Silent threat: Understanding and confronting hypertension

High blood pressure, medically known as hypertension, often lurks unnoticed, earning its reputation as the “silent killer.” However, its effects, when left unchecked, can be catastrophic, impacting various vital organs and overall quality of life.

Dr Sreeram Gopalakrishnan, Specialist Cardiologist, Aster Clinic, Al Muteena, Deira, says the damage inflicted by high blood pressure typically occurs gradually over time. However, if not promptly detected and managed, hypertension can wreak havoc on multiple organs, leading to dire outcomes. “Elevated blood pressure promotes arterial blockages, increasing the risk of a heart attack,” he says. “Blood vessels supplying the brain are susceptible to blockages or ruptures due to high blood pressure, potentially triggering a stroke.”

Dr Gopalakrishnan adds that when the heart is forced to work harder to pump blood, it leads to enlargement and eventual failure. High blood pressure also damages the kidneys’ blood supply, impairing their ability to filter blood effectively. “Strained and damaged blood vessels in the eyes contribute to impaired vision,” he adds. “Impaired blood flow, a consequence of hypertension, can manifest as erectile dysfunction, while prolonged hypertension is associated with cognitive decline, including memory loss and dementia.”

Dr Harish Prabhu, Specialist Nephrology, Burjeel Royal Hospital, Al Ain, underscores that hypertension isn’t confined to the heart but affects arteries throughout the body, posing grave risks if left unchecked. “Uncontrolled hypertension can precipitate a cascade of complications, including heart disease, stroke, kidney failure, and vision impairment,” says Dr Prabhu. “Despite its silent nature, the consequences can be fatal if untreated over an extended period.”

The profound effect

Hypertension, commonly known as high blood pressure, is not merely a standalone condition but a precursor to a multitude of serious health issues. Dr Gopalakrishnan highlights the profound impact of prolonged high blood pressure on the delicate vascular system. He says elevated blood pressure inflicts gradual damage to the walls of blood vessels supplying vital organs such as the heart, brain, and kidneys. “This damage leads to abnormal thickening and the formation of tiny tears in the vessel walls, creating a breeding ground for plaques composed of cholesterol and unhealthy fats,” Dr Gopalakrishnan explains. “These plaques obstruct blood flow, setting the stage for catastrophic events like heart attacks and strokes.”

Dr Gopalakrishnan underscores that timely management of blood pressure is pivotal in preventing vascular damage and thwarting life-threatening conditions.

Dr Rajan Maruthanayagam, a Specialist Interventional Cardiologist, Zulekha Hospital, elucidates hypertension’s staggering contribution to cardiovascular disease. “Hypertension surpasses other modifiable risk factors like smoking, dyslipidemia, and diabetes in its prevalence and impact on heart health,” says Dr. Maruthanayagam. “For every 20 mmHg higher systolic and 10 mmHg higher diastolic blood pressure, the risk of death from heart disease or strokes doubles.

“Even though only a few patients with apparent primary (essential) hypertension develop progressive kidney disease, the total number of patients with hypertension is so large that even the small percentage at risk constitutes a large number of chronic kidney disease burden.”

Dr Maruthanayagam warns that severe uncontrolled hypertension is a strong risk factor for both ischemic and hemorrhagic stroke.

Dr Prabhu explains the symbiotic relationship between hypertension and its complications, including heart disease, stroke, and kidney dysfunction. “Hypertension, particularly when coupled with diabetes mellitus, significantly heightens the risk of these debilitating conditions,” he says. Dr Prabhu backs a comprehensive approach to blood pressure management, incorporating lifestyle modifications and medication to mitigate the risk of complications and preserve overall health.

Lifestyle changes

Dr Gopalakrishnan singles out the pivotal role of dietary choices in blood pressure management. Encouraging individuals to adopt a heart-healthy diet, Dr Gopalakrishnan favours the inclusion of fruits, vegetables, whole grains, lean proteins, nuts, and legumes while limiting saturated fats, sodium, alcoholic beverages, and added sugars. He supports the significance of reducing salt intake, highlighting its impact on blood pressure regulation.

“Reducing the intake of salt can help lower blood pressure,” he says. “Most sodium in our diets comes from packaged and processed foods and eating these foods less often can help reduce your sodium intake and lower blood pressure.”

Dr Gopalakrishnan recommends adhering to the American Heart Association’s guidelines, urging individuals to monitor their sodium consumption diligently.

Dr Krupal Reddy, a Specialist Interventional Cardiologist, Zulekha Hospital, champions the Dietary Approaches to Stop Hypertension (DASH) diet as a cornerstone of hypertension management. “The DASH diet prioritises foods rich in potassium, calcium, and magnesium, crucial nutrients for blood pressure control,” says Dr Reddy.

Dr Reddy subscribes to a balanced diet comprising fruits, vegetables, whole grains, lean proteins, and nuts, while minimising sodium, fatty meats, full-fat dairy products, and sugary beverages. “Foods high in potassium, such as bananas, potatoes, tomatoes, kidney beans, oranges, and spinach, are particularly important as potassium helps balance the sodium levels in your cells, which is essential for preventing and controlling high blood pressure,” says Dr Reddy.

Besides, Dr Reddy recommends getting a regular healthcare checkup and taking up cardiovascular exercises, such as walking, running, cycling, swimming, or dancing. “Strive to engage in a minimum of 150 minutes of aerobic activity with moderate intensity per week, or alternatively, 75 minutes of vigorous-intensity activity,” he says. “Take up resistance training that facilitates the preservation of muscle mass, which is advantageous for metabolism and the control of body weight.”

Dr Prabhu accentuates lifestyle modifications beyond dietary adjustments. He underscores the significance of weight reduction, smoking cessation, regular exercise, moderate alcohol consumption, stress management, and adequate sleep in hypertension management. Dr Prabhu calls for a holistic approach to health, encompassing physical activity, dietary modifications, and stress reduction techniques to achieve optimal blood pressure control.

Regular monitoring

Dr Gopalakrishnan strongly backs early detection through vigilant blood pressure monitoring. Identifying high-risk individuals, including those with a family history of hypertension, smokers, chronic sleep deprivation, and previous elevated readings, is paramount. “Timely diagnosis and intervention are crucial in preventing severe complications such as heart attack, stroke, kidney failure, heart failure, and dementia,” he says.

He recommends the integration of home blood pressure monitoring into routine health practices, complemented by regular physician visits, to mitigate the risks associated with uncontrolled hypertension.

Echoing Dr Gopalakrishnan’s sentiments, Dr Prabhu underscores the broader spectrum of individuals at risk of hypertension. Elderly individuals, smokers, the obese, those with diabetes, sedentary lifestyles, and unhealthy dietary habits are all susceptible.

Dr Prabhu emphasises the pivotal role of early detection, lifestyle modifications, pharmacological interventions, and regular blood pressure monitoring in averting hypertension-related complications. “By adopting proactive measures and closely monitoring blood pressure levels, individuals can exert control over their cardiovascular health and mitigate the potentially dire consequences of untreated hypertension,” he says.