Dr Tariq Jagnarine
Fam Med, Endocrinology/ Diabetes

This year’s theme is ‘Measure Your Blood Pressure Accurately, Control It, Live Longer’, focusing on combating low awareness rates worldwide, especially in low to middle income areas, and accurate blood pressure measurement methods.
Hypertension is another name for high blood pressure. It can lead to severe health complications and increase the risk of heart disease, stroke, and sometimes death.Blood pressure is the force that a person’s blood exerts against the walls of their blood vessels. This pressure depends on the resistance of the blood vessels and how hard the heart has to work.
Hypertension is a primary risk factor for cardiovascular disease, including stroke, heart attack, heart failure, and aneurysm. Keeping one’s blood pressure under control is essential for preserving health and reducing the risk of these dangerous conditions.
Hypertension is responsible for 20% to 50% of all cardiovascular mortality and morbidity, which contributes to increased health care costs.
In Guyana, hypertension is the leading cause of mortality among those between 45 and 64 years.According to the latest WHO data published in 2018 Hypertension Deaths in Guyana reached 234 or 3.94% of total deaths. The age adjusted Death Rate is 46.59 per 100,000 of population ranks Guyana #5 in the world.
 Second leading cause of morbidity
 2001-2011: ~ 15,000 new cases were diagnosed
 2007-2017: prevalence ↑ 32%
 Women have a higher rate of death

A number of factors increase the risk of hypertension.
• Age: Hypertension is more common in people who are more than 60 years of age.

Blood pressure can increase steadily with age as the arteries stiffen and narrow due to plaque buildup.
• Ethnicity: Some ethnic groups are more prone to hypertension than others. Africans have a higher risk than other ethnic groups,
• Alcohol and tobacco use: Regularly consuming large quantities of alcohol or tobacco can increase blood pressure.
• Sex: According to a 2018 review, males have a higher risk of developing hypertension than females. However, this is only until after women reach menopause.
• Existing health conditions: Cardiovascular disease, diabetes, chronic kidney disease, and high cholesterol levels can lead to hypertension, especially as people age.
• Obesity
Other risk factors include:
• Sedentary lifestyle
• Salt rich, high fat diet
• Low potassium intake
• Poorly managed stress and a family history of high blood pressure can also contribute to the risk of developing hypertension.

The cause of hypertension is often not known. In many cases, it is the result of an underlying condition.
High blood pressure that is not due to another condition or disease is called primary or essential hypertension.
If an underlying condition is the cause of increasing blood pressure, this is referred to as secondary hypertension.
Primary hypertension can result from multiple factors, including:
• Blood plasma volume
• Hormone activity in people who manage blood volume and pressure using medication
• Environmental factors, such as stress and lack of exercise
Secondary hypertension has specific causes and is a complication of another health problem.Conditions that can lead to hypertension include:
• Diabetes, due to kidney problems and nerve damage
• Kidney disease
• Pheochromocytoma, a rare cancer of the adrenal gland
• Cushing syndrome that corticosteroid drugs can cause
• Congenital adrenal hyperplasia, a disorder of the cortisol-secreting adrenal glands
• Hyperthyroidism, or an overactive thyroid gland
• Hyperparathyroidism, which affects calcium and phosphorous levels
• Pregnancy
• Sleep apnea
• Obesity
Most people experience no symptoms from hypertension and may not be aware they have it, so people often call it the “silent killer.” Without detection, hypertension can damage the heart, blood vessels, and other organs, such as the kidneys.
It is vital to check blood pressure regularly.
In rare and severe cases, high blood pressure causes:sweating, anxiety, sleeping problems, and blushing. However, most people with hypertension will experience no symptoms at all.
If high blood pressure becomes a hypertensive crisis, a person may experience headaches and nosebleeds.
A sphygmomanometer, or blood pressure monitor, can help people keep track of their blood pressure.
Having high blood pressure for a short time can be a normal response to many situations. Acute stress and intense exercise, for example, can briefly elevate blood pressure in an otherwise healthy person.
For this reason, a diagnosis of hypertension requires several readings that show sustained high blood pressure over time.
The AHA issued guidelines in November 2017 that define hypertension as blood pressure that is consistently higher than 130 over 80 millimeters of mercury (mmHg).
The systolic reading of 130 mmHg refers to the pressure as the heart pumps blood around the body. The diastolic reading of 80 mmHg refers to the pressure as the heart relaxes and refills with blood.
The AHA 2017 guidelines define the following ranges of blood pressure:
Systolic (mmHg) Diastolic (mmHg)
Normal blood pressure Less than 120 Less than 80
Elevated Between 120 and 129 Less than 80
Stage 1 hypertension Between 130 and 139 Between 80 and 89
Stage 2 hypertension At least 140-160 At least 90-100
Hypertensive crisis Over 180 Over 120
If the reading indicates a hypertensive crisis, wait 2 or 3 minutes and then repeat the test. If the reading is the same or higher, this indicates a medical emergency. The person should seek immediate assistance at the nearest hospital.
This is one time that the old adage, “An ounce of prevention is worth a pound of cure,” is particularly apt. It’s best to avoid high blood pressure altogether. Healthy lifestyle choices are a great place to start.With proper treatment and management, persons can control their blood pressure to help them live a long and healthy life.