Risk factors related to hypertension or high blood pressure

Some health conditions, as well as lifestyle and genetic factors, can put people at a higher risk for developing high blood pressure. However, everyone can take steps to lower their blood pressure. The information provided here is based on CDC data, facts and figures.

Conditions

Because blood pressure tends to rise as people get older, everyone's risk for high blood pressure increases with age. In addition, some medical conditions can also raise your risk of high blood pressure.

Prehypertension

Prehypertension—blood pressure levels that are slightly higher than normal—increases the risk that you will go on to develop chronic high blood pressure.

Blood Pressure Levels
Normal	Systolic: less than 120 mmHg Diastolic: less than 80 mmHg
At Risk (Prehypertension)	Systolic: 120–139 mmHg Diastolic: 80–89 mmHg
High	Systolic: 140 mmHg or higher Diastolic: 90 mmHg or higher

Diabetes

Diabetes affects the body's use of a hormone called insulin. This hormone tells the body to remove sugar from the blood. With diabetes, the body either doesn't make enough insulin, can't use its own insulin as well as it should, or both. This causes sugars to build up in the blood. About 60% of people who have diabetes also have high blood pressure

Behavior

Healthy behaviors contribute to keeping your blood pressure low, which in turn decreases your risk of heart disease.

Diet

Sodium is the element in salt that can raise blood pressure. Most of the sodium we eat comes from processed and restaurant foods. Eating too much sodium can increase blood pressure. Not eating enough potassium (from fruits and vegetables) can also increase blood pressure.

Weight

Being overweight can cause high blood pressure.

Physical Inactivity

Not getting enough exercise can make you gain weight, which can lead to high blood pressure.

Alcohol Use

Drinking too much alcohol can raise your blood pressure.

Tobacco Use

Smoking raises your risk for high blood pressure.

Prehypertension

Blood pressure levels that are higher than normal put you at risk for developing high blood pressure.

Blood Pressure Levels
Normal	Systolic: less than 120 mmHg Diastolic: less than 80 mmHg
At risk (prehypertension)	Systolic: 120–139 mmHg Diastolic: 80–89 mmHg
High	Systolic: 140 mmHg or higher Diastolic: 90 mmHg or higher

Heredity

There are also several factors that you cannot change that affect your blood pressure, like heredity.

Age

Blood pressure tends to rise as people get older.

Race or Ethnicity

African Americans are more likely to develop high blood pressure than whites.¹

Diabetes

About 60% of people who have diabetes also have high blood pressure.²

Family History

High blood pressure can run in families. People can inherit genes that make them more likely to develop the condition. The risk for high blood pressure can increase even more when heredity is combined with unhealthy lifestyle choices, such as smoking cigarettes and eating a poor diet.

Consume Less Sodium (1,500 mg/day or less)

Most of the sodium we consume is in the form of salt, and the vast majority of sodium we consume is in processed and restaurant foods. Too much sodium is bad for your health. It can increase your blood pressure and your risk for a heart attack and stroke. Heart disease and stroke are the first and third killers of men and women in the United States each year.

Current dietary guidelines for Americans recommend that adults in general should consume no more than 2,300 mg of sodium per day. At the same time, consume potassium-rich foods, such as fruits and vegetables. However, if you are in the following population groups, you should consume no more than 1,500 mg of sodium per day, and meet the potassium recommendation (4,700 mg/day) with food.

• You are 51 years of age or older.
• You are African American.
• You have high blood pressure.
• You have diabetes.
• You have chronic kidney disease.

The 1,500 mg recommendation applies to about half of the U.S. population overall and the majority of adults. Nearly everyone benefits from reduced sodium consumption. Eating less sodium can help prevent, or control, high blood pressure.

Most of the sodium we eat comes from packaged, processed, store-bought, and restaurants foods. Only a small amount comes from salt added during cooking and from being added at the table. You can find out how much sodium you are eating by checking the labels on food products and adding up the milligrams of sodium. If at a restaurant, ask for nutritional information facts that include sodium.

Source: Mattes, RD, Donnelly, D. Relative contributions of dietary sodium sources. Journal of the American College of Nutrition 1991;10(4):383–393.

Choose a Heart-Healthy Diet

The DASH eating plan (Dietary Approaches to Stop Hypertension) is a simple heart healthy diet that can help prevent or lower high blood pressure.

This diet is LOW in sodium, cholesterol, saturated and total fat, and HIGH in fruits and vegetables, fiber, potassium, and low-fat dairy products.

Making other lifestyle changes, like getting more physical activity, while on the DASH eating plan gives you the biggest benefits. 

Hypertension kills: All about high blood pressure

Blood pressure is the force of blood against your artery walls as it circulates through your body. Blood pressure normally rises and falls throughout the day, but it can cause health problems if it stays high for a long time. Having high blood pressure raises your risk for heart disease and stroke. High blood pressure is called the "silent killer" because many people don't realize they have it. High blood pressure often has no warning signs or symptoms.

Diastolic and Systolic

Measuring Your Blood Pressure

Measuring your blood pressure is quick and painless. A doctor or health professional wraps an inflatable cuff with a pressure gauge around your arm to squeeze the blood vessels. Then he or she listens to your pulse with a stethoscope while releasing air from the cuff and watching the gauge. The gauge measures blood pressure in millimeters of mercury, which is abbreviated as mmHg.

Blood pressure is measured using two numbers. The first (systolic) number represents the pressure in your blood vessels when your heart beats. The second (diastolic) number represents the pressure in your vessels when your heart rests between beats. If the measurement reads 120 systolic and 80 diastolic, you would say "120 over 80" or write "120/80 mmHg."

Effects of High Blood Pressure

High blood pressure can damage your health in many ways.

For instance, it can harden the arteries, decreasing the flow of blood and oxygen to the heart. This reduced flow can cause—

• Chest pain, also called angina.
• Heart failure, which occurs when the heart can't pump enough blood and oxygen to your other organs.
• Heart attack, which occurs when the blood supply to your heart is blocked and heart muscle cells die from a lack of oxygen. The longer the blood flow is blocked, the greater the damage to the heart.

High blood pressure can burst or block arteries that supply blood and oxygen to the brain, causing a stroke.

Blood Pressure Signs and Symptoms

High blood pressure is called the "silent killer" because many people don't realize they have it. High blood pressure often has no warning signs or symptoms.

The only way to detect whether or not you have high blood pressure is to have your blood pressure measured by a doctor or health professional—it is quick and painless. (Courtesy: CDC)

How to prevent high blood pressure or hypertension

About 1 of 3 adults has high blood pressure, which increases the risk for heart disease and stroke, the major causes of death. High blood pressure is called the "silent killer" because it often has no warning signs or symptoms, and many people don't realize they have it. That's why it's important to get your blood pressure checked regularly. The good news is that you can take steps to prevent high blood pressure, or to treat it if it is already high. Here is the information as provided by the Centers for Disease Control and Prevention.

Increases in blood pressure increases your risk for heart disease. People at any age can take steps each day to keep blood pressure levels normal.

Lifestyle

• Eat a healthy diet. Eating healthfully can help keep your blood pressure down. Eat lots of fresh fruits and vegetables, which provide nutrients such as potassium and fiber. Also, eat foods that are low in saturated fat and cholesterol.
  Avoid sodium by limiting the amount of salt you add to your food. Be aware that many processed foods and restaurant meals are high in sodium.
  Studies¹ have shown that people who eat a healthy diet can lower their blood pressure. For more information on healthy diet and nutrition.

• Maintain a healthy weight. Being overweight can raise your blood pressure. Losing weight can help you lower your blood pressure.
  To find out whether your weight is healthy, doctors often calculate a number called the body mass index (BMI). Doctors sometimes also use waist and hip measurements to measure a person’s excess body fat.
  Be physically active. Physical activity can help lower blood pressure. The Surgeon General recommends that adults should engage in moderate physical activities for at least 30 minutes on most days of the week.
• Key Definitions

  • Cholesterol is a fat-like substance in the body. High levels in the blood can lead to heart disease and stroke.
  • Saturated fats come largely from animal fat in the diet, but also from some vegetable oils such as palm oil.
  • Sodium is the element in salt that can raise blood pressure. Most of the sodium we eat comes from processed and restaurant foods.
  • Diabetes is a disease that affects the body’s use of insulin. Insulin tells the body to remove sugar from the blood. People with diabetes either don't make enough insulin, can't use their own insulin as well as they should, or both.
  Don't smoke. Smoking injures blood vessels and speeds up the hardening of the arteries. Further, smoking is a major risk for heart disease and stroke.
• If you don’t smoke, don’t start. If you do smoke, quitting will lower your risk for heart disease and stroke. Your doctor can suggest programs to help you quit.
  Limit alcohol use. Drinking too much alcohol is associated with high blood pressure.
• If you drink alcohol, you should do so in moderation—no more than one drink per day for women or two drinks per day for men.
  What You Can Do

• Check your blood pressure. Getting your blood pressure checked is important because high blood pressure often has no symptoms.
  Your doctor can measure your blood pressure, or you can use a machine available at many pharmacies. You can also use a home monitoring device to measure your blood pressure.
  Blood pressure is written as two numbers. The first (systolic) number represents the pressure in your blood vessels when your heart beats. The second (diastolic) number represents the pressure in your vessels when your heart rests between beats.

Blood Pressure Levels
Normal	Systolic: less than 120 mmHg Diastolic: less than 80 mmHg
At risk (prehypertension)	Systolic: 120–139 mmHg Diastolic: 80–89 mmHg
High	Systolic: 140 mmHg or higher Diastolic: 90 mmHg or higher

Prevent or Treat Your Medical Conditions

• Prevent and manage diabetes. You can reduce your risk of diabetes by eating a healthy diet, maintaining a healthy weight, and being physically active.
  About 60% of people who have diabetes also have high blood pressure.² If you have diabetes, you can lower your risk for high blood pressure by following the healthy guidelines listed here.
  Treat high blood pressure. If you already have high blood pressure, your doctor may prescribe medications in addition to lifestyle changes.
• All drugs may have side effects, so talk with your doctor on a regular basis. As your blood pressure improves, your doctor will want to monitor it often.
  Lifestyle changes are just as important as taking medications.
  
  

Male condom: Effectiveness of male latex condoms in preventing sexually transmitted infections including HIV

A condom is a sheath that is worn either over the penis (male condom) or inside the vagina (female condom) during sexual intercourse, for the purpose of preventing pregnancy or protecting against sexually transmitted infection.

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Condoms are the only contraceptive method proven to reduce the risk of sexually transmitted infections (STIs), including HIV. They can be used as a dual-purpose method, both for prevention of pregnancy and protection against STIs.

An extensive review was conducted by a panel convened by National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) in June 2000 in the United States of America, with the participation of WHO. The review concluded that condoms, when used correctly and consistently, are effective for preventing HIV infection in women and men and gonorrhoea in men. For other STIs, however, the available data are less complete.

The key findings of the report are:

• The consistent use of male latex condoms significantly reduces the risk of HIV infection in men and women and of gonorrhoea in men;
• Laboratory studies have established the impermeability of male latex condoms to infectious agents contained in genital secretions, including the smallest viruses.
• Male condoms may be less effective in protecting against those STIs that are transmitted by skin-to-skin contact, since the infected areas may not be covered by the condom.

The report concluded that additional research was needed to fill the gaps in currently available evidence. 

Music helps improve surgical procedures in operation theatres

Syed Akbar
Hyderabad: Dr Mangalampalli Balamurali Krishna, MS
Subbulakshmi, Ustad Bismillah Khan and other great musicians and singers
have one thing in common in operation theatres: they inspire surgeons,
anaesthesiologists and nursing staff to perform surgeries more skilfully and
with better coordination.

The practice of listening to music in operation theatres while performing
surgeries is fast catching up in the country with more and more doctors and
paramedical staff playing soft classical instrumental music, ghazals and even
filmi songs. Doctors in some hospitals have made special arrangement to
listen to their favourite music, while a few corporate hospitals have set up
operation theatres and catheter labs with inbuilt speakers. In some hospitals,
patients, who are put on local or regional anaesthesia, are asked before hand
which type of music they would prefer in the operation theatre.

According to Dr N Ranga Bhashyam, senior gastroenterologist and former
honorary surgeon to the President, playing slow classical music in operation
theatre gives a sedative effect to patients, lessens irritation and provides a
sense of calmness to doctors. "Playing music during childbirth has a great
impact on the patient. Even violent people in mental hospitals can be
controlled through slow music of instruments like flute, violin and veena," he
adds.

Dr J Shiv Kumar, cardiologist, says he plays music in his cath lab to keep the
blood pressure and heart beat of his patients under control. "Any music
including rock gives a definite impact in theatre. It is fast catching up here as
many doctors believe that it gives them enough confidence," he adds.

Cancer surgeon Dr P Raghuram points out that playing soft instrumental
music soothes the mind of the surgeon. "The volume must be low and the
music should be only in the background. It encourages organised thought,
improves concentration and dexterity of surgeons In some theatres pop music
is played, but it detracts the attention," he says.

According to senior urologist Dr Kim Mammen, who conducted a study on
the impact of music on surgical staff, playing music in operation theatre
helped in "reducing the autonomic reactivity of theatre personnel in stressful
surgeries allowing them to approach their surgeries in a more thoughtful and
relaxed manner."

Dr Kim said they found that instrumental music was the most sought after
type of music, followed by FM radio, ghazals, English country, English
classical and Indian classical.

Viral load in hepatitis B: Indian scientists discover a DNA probe

Syed Akbar
Hyderabad: City scientists have designed a new DNA probe that
could accurately tell doctors the number of copies of virus in hepatitis B
patients for easy monitoring of the disease.

This is the first indigenously developed DNA probe for detection of "viral
load" (number of copies of the virus) in hepatitis B patients. It has 100 per
cent sensitivity result and can detect all sub-types of hepatitis B virus.
Further, the new DNA probe will cut down the cost of diagnostic tests as it is
designed in the country.

"During diagnosis of hepatitis B virus, chances are that certain sub-types are
not detected. Moreover, for the virus to be detected it has to be present in
certain number. Our DNA probe saves money for patients and help doctors to
change the treatment modalities as it tells them whether or not the patient is
responding to the treatment," said senior scientist Dr MN Khaja.

Dr Khaja and other city scientists Dr Naresh Yalamanchili, Dr Syed
Rahmatullah, Dr Madhavi Chandra, Dr Vishnupriya Satti, Dr Ramachandra
Rao and Dr M Aejaz Habeeb are part of the team that designed the new DNA
probe. They are from the Centre for Liver Research and Diagnostics, Owaisi
Hospital and Research Centre, and Department of Genetics, Osmania
University. Since the probe does not skip any of the virus varieties present in
the patient, it will give the exact viral load he or she is suffering from.

The higher the viral load the greater the severity of the disease. Hepatitis B
positive patients are put on six or 24 weeks of treatment regimen and during
this period the viral load is accessed at regular intervals. If the viral load
comes down, it means the patient is responding to the treatment. If the patient
is not responding, the doctor will change the treatment mode. The city team's
DNA probe helps in this process.