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7th April 2017 #1
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Blood pressure - we ALL have it !
It’s been some time since my original thread on this topic ( now closed ).
The systolic pressure is a measure of the force at which your heart pumps blood around the body ; diastolic pressure ( lower number ) is a measure of resistance to blood flow in your arteries. Averages around the world are ~127/79 mmHg for men, and ~122/77 mmHg for women.
Raised blood pressure / hypertension is the major risk factor for cardiovascular diseases and chronic kidney disease. One in eight deaths worldwide are due to hypertension, because of its effects on heart and kidneys and the increased chance of a stroke. Blood pressure is " continuously distributed " - meaning there’s no sudden " cut off point " above which there is hypertension. However, usually hypertension requiring treatment is taken to be 140/90 mmHg or higher.
I have a longstanding interest in hypertension, and much has changed over the past 40 years.
Numbers of adults globally with hypertension in 1975 was ~600 million ; by 2015 it had increased to ~1.13 billion - around a fifth of women and a quarter of men. It was commonly thought of as a disease of affluence - but the data says otherwise. Most of the increase in these four decades has been in low- middle income countries, largely driven by the growth and ageing of the population. Best estimates for its frequency in the Philippines show it to be ~20% and increasing each year. For the UK it’s now ~25%.
Of course the only way to find out if you have hypertension is to have your blood pressure checked. Hypertension itself doesn’t usually have symptoms, until it’s complicated by something like heart disease or a stroke. This is why a proportion of hypertensive people don’t know they have the condition. Once every 5 years is usually suggested.
Surprisingly in most cases we ( still ) don’t know the cause(s) of hypertension. It’s called " essential ", and only in a small proportion is there a ( treatable ) cause such as kidney or adrenal gland disease. This is despite a huge amount of research, some of which was done while I worked in Glasgow, at the MRC Blood Pressure Unit. We honestly thought in those days we would find the cause(s) of hypertension !
We DO know risk factors which make hypertension more likely. These include increasing age, which we obviously can’t control ; diabetes, and the " usual " culprits of unhealthy lifestyle ( such as lack of exercise, being overweight, smoking, diets including too much salt and alcohol and not enough fruit and vegetables ). Other factors may include early-life nutrition, and other air pollution.
There are also now many more medicines for reducing high blood pressure than 40 years ago. These are of several different types, based on our improved understanding of the factors involved in causing hypertension. At least eight varieties of medicines affect various biochemical systems.
" NHS Choices " gives a good account of high blood pressure and its treatment - see link.
A detailed study looking at hypertension around the world and how it has changed is in this link.
For the Philippines, see here ; South-East Asia, see here.
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