“KNOW YOUR NUMBERS”
….Celebrating World Hypertension Day 2018
By Dr. Uche Enumah @ NNPC/DPR RETIRED STAFF ASSOCIATION, LAGOS BRANCH.
- To impart adequate knowledge on definition, meaning, of hypertension
- To reveal the life numbers to watch out for
- To ascertain some of the risk factors to the aetiology, and highlight the preventive measures
- To outline steps for the management of hypertension.
- To establish healthy life style as a holistic strategy for controlling hypertension.
- Health Explained
- World Hypertension Day
- Know Your Numbers
- BMI – Body Mass Index
- Blood Sugar
- Blood Pressure
- Step/process towards blood pressure management plan
- Conclusion and Take away.
Health is the ever-changing process of achieving
individual potential in the physical, emotional, social, mental, spiritual, and environmental dimensions.
World health organization (who) definition of health – the state of complete physical, mental and social wellbeing and not merely the absence of disease…WHO 1950
Wellness is the achievement of the highest level of health possible in each dimension of health
- Everyone wants to look and feel healthy.
- By choosing safer food, healthier nutrition and regular physical activity, HEALTHIER CHOICES and SAFER BEHAVIOURS you can improve your health throughout your life.
- These key behaviors/Choices are important for your health no matter how old you are or where you live in the world.
WORLD HYPERTENSION DAY (WHD)
- Every year, 17th May is dedicated to World Hypertension Day (WHD).
- This is an initiative of the World Hypertension League (WHL), affiliated to the International Society for Hypertension (ISH).
- First inaugurated in May 2005, has become an annual event ever since.
- The objective is to promote public awareness of HTN and to encourage citizens of all countries to prevent and control this silent killer, the modern epidemic.
- This year’s theme is “KNOW YOUR NUMBERS” but we will focus more on How to live with it.
Step/process towards blood pressure management plan
- Obtain a high-quality home blood pressure monitor.
- Check blood pressure twice a day, every day of the week.
- Make an up-to-date list of all current medications.
- List the lifestyle approaches to lowering BP that you are following (or interested in).
- Make an appointment to discuss blood pressure management with your usual doctor.
- Plan to follow-up on any changes to the plan.
Obtain a high-quality home blood pressure monitor.
- Studies have found that home-based measurements are better than office-based BP measurements. They better reflect a person’s BP over 24 hours.
- According to a recent survey, nearly fifty percent of NNPC staff are over forty years old and age and ageing workforce are proven risk factors for Hypertension.
- Here in Lagos Medical Area, Hypertension is responsible for 14-16% of hospital visits to our clinics.
- The statistics in Africa and the rest of the world is even more alarming.
Check blood pressure twice a day, every day of the week.
- Blood pressure is constantly changing a bit — or sometimes a lot — in the body, checking several days in a row means that you’ll have several readings that can be averaged.
- Aim to check at the same times every day. An average of several daily readings provides a more accurate picture of a person’s BP.
- Optional but helpful:Use a “three measurements in a row” technique if possible. The SPRINT trial measured BP by letting participants rest quietly for five minutes, and then having the monitor check the BP three times in a row, with a one minute pause between each check.
- Those three readings were then averaged into a reading for the day.
Make an up-to-date list of all current medications.
- Your doctors will need to know exactly what medications you are taking, in order to evaluate your blood pressure treatment plan.
- Start by listing those for heart or BP.
- But list all others, because some medications that are not prescribed for BP can still affect BP (such as Flomax, which can be used to improve urination when a man has an enlarged prostate).
- Also list all supplements, vitamins, herbs, and over-the-counter medications.
- Be sure to note if any medication is not being taken exactly as prescribed. The doctors to know if an older person has been skipping any of the medications that affect BP.
- Note any concerns about side-effects, cost, or other concerns related to continuing the medication
List the lifestyle approaches to lowering BP that you are following (or interested in).
- Although prescription medications are the main way doctors often try to treat hypertension, many lifestyle changes have been shown to help lower BP as well.
- Many of these lifestyle changes are great for older adults, because they benefit health in many ways but have fewer risks than taking prescription medication.
- Proven approaches to lower high blood pressure include:
- Weight loss
- The DASH (Dietary Approaches to Stop Hypertension) diet
- Reducing sodium (salt) intake, especially in people who seem to be salt-sensitive
- Not smoking
DIET AND EATING
- Diet - food and drink considered in terms of its qualities, composition, and its effects on health
- Dieting- the act of limiting a balanced consumption of the necessary foods and drinks to maintain a healthy lifestyle
- Though somewhat similar, society has morphed these two terms into completely different things
- Society has accepted dietingas a form of losing weight.
- This shouldn't be the case.
- Continued, balanced nutrition is the way to proper weight control and healthy internal organs.
- Dieting is often used in combination with physical exercise to lose weight, commonly in those who are overweight or obese.
- Some people, however, follow a diet to gain weight (usually in the form of muscle). Diets can also be used to maintain a stable body weight.
There are three main abnormalities:
- Undernutrition: when a diet is inadequate in quantity – either because it is not available or the person chose not to eat enough
- Malnutrition: when a diet is inadequate in quality – amount may be enough but the essential nutrients are missing due to poor selection or not affordable.
- Overnutrition: when a diet contains excessive amounts of calories and fat; at the same time, the diet may be deficient in protein and minerals
- Weight managementis a long-term approach to a healthy lifestyle. It includes a balance of healthy eating and physical exercise to equate energy expenditure and energy intake.
- It means keeping your body weight at a healthy level.
- Obesity is defined as a body weight greater than 20% of normal weight for height.
- The World Health Organization has formulated an index for defining obesity.
- Known as the body mass index (BMI), it is based on the patient's height in meters and weight in kilograms: BMI = weight in kilograms (height in meters)2
- WHO defines physical activity as any bodily movement produced by skeletal muscles that requires energy expenditure
- including activities undertaken while working, playing, carrying out household chores, travelling, and engaging in recreational pursuits?
- The term "physical activity" should not be confused with "exercise",
- which is a subcategory of physical activity that is planned, structured, repetitive, and aims to improve or maintain one or more components of physical fitness.
- Physical fitnessis your ability to carry out tasks without undue fatigue.
- Learn about the components of physical fitness: cardiorespiratory endurance, muscle strength, muscle endurance, flexibility and body composition .
Make an appointment to discuss blood pressure management with your usual doctor
- Your doctor can help you identify a good target blood pressure goal, and can help you develop a plan to reach that goal.
- Be sure to bring up any concerns regarding falls, or other potential side-effects of treatment.
- Bring in your home BP readings and your up-to-date medication list.
- Consider asking the doctor to check BP sitting and standing, especially if you’ve had any concerns about falls
- Ask your doctor what target BP goal they recommend for you, given your health history.
Plan to follow-up on any changes to the plan
- Whatever you and your doctors decide to do, you’ll want to make a plan for seeing how your blood pressure responds to the changes.
- Remember that experts say a week’s worth of home BP monitoring is more accurate than a follow-up BP check in the office.
- Be sure to ask your doctor to specify:
- When should you undertake this home monitoring? (Most BP medications will take their full effect within 1 week. Lifestyle changes will take weeks to months to have an effect.)
- When will you be meeting — by phone or in person — to discuss the results of the follow-up BP monitoring?
- What level of high (or low) BP should trigger a call to the office?
KNOW YOUR (LIFE) NUMBERS
- Ideal body Mass Index: BMI=22-23 (18.5 – 24.9 Kg/M2),maximum waist circumference of 88cm in female and 102cm in males.
- Blood pressure <130/80mmHg
- FBS = 70-110mg/dL (3.5 – 5.5 mMoles/L)
- 2hPP = 70-140mg/dL
- HbA1c <7%,
- Cholesterol <5mmol
- No proteinuria
Do you know your numbers? Prevention is better that cure.