Hypertension popularly known as BP or High Blood Pressure is on the rise and is also one of the major non-communicable diseases silently killing millions in Ghana and in the world at large.  In Ghana, 5 million people die of high blood pressure every year. An individual is known to be hypertensive or is diagnosed with hypertension when he or she has recorded a blood pressure of greater than or equal to 140/90 mmHg on an account of three or four measures at different times.

RISK FACTORS OF HYPERTENSION

Though its cause is unknown, there are lots of other factors that increases our risk of developing hypertension. These risk factors for hypertension are classified into two groups;

Modifiable risk factors (one which can be controlled) include;

• unhealthy diets (excessive salt consumption, a diet high in saturated fat and trans fats, low intake of fruits and vegetables),
• physical inactivity (i.e. lack of exercise)
• consumption of tobacco and alcohol and
• being overweight or obese
• excessive stress

Non-modifiable risk factors (which cannot be controlled) include:

• a family history of hypertension either from your mother’s or father’s side
• age over 65 years
• co-existing diseases such as diabetes or kidney diseases.

Poor lifestyle choices may exacerbate the problem, since it appears to have a strong genetic component.

SIGNS & SYMPTOMS

Hypertension is called the ‘silent killer’ because it shows no clear warning signs or symptoms as other medical conditions do.  Most people with hypertension are unaware of the problem because it may have no warning signs or symptoms.  For this reason, it is essential that blood pressure is measured regularly. Where symptoms do occur, they can include early morning headaches Nosebleeds, irregular heart rhythms, vision changes and buzzing in the ears. Severe hypertension can cause fatigue, nausea, vomiting, confusion, anxiety, chest pain, and muscle tremor. The only way to detect hypertension is to have a health professional measure blood pressure. Having blood pressured is quick and painless. Individuals can also measure their own blood pressure using the automated devices, however an evaluation by a health professional is important for assessment of rick and associated conditions.

THE COMPLICATIONS OF UNCONTROLLED HYPERTENSION

Uncontrolled hypertension can cause heart attack, heart failure, kidney failure, irregular heartbeat, chest pain (also angina), vision problems, stroke, and sometimes death if left untreated. Among other complications, hypertension can cause serious damage to the heart. Excessive pressure can harden arteries, decreasing the flow of blood and oxygen to the heart. Due the pressure posed on arteries that supply blood and oxygen to the brain, hypertension can also burst or block arteries causing a stroke. The only ideal way to preserve your health and also reduce your risk of these dangerous complications is by keeping your blood pressure under control.

HOW TO PREVENT HYPERTENSION

Everybody can prevent or reduce the risk of developing hypertension by controlling the dietary and lifestyle factors that predisposes one to this condition. Below are some healthy guidelines;

• Reducing salt intake (to less than 5g daily equivalent to a teaspoon of salt per day)
• Eating more fruits and non-creamed salads
• Garnish your stews and soups with vegetables
• Be physically active on a regular basis
• Avoiding the use of tobacco
• Avoid the intake of alcoholic and caffeinated beverages
• Limit the intakes snacks high in fats and sugar
• Cook with vegetable oils
• Eat more breakfast cereals
• Choose fat-free or law-fat dairy products

HOW TO KEEP YOUR BLOOD PRESSURE BELOW 140/90 mmHg

The management of hypertension involves a combination of drug therapy and a diet and lifestyle adjustment which are the standard, first line treatment for hypertension

• Regular physical exercise: Exercising or being physically active is essential in helping you prevent hypertension or control you blood pressure if you are hypertensive. The current research and guidelines for hypertension recommend that all persons, including those with hypertension, should engage in at least 30 minutes per day or 150 minutes per week of moderate to high intensity aerobic exercise like brisk walking, cycling, swimming and jogging. Individuals who cannot exercise as result of old age or having a knee or joint problems can also engage in themselves in some home chores like cleaning, sweeping, and cooking as a way to be physically active.
• Stress reduction: Continuous or excessive stress is also one of the contributing factors for the occurrence hypertension. It is recommended that having 8 hours of sleep daily is a good practice to manage stress and also control your blood pressure. Individuals with busy schedules or high workloads within the day can have 30 minutes of intermittent rest throughout their daily activities. Warm baths, listening to music or going long but less stressful strolls are relaxation techniques that helps relieve stress and control blood pressure.
• Avoid the intake Alcohol & Smoking of cigarette or tobacco: Alcohol intake, active and passive smoking also have a high tendency of increasing your blood pressure. We encourage individuals and groups who use alcohol and tobacco to release stress to rather consider the other relaxation techniques stated above or to also contact their medical doctors for help.
• Medication: Hypertension or High blood pressure is also managed with some prescribed medications which can be recommended by only your medical doctor. This because some antihypertensive drugs have side effects which needs to monitored your medical doctor. Also the choice depends on the individual and any underlying medical conditions the individual may experience.  

• Limit the intake of sodium: Research has proven that high intake of sodium increases the blood pressure. We get sodium from salt, can foods like sardine, mackerel, tomato paste, can vegetables in brine solution, biscuits and in some sea foods.

Ghana Academy of Nutrition and Dietetics recommends that individual with hypertension are take 2300 mg of sodium maximum and a minimum of 1500mg of sodium. This can be translated into 1 teaspoon of salt maximum and 2/3 of teaspoon of salt minimum. They should also avoid the intake of can foods and rule out foods that contain sodium from their shopping after reading food labels.

DIET AND EATING PLAN FOR HYPERTENSIVES

Individuals with hypertension have their own eating plan which is designed to helping them improve their health and reduce or and maintain their blood pressure below 140/90 mmHg. This eating plan is popularly known as the DASH diet which is an acronym meaning Dietary Approaches to Stop Hypertension. The DASH diet is focused on eating the right portion sizes, limiting sodium intake, and consuming variety of plant-based foods to get the appropriate nutrients for your body. People who follow this eating plan turn to lose weight, lower their cholesterol levels, and also reduce their risk developing diabetes, stroke and heart diseases.

The DASH diet is made up of;

• 6-8 servings of Whole grains per day: Whole grains play essential role in controlling your blood pressure and blood glucose levels. Most individuals eat whole grains as should part of their meals for breakfast. Examples of whole grains you can consider include whole-grain breakfast cereal such as corn porridge or tom brown, brown rice, whole-wheat, oatmeal, whole-grain bread such as whole-wheat bread, bulgur, and quinoa. These foods are naturally low in fat and contain lots of fiber and nutrients than the refined grains. A servings of whole grain can be translated into our normal meals as 1 slice of whole-grain bread, 1 soup ladle of a whole breakfast cereal, 1 stew ladle of cooked rice or any cooked cereal.
• 4 to 5 servings of Vegetables a day: All vegetables are allowed and included on the Dash diet eating plan. Eating a variety of vegetables in moderation can help reduce your pressure or reduce your risk of developing hypertension. A serving of vegetable can be translated into our normal meals as; 1 soup ladles of cooked vegetables or 2 soup ladle of raw vegetables. Vegetables can be eaten as a whole meal as salad or jollof rice-gravy, or as an accompaniment i.e. vegetable soup and stew. Some vegetables you may enjoy include tomatoes, sweet pepper, cabbage, carrots, broccoli, cucumber, and garden eggs.
• 4 to 5 servings of Fruits: Fruits are the essential healthy snack sources in a DASH diet. All fruits are allowed and included on the Dash diet eating plan (especially the ones within the individual’s preferences). Eating a variety of fruits in moderation can help reduce your pressure or reduce your risk of developing hypertension. Example of fruits you can consider include orange, banana, coconut, watermelon, pineapple, apple, grapes, any many more. 1 serving of fruit is equivalent to 2 small fingers banana, a wedge of watermelon, medium size orange or apple or mango, small size of pineapple, and 10 pieces of grape fruits.

• 2-3 servings of fat-free or low-fat dairy foods: Dairy products are alternate source of calcium and proteins in the Dash diet eating plan. These dairy products should be low in fat. Example of fat-free or low-fat dairy foods include skimmed milk, and low-fat cheese and yogurt. A serving of low-fat dairy is equivalent to 1 desert spoon of milk.

• 2-3 servings of lean meat, poultry and fish: Lean meat, poultry and fish are the main source of proteins in the DASH diet eating plan. To make your meat or poultry lean is to grill it and peel off the skin around it. A serving of meat, poultry and fish can be matched up to the size of a match box. So we say 1 serving of fish is equivalent to 1 match box size of fish. Occasionally red meats can be added to stews and soups where vegetables and herbs have taken center stage during preparation.
• 4-5 servings of Seeds and Nuts and legumes per day: These include almonds, peanuts, tiger nuts, walnuts, sunflower seeds, flaxseeds, kidney beans, soy beans, lentils and split peas. Example of a serving include, 1 soup ladle of cooked legumes or 1 teaspoon of nut butter.

• 2-3 servings Fats and Oils per day: Fats are important in keeping us healthy but when eaten without control can pose dangerous outcome. Among hypertensive, fried foods should be limited, deep fried foods should also be avoided with most at times opting for more boiled and grilled options. Control your fat intake

The DASH diet recommends vegetable oils over other oils. These include margarines and oils like canola, corn, olive or safflower. It also recommends low-fat mayonnaise and light salad dressing

FOODS TO BE AVOIDED BY HYPERTENSIVES

Avoid the intake of excessive fried foods

Avoid the intake high sugary and carbonated drinks

Avoid the intake of caffeinated and alcoholic beverages

Avoid the use of artificial spices in meal preparation

Avoid the intake biscuits and can foods with sodium in them

Individuals with or without hypertension are to check their blood pressure regularly and also take their medicines if they may have other medical conditions like diabetes, stroke, or any heart conditions to prevent further complications.

For more Dietary counseling & menu plan, please contact us via email. See you soon again for more health & wellness talks.