Hypertension or high blood pressure is a chronic disease that affects one out of four South Africans between the ages of 15 and 64 and is one of the leading causes of heart attacks, strokes, kidney failure and premature death according to the World Health Organisation (WHO).
Hypertension or high blood pressure is a chronic disease that affects one out of four South Africans between the ages of 15 and 64 and is one of the leading causes of heart attacks, strokes, kidney failure and premature death according to the World Health Organisation (WHO).
According to Sunitha Srinivas, associate professor of Pharmacy at Rhodes, the tragedy of hypertension and most other diseases which are not contagious such as diabetes and obesity is that they are entirely preventable. “When hypertension is uncontrolled it can lead to slow and uneccessary deaths. People do not have to die from these diseases because they can be avoided and controlled,” she said.
According to Srinivas, hypertension often co-exists with other risk factors for chronic lifestyle related diseases such as diabetes and obesity, and she said the three are often interlinked. “Unhealthy eating and minimal exercise leads to serious health problems and a mixture of hypertension, obesity and diabetes are often found in patients who do not lead healthy lifestyles,” she said.
According to the Heart and Stroke Foundation of South Africa, blood pressure is the force of blood that pushes up against the walls of the blood vessels during every heartbeat. If the pressure is too high, the heart has to work harder to pump, and this could lead to numerous illnesses including:
– Stroke Increased pressure on the walls of blood vessels results in build up of fatty deposits in blood vessels and weakened blood vessels,
– Heart attack Chronic blockage of blood and oxygen to the heart,
– Heart failure Constant excess force to work harder results in the heart not being able to pump enough blood, leading to its eventual collapse,
– Kidney damage Narrowing and thickening of the arteries results in increased waste products in the blood,
– Organ damage Iimportant organs such as eyes can be damaged due to high blood pressure
The normal level for blood pressure is below 120/80, where 120 represents the systolic measurement (peak pressure around the arteries) and 80 represents the diastolic measurement (minimum pressure in the arteries). Blood pressure between 120/80 and 139/89 is called prehypertension (to denote increased risk of hypertension), and a blood pressure of 140/90 or above is considered as being hypertension.
Also known as the silent killer, hypertension rarely presents any visible symptoms and warnings that your blood pressure is high. As a result, hypertension often goes undiagnosed until when the patient is in serious trouble. According to the Heart and Stroke Foundation of South Africa, two out of three people with high blood pressure are unaware of the condition. In more advanced cases headaches, visual disturbances, nosebleeds, nausea, vomiting and sleepiness may be experienced, which indicate that something is wrong but in many cases people are unaware of the diagnosis until it’s too late.
Hypertension, which is thought to be the most common cardiovascular disease risk factor, is one of the leading causes of death in developing countries and was found to be most prevalent in black African communities in a 1998 Demographic and Health Survey, the first of its kind to be conducted in South Africa.
Srinivas says there are a combination of reasons as to why this is the case. “When it comes to healthy eating many factors are involved. Education is a crucial element because when people have not been taught which foods to eat, they can hardly be expected to lead a healthy lifestyle. Socio-economic standing is another issue which affects the lifestyle choices we make and whether or not we are lucky enough to be able to make the right ones.” It is also a matter of affordability, according to Khanyisa Xotyeni, who manages the outpatient department at Settlers Hospital. "Healthy food is expensive and most people can’t afford it.
Most of the time we eat junk food because it’s cheaper and this causes big health problems." Xotyeni said approximately one third of their patients suffer from a combination of hypertension, diabetes and obesity.
Srinivas said in most cases poorer people buy cheap food which is high in sugar, salt and fat and that this leads to serious health problems later on. "Unfortunately food made from flour, sugar and fat is cheap and people buy it to fill the hole in their tummies. What people need to learn is that this food is very dangerous and they should rather spend their money on fresh fruits and vegetables," she said.
Srinivas said that accessibility to cheap, fatty foods in the developing world is increasing at an alarming rate, leading to these preventable diseases causing more deaths worldwide than HIV/Aids, malaria and TB combined. “You wouldn’t expect obesity and hypertension to be leading killers in poor areas, but what happens is that people save up money to buy one ‘good’ meal from a fast food outlet. Of course these meals are high in sugar and fat and what you end up with is a society of overweight, malnutritioned individuals.”
Additionally, she said food shortages and effective advertising campaigns were to blame for the “coolness” associated with unhealthy fast foods because they encourage foods that are far removed from the recommended diet. “South Africa has a very young population, up to 50% are below the age of 20.
Advertising campaigns are gunning for the younger generations and we need to start paying attention to this. It is dangerous and we need to call on government to pay more attention to it.”
Srinivas said the increase in hypertension-related cases in the third world is also due to certain shifts regarding trends in food intake. These involve an increased intake of caloric sweeteners, from breast milk and water to a large variety of caloric beverages; increased animal source foods; increased intake of processed foods and refined carbohydrates; the phenomenon of snacking on unhealthy food; reduced intake of fruits, vegetables and legumes; reduced preparation time and the increased intake of pre-cooked foods.
