By Dr S Manoj
MBBS, MD (General Medicine), DNB (General Medicine, Cardiology), DM (Cardiology), MNAMS

Research shows a strong dose-dependent relationship between consuming too much salt and raised levels of blood pressure. Populations who consume diets low in salt do not experience the increase in blood pressure with age that is seen in most Western countries.

When salt intake is reduced, blood pressure begins falling within weeks on average. Reducing sodium intake lowers blood pressure, with greater effects among people with hypertension.

Facts on Hypertension:

• About 30% of cases are related to increased salt consumption, and about 20% are related to low dietary potassium (low consumption of fruit and vegetables)
• Physical inactivity is related to about 20% of hypertension
• Obesity (caused by dietary caloric excess and lack of activity) is related to about 30% of hypertension
• Excess alcohol consumption also causes hypertension.

Points to note while taking Blood Pressure:

Your blood pressure readings may be higher than normal under the following conditions:

1. After an exercise or after performing a physically strenuous activity
2. After a heavy meal, after drinking coffee or cigarette smoking
3. When you are anxious, nervous or upset about something
4. When you are in a hurry

Therefore, always try to take your blood pressure when you are relaxed or when you have rested for approximately 15 minutes after any strenuous physical activities. Be sure to note down any reason which you think may affect your blood pressure reading.

Self-Care:

High blood pressure is a lifelong disease. It can be controlled but not cured. You can help your blood pressure control by:

1. Eating sensibly - Reducing your salt and fat intake; reducing your calorie and sugar intake
2. Reducing your alcohol intake
3. Exercising regularly and losing weight
4. Stop smoking
5. Keeping stress under control
6. Taking your medicines regularly.
7. Equally important is keeping up with your doctor’s appointment
8. Monitoring your blood pressure regularly.
9. Catch at least 6 hours of adequate sleep.

DO NOT DISCONTINUE THERAPIES:

Discontinuation of therapies often a cause for more profound rise in BP – due to phenomenon of rebound high BP- upon stopping the drugs abruptly. This is a commonly encountered scenario in clinical practice. The reason for such discontinuation of drug therapy is often the unfound fear of drug related adverse effects which are in many instances transient or mild. They often seem to ignore the grave risk of fatal / non-fatal serious complication that they are constantly exposed from Hypertension. A visit to the physician often would allay such fears and allow understanding the benefits of a well-controlled Hypertension and continued drug therapy which is lifelong. It’s a regular behaviour in the current era to Google the drugs and read more about the side effects than knowing about the beneficial responses the drugs contribute.

Common reasons for Hypertension remaining uncontrolled are poor drug / diet compliance – often high salt intake in diet and sub-optimal dose of drugs, continued smoking, consumption of alcohol on regular basis and unrelieved psycho-social stress and in a few Hormonal / Kidney disorders.

Educating the favourable changes in life style and adherence to drug treatment which is often required in many, will go a long way in complying with the comprehensive control of Hypertension and reducing profoundly its risks in the population.

Dr S Manoj is a senior consultant and interventional cardiologist. He consults at Kauvery Hospital, Venkateswara Hospital, Nandanam. Chennai.

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