In my short years as a practicing medical doctor, I have heard quite a number of interesting, albeit false, ideas about chronic diseases, especially diabetes mellitus and hypertension. Just a few days ago I heard the most ridiculous one, and I had to gather up all the professionalism and nobility in me to avoid bursting into laughter.
[contextly_sidebar id=”C5zX0rCKE88PLcNm7NAhDJaLIe0Plks3″]Hypertension and diabetes are both considered to be lifestyle diseases, meaning most of their risk factors have to do with how we live our lives daily, eg. our diet, our activity levels, whether or not we smoke, how much alcohol we drink, etc.
There are many myths surrounding the two diseases and I am going to dispel as many as I can. We will do this as a two part series, starting with hypertension.
Hypertension simply means the pressure (tension) in the blood vessels is high (hyper). Blood pressure (BP) is stated as two figures, systolic (the greater figure) and diastolic (the lesser figure), which depend on whether the heart muscle is contracting (systole) or relaxed between beats (diastole). A BP of up to 120/80mmHg is considered normal. Hypertension is diagnosed when the measurement is consistently at or above 140/90 mmHg. Hypertension can lead to strokes, heart failure, blindness and kidney disease. In about 90% of cases of hypertension, a specific cause cannot be found, and in that case, treatment is for life.
Now let’s dispel some myths and untruths about hypertension.
1. If you don’t feel anything is wrong with you, it means your BP is fine:
This may come as a surprise to many, but in most cases high blood pressure is asymptomatic. Some people report experiencing a headache or palpitations when their blood pressure rises, but for most people there are no symptoms. If you are waiting to feel something before you start taking your medication, you may well be digging your own grave.
2. My parents have hypertension so I will get it too; there is nothing I can do about it: Hypertension as mentioned above is a lifestyle disease. There may be a genetic predisposition to hypertension if either or both parents have the disease. This predisposition is just one risk factor out of many, although a strong one. However, this finding is a very good reason to institute lifestyle modifications that will prevent you from getting hypertension. Having a family history of hypertension should make you start regular exercising and healthy dieting early in life, rather than sit back and blame your parents for bad fortune. Even if you don’t avoid getting it, you will delay its onset.
3. Once you are able to avoid getting hypertension by a certain age, it means you will never get it: It is true that most cases of hypertension are first diagnosed between 35 and 50 yrs. This is when the many preceding years of an unhealthy lifestyle come back to haunt you. However, escaping this age range does not mean you are immune from getting hypertension. In actual fact your cumulative risk increases as you age and you must continue doing all the right things to stay healthy. You should never get tired of avoiding hypertension.
4. Taking hypertension medication for too long will lead to failure of the internal organs:
The organ mentioned most is the kidney. On the contrary, not taking your hypertension medicines (antihypertensives) will rather lead to kidney failure. There are some antihypertensives that are actually known to protect the kidneys. This fear of kidney failure is so pervasive that some patients prefer to take herbal preparations instead of orthodox medication. For our information, herbal preparations are also drugs, some of which can lead to kidney and liver damage. Also, there are so many herbal preparations out there, quite a number of which have not been validated by any institution, and have no proof of safety or efficacy.
5. If your BP reading is normal you need not take your medication: Many of my patients ask me this question. The reason for prescribing medication for you is to maintain your blood pressure as close to the normal as possible, for the rest of your life. When your blood pressure drops to normal it does not mean you are cured. It rather means we have found the winning team, that should keep playing to maintain normal values. We usually don’t rush to start you on hypertension medication, but when we do, it is usually for life.
6. Table salt is bad for hypertension so artificial spice is a better alternative: When we advise that you reduce your salt intake because of hypertension, we mean reduce your sodium intake. It is the sodium that will increase your blood pressure. Sodium is found in high amounts in table salt, artificial spices, some canned foods, some salad dressings, salted nuts, cured meats like bacon and in instant noodles. So replacing salt with artificial spices does not make things better. It probably makes things worse.
7. A diagnosis of hypertension is equal to a death certificate: This couldn’t be any more false. A diagnosis of hypertension is not a death sentence. If managed well, many people can die with hypertension, and not of it. Hypertension in itself will not kill anyone, it is its complications that are fatal. Once you avoid these complications, you have a high chance of survival. You avoid these complications by avoiding surges in the blood pressure and keeping it as close to normal as possible: this you do by sticking to the management plan you have discussed with your doctor.
Hypertension is not as mysterious as some may think, but our misconceptions can make its management very difficult. If managed well, you can live a normal or near-normal life.
Next week, we will dispel some myths about diabetes.