Diabetes, hypertension: THE SILENT KILLERS

IN times gone by in the Caribbean, infectious/communicable diseases like cholera, dengue, measles and gastroenteritis were prevalent. They were feared, as they were the leading cause of death, so much so that the islands quickly developed vaccination strategies and hygiene campaigns. Specialisations in the field of public health blossomed and various categories of infection control personnel were employed. Thus the rates of communicable diseases fell.

We are now going through an epidemic of non-communicable diseases, and according to Dr Tanesha Davis, internist at the St Ann’s Bay Hospital, as a nation we are asleep at the wheel.

“We are going through an epidemic of diabetes and hypertension of some sort. Recent national surveys among people 15-74 years of age show an upward trend in the prevalence of obesity, hypertension and diabetes,” she said.

Dr Davis said the top 10 leading causes of death in the world published by the World Health Organisation in 2012 include ischaemic heart disease (caused by heart attacks), stroke, diabetes and hypertensive heart disease. To explain the grave impact of both diseases, she said during the period September 30 to October 8 2014, one person died of Ebola in the United States while approximately 1,620 people died from diabetes.

Dr Davis said up to 80 per cent of people with diabetes live in low to middle-income countries and almost every one in 10 people are diabetic.

“If you’re sitting in an office at your desk with nine other people around you, chances are one of you has diabetes. Globally it is estimated that 50 per cent of individuals remain undiagnosed,” she said.

The internist explained that in the United States the disease is the leading cause of new blindness in adults, kidney failure and non-traumatic limb amputation, but many of the diabetes-related complications can be prevented or delayed with early detection, aggressive blood sugar control and efforts to minimise risk of complications.

With regards to hypertension, Dr Davis said it is one of the leading causes of the global burden of disease, and 15 per cent of all deaths were attributable to hypertension in 2001.

She explained that a person is hypertensive when a blood pressure reading of greater than 140/90 is noted on two or more office visits.

Dr Davis said an elevated blood pressure usually causes symptoms only when extremely high, and as a result often goes undetected unless it is checked.

“The effect that this elevated blood pressure has on the body — brain, heart, kidneys, blood vessels — over time is responsible for the top two leading causes of death currently in Jamaica which are ischaemic heart disease and stroke. Hypertension doubles the risk of heart attacks, strokes, kidney failure, peripheral arterial disease (poor circulation) and kidney failure,” she said.

Using the same office desk analogy, Dr Davis said amongst the nine co-workers, three are likely to have high blood pressure.

“That likelihood most certainly will increase with age; 65 per cent of individuals over 60 years old will have hypertension,” she said. “The figures of hypertension are also increasing and similar to the risk factors associated with diabetes, obesity and the ageing population are the factors cited. Dietary sodium/salt intake, alcohol consumption, psychosocial stress, and low levels of physical activity may also contribute to hypertension.”

But all hope is not lost, and Dr Davis said there are changes that can be made to fight the epidemic.

“The health care industry is challenged to find ways to empower patients to play a greater role in the management of their illnesses. One way in which patients will be better able to manage their illnesses is by adhering to their medication regimens,” she said.

She explained that medication adherence is a big problem and up to 60 per cent of patients do not take their medications as ordered, especially if the patient is feeling well.

“Hypertension and diabetes are silent killers; their long-term effects on the body occur over years and usually the patient feels nothing until they present to hospital with a massive stroke, heart attack or failing kidneys, and at that time we are fighting to save a life,” she said.

In addition to medication, Dr Davis said a few simple adjustments to our lives can help fight the diseases. These include:

1. Telling your doctor about the possible side effects you may be experiencing so they can make the necessary adjustments.

2. If you have been forgetting to take your pills, set an alarm on your phone or involve other family members to remind you.

3. Ensure you have an NHF and or a JADEP card to assist with the costs.

To further assist, she gave what she terms as life’s 7s to reduce the risk of developing hypertension and diabetes. These are:

1. Manage your blood pressure

2. Control cholesterol

3. Reduce blood sugar

4. Get active (exercise)

5. Eat better and incorporate at least five servings of fruit, vegetables and nuts per day. Reduce your salt intake, and have at least two servings of fish per week

6. Lose weight

7. Stop smoking.

“Don’t be fooled by quick fixes or promises of a cure,” Dr Davis said.

“Presently there is no cure for the most commonly encountered causes of diabetes and hypertension. We must focus our attention on prevention by adopting a healthy lifestyle and adhering to your medications and the suggested lifestyle changes.”