidence of high blood Pressure has been found to be higher in smokers. Smokers more often fall Victims to atherosclerosis, heart attack and cerebral hemorrhages. 

Alcohol Consumption :- The incidence of high blood pressure in drinking is 2 ½ times higher than that in non – drinkers. 

Age :- High blood pressure is common in older age group. 

Prevalence : One in three adults worldwide has high blood pressure. The proportion increases with age from 1 in 10 people in their 20s & 30s to 5 in 10 people in their 50s. 70 million Americans and 1 billion people worldwide have high blood pressure. The global burden of hypertension is rising and Projected to affect 1.5 billion persons, one third of the world's population by the year 2025. 

In India, it was reported on 1995 from Jaipur, the incidence of Hypertension was 30% in male and 33% in female. Again on 1999 the incidence at Mumbai was 44% in male and 45% in Female. In Manipur there is no clear cut study report but many Hypertensive patients are brought to the hospitals with severe complications. 

Signs and Symptoms 

High blood pressure is called the silent killer because it often does not produce any signs or symptoms to some patients. Patient may have headache, dizziness or nosebleeding, palpitation, muscle cramps, giddiness, burning of eyes, distended neck veins, insomnia, neck pain & vertigo. But some patients have high blood pressure for years without every knowing it. Sign and symptoms typically don't occur until high blood pressure has advanced to a higher possibility of life threatening-stage. 

Hazards of High Blood Pressure 
In patients of high blood pressure the blood vessels are narrow, hard and brittle. This disorder is term atherosclerosis. Heart attack, heart failure, kidney failure and cerebral haemorrhage are the natural consequences of high blood pressure. Also it shortens the life and drags its victim to a premature death. 

Prevention of High Blood Pressure 

High blood pressure is preventable and treatable. The old adage, 'Prevention is better than cure' is especially true for high blood pressure.
Reducing salt intake 2-4 gms/day, avoid salty foods as much as possible.
Eating a balance diet.
Avoiding harmful use of alcohol.
Taking regular physical activity at least 1 hr per day.
Avoid tobacco use.
Control Blood cholesterol and blood sugar.
Sound sleep at night. Sleep 2 hrs gap after dinner. 

The ultimate goal of World Health Day 2013 is to reduce heart attacks and strokes. 

Pregnancy Induced Hypertension

What Is High Blood Pressure?

Blood pressure is the amount of force exerted by the blood against the walls of the arteries. A person's blood pressure is considered high when the readings are greater than 140 mm Hg systolic (the top number in the blood pressure reading) or 90 mm Hg diastolic (the bottom number). In general, high blood pressure, or hypertension, contributes to the development of coronary heart disease, stroke, heart failure and kidney disease.

What Are the Effects of High Blood Pressure in Pregnancy?

Although many pregnant women with high blood pressure have healthy babies without serious problems, high blood pressure can be dangerous for both the mother and the fetus. Women with pre-existing, or chronic, high blood pressure are more likely to have certain complications during pregnancy than those with normal blood pressure. However, some women develop high blood pressure while they are pregnant (often called gestational hypertension).

The effects of high blood pressure range from mild to severe. High blood pressure can harm the mother's kidneys and other organs, and it can cause low birth weight and early delivery. In the most serious cases, the mother develops preeclampsia - or "toxemia of pregnancy"--which can threaten the lives of both the mother and the fetus.

What Is Preeclampsia?

Preeclampsia is a condition that typically starts after the 20th week of pregnancy and is related to increased blood pressure and protein in the mother's urine (as a result of kidney problems). Preeclampsia affects the placenta, and it can affect the mother's kidney, liver, and brain. When preeclampsia causes seizures, the condition is known as eclampsia--the second leading cause of maternal death in the U.S. Preeclampsia is also a leading cause of fetal complications, which include low birth weight, premature birth, and stillbirth.

There is no proven way to prevent preeclampsia. Most women who develop signs of preeclampsia, however, are closely monitored to lessen or avoid related problems. The only way to "cure" preeclampsia is to deliver the baby.

How Common Are High Blood Pressure and Preeclampsia in Pregnancy?

High blood pressure problems occur in 6 percent to 8 percent of all pregnancies in the U.S., about 70 percent of which are first-time pregnancies. In 1998, more than 146,320 cases of preeclampsia alone were diagnosed.

Although the proportion of pregnancies with gestational hypertension and eclampsia has remained about the same in the U.S. over the past decade, the rate of preeclampsia has increased by nearly one-third. This increase is due in part to a rise in the numbers of older mothers and of multiple births, where preeclampsia occurs more frequently. For example, in 1998 birth rates among women ages 30 to 44 and the number of births to women ages 45 and older were at the highest levels in 3 decades, according to the National Center for Health Statistics. Furthermore, between 1980 and 1998, rates of twin births increased about 50 percent overall and 1,000 percent among women ages 45 to 49; rates of triplet and other higher-order multiple births jumped more than 400 percent overall, and 1,000 percent among women in their 40s.

Who Is More Likely to Develop Preeclampsia?

·         Women with chronic hypertension (high blood pressure before becoming pregnant).

·         Women who developed high blood pressure or preeclampsia during a previous pregnancy, especially if these conditions occurred early in the pregnancy.

·         Women who are obese prior to pregnancy.

·         Pregnant women under the age of 20 or over the age of 40.

·         Women who are pregnant with more than one baby.

·         Women with diabetes, kidney disease, rheumatoid arthritis, lupus, orscleroderma.

What Are the Symptoms of Preeclampsia and How Is It Detected?

Unfortunately, there is no single test to predict or diagnose preeclampsia. Key signs are increased blood pressure and protein in the urine (proteinuria). Other symptoms that seem to occur with preeclampsia includepersistent headaches, blurred vision or sensitivity to light, and abdominal pain.

All of these sensations can be caused by other disorders; they can also occur in healthy pregnancies. Regular visits with your doctor help him or her to track your blood pressure and level of protein in your urine, to order and analyze blood tests that detect signs of preeclampsia, and to monitor fetal development more closely.

How Can Women with High Blood Pressure Prevent Problems During Pregnancy?

If you are thinking about having a baby and you have high blood pressure, talk first to your doctor or nurse. Taking steps to control your blood pressure before and during pregnancy-and getting regular prenatal care-go a long way toward ensuring your well-being and your baby's health.

Before becoming pregnant:

·         Be sure your blood pressure is under control. Lifestyle changes such as limiting your salt intake, participating in regular physical activity, and losing weight if you are overweight can be helpful.

·         Discuss with your doctor how hypertension might affect you and your baby during pregnancy, and what you can do to prevent or lessen problems.

·         If you take medicines for your blood pressure, ask your doctor whether you should change the amount you take or stop taking them during pregnancy. Experts currently recommend avoiding angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II (AII) receptor antagonists during pregnancy; other blood pressure medications may be OK for you to use. Do not, however, stop or change your medicines unless your doctor tells you to do so.

While you are pregnant:

·         Obtain regular prenatal medical care.

·         Avoid alcohol and tobacco.

·         Talk to your doctor about any over-the-counter medications you are taking or are thinking about taking.

Does Hypertension or Preeclampsia During Pregnancy Cause Long-Term Heart and Blood Vessel Problems?

The effects of high blood pressure during pregnancy vary depending on the disorder and other factors. According to the National High Blood Pressure Education Program (NHBPEP), preeclampsia does not in general increase a woman's risk for developing chronic hypertension or other heart-related problems. The NHBPEP also reports that in women with normal blood pressure who develop preeclampsia after the 20th week of their first pregnancy, short-term complications-including increased blood pressure-usually go away within about 6 weeks after delivery.

Some women, however, may be more likely to develop high blood pressure or otherheart disease later in life. More research is needed to determine the long-term health effects of hypertensive disorders in pregnancy and to develop better methods for identifying, diagnosing, and treating women at risk for these conditions.

Even though high blood pressure and related disorders during pregnancy can be serious, most women with high blood pressure and those who develop preeclampsia have successful pregnancies. Obtaining early and regular prenatal care is the most important thing you can do for you and your baby.

 Dr. Sarita Kapoor, MS (Ob & Gyn), Getwell Medical Center, Dubai

Hypertension

HYPERTENSION means that at least one of the two: systolic pressure or diastolic pressure is high. You can find out whether you are hypertensive or not by measuring your blood pressure on a regular basis.

Above 140/99 MM of HG on two or More occasional indicates High BP.

FACTS TO THINK UPON:

1. Hypertension increases stroke by 4-6 times.
2.  It is one of the common causes of hemorrhagic stroke.
3. People who have hypertensive parents are twice more likely to develop high blood pressure.
4. Smoking 2 cigarettes cause a temporary rise in both systolic and diastolic pressure by an average of 10 mmHg each. If you smoke heavily, your blood pressure is increased throughout the day.
5. Smoking can interfere with certain hypertensive medications.

Author: Dr. Ashok Kapoor, MD (Int. Medicine), DM (Cardiology), Specialist in Cardiologist

Learning to Laugh

Learning to laugh with a group is often easier, you can benefit from laughing by yourself for 15 minutes a day.

Here's the laughter exercise:

1. Give 3 big, noisy sighs as you inhale through your nose and exhale through your mouth.
2. Stretch gently. Bring your shoulders to your ears; then lower gently. Rotate feet and elbows; turn your head from side to side—gently.
3. Take a few deep abdominal breaths and release slowly.
4. Holding your hands under your belly, make a laughing "ho-ho-ho." Make sure the sound comes from your core (you'll feel it in your hands when you're doing it right). Repeat 3 groups of 3, several times.
5. Change the sound to "ha-ha-ha" and repeat as above.
6. Change the sound to "hee-hee-hee" and repeat as above.
7. Put all 3 sounds together—"ho-ho-ho, ha-ha-ha, hee-hee-hee"—and repeat for 3 rounds, continuing until you develop a rhythm.
8. After the final round, break into your own natural laughter. Continue for a few minutes. If it becomes difficult, stop and go back to step #3 and start the laughing cycle again.

The exercise may feel contrived at first, but your normal laugh will come.

"We have gotten ourselves so overscheduled and overwhelmed that we forget to be like children. We forget to give ourselves permission to be happy, to smile,".

"This is one tool to put in your toolbox to make your life more rewarding and make you feel better."

To Protect a Million Hearts

A bold initiative called Million Hearts aims to prevent one million heart attacks and strokes from happening over the next five years. “This wide-ranging collaboration among communities, health systems, government agencies, and private-sector partners will rely on individuals like you and me to meet that goal.

The initiative is spearheaded by the federal Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services. Its main focus is to encourage more widespread and appropriate use of simple, effective, and inexpensive actions dubbed the ABCS:

• taking daily low-dose Aspirin, if prescribed. Only half of Americans who should be taking aspirin are doing it.
• managing Blood pressure and Cholesterol levels. Both of these silent conditions contribute to heart attack and stroke.
• quitting Smoking. Help is available for anyone who wants to quit.

In addition to reviewing the most current targets for blood pressure, cholesterol, and smoking cessation—and strategies for hitting them—we added D (for Diet) and E (for Exercise) to the Million Hearts alphabet. Because eating healthfully and staying physically active are important contributors to preventing cardiovascular disease.