Tag Archives: Health

How to Live with Diabetes.

If you have diabetes, you’ll be looking into improving and maintaining your health for the long run. You control your diabetes successfully, by eating well, exercising and keeping informed about developments for better treatment. Your quality of life is also about finding ways to be happy, share with others and have fun in your life. While you’ve got a condition which will affect you medically, it is possible to start each day afresh and take control of your health rather than let it dictate your routine.

Make an appointment to discuss your overall health with your trusted health team. This is important, both so that you understand what will help you and you don’t feel alone dealing with this disease. In particular:

  • Always seek medical advice for any questions or concerns you may have.
  • Do not let small things go unnoticed––even little changes can mean something significant and the sooner you bring it to the attention of your doctor, the better.
  • If you have not been following your recommended diet, or taking your medications as directed, you need to see your doctor.

Follow your recommended diet with care. Your doctor or dietitian should have given you a diet to follow; diet is key to maintaining wellness when you have diabetes. Every diabetic individual has differing needs, so it’s likely that your doctor has tailored the diet suggestion to your specific needs.

  • If you haven’t been given a recommended diet, ask for one.
  • Ask questions about what special needs you have and where you can source healthful options from if they’re hard to obtain in your area.
  • Remember to drink carefully too––many commercial and homemade drinks contain sugar and other additions that may spoil a carefully followed diet if not accounted for.
  • A food diary can be helpful if you’re struggling to stay on track. This will let you see where you have food triggers (such as emotional eating when upset or eating sugary foods when tired, etc.) and allows you to plan ahead and prevent bad eating habits.
  • Learn to read labels. Everyone should read nutrition labels on food but for diabetics, this is even more important.

Know what is healthy to eat as a diabetic. The American Diabetes Association recommends food that is healthy for all persons, whether diabetic or not, so it’s nice to know that you are eating for health generally, not just to control the diabetes. The Association’s recommended foods include:

  • Whole grains, beans, noodles, and starchy vegetables (including unrefined potatoes): 6 or more total servings per day. (Breads and cereals should be limited and low in sodium, avoiding white flour.)
  • Fruit: 2-4 servings per day
  • Vegetables: 3-5 servings per day
  • Meat, fish, and cheese: 2-3 servings per day
  • Milk and yogurt: 2-3 servings per day
  • Fats, sweets, and alcohol: Small amounts (subject to your doctor’s recommendations)
  • Condiments should be low in sodium and free of sugar. Check the labels of foods that have been cured, pickled, corned, marinated, smoked and canned.
  • Keep abreast of changes in advice about food intake, as revisions do occur from time to time. Get updates in email format, talk to your doctor regularly and stay alert about nutritional discoveries for diabetics.

Drink at least 6 to 8 cups of fluid daily. While tap water is your absolute best first choice, you can also consume tea, coffee, unflavored soda/mineral waters, diet drinks, artificially sweetened drink powders, low calorie drinks, etc., unless otherwise advised by your doctor. You may need to limit the intake of milk due to its natural milk sugars––ask your doctor for advice.

Include “treats” in your diet. Be sure to ask your health advisers about the role of treats in your diet and what sort of treats are permissible. While sugary confectionery and sugary baked items are now out, this doesn’t mean the end of enjoying sweet treats. There are plenty of good diabetic cookbooks both in stores and online that you can use to recreate sugar-free treats that still taste fantastic. Many health food stores stock diabetic-suitable sweets and treats too, so start hunting around for substitutes that will still “hit the spot” and keep your sweet tooth satisfied.

Exercise regularly. Ask your doctor for the recommended amount of exercise in your case. Usually 20-30 minutes most days of the week is enough. Go for a walk with your friends, or maybe you like going to the gym. Different exercise works for different people, so experiment to find the exercise that you like most, after taking advice from your doctor.

Take your medications as directed. If you have been skipping doses of your medications, then you’re skipping life saving help and risk complications developing. Follow your doctor’s instructions for taking your medications on time and in the correct dosage.

Keep your records updated. Your doctor gave you a record sheet to record your blood glucose levels. While it may seem like a chore, it is important to keep those records accurately and to show them to your doctor regularly.

Watch for diabetic complications. Knowledge is power over fear and if you’re aware of what can go wrong, you have a better chance of noticing the signs early enough to do something about them. Some of the complications that can arise when diabetic include:

  • Heart Disease and Stroke: People with diabetes have extra reasons to be mindful of heart and blood vessel disease. Diabetes carries an increased risk for heart attack, stroke, and complications related to poor circulation.
  • Kidney Disease: Diabetes can damage the kidneys, which not only can cause them to fail, but can also make them lose their ability to filter out waste products.
  • Eye Complications: Diabetes can cause eye problems and may lead to blindness. People with diabetes do have a higher risk of blindness than people without diabetes. Early detection and treatment of eye problems can save your sight.
  • Oral Health and Hygiene: Diabetes gives you a greater risk for gum disease. It’s a good idea to see your dentist regularly.
  • Diabetic Neuropathy and Nerve Damage: One of the most common complications of diabetes is diabetic neuropathy. Neuropathy means damage to the nerves that run throughout the body, connecting the spinal cord to muscles, skin, blood vessels, and other organs.
  • Foot Complications: People with diabetes can develop many different foot problems. Foot problems most often happen when there is nerve damage in the feet or when blood flow is poor.
  • Skin Complications: As many as one-third of people with diabetes will have a skin disorder caused or affected by diabetes at some time in their lives. In fact, such problems are sometimes the first sign that a person has diabetes. Luckily, most skin conditions can be prevented or easily treated if caught early.
  • Gastroparesis and Diabetes: Gastroparesis is a disorder that affects people with both type 1 and type 2 diabetes.
  • Depression: Feeling down once in a while is normal. But some people feel a sadness that just won’t go away. Life seems hopeless. Feeling this way most of the day for two weeks or more is a sign of serious depression.

Seek support from people who care about you and from people who know what you’re going through. Explain your disease and how it impacts you to your loved ones and friends. They will be supportive when they understand how it affects your life. In some cases, you’ll probably find that family and friends are willing to help you with exercise, food choices and doctor’s visits. Beyond your close circle of friends, you can also reach out to people who have diabetes just like you, by joining a local diabetes support group and attending meet-ups. You may even make new friends but most importantly, you will get a sense of support and discover what others do to cope and lead a healthy life with diabetes.

Ask your doctor about lowering your blood sugar and the need for insulin or snacks for your sleep (night or day): not eating other than light protein snack near bedtime, especially stopping non-essential nutrients 2 or 3 hours before your sleep-time, drinking only water (not alcohol, no caffeine or other stimulants) at such times, telling yourself: “That food will be here tomorrow!”

  • Realize, those late-night snacks should be a no-no for people who have diabetes,per Mayo Clinic article.

  • Hungry after dinner — these “free” foods have few, if any, carbohydrates and calories, so “one” of them won’t cause weight gain or increased blood sugar. Choose a “free” food, such as:

    • A can of diet soda,
    • A serving of sugar-free gelatin,
    • Five baby carrots,
    • Two saltine crackers,
    • One vanilla wafer,
    • Four almonds (or similar nuts),
    • One piece of gum or small hard candy…
  • Give your nerves, liver and the digestive system time to finish work, and to rest and for general recovery, from the sugar produced by [continuing] digestion when asleep;

    Stop blood sugar being unnecessarily elevated during sleep.

    Stop fats or sugars being processed all night in the liver (and allow in-digestion to clear, as well).

Sleep (on an almost empty stomach!) — get 6, preferably 7 or more hours of sleep for recovery time for the nerves and all other systems to settle and rest. This will lower your diabetes problems, i.e.: blood sugar levels [and improve your blood pressure].

Follow these steps and don’t give up. Your life is not over it just needs a little tweak.

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10 Practical ways to handle stress.

Stress is inevitable. It walks in and out of our lives on a regular basis. And it can easily walk all over us unless we take action. Fortunately, there are many things you can do to minimize and cope with stress. Here are 10 ideas for handling stress without causing more strain and hassle.

1. Figure out where the stress is coming from.

Oftentimes, when we’re stressed, it seems like a big mess with stressors appearing from every angle. We start to feel like we’re playing a game of dodge ball, ducking and darting so we don’t get smacked by a barrage of balls. We take a defensive position, and not a good one at that.

Instead of feeling like you’re flailing day to day, identify what you’re actually stressed about. Is it a specific project at work, an upcoming exam, a dispute with your boss, a heap of laundry, a fight with your family? By getting specific and pinpointing the stressors in your life, you’re one step closer to getting organized and taking action.

 

2. Consider what you can control—and work on that.

While you can’t control what your boss does, what your in-laws say or the sour state of the economy, you can control how you react, how you accomplish work, how you spend your time and what you spend your money on.

The worst thing for stress is trying to take control over uncontrollable things. Because when you inevitably fail — since it’s beyond your control — you only get more stressed out and feel helpless. So after you’ve thought through what’s stressing you out, identify the stressors that you can control, and determine the best ways to take action.

Take the example of a work project. If the scope is stressing you out, talk it over with your supervisor or break the project down into step-wise tasks and deadlines. Stress can be paralyzing. Doing what’s within your power moves you forward and is empowering and invigorating.

3. Do what you love.

It’s so much easier to manage pockets of stress when the rest of your life is filled with activities you love. Even if your job is stress central, you can find one hobby or two that enrich your world. What are you passionate about? If you’re not sure, experiment with a variety of activities to find something that’s especially meaningful and fulfilling.

4. Manage your time well.

One of the biggest stressors for many people is lack of time. Their to-do list expands, while time flies. How often have you wished for more hours in the day or heard others lament their lack of time? But you’ve got more time than you think.We all have the same 168 hours, and yet there are plenty of people who are dedicated parents and full-time employees and who get at least seven hours of sleep a night and lead fulfilling lives.

5. Create a toolbox of techniques.

One stress-shrinking strategy won’t work for all your problems. For instance, while deep breathing is helpful when you’re stuck in traffic or hanging at home, it might not rescue you during a business meeting.

6. Pick off the negotiables from your plate.

Review your daily and weekly activities to see what you can pick off your plate. “Do your kids really love their extracurricular activities, or are they doing them to please you? Are you volunteering for too many causes, and so stealing time from the ones where you could make the most impact? Does your whole department really need to meet once per week or have that daily conference call?

Reducing your stack of negotiable tasks can greatly reduce your stress.

7. Are you leaving yourself extra vulnerable to stress?

Whether you perceive something as a stressor depends in part on your current state of mind and body. Each transaction we’re involved in takes place in a very specific context that’s affected by our health, sleep, psychoactive substances, whether we’ve had breakfast that day and whether we’re physically fit.”

So if you’re not getting sufficient sleep or physical activity during the week, you may be leaving yourself extra susceptible to stress. When you’re sleep-deprived, sedentary and filled to the brim with coffee, even the smallest stressors can have a huge impact.

8. Preserve good boundaries.

If you’re a people-pleaser like me, saying no feels like you’re abandoning someone, have become a terrible person or are throwing all civility out the window. But of course that couldn’t be further from the truth. Plus, those few seconds of discomfort are well worth avoiding the stress of taking on an extra activity or doing something that doesn’t contribute value to your life.

One thing I’ve noticed about productive, happy people is that they’re very protective of their time and having their boundaries crossed. But not to worry, Building boundaries is a skill you can learn.

9. Realize there’s a difference between worrying and caring.

Sometimes, our mindset can boost stress, so a small issue mushrooms into a pile of problems. We continue worrying, somehow thinking that this is a productive — or at least inevitable — response to stress. But we mistake worry for action.

Worrying is an attempt to exert control over the future by thinking about it, whereas caring is taking action. “When we are caring for someone or something, we do the things that support or advance the best interests of the person or thing that we care about.”

Similarly, fretting about your finances does nothing but get you worked up (and likely prevent you from taking action). Caring about your finances, however, means creating a budget, paying bills on time, using coupons and reducing how often you dine out.

Just this small shift in mindset from worrying to caring can help you adjust your reaction to stress. To see this distinction between worrying and caring, For example:

Worrying about your health involves…

Caring about your health involves…

Worrying about your career involves…

Caring about your career involves…

10. Embrace mistakes—or at least don’t drown in perfectionism.

Another mindset that can exacerbate stress is perfectionism. Trying to be mistake-free and essentially spending your days walking on eggshells is exhausting and anxiety-provoking. Talk about putting pressure on yourself! And as we all know but tend to forget: Perfectionism is impossible and not human, anyway.

“Perfectionism is not the same thing as striving to be your best. Perfectionism is not about healthy achievement and growth” and it’s not self-improvement.

Nothing good can come from perfectionism. Brown writes: “Research shows that perfectionism hampers success. In fact, it’s often the path to depression, anxiety, addiction and life-paralysis [‘all the opportunities we miss because we’re too afraid to put anything out in the world that could be imperfect’].”

Plus, mistake- mistaking can lead to growth. To overcome perfectionism  become more compassionate toward yourself, and  I couldn’t agree more.

What is the diet as a diabetic?

I know the most frequent asked question is “What foods are appropriate for diabetics?” Being a diabetic doesn’t mean all foods have to be restricted. By doing just a little research you can easily find out what you can eat, how much of it you can consume and how often you can enjoy it.

Recommended foods:

  • Healthy carbohydrates. During digestion, sugars (simple carbohydrates) and starches (complex carbohydrates) break down into blood glucose. Focus on the healthiest carbohydrates, such as fruits, vegetables, whole grains, legumes (beans, peas and lentils) and low-fat dairy products.
  • Fiber-rich foods. Dietary fiber includes all parts of plant foods that your body can’t digest or absorb. Fiber can decrease the risk of heart disease and help control blood sugar levels. Foods high in fiber include vegetables, fruits, nuts, legumes (beans, peas and lentils), whole-wheat flour and wheat bran.
  • Heart-healthy fish. Eat heart-healthy fish at least twice a week. Fish can be a good alternative to high-fat meats. Cod, tuna and halibut, for example, have less total fat, saturated fat and cholesterol than do meat and poultry. Fish such as salmon, mackerel and herring are rich in omega-3 fatty acids, which promote heart health by lowering blood fats called triglycerides. However, avoid fried fish and fish with high levels of mercury, such as tilefish, swordfish and king mackerel.
  • ‘Good’ fats. Foods containing monounsaturated and polyunsaturated fats — such as avocados, almonds, pecans, walnuts, olives, and canola, olive and peanut oils — can help lower your cholesterol levels. Eat them sparingly, however, as all fats are high in calories.

Foods to avoid Diabetes increases your risk of heart disease and stroke by accelerating the development of clogged and hardened arteries. Foods containing the following can work against your goal of a heart-healthy diet.

  • Saturated fats. High-fat dairy products and animal proteins such as beef, hot dogs, sausage and bacon contain saturated fats. Get no more than 7 percent of your daily calories from saturated fat.
  • Trans fats. These types of fats are found in processed snacks, baked goods, shortening and stick margarines and should be avoided completely.
  • Cholesterol. Sources of cholesterol include high-fat dairy products and high-fat animal proteins, egg yolks, shellfish, liver and other organ meats. Aim for no more than 200 milligrams (mg) of cholesterol a day.
  • Sodium. Aim for less than 2,000 mg of sodium a day.

How does one person know they are diabetic?

How does a person know they are a diabetic? One of my family members is a diabetic, he had to find out through a doctor but he denies being one, so  I did a lot of research when I found out about my uncle’s diabetes and I have come up with this:

Diabetes mellitus is a disorder characterized by the inability
of the body to either produce or respond to insulin making it impossible to
maintain proper levels of glucose (sugar) in the blood. The extra glucose is
excreted in the urine and because of the high level of glucose more water is
flushed through. The diabetic experiences excessive urination and
thirst. The
term Diabetes mellitus literally explains these symptoms: The Greek term
diabainein, means “to pass through” (referring to the excessive urination) and
mellitus comes from the Latin “sweetened with honey” (referring to the excessive
presence of sugar).
There are basically two major types of diabetes: Type 1
(insulin-dependent) and Type 2 (non-insulin dependent).

Type 1
(formerly known juvenile-onset diabetes, because it is diagnosed in children or
young adults) is caused by both genetic and environmental causes. In this case,
the person’s immune system produces antibodies that destroy the cells that
produce insulin. Because the body can’t produce insulin on its own, daily
insulin injections are required.

Type 2
(formerly known as adult-onset diabetes, because it normally appears in people
aged over 40) is the most common form of diabetes, accounting for about 90% of
cases. Genetic factors play a major role in the development of Type 2, but
obesity is also a major factor. A typical Western lifestyle means a diet that is
high in fat and low in carbohydrates and a minimal exercise plan and these
habits are strong risk factors. Interestingly, people who do not live in
Westernized areas do not tend to get Type 2 diabetes, regardless of their family
history.

A third type of diabetes, known as Gestational Diabetes,
affects women who have high blood-sugar levels during pregnancy. This should be
monitored as it can adversely affect the baby. There is also a high probably
that women who experience gestational diabetes will develop Type 2 diabetes at a
later stage.

Diabetes symptoms to watch out for include; frequent
urination, excessive thirst and hunger, unusual weight loss, increased fatigue,
irritability and blurry vision. The American Diabetes Association (ADA) website
is an informative starting point for all. Visit the site today and take the
Online Diabetes Risk Test, which can help you determine if you are at risk of
developing diabetes. If you are deemed at risk and are experiencing one or more
of the above mentioned symptoms you should see your doctor immediately. If you are diagnosed with diabetes the ADA website has informative articles the disease, plus lots of suggestions on lifestyle and diet changes for those diagnosed with diabetes. A quick Internet search for “Diabetes Supply” will also bring up various sites offering products suitable for those living with diabetes.There’s nothing at all to be scared of. There’s lots of help and advice available literally at your fingertips.

Diabetes and Hypertension

Hypertension, a problem of very high blood pressure, is a common problem  particularly in the United States where as many as one in four people suffer  from it. However, those with diabetes are even more susceptible to the problem,  and are doubly as likely to have hypertension. Depending on other factors, a  person with diabetes may have as much as a 60% chance of also having  hypertension.

The two problems are linked by a variety of different factors. The most  common and important of which is being very overweight, a problem associated  with type 2 diabetes. However, insulin resistance, immune system and autonomic  factors all come into play as well. Additionally, hypertension can make some  symptoms and conditions of diabetes more dangerous and more prevalent.

Those that have diabetes typically already have stricter blood pressure  requirements than those in the rest of the population. This can make  hypertension all the more serious, and it’s something that shouldn’t be taken  lightly. Serious problems ranging from heart attacks to strokes and more can all  stem from prolonged hypertension.

A person who has both diabetes and hypertension can seek out a variety of  treatments. There are several classes of drugs which can attack the problem in  different ways. Considering the seriousness of hypertension, particularly in  those with diabetes, drugs are often recommended as a primary way for combating  the issue.

This should also be combined however with a general health and fitness plan  designed to lose weight and be healthier. Even moderate amounts of mild exercise  can make a big difference over the long term in lowering blood pressure.  Participating in moderate to intense exercise several times a week is even  better. The physical exertion is healthy in and of itself but should also pay  dividends towards a goal of achieving weight loss.

Eating better foods can also make a big difference towards hypertension and  high blood pressure levels. Particularly, cutting back on sodium in your diet  can have a positive effect as one example. Potassium is a key nutrient that you  should be sure to include heavily in your diet as well. While weight loss is a  goal, weight loss drugs have to be taken with care. For example, some appetite  suppressants actually increase blood pressure as a side effect. Always consult  your doctor when considering various medications.

Additionally, smoking can add to the problem of hypertension and needs to be  stopped. Avoiding or moderating your intake of alcohol is also important, and  other stimulants such as caffeine should be monitored.

With these lifestyle changes you can make a big dent in a combined  hypertension and diabetes problem. However, to reach the target goals of  improvement and to ensure success it is usually recommended to make these  healthier life decisions while also taking one or more medications to help  control the problem as well. Considering the seriousness of hypertension and  it’s extremely high correlation with diabetes, it is a problem that cannot be  overlooked. (by Jennifer Kirkman)

Ten best ways to measure your health and fitness!

How does one measure health?  It depends on who you ask.  A physician may  measure health in terms of lab values – cholesterol, blood sugar and so on.  A  personal trainer might tell you that your body fat percentage is the best  indicator of good health.  You might base it on what the scale tells you or how  your clothes fit.

I’m a big believer in monitoring all of these things and then some.  Seems  like a big job, but really it only takes a few minutes to do each one, involves  inexpensive equipment or can be a regular part of a visit to your physician.  I  call them “The Big Ten Health and Fitness Measures.”

  1. Weight
  2. BMI (Body Mass Index)
  3. Body composition
  4. Measurements
  5. Resting and target heart rates
  6. Cardiorespiratory fitness
  7. Energy level
  8. Blood pressure
  9. Glucose & cholesterol
  10. Pain

Why keep track of all these things?  First, because there isn’t one single  good way to define what makes a person healthy or fit.  For instance, just  because you are at a healthy weight, does not mean that you don’t have high  cholesterol.  Also, it can be discouraging to use just one method.  You may find  yourself in a situation where even though you did not lose any weight in a given  week, you may have lost inches.

Monitoring several indicators of health and fitness helps you to get a  well-rounded picture of your entire self.  We do not judge our children in just  one subject at school right?  And just because the child does poorly in math  does not mean he won’t excel at other subjects.  And just because you have not  lost any weight on the scale does not mean that your waist isn’t getting  smaller.

Secondly, we have all heard the adage, “a problem defined is 95% solved.”   Knowing your target ranges for health indicators like weight, body fat and BMI  can help you to define what you need to work on.  You avoid unnecessary changes  and difficulties by having the correct information.  For instance, someone with  good cholesterol levels has no need for an ultra-low fat diet.

Third, it serves as a point of inspiration to see how far you have come.   Since the changes you are making will be small and incremental, it may be  discouraging at times not to see overt progress.  However, by keeping track of a  variety of fitness indicators, it is easier to see, in black and white, all of  the progress you are making.

Jennifer D. Wetmore, DPT has been involved in health and fitness for over a  decade working with a range of clients and patients from health clubs to  hospitals.  Dr. Wetmore is the author of “Small Changes, Big Results:  The  Health and Fitness Manual with the Secrets to Working Smarter, Not Harder.”   Please visit [http://www.LifeHealthPT.com] for more information about the Big 10  Health and Fitness Measures. ( By Jennifer Wetmore)

What Is Hypertension?

WHAT IS HYPERTENSION?

Hypertension is derived from two root words; Hyper meaning High and Tension  meaning Pressure. Hypertension simply means high blood pressure. Pressure is the  force generated when the heart contracts and pump blood through the blood  vessels that conduct the blood to various parts of the blood.  Although  hypertension does not mean or result from excessive emotional tension, but  evidence shows that stress and emotional tension do cause increase in blood  pressure, and if continuous, could be sustained. High blood pressure is  therefore generally defined as a blood pressure exceeding 140/90mmHg confirmed  on multiple occasions. The top number (140) is called the SYSTOLIC PRESSURE, and  it represents the pressure in the blood vessels (arteries) as the heart  contracts and pump blood into circulation. The bottom number (90) is called  DIASTOLIC PRESSURE, and it represents the pressure in the blood vessels as the  heart relaxes after contraction. These figures measured in millimeters of  Mercury (mmHg) reflect the highest and lowest pressures the heart and blood  vessels are exposed to during circulation. The generally accepted normal value  for blood pressure is 120/80mmHg. Above this value but less than 140/90mmHg is  not considered to be hypertensive yet but signals danger, it is therefore called  High normal.

An elevation of the blood pressure (Hypertension) increases the risk of  developing Heart (Cardiac) diseases such as Heart Failure and Heart attack,  Kidney diseases, Vascular diseases like athelosclerosis (hardening and narrowing  of blood vessels), Eye damage and Stroke (brain damage). These complications  called End organ damage arise as a result of long standing (chronic)  hypertension. But victims of hypertension are not aware, at an early stage, that  they have the disease, until these complications start appearing. This is  because hypertension shows virtually no signs/symptoms at the early stage. For  this reason, it is generally referred to as the ‘Silent Killer’.

The damage caused by hypertension increases in severity as the blood pressure  increases. Based on this hypertension can be classified as follows:

CATEGORY        SYSTOLIC(mmHg)   DIASTOLIC(mmHg) Normal Less than  130 Less than 85 High Normal 130 – 139 85 – 89 Mild  Hypertension 140 – 159 90 – 99  Moderate Hypertension 160 –  179 100 – 109 Severe Hypertension 180 – 209 110 – 119 Very  Severe Hypertension Greater than 210 Greater than 120

BORDERLINE HYPERTENSION.

Borderline Hypertension is defined as mildly elevated blood pressure that is  found to be higher than 140/90mmHg at some times and lower than that at other  times.

Patients with borderline value need to have their blood pressure monitored  more frequently. They also need to assess end organ damage to be aware of the  significance of their hypertension.

It should, however, be emphasized that patients with borderline hypertension  have a higher tendency to develop a more sustained hypertension as they get  older. They stand a modest risk of having heart related diseases. A close  monitoring of their blood pressure and lifestyles could be very useful in this  regard.

WHITE COAT HYPERTENSION

A single elevated blood pressure reading in the doctor’s office could be  misleading, because the elevation might only be temporary. Evidence over the  years has shown that anxiety related to the stress of the examination and fear  of the result often result in blood pressure elevation noticed in the doctor’s  office only. Infact, it has been suggested that one out of every four persons  thought to have mild hypertension, actually may have normal blood pressure  outside the physician’s office. This sort of elevated blood pressure noticed in  the physician’s office is called ‘White Coat Hypertension’. Suggesting that the  white coat, symbolic of the physician, induces the patient’s anxiety and a  passing increase in blood pressure. Accordingly, monitoring of blood pressure at  home, when in a more relaxed state of mind, can provide a more reliable estimate  of the frequency and/or consistency of blood pressure changes.

WHAT CAUSES HYPERTENSION?

The Blood pressure is determined by two major parameters; Cardiac output i.e.  the volume of blood pumped by the heart, and the Total peripheral resistance  i.e. the resistance of the blood vessels through which blood flows. Hypertension  is therefore an end result of either increased force of pumping by the heart, or  constriction/narrowing of blood vessels causing increased resistance to blood  flow or both. Using the cause of hypertension as a yardstick, two major  types of hypertension can be described;

Essential Hypertension

Secondary hypertension

The former also called Primary or Idiopathic hypertension is by far the most  prevalent type of hypertension. It accounts for over 90% of all hypertension  cases. No clear cut cause(s) can be identified for this type of accommodation,  hence the name Idiopathic.

The later accounts for less than 10% of all cases. In this case, the  hypertension is secondary to an existing abnormality in one or more systems or  organs of the body. The most common causes are related to kidney and hormonal  problems. The persistent uncontrolled use of contraceptives, especially in  females over 35years of age fall under hormonal causes of hypertension.

Since no clear-cut cause(s) can be adduce for the most common types of  hypertension, as with the case with most non-communicable diseases, we therefore  talk in terms of ‘Risk Factors’ and not causes. These Risk Factors are  actions/inactions that increases chances of getting a disease. Several  researches over the years have shown that some factors are directly or  indirectly related to the occurrence of hypertension. Some of the factors  include:

HEREDITARY: High blood pressure tends to run in some families and races. It  is believed that some inherited traits predispose some people to hypertension.  For example, high blood pressure tends to be more prevalent in blacks than  whites.

A family history of hypertension increases one chances of high blood  pressure. Regular monitoring of blood pressure becomes very vital. HIGH SALT  INTAKE: High intake of Sodium Chloride (table salt) has being linked to high  blood pressure. The condition develops mostly in societies or communities that  have a fairly high intake of salt, exceeding 5.8grams daily. In fact, salt  intake may be a particularly important factor in relation to essential  hypertension that is associated with advancing age, black racial background,  hereditary susceptibility, obesity and kidney failure.  Research has shown  that:

a. Rise in blood pressure with age is directly related to increase level of  sat intake, especially in blacks.

b. People who consume little sodium chloride develop no high blood pressure  when they consume more, hypertension appears.

c. Increased Sodium is found in the blood vessels and blood of most  hypertensives.

Cutting down on salt intake is therefore a reasonable step in preventing  hypertension

OBESITY:

A close relationship exists between hypertension and obesity. In fact it is  believed that most hypertensives are more than 10% overweight. Fat accumulation  in the trunk or abdomen is not only related to hypertension but also to diabetes  and hyperlipideamia (excess fat in the body). Obesity can contribute to  hypertension in several ways. For one thing, obesity leads to a greater output  of blood, because the heart has to pump more blood to supply the excess tissues.  The increased cardiac output then can raise the blood pressure. For another  thing, obese hypertensive individuals have a greater stiffness (resistance) in  the peripheral arteries throughout the body. Finally, obesity may be associated  with a tendency for the kidneys to retain salt in the body. Weight loss may help  reverse problems related to obesity while also lowering blood pressure. It has  been estimated that the blood pressure can be decreased 0.32mmHg for every 1kg  (2.2pounds) of weight loss.

The International standard for measuring overweight and obesity is based on a  value called BODY MASS INDEX (BMI). This value is derived by dividing the body  weight (in Kilograms) by the square of height (in Metres).

i.e. BMI = Body weight (Kg)

Height2 (Metres). Note: 1ft = 0.305metres. For adults, a BMI less  than 25kg/m2  is preferred. 25 – 29kg/m2 is considered overweight and above  30kg/m2 is Obesity.

LACK OF EXERCISE:

Sedentary normal individuals have a 20 – 50% higher risk of developing  hypertension when compared to very active individuals. Exercise lowers both  systolic and diastolic blood pressures.  For example dynamic exercises such as  brisk walking or jogging, swimming or bicycle ridding for 30 – 45mins daily or  3-5times a week may lower blood pressure by as much as 5 – 15mmHg. Moreover,  there appears to be a relationship between the amount of exercise and the degree  to which blood pressure is lowered. Thus, to a point, the more you exercise, the  more you lower your blood pressure. Provided you do not over strain yourself.  Normally, a particularly type of exercise is started, and gradually built up to  a satisfactory level over time. Regular exercise reduces blood pressure, burn  out unnecessarily fat and also makes the body healthier.

ALCOHOL AND SMOKING:

These two constitute the social factors most related to high blood pressure.  People who drink alcohol excessively (over two drinks per day) have a one and  half to two times increase in the frequency of hypertension. The association  between alcohol and high blood pressure becomes particularly noticeable when the  alcohol intake exceeds the above per day. Moreover, the connection is a dose  related phenomenon. In other words, the more alcohol consumed, the stronger the  chances of hypertension. This, probably will explain the prevalence of  hypertension in populations where alcohol consumption is a habit.

Although smoking increases the risk of vascular complications (for example,  heart diseases and stroke) in people who already have hypertension, it cannot be  directly linked with increase in the development of hypertension. Nevertheless,  smoking a cigarette can repeatedly produce an immediate, temporary rise in blood  pressure of 5 – 10mmHg, but a permanent increase cannot be established. However,  it is known that some substances in cigarette, e.g. nicotine, alters the  composition of the blood and also affects the blood vessels.

Smoking and alcohol control are integral part of any effort towards the  primary control of cardiovascular diseases in any population. STRESS:  Although the role of stress and other emotional factors in hypertension is  difficult to define. However, it is known that stress causes a physiological  rise in blood pressure and this could be sustained if the stress becomes chronic  (prolonged).

A STICH IN TIME

Since lifestyle components such as dietary patterns, obesity, physical  activity, alcohol and smoking have been recognized as important risk factors,  steps to reduce the occurrence of hypertension or to alleviate the condition   (for those who are hypertensives) should involve lifestyle modification.

Dietary modifications include restricting salt intake cutting down or cutting  out alcohol, reduced fat consumption, and reducing weight if overweight. The  American Heart Association recommends a daily consumption of less than 6grams of  table salt for normal individuals, and less than 4grams for hypertensives.

A regular exercise program such as brisk walking, jogging, swimming, cycling  e.t.c.  for 30 – 45mins daily or 3-5 times a week could be very helpful.

Conclusively, it is very important to remember that the only way to know if  one’s blood pressure is on the high side is by taking your blood pressure  frequently. Normally, your doctor would do that for you. But for a more  consistent and reliable monitor of blood pressure, a self-operated blood  pressure monitor is crucial. Being very handy and always around, it allows you  to follow up your blood pressure regularly and report an increase  immediately.

Finally, always remember the WHO slogan “Know your Blood Pressure, if it’s  high have it treated”. A healthy Heart adds life to years. A stitch in time,  they say, saves nine.