High blood pressure and heart disease
HIGH blood pressure is often called the silent killer due to the fact that most people with the condition have no symptoms, and the increased pressure of the blood flowing in the arteries may cause damage to your body organs such as the eyes, the kidneys and the heart.
According to general, laparoscopic and bariatric surgeon Dr Alfred Dawes, high blood pressure causes hypertensive heart disease over time, which is usually manifested as ischaemic heart disease, left ventricular hypertrophy or enlargement of the heart muscles, and heart failure when the heart is unable to meet the demands of pumping blood against the high pressures.
“High blood pressure damages the lining of the blood vessels. Normally the heart pumps the blood through the blood vessels and the vessel walls are elastic, so it absorbs some of the energy and doesn’t cause the blood flow to bounce back into the heart, requiring the heart to pump against that rush of blood that is flowing back,” he said.
“When the blood vessels become stiff from osteosclerosis and hypertension, they become narrowed. If this narrowing affects the coronary arteries, which are the main blood vessels supplying the heart, then you may end up with ischaemic heart disease. The reduced blood flow can cause angina, irregular heartbeat, and in severe cases, heart attacks.”
To further explain how high blood pressure can cause damage to the heart, Dr Dawes said if you throw a ball against a sheet that is hanging on a clothes line, the sheet will absorb energy from the ball and it will fall close to the sheet. However, if you throw a ball against a wall, the ball will bounce back towards you. He said such is the case when the heart is pumping blood through blood vessels that are elastic (sheet) and when the blood vessels are stiff (wall).
“If the heart has to work extra hard to pump out the blood that is being bounced back, then over time this extra work will cause the heart to enlarge in order to overcome the high pressures. This enlargement of the heart muscles is called hypertrophy, and it worsens the chances of you getting ischaemic heart disease because there is now greater mass requiring more blood flow from arteries that may be narrowed,” he said.
He said if over time the heart is working hard to pump blood through stiff blood vessels to overcome high blood pressure, then it may give out and be unable to pump effectively.
“When this happens the kidneys reabsorb more water, so you end up with fluid overload and heart failure. This is one of the common results of hypertension in our population. In some cases the heart may not even be able to pump out 15 per cent of the blood inside its chambers, and you may require the implantation of a device to help the heart to pump more effectively,” he said, adding that in case of heart failure, a heart transplant may even be required.
Dr Dawes urged hypertensive individuals to take care to monitor their blood pressure levels and take the required medication.
He also advised the general population to cut back on their intake of salt and do their regular health checks, which will provide guidance in this regard.
