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By Dr Dulcy Rakumakoe

Chief Executive Officer


Hypertension is a problem

Better lifestyle choices can reduce the risk of heart attack and stroke. High blood pressure: one in three South Africans suffer from it.


Hypertension, commonly known as high blood pressure, is a serious condition that can lead to cardiac arrest or heart attack, stroke, heart, kidney failure, blindness and more. South Africa has one of the highest rates of hypertension worldwide, with an estimated 6.3 million people known to be currently living with the condition – that's one in three SA adults. Increasing the severity of the situation is the fact that many more people remain undiagnosed, hence it can be assumed that the true number may be significantly higher. It is important to check your blood pressure regularly, especially if there is…

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Hypertension, commonly known as high blood pressure, is a serious condition that can lead to cardiac arrest or heart attack, stroke, heart, kidney failure, blindness and more.

South Africa has one of the highest rates of hypertension worldwide, with an estimated 6.3 million people known to be currently living with the condition – that’s one in three SA adults.

Increasing the severity of the situation is the fact that many more people remain undiagnosed, hence it can be assumed that the true number may be significantly higher.

It is important to check your blood pressure regularly, especially if there is a positive family history, Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries.

The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. You can have high blood pressure for years without any symptoms. Even without symptoms, damage to blood vessels and your heart continues, and can be detected. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.

Although high blood pressure is most common in adults, children may be at risk, too. For some children, high blood pressure is caused by problems with the kidneys or heart. But for a growing number of kids, poor lifestyle habits – an unhealthy diet, obesity and lack of exercise – contribute. Most people with high blood pressure have no symptoms, even if blood pressure readings reach dangerously high levels.

have headaches, shortness of breath or nosebleeds, but these signs aren’t specific and usually don’t occur until blood pressure has reached a severe or life-threatening stage. If you have persistent unexplained headache, it might be worth getting your blood pressure checked, since none of the symptoms are specific to the condition.

Elderly patient with bp, heart rate, digital pulse check equipment for medical geriatric awareness in stroke systolic high blood pressure, hypertension, hypotension and cardiovascular disease in aged senior older woman person.Image: Istock

Risk factors The following factors increase the risk of one developing hypertension:

Age- At around age 45, high blood pressure is more common in men. Women are more likely to develop it after 65.
Race- It is particularly common among blacks, often d e v e l o p i n g at an earlier age than in whites.
Family history- If a family member has it, you check it regularly with your local clinic.
Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs.
Illegal drugs- such as cocaine and amphetamines.
Being overweight or obese –The more you weigh the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated increases, so does the pressure on artery walls.
Not being physically active- People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work and the stronger the force on arteries.
Using tobacco –Tobacco can damage the lining of artery walls, causing them to narrow and increasing blood pressure. Even second-hand smoke can increase blood pressure.
Too much salt- (sodium) in your diet can cause your body to retain fluid, which increases blood pressure.
Too little potassium in your diet- Potassium helps balance the amount of sodium in your cells.
Drinking too much alcohol- Over time, heavy drinking can damage your heart. Having more than two drinks a day for men and one for women may affect blood pressure.                                                                                                  Stress- can lead to a temporary increase in blood pressure.Certain chronic conditions, such as kidney disease, diabetes and sleep apnoea.                                                                                                                                                Pregnancy- Some women develop gestational hypertension, which will go away once the baby is born, though it might stay on as a chronic condition.

Lifestyle and hypertension It is largely a disease of poor lifestyle choices that can be better managed using diet and behaviour changes. Normal blood pressure is below 120/80, pre-hypertension is 120/80 to 139/89, stage 1 hypertension is 140/90 to 159/99, and stage 2 hypertension is above 160/100.By addressing underlying issues with diet, and lifestyle changes, you may be able to reduce your blood pressure without resorting to drug treatment. One of the most important contributors is high blood sugar and insulin resistance, which should be primary targets for dietary intervention.

Cutting out beverages with high sugar content should be the first step in any hypertension treatment, and can also help with shedding excess weight and reducing high blood sugar. A reduction in carbohydrate consumption has been more effective in lowering blood pressure than eating a low-fat diet. Reducing your carbohydrate intake to less than 100 grams per day will reduce your blood pressure by a variety of mechanisms. It will reduce insulin resistance, thus activation of the sympathetic nervous system, cause blood vessel relaxation and dilation by increasing the production of nitric oxide and reverse the abnormal sodium retention. Additionally, it will reduce the amount of fat you have deposited within your abdominal cavity.

Ask the doctor 
Dear doctor Is it possible for a 20 year old to have arthritis and what causes it?

A: Yes it is possible. There are different types of arthritis. The inflammatory one is the one that mostly happens even in children. It can be due to infections or it can be inherited. The degenerative arthritis is the one commonest in older people. There could be joint overuse ot it could be work or age related. If you suspect you have it, go see a doctor for him to check your history and for a proper examination.

Dear doctor I have a cut on my leg caused by a rusty can. It’s a bit swollen. Can I treat this at home or must I go to the doctor? 
A: In fact, you were supposed to go to the doctor immediately after the injury. There are infections like tetanus that can happen due to that and require prompt prevention or treatment. Please do not treat at home.

Dear doctor I had a broken arm that healed and is out the cast. But now it looks much smaller than my other arm. What can I do to fix this? Is this normal or hasn’t the break healed properly? 
A: It will most probably heal over time. When an arm is in a cast it is quite compressed and also the muscles are not functioning as much as the other arm. Hence the arm looks smaller. Resume physical activity and it will slowly get back to normal. Seeing a physiotherapist will also help to speed up the healing the process.

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