In our Healthy Heart project in district Pulwama, we started with a symposium on High blood pressure (Hypertension). The meeting was organized by Dr Haseena Mir, the CMO and her team from Pulwama and all the doctors working in the subdistricts and blocks participated. It was a very interactive event including a lecture from me, which was chaired by her. The event was held in the General Nursing midwifery (GNM) hall of the district Hospital on 26th November.
Importance of High BP:
High Blood Pressure (Hypertension) is the most important cause of death world-wide. Contrary to popular belief it exceeds cigarette smoking, diabetes, high cholesterol, obesity and physical inactivity etc. One out of 5 young adults in India has high BP and the estimated number according to a recent Indian study there are an estimated 234 million adults with hypertension in India. More than 3.5 million persons may be suffering from hypertension in Kashmir and at least 2.2 lac persons in district Pulwama. Unfortunately, only 25% in rural and 40% people in urban milieu are aware that they have high BP. Complications of untreated or under-treated hypertension lead to serious damage to the muscles of the heart because of more force needed to pump blood. It also leads to hardening of the arteries of the body including those supplying blood to heart, brain, kidneys and eyes. This can lead to heart attacks, brain strokes, blindness and kidney failure. In addition, it can lead to heart failure, impotence, irregularity of heart beat and even sudden death. It is very important for everybody to know his/her BP, because hypertension is very often asymptomatic (Silent Killer).
Diagnosis of High BP:
Measuring BP is easy. These days preference is given to well calibrated instruments made by a number of reliable companies. The digital instruments using an oscillometer method are the preferred ones over the dial type or manometric instruments. Mercury manometers which are still used in many places have been completely banned all over the world because of the toxicity of mercury. It has also been recognized that self-measured home recording is the best way to record the BP. It obviates the problem of white coat hypertension (high BP only in clinic and not at home) seen in about 25% of our population, in a very large “India Heart Study” The other finding from this study was that the evening BP in our population was higher than the morning recordings which was believed to be higher as a customary belief. These findings can have some bearing on the time of drug administration for treating high BP in our patients. 24 hours ambulatory BP monitoring is also a very useful way of finding the average BP before initiating treatment in persons with wide fluctuations or in those with difficult to control BP by office and home recordings.