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Control that blood pressure–Now!

ABOUT 76 percent of Filipino business owners are highly stressed, according to a survey conducted by the Grant Thornton International. The result: less productivity and more work absenteeism.

Aside from affecting one’s work, work-related stress may also have an impact on his or her quality of life (QOL), the study found out. Defined as “the general well-being of individuals and societies,” QOL has a wide range of contexts, including the fields of international development, healthcare, politics and employment.

hf04a-112516“Prioritizing work over quality of life could only do harm than good,” said Thomas Marcelo G. Agana III, president and chief executive officer of Pharex Health Corporation. “The quality of your work, for one will be affected. When that happens, everything will follow.”

Work-related stress, he pointed out, may lead to poor work output and eventually affecting employees and customers.

But work-related stress may not only affect the output but also the health of the person.  Foremost is hypertension, which is a risk factor for heart disease. Currently, 28 percent of Filipino adults have hypertension or high blood pressure.

Out of the 28 percent of Filipinos with hypertension, 9 percent are unaware of their disease and 19 percent are unaware of it, according to Dr. Jorge Sison of the Council on Hypertension.

Stubborn problem

Health authorities consider hypertension a stubborn problem because it involves so many of the body’s interlocking systems, and lying at the center of it all is the heart. Blood travels through our body by flowing through arteries, carrying oxygen-rich blood from our heart to other tissues and organs. Once oxygen is delivered to our tissues and organs, oxygen-poor blood travels back to our heart through our veins. Our heart then pumps this blood into our lungs, where it is replenished with oxygen. After returning to our heart, the blood is pumped out into our arteries again.

Blood pressure (BP) is the force exerted by blood against artery walls as it circulates through our body, explains Dr. Willie T. Ong, an active consultant in cardiology at the Manila Doctors Hospital and Makati Medical Center.  Normally, people have certain standards of BP, with a reading of 140/90 considered the median or average. The upper number, called the systolic, refers to the pumping capability of the heart, while the lower number, termed the diastolic, refers to the pressure exerted by the blood vessels all over the body.

hf04b-112516A person is said to be hypertensive if he or she has persistent elevations of BP: a systolic blood pressure greater than 140 mm Hg (millimeters mercury) or a diastolic blood pressure of more than 90 mm Hg.

The Merck Manual of Medical Information says an individual has a mild hypertension if the systolic BP is between 140 to 159 mm Hg or the diastolic BP is between 90 to 99 mm Hg. When the systolic BP is higher than 160 mm Hg or a diastolic BP is greater than 100 mm Hg, a person is said to have a moderate to severe hypertension.

Many things can cause blood pressure to rise. When we are asleep, our blood pressure is low because our body needs less oxygen-rich blood when it is at rest. On the other hand, when we are exercising, our body’s demands are greater, and so our blood pressure increases.

“It is perfectly normal for your blood pressure to rise and fall in response to your body’s needs throughout the day,” says Ong.

Complications

Majority of Filipinos with hypertension, however, have no symptoms and many don’t even realize they have high blood pressure. “Practically nine out of 10 hypertensive patients have uncontrolled blood pressure, which makes them good candidates to develop heart attacks and strokes, or literally drop dead before they could realize what was wrong with them,” said Dr. Esperanza Cabral, past president of the Philippine Society of Hypertension. 

Dr. Rafael Castillo, a cardiologist at the Manila Doctors’ Hospital, noted that detection comes late in many cases so that in 59 percent of patients detected by physicians for the first time.  “Which might be too late already,” he lamented, as the harm has already started even before these people get treatment.

“Hypertension is the leading risk factor for heart attack, or myocardial infarction,” informs Dr. Julian Whitaker, author of Reversing Hypertension: A Vital New Program to Prevent, Treat, and Reduce High Blood Pressure. “A heart attack occurs when part of the heart’s blood supply is suddenly reduced or cut off; usually due to a blockage in one of the coronary arteries supplying blood to the heart. The portions of the heart muscle that cannot get adequate oxygen and nutrients die. The more extensive the damage, the more serious the heart attack.”

Hypertension is the primary factor underlying strokes and stroke-related deaths. “Too much pressure can cause the bursting of a vessel—especially if that vessel has been weakened by age and the excess pressure of hypertension,” explains Whitaker.

“Hypertension also contributes to atherosclerosis and arteriosclerosis, the narrowing and stiffening of the arteries that increases the likelihood of blood clots cutting off blood supply,” Dr. Whitaker continues.  “When either of these scenarios occurs in an artery in the brain, the result is a stroke.  There is a reduction in oxygen supply to that area of the brain, followed by cell degeneration and death.”

The Department of Health reports that heart disease and stroke remain the leading causes of mortality, comprising 35 percent of total deaths, among Filipinos. Philippine Health Statistics data show that in 2009, about 167,000 Filipinos died from heart disease and stroke. Half of these tragic deaths are likely related to high blood pressure.

A lesser-known outcome of hypertension is memory loss and an increased risk of dementia and Alzheimer’s disease. “It is believed that hypertension’s adverse effects on the brain are caused by the relentless pounding on the small vessels in the brain,” Whitaker writes. The brains of patients with hypertension actually shrink—by as much as 20 percent, according to some studies.

Hypertension also accelerates the aging of the kidneys.  High blood pressure damages the arteries and arterioles that supply blood and nutrients to the kidneys. As these arteries become stiff and less elastic, blood supply to the kidneys is reduced or, in some cases, cut off, causing damage to the kidneys themselves.

“Severe high blood pressure causes kidney malfunction over a relatively short period of time; however, even milder forms of uncontrolled hypertension can damage kidneys over several years, with no evident symptoms until severe damage has already occurred,” Whitaker claims. “Poorly controlled high blood pressure is responsible for approximately 25 percent of all cases of chronic kidney failure.”

The Mayo Clinic clarifies that until now, there’s no proof that stress by itself causes long-term high blood pressure.  It may be that other behaviors linked to stress—such as overeating, drinking alcohol and poor sleeping habits—cause high blood pressure. “However, short-term stress-related spikes in your blood pressure added up over time may put you at risk of developing long-term high blood pressure,” it Minnesota-based hospital points out.

It’s also possible that health conditions related to stress—such as anxiety, depression and isolation from friends and family—may be linked to heart disease, “but there’s no evidence they’re linked to high blood pressure,” the Mayo Clinic says.

Do something

Hypertension can be controlled—but only if you find it first. As Dr. Enrique Ona, former health secretary, puts it: “Detecting high blood pressure is the first step in preventing and controlling it; when people know their blood pressure level, they can take steps to control it.”

However, Ona also emphasized the need to tackle other risks for noncommunicable diseases (NCDs), in addition to high blood pressure. “Addressing high blood pressure should be addressed with the other risk factors under the total risk approach for managing NCDs,” he said. “This is because that NCD risks factors add up, and the health consequences of high blood pressure can be compounded by tobacco use, unhealthy diet, harmful use of alcohol, lack of physical activity, as well as obesity, high cholesterol and diabetes. The presence of multiple risk factors will more alarmingly increase the odds of heart attack and stroke for affected individuals.”

Meanwhile, Dr. Amado I. Nazal, medical director of Pharex Health Corp., urged hypertensive patients to comply with the medication schedule even when symptoms are not surfacing.  He also advised to maintain a healthy diet aside from taking the prescribed medication.

“Without complying with your therapy, your health will eventually deteriorate, leading to a lower quality of life—or even death,” Nazal told Vital Signs, a monthly publication for health professionals.  “Embarking on a lifestyle journey is not one-time travel—it is a life’s worth of adventure you can give to yourself, and someday, you’ll thank yourself if you did.”

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