BLOOD PRESSURE is the force per square unit area exerted within the walls of a blood vessel, during the phases of the heart’s contraction. It is measured in millimetres per mercury (mmHg) and stated as a fraction, with the systolic blood pressure as the numerator and the diastolic blood pressure as the denominator. Every human being has a blood pressure reading which changes continuously based on several factors, some of which are physical activity, drugs taken, smoking, and exercise.

Hypertension, also termed high blood pressure, is diagnosed in adults after consistent readings of greater than or equal to 140mmHg systolic and 90mmHg diastolic.

Even with the best education efforts, there are a few myths about hypertension that are preventing patients from avoiding or reducing end-organ damage, which can result in stroke, heart attack, kidney failure, visual impairment, and blindness. Let’s debunk a few of those myths.

MYTHS

After a course of medication (three months), you are cured of hypertension and do not need to go back to the doctor or take any more medication.

Once diagnosed with hypertension, you have a lifelong illness that requires lifestyle changes and maybe medication. This is the reason multiple readings – at least three – are taken with the sphygmomanometer after relaxing for five minutes, and not after drinking caffeine, smoking nor exercising up to 30 minutes prior.

Lifestyle changes include reducing the amount of salt intake per day, daily aerobic exercise as advised after consulting a physician, keeping to an ideal body weight, quitting smoking, reducing alcohol intake and stress level.

Medication, once started, usually require lifelong compliance – they must be taken daily – to ensure the blood pressure is less than 140mmHg and 90mmHg, if there is no kidney disease nor diabetes, which would then require blood pressures lower than 130/80 mmHg.

Medication for hypertension causes a man to lose his nature (prevents him from having a good erection).

There are different types of drugs used to control high blood pressure. Their actions vary. Some medication reduce the amount of force and rate of contraction of the heart, while others act on receptors on the blood vessels to dilate them, and still some cause the blood volume and salts to be reduced (urinate a lot, for example diuretics).

Some of these drugs have side effects of reducing a man’s libido or causing impotence, for example the beta blockers, and so would only be used as a last resort to control high blood pressure in a sexually active man. Other drugs are utilised and are effective, so this should not be a deterrent for compliance with antihypertensives.

Headaches can be used to determine if the blood pressure is high.

Headaches should not be used as a warning sign to take antihypertensives or to see the doctor. High blood pressure usually exists without signs such as headache or dizziness. The likelihood that there is now headache associated with elevated blood pressure means that it is very high (a diastolic, that is bottom value, of at least 110mmHg). Therefore, waiting on a headache will result in damage to the targeted organs like the heart, kidney, brain, and eyes, which is sometimes irreversible.

The take-home message is do not wait for symptoms to take medication daily, as prescribed by your physician.

Taking medication daily will make a patient dependent on the drugs.

Once high blood pressure is diagnosed and medication recommended, these drugs are necessary to keep the pressure below 140/90 mmHG in adults. It is not that the body will change to need the drugs, but the drugs are needed daily to control the pressure and are usually to be taken throughout a person’s life.

Hypertension only occurs in old people, so I don’t need to worry as a young person.

Hypertension can be diagnosed in young persons as well as in adults. Hypertension can be primary or essential, where a cause is not known, or it can be secondary – where it is due to a tumour, a disease or abnormality in certain hormones. Hypertension is very common in the black race and has been found to be linked to genetic predisposition. Lifestyle changes that apply to adults should also be observed in the younger age groups to try to prevent the development of hypertension.

There is no need to take medication for blood pressure on the day of routine physician visit.

It is essential to take medication daily and especially on the day of the physician visit. This will ensure that the doctor sees a true reading and can alter the medication accordingly. If the medication is not taken on that day, the reading may be high and give a false impression that the drugs are not controlling the blood pressure. The physician also cannot adjust the current medication, and another visit would be necessary when all medication are taken to give a true reading and evaluation.

Dr Romayne Edwards is a consultant emergency physician at the University Hospital of the West Indies and an associate lecturer at the University of the West Indies.