Hypertension The Silent killer

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Hypertension, though originally associated with the older age group (50 and above), is now increasingly found in a much younger age group. Youngsters, in their 20,s and 30’s are now suffering from “High Blood Pressure”.

Blood pressure is the force applied against the walls of the arteries as the heart pumps blood through the body. The pressure is determined by the force and amount of blood pumped and the size and flexibility of the arteries. Hypertension is a disorder characterized by chronic high blood pressure.

To measure blood pressure, your doctor uses an instrument call a "sphygmomanometer", commonly referred to as a blood pressure cuff. The cuff is wrapped around your upper arm and inflated to stop the flow of blood in your artery. As the cuff is slowly deflated, your doctor uses a stethoscope to listen to the blood pumping through the artery. These pumping sounds register on a gauge attached to the cuff. The first pumping sound your doctor hears is recorded as the systolic pressure, and the last sound is the diastolic pressure: The highest pressure reached during each heart beat is the systolic pressure, and the lowest pressure exerted between 2 heart beats is the diastolic pressure. Normal blood pressure in adults should not exceed 120mmHg systolic and 80mmHg diastolic (expressed as 120/80 mmHg). You are diagnosed as a hypertensive if your systolic blood pressure is consistently above 140 and diastolic blood pressure is consistently above 90.

Hypertension may be primary or secondary.

Secondary hypertension is due to the disease of the kidney or endocrine glands etc. If a specific cause cannot be found for hypertension the condition is said to be primary, or “Essential Hypertension”. Approximately, 85-90% of all hypertensive patients fall in this category.

Blood pressure generally increases with

  1. age
  2. family history of hypertension
  3. emotional stress
  4. tobacco abuse, excessive caffeine intake
  5. obesity
  6. wrong dietary habits  
  7. lack of physical activity
  8. Oral contraceptive users, and alcoholics may have blood pressure 15-20% above normal.
High blood pressure is the major risk for coronary heart diseases, stroke, kidney diseases, arteriosclerosis, and loss of vision.

The aim of treatment in hypertension is to reduce the blood pressure to a level where the risk of complications is minimum.Treatment will include:
  • Medications (as advised by your physician)
  • Regular lifelong monitoring of blood pressure
  • Lifestyle changes which will include Diet, Exercise, Weight loss.
Hypertension is fully controllable with treatment. It involves lifelong monitoring and the treatment  may require adjustments periodically.

Hypertensive diet is known as the DASH diet (Dietary Approach to Stop Hypertension)

The key for many is to reduce their salt intake. Medical evidence over the past three decades suggests a correlation between salt and hypertension.

In olden times, salt was a relatively rare and valued commodity. Today, however, salt is widely used throughout world. Most people consume more salt than they actually need for good health, and this amount can be safely reduced.

Table salt is a common name for sodium chloride. Sodium is the mineral that is found in nearly all the food we eat. Water contains some amount of sodium too! Sodium compounds are added to most packaged foods in the form of preservatives.

Most people get far more sodium than they actually need. With the advent of fast foods, convenience foods and processed foods, there has been an increasing trend in the salt consumption of people. The extra sodium in your in your diet generally comes from salt, gravies, dressings and certain seasoning added during and after cooking or processing. So-called “Fast Foods” can contain up to 10-15 times the amount of salt needed daily.

Cutting down on salt can compromise flavours, but replacing taste isn’t all that difficult. Using herbs and spices can add up the flavour considerably and can even make it better than the salt did.

SAY YES TO (Foods low in sodium)                
  • Whole grain cereals(wheat, bajra, jowar, maize, rice)\
  • Fresh fruits
  • Vegetables
  • Dry fruits(unsalted)
  • Unsalted butter, ghee, oil (in moderate amounts)
SAY NO TO (Foods high in sodium)                              
  • Canned foods
  • Chinese foods contain monosodium glutamate
  • Bread, biscuits, self raising flours, cakes and pastries contain sodium carbonate.
  • Soft drinks tinned fruit juices contain sodium benzoate
  • Papads, pickles
  • Proprietary drinks
  • Salted snacks as chips, nuts, chivda, farsaan.
  • Commercial salad dressings, soup cubes, ketchup.
  •  Salted or smoked fish, bacon, beef.
  • Dry fruits and nuts (salted)
  • Salted butter
Helpful hints to shake the habit:
  •  To enhance the flavor of the food with less salt, make use of sour lime, tamarind, vinegar, amchur, kokam, garlic, pepper, cumin seeds or mustard.
  • Do not add salt to food at the table
  • Check the tables on food containers for the sodium content.
  • Certain over-the-counter drugs are high in sodium content.
  • Eat abundance of unrefined foods like whole grains, fruits and vegetables which are low in sodium and fat; high in potassium, fibre, vitamins and minerals. 
It is not enough to avoid certain foods, it is equally essential to add a few foods to your existing diet to help reduce hypertension naturally.
  1. Apple:   Apples are valuable in reducing blood pressure. They have a diuretic effect, being high in potassium they reduce the sodium level in blood, and relieve the kidneys by reducing the supply of sodium chloride.
  2. Calcium-rich foods:  Low intake of calcium-containing foods is associated with hypertension, and studies have shown that introduction of low fat dairy products to diets in hypertensive patients can reduce systolic BP by 11 mmHg and diastolic BP by 5-6 mmHg.  One theory is that sodium causes water retention, and calcium acts as a diuretic, naturally helping to excrete water and sodium through the kidneys, thereby reducing BP.
    Eg. Of calcium rich foods are Milk and milk products (choose low fat varieties like skimmed milk, butter milk, curds made from low fat milk), leafy green vegetables like Amaranth, Spinach, broccoli; cauliflower, drumsticks, carrots; ragi (nachni); fish; and almonds.
  3. Potassium-rich foods:  Potassium rich foods have been found to be beneficial in reducing blood pressure. Research shows that reduced intake of dietary potassium leads to sodium retention in the tissues, causing elevated blood pressure over time. Boosting potassium intake by 60%, and reducing sodium simultaneously, will bring down blood pressure significantly in hypertensive individuals. Rich sources of Potassium are: Bananas (an average green banana will give you 24% of your daily requirement of potassium, besides being a good source of iron, calcium, and phosphorus), Coconut water, raisins, nuts, milk and buttermilk, pulses and legumes, dry lotus stem.
  4. Celery: Celery has long been used by the Chinese to reduce blood pressure, and now scientists have isolated the active substance pthalides, which relax the muscles of the arteries that regulate blood pressure, allowing these vessels to dilate. Pthalides also reduce stress hormones, one of whose effects is to cause blood vessels to constrict.      
    1. To clean celery, cut off the base and leaves, then wash the leaves and stalks under running   water. Cut the stalks into pieces of desired length. If the outside of the celery stalk has fibrous strings, remove them by making a thin cut into one end of the stalk and peeling away the fibers. Be sure to use the leaves--they contain the most vitamin C, calcium and potassium--but use them within a day or two as they do not store very well. 
    2. Celery should not be kept at room temperature for too long since, because of its high water content, it has a tendency to wilt quickly.
    3. A few quick serving ideas:
      - Add chopped celery to your favorite salad recipe.
      - Enjoy the delicious tradition of eating peanut butter on celery stalks.
      - Use celery leaves in salads.
      - Braise chopped celery, radicchio and onions and serve topped with walnuts and your favorite soft cheese.
  5. Garlic: Garlic has long been used as an aid to reducing high blood pressure. 2 cloves of garlic each day (in raw or cooked form) will reduce both systolic and diastolic blood pressure in 3 months.
  6. Vitamin C: The anti-oxidant qualities of Vitamin C may be associated with lowering blood pressure in hypertensive individuals. Low intake of Vitamin C has been associated with Hypertension in some studies. This vitamin is also required for the formation of collagen, maintenance of bones, proper functioning of Adrenal and Thyroid glands. It protects the body against the harmful effects of physical and mental stress. The Indian Gooseberry (amla) is an excellent source of this vitamin. A Tbsp of Amla Juice mixed with honey can be taken in the morning with a glass of water. Other sources of Vitamin C are: Citrus fruits, Guava, Sprouted pulses (not in the dry state. They have to be sprouted for 48 hrs to be a good source of vitamin C), Muli leaves and Cabbage.
  7. Vegetable Juices: Raw vegetable juice with carrot and spinach is a good blood pressure reducing food.

Lifestyle measures such as correcting wrong dietary habits, regular physical exercise, maintaining ideal body weight, avoiding excessive intake of alcohol and caffeine and managing stress, play a vital role in controlling hypertension. These positive lifestyle changes can even aid in reducing the risk of developing high blood pressure in those with normal pressure.
  • Read labels and avoid foods that have Sodium, sodium benzoate, sodium citrate etc.
  • Avoid table salt completely
  • Avoid using baking soda, cooking soda, ajinomoto.
  • Avoid eating pickles, ketchup, soya sauce, canned fruits, canned vegetables, ready to eat foods and soups.
  • Avoid cheese, butter, salted nuts etc.
  • Include a lot of Vit. C in your daily diet. (Strawberries, oranges, sweetlime, lemon, capsicum etc)
  • Avoid high salt vegetables like  spinach, fenugreek,tender redgram, tender field beans, cowpeas, amaranth and beet,  and fruits like lichies & muskmelon
  • Boil fresh meats and fish in water and discard the liquid.
  • Avoid sea fish, salted meat, salted dry fish and organ meat.
  • Avoid potato chips, salted pop-corn, chivda, sev, bhajia, vada
  • Don’t use drugs containing sodium such as laxatives, antibiotics, alkalizers, cough medicines, sedatives without doctor’s advice.
  • Spices, herbs and lemon juice may be used freely to make the sodium restricted diet more palatable and appetizing.
  • Chilli powder often contains added table salt and hence should be used carefully.