Last week, we learnt about the signs, symptoms, myths, misconceptions, causes and risk factors of hypertension. This week we will delve into how you can accurately measure your blood pressure(BP) how crucial it is to personally monitor your blood pressure and psychological aspect with regards to hypertension (HPT).

Why must I monitor my Blood Pressure.

The truth is that no one is ever diagnosed with hypertension all at once. Hypertension is a progressive mechanism rather than an occurrence that occurs all at once. Because of the insidious nature of hypertension’s development that often goes unnoticed, routine, thorough, and accurate blood pressure monitoring is important. Two types of blood pressure(BP) exist; systolic and diastolic BPs. The number written on top as numerator is systolic BP and the denominator being diastolic BP. Let’s assume that our heart is the pump of the water system at Ghana water company and the blood vessels are the water pipelines leading to our homes. The systolic blood pressure then is, the pressure inside the pump ie. heart with which it pushes blood into the blood vessels connected to it during a heartbeat. The diastolic BP is the pressure inside the pipelines ie. blood vessels between 2 consecutive heartbeats. Hypertension(HPT) is systolic BP above 140mmHg and/or diastolic BP >90mmHg while the optimal BP is systolic of up to 120mmHg and a diastolic of 80mmHg. The window between the optimal BP and HPT ranges is termed pre-hypertension(aka. Borderline HPT). “but wait! My BP is almost always less 100mmHg for systolic and 70mmHg for diastolic when I go for checkups. Is that normal?”. Yes that’s okay. But that does not mean that you are far from the HPT mark stated above. Remember last week we discussed that HPT is a symptomless disease. This is why regular checking of BP is important to catch early changes in BP.

It is strongly advised by authorities that you personally own a sphygmomanometer(BP measuring device) otherwise regularize going for checkup for no apparent reason or visit pharmacies nearby who can help you measure your BP. The beauty of BP dynamics is that the lifestyle changes I mentioned last week have a huge impact on BP. I know of a 53 year old female who reported to the hospital with palpitation. After brief checks of her BP at a 4hr interval and clinical examinations, she was informed that she was in the borderline HPT range ie 136mmHg systolic and 94mmHg. She was then counselled on her diet, weight, and exercise which she diligently followed with regular home checks with her personal BP machine. The doctor added that she should take not more than half a teaspoon of salt a day, cut down her favourite “momoni” and “koobi” because they contained unhealthy amounts of salt. And to follow a 30mins brisk walking daily regimen (which is world health organization recommended) to reduce her weight. This is what we call lifestyle modification; when you’re trying to do away with normal daily routines that affect your BPs negatively, shooting them up. To be completely honest with you, dear reader, she admitted that it was difficult at first because her food was tasteless and unpalatable. Exercise isn’t her strong suit, but she persisted. She did admit, however, that following the doctor’s and dietician’s advice resulted in a significant drop in her blood pressure, as much as 20mmHg for systolic and 15mmHg for diastolic. Her desired results didn’t happen overnight; bearing in mind my opening statement that, HPT is not an event but a process. So by extrapolation, reduction in BPs takes time. I say this because many others may have gone through the regimen of this 53 year old woman or even better but didn’t see much improvement and so give up. Take heart, dear reader; things will improve over time. Soon, you’ll notice a difference. JUST BE CONSISTENT.

The importance of measuring your blood pressure even though you are not hypertensive cannot be overstated, as it allows for excessive changes in blood pressure to be detected early and treated appropriately, as certain increases in blood pressure can be warning signs of developing kidney disease.


How to accurately measure your BP

As already stated, getting a personal BP machine is important. You may also take the opportunity of visiting a certified pharmacy (please not a “drug store” or any chemical shop) or walk to the OPD of any health facility. The advantage of having a personal BP machine is that 1. It is convenient  2. You can check your BP two times a day. Some BP machines come with an in-built recorder and you will not have to write your measured BP in a book. Additionally, you don’t have to pay to have your BP to be checked. The pharmacy option is a paid option and you must periodically write down the BP recorded with their respective dates so that your health care provider can keep track of it. For certain people, the OPD alternative, though free, can not provide an accurate BP reading because they become nervous when they visit the health facility, resulting in an erroneously high BP. This is termed the whitecoat effect. . This is why having a personal BP machine at home will help you get accurate readings when you’re not at the doctor’s office. Take a healthy rest of 10-20 minutes before measuring the blood pressure.

Since blood pressure rises with exercise, taking a blood pressure reading right after any activity can result in inaccurate results. Also the BP machine should be placed on a table at chest level with the individual sitting comfortably on a chair. First timers may send their newly bought BP machine to a certified healthcare provider to help them on how to secure it on their arm before readings.


The psychological aspect of hypertension.

Imagine submerging an inflated ball in a water. You’ll agree with me that the ball will stay in the water so long as your hand secures it in that position. You’ll also side with me that the ball will resurface if you remove your hand. With this same analogy, the BP is the ball and the hand stands for the drugs and lifestyle modifications that keeps HPT at bay. BP is very sensitive to changes like quitting smoking, reducing alcohol intake, regular exercise to reduce weight, eating of fruits and vegetables, low animal fat and protein intake as well as low salt intake with religious intake of antihypertensive drugs. I recall a 67 year old hypertensive man who was advised in like manner to that of the 53year old woman above about the need to follow the drug regimen and lifestyle modifications. He did otherwise, developed recurrent strokes, total incurable blindness in one eye together with kidney disease where he needed dialysis every 3 days to survive amounting to about GHC 1000 weekly.

I admit that quitting something you’ve done for a long time, such as smoking or consuming alcohol, is tough, but living with the consequences of uncontrolled hypertension is much more costly. HPT cannot be cured; it can only be managed after it has been diagnosed. IT IS NOT A DEATH SENTENCE.

The prescribed antihypertensive drugs do not CURE the disease but puts BP in a tolerable range. People have lived to cross 80 years because they diligently took their drugs and followed the lifestyle modifications seriously. No one can tell you to stop your medication except your doctor; not a herbalist or any other person. It is important to register with the specialist for periodic and close monitoring. If you have concerns with regards to a particular medication speak with your specialist.