The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.
OVERVIEW
Hypertension, commonly referred to as high blood pressure, is when the pressure in your blood vessels is consistently too high. This means the force of the blood pushing against the artery walls is too high, and your heart has to work harder to pump blood.
It’s a common illness, with the World Health Organisation estimating that 1.28 billion adults aged 30-79 years worldwide have hypertension.
Hypertension can be serious if not treated. In the worst-case scenario, it is fatal. Less than half of adults living with hypertension are diagnosed and treated. It is an underlying cause of heart disease and stroke, both of which are in the top ten causes of premature death around the globe.
WHAT CAUSES HYPERTENSION?
Some of the causes of hypertension are out of our control. Women over 55 years, a family history of hypertension, environmental factors like air pollution, and even some diseases like diabetes, can all cause hypertension. Hormonal contraceptives can also cause heightened blood pressure.
Many of the causes of hypertension can be controlled, however, as poor lifestyle decisions can lead to hypertension:
- An unhealthy diet high in salt, saturated- and trans fats, and low in fruit and vegetables
- Not being physically active
- Being overweight or obese
- Drinking too much alcohol and/or smoking
- Poor sleep
- Chronic stress
HYPERTENSION IN SOUTH AFRICAN WOMEN
The South African Heart and Stroke Foundation states that hypertension is responsible for 1 in every 2 strokes and 2 in every 5 heart attacks in our country.
A study in the journal Global Epidemiology reports that about 45% of men and 48% of women older than 15 years in South Africa have hypertension. Of these, only about 18% of men and 29% of women are aware they have the condition.
In South Africa, people suffering from hypertension are more likely to be living in urban areas, to be obese, and to have a previous history of diabetes, high blood cholesterol, coronary heart disease and stroke. Rate of hypertension are increasing in across all race categories.
Cardiovascular disease claims more women’s lives than any other disease. Hypertension is an important risk factor for cardiovascular disease in women but is often underestimated and undiagnosed and there is an ongoing misperception that women are at a lower risk of cardiovascular disease than men. This even though a 2022 study published in the National Library of Medicine found that rates of hypertension were greater for women, and that women were estimated to experience more hypertensive crises, hypertension-related strokes, and hypertension-related cases of Chronic Kidney Disease. In fact, almost 52% of deaths from high blood pressure are women.
While high blood pressure isn’t directly related to sex, there are risk factors that are unique for women. Health issues like pregnancy, pregnancy prevention (birth control) and menopause can increase the risk of developing high blood pressure.
HOW DO I KNOW IF I HAVE HYPERTENSION?
Unfortunately, people with high blood pressure often do not have any symptoms – which is why it is referred to as the ‘silent killer’. The only way to know if you have hypertension is to have your blood pressure checked.
People with extremely high blood pressure may suffer:
- Headaches
- Shortness of breath
- Nosebleeds
HOW IS BLOOD PRESSURE MEASURED?
Blood pressure is measured in millimeters of mercury (mm Hg) and is written as two numbers. The first (systolic) number represents the pressure in blood vessels when the heart contracts or beats. The second (diastolic) number represents the pressure in the vessels when the heart rests between beats.
- Normal blood pressure: lower than 120/80 mm Hg.
- Elevated blood pressure: 120/80 mm Hg to 129/80 mm Hg.
- Stage 1 hypertension: 130 to 139 mm Hg over 80 to 89 mm Hg.
- Stage 2 hypertension: 140/90 mm Hg or higher
Blood pressure higher than 180/120 mm Hg is considered a hypertensive emergency.
HOW DOES HYPERTENSION AFFECT US?
High blood pressure puts stress on your heart and arteries, which increases your chances of a heart attack or stroke.
Over time, the problems in your arteries can decrease blood flow to the organs in your body, negatively affecting things like your brain, your kidneys, your eyesight and even your sex life.
Older women with hypertension are more likely to have trouble with osteoporosis (weak bones that break easily). This is because hypertension can cause you to excrete too much calcium in your urine. Your body then pulls out calcium from your bones to make up for that, weakening your bones.
TREATMENT
Changing your lifestyle can help control your hypertension:
- Eat a heart-healthy diet with less salt. The Heart and Stroke Foundation of South Africa has a range of guides on healthy eating, as well as free cook books you can download.
- Get regular physical exercise.
- Lose weight if you are overweight.
- Limit alcohol and stop smoking.
- Get 7-9 hours of good quality sleep daily.
Sometimes lifestyle changes are not enough to lower your blood pressure, and you will need medication. Once you start blood pressure medication it is usually permanent, and you must take it regularly for it to work well.
Making lifestyle changes along with medication is important to achieve the best possible results.