Common myths about high blood pressure

Silent Killer

Measurement of blood pressure is quick and painless. Written as two numbers, the first (systolic) number represents pressure in blood vessels when the heart contracts or beats and second (diastolic) number represents pressure in the vessels when the heart rests between beats. Hypertension is diagnosed if, when measured twice on different days, systolic blood pressure on both readings is ≥140 mmHg and/or diastolic blood pressure on both readings is ≥90 mmHg. It is important to know one’s blood pressure reading by checking it regularly, adopting a healthy lifestyle and staying on prescribed treatment to reduce hypertension and its complications.

It is very concerning to note that of the 22 million hypertensives the BP control  to less than 140/90 is achieved in less than 12%. Hypertension kills more adults than any other cause and is readily preventable and treatable. One of the important reasons is poor motivation in the patients to stay on the long-term treatment and the myths associated with this medical problem. Herein we will discuss these myths so that the readers understand them and propagate it to their family members and acquaintances so that they do not fall in the trap of ignorance.

Myth: I feel fine and I do not need any treatment 

Uncomplicated hypertension is most often not associated with symptoms and it is for this reason that it is called a “silent killer”. Not treating it leads to strokes, heart attacks, kidney failure, retinal problems leading to loss of sight etc.

Myth: High blood pressure runs in my family. There is nothing I can do to prevent it.

It is true people whose one or both parents have high BP have a higher chance to have hypertension. That, however, does not mean that if preventive measures like healthy life style adoption is started during adulthood it cannot be avoided or prevented.

Myth: I don’t use table salt, so I’m in control of my sodium intake, hence my blood pressure.

Only not adding salt to food at the time of consuming food is a very minor component of additional salt. It needs to be understood that all processed foods, tomato sauce, pre mixed soups, canned foods have good amount of sodium. In this regard sodium chloride or sodium bicarbonate both have sodium the offending agent in common. One should look out for sodium or Na content on the label of the product to be consumed. Besides these pickles, chutneys, Papad etc., have good amount of sodium in it. Normal need of the body is around 3 to 4 gram of sodium in 24 hours but most of us consume around 10 gram which is grossly in excess and is an important contributor to high BP.

Myth: Rock salt, Kosher salt or sea salt for cooking is better than the ordinary table salt because it has lower sodium content

Rock and sea salt or Kosher salt has the same sodium content as the table or the regular kitchen salt and in no way is healthier for people with or without hypertension.

Myth: I have high blood pressure. My health care professional checks it for me and home measurement of BP is not required.

Home measurement of BP is very important because it often gives the correct estimate before starting medicines and also the level of control achieved. It rules out white coat hypertension seen in around 20% patients and also diagnoses masked hypertension (clinic BP normal but home BP higher), The instrument used should be a reliable one and calibrated properly by comparing the readings taken on anther accurate machine periodically.

Myth: I was diagnosed with high blood pressure. I have recently had lower readings, so I can stop taking my medication.

A person with well controlled BP on medical treatment is destined to have low chances of developing vascular complications. Pressure up to 130 /80 are desirable. Tampering and reducing drugs or stopping them should never be done unless the treating doctor advises. This can expose the person to getting complications like strokes and heart attacks. Most people with high BP need long term medicines often life long also.

Myth: I take blood pressure medication, so I don’t need to adjust my lifestyle

Life style modification is an important adjunct in the treatment Just because you are taking tablets to control BP does not mean that it has no value. In fact, it has additional value. Increased salt intake makes the BP lowering property of drugs belonging to several classes. BP control can be achieved with a smaller number of drugs and at lower doses. Hence non-drug measures must continue parallelly.

Myth: The target BP in senior citizen and very old people is higher than in the younger people.

BP of less than 140/90 continues to be the target. The recent guidelines recommend BP of less than 120/80 mms in persons more than 65 years of age. Therefore, the recommendation of higher BP cut offs in elderly is erroneous. Higher the age more is the risk of complications in inadequately controlled BP.

It is important to understand that one of the reasons for poor compliance of taking long term treatment and inadequate or no control is the cause of hypertension being the commonest cause of death from non -communicable diseases.

Prof Upendra Kaul, Founder Director Gauri Kaul Foundation