HYPERTENSION: THE SILENT KILLER AMONG US

By Dr. Tariq Jagnarine
Fam Medicine, Endocrinology/Diabetes

A Hidden Threat
Hypertension – commonly called high blood pressure – is one of the leading causes of death worldwide, yet it often goes unnoticed until serious damage is done. Because it shows few or no symptoms, it has earned the nickname “the silent killer.”
Globally, the World Health Organization (WHO) estimates that more than 1.2 billion adults have hypertension, with two-thirds living in low- and middle-income countries. In the Caribbean, hypertension affects nearly one in every four adults, contributing significantly to strokes, heart attacks, and kidney failure.
In Guyana, hypertension ranks among the top five causes of hospital admissions and premature death – making early detection and lifestyle management urgent public-health priorities.

What Is Hypertension?
Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps. Hypertension occurs when this pressure remains consistently higher than normal, forcing the heart to work harder and damaging blood vessels over time.
Normal blood pressure is below 120/80 mmHg.
Hypertension is diagnosed when readings are 140/90 mmHg or higher on two or more separate occasions.

Types of Hypertension
1. Primary (Essential) Hypertension – develops gradually over years, often linked to genetics, stress, or lifestyle.
2. Secondary Hypertension – caused by underlying conditions such as kidney disease, hormonal disorders, or medication side effects.
3. Gestational Hypertension – high blood pressure that occurs during pregnancy and can lead to pre-eclampsia if untreated.

Common Risk Factors
• Family history of hypertension
• Overweight or obesity
• Excessive salt or fatty-food intake
• Smoking and alcohol consumption
• Physical inactivity
• Chronic stress
• Age above 40 years
• Underlying diseases such as diabetes or kidney disease

Signs and Symptoms
Hypertension often has no early warning signs, but severe or prolonged elevation can cause:
• Persistent headaches or dizziness
• Blurred vision
• Chest pain or shortness of breath
• Irregular heartbeat
• Fatigue or nosebleeds (in advanced stages)
Because symptoms appear late, regular screening is vital – even when you feel healthy.

Diagnosis
Diagnosis is simple and painless:
• Blood-pressure measurement using a digital or manual sphygmomanometer.
• Multiple readings taken on different days confirm diagnosis.
• Additional tests – cholesterol, blood sugar, kidney function, ECG – help identify complications or related diseases.

Complications of Uncontrolled Hypertension
Unchecked high blood pressure can quietly damage every major organ system:
• Heart disease and heart failure
• Stroke and brain hemorrhage
• Kidney failure
• Loss of vision (hypertensive retinopathy)
• Peripheral artery disease leading to poor circulation
• Cognitive decline and memory loss

Treatment and Management
1. Lifestyle Modification
• Reduce salt intake to less than 5 grams per day (about one teaspoon).
• Eat a heart-healthy diet rich in fruits, vegetables, and whole grains (DASH diet).
• Exercise at least 30 minutes, five days per week – walking, cycling, swimming.
• Maintain a healthy weight; even a small loss lowers blood pressure.
• Quit smoking and limit alcohol.
• Manage stress through relaxation, deep breathing, or meditation.
2. Medication
When lifestyle changes aren’t enough, doctors may prescribe antihypertensive drugs such as:
• Diuretics (help remove excess salt/water)
• ACE inhibitors or ARBs (relax blood vessels)
• Beta-blockers (reduce heart workload)
• Calcium-channel blockers (improve blood flow)
Always take medication exactly as prescribed – stopping suddenly can be dangerous.
3. Regular Monitoring
Check blood pressure at least once every 3 months, or more often if advised.
Home monitors are affordable and useful for tracking daily trends.

Home and Natural Support
Some natural practices can complement medical treatment:
• Garlic and beetroot juice may help reduce blood pressure naturally.
• Green tea, hibiscus (sorrel), and omega-3-rich foods (fish, flaxseed) support heart health.
• Stay hydrated and avoid excess caffeine.
(Always consult a healthcare provider before using herbal remedies.)

Prevention: Every Step Counts
• Eat more fruits, vegetables, and whole grains.
• Limit salt and processed foods.
• Be physically active daily.
• Avoid tobacco and excessive alcohol.
• Maintain a healthy weight and manage stress.
• Get your blood pressure checked regularly.

Prognosis: A Manageable Condition
With early detection and consistent management, people with hypertension can live long, healthy lives.
• Controlled blood pressure drastically lowers the risk of heart attack and stroke.
• Lifestyle improvements benefit the entire family – when one person eats and moves healthier, others follow.
Hypertension is not inevitable – it’s manageable and preventable when we take action early.

Key Facts
• One in three adults in the Caribbean has hypertension.
• About half are unaware of their condition.
• Reducing salt and increasing physical activity can prevent up to 30 percent of new cases.
• Early treatment can reduce stroke risk by 40 percent and heart failure by 50 percent.
Check it. Control it. Live longer.
Make blood-pressure screening part of your routine, just like brushing your teeth or drinking water.
This simple step can save your heart – and your life.