Hypertension: A Major Cause of Morbidity & Mortality

Hypertension is the leading cause of sudden, unexpected natural deaths in Nigeria, and it has led to the untimely death of many youth in our Nanka Community. Majority of people with hypertension in our community are unaware of this, and those with hypertension do not seek treatment, or are non-compliant with medical treatment, and do not follow up with a healthy diet. Hypertension is defined as having systolic blood pressure greater than 140 mmHg, and/ or greater than 90 mmHg for diastolic pressure or being on antihypertensive therapy.

There has been an increase in the number of people with hypertension in our community, and this has also resulted in increase in the number complications, and deaths. The recent increase in consumption of western diets, has increased the number of people with obesity, increased waist or abdominal girth, and hypertension and its complications. Studies have shown that communities who adhere to their local diet of fruit, and vegetables, and less of the fatty food of western diet did not experience an overall increase in blood pressure. However, communities that change their diet to western type diet has seen an increase in blood pressure, its complications, and deaths.

The lack of awareness of the dangers of hypertension is a major problem in most communities. In a study done at Market population at Ogbete Market in Enugu, showed a shocking 42.2% prevalence of hypertension and only 29.4% were aware of their hypertension. 3% of hypertensive people die each year. This can be extrapolated to our community and explain the increased in death rate of the youth. The increased westernization of our diet, sedentary life style, and lack of awareness of hypertension are the 3 most important factors responsible for increased blood pressure, its complications, and increased deaths in our community.

Hypertension is among the leading cause of non-communicable disease burdens, and deaths, through its complications, of cardiovascular disease, ischemia heart disease, heart failure, sudden cardiac death, stroke, kidney disease, Kidney failure, blindness, different spectrum of erectile dysfunction, hearing loss, gastrointestinal diseases, ischemic colitis. It can affect practically any organ - system in our body from atherosclerosis, the narrowing of any blood vessel, resulting in diminished blood low to any organ.

Prevention of hypertension is the best approach to reduce its disease burden and the public health burden to our community, especially the sudden, untimely deaths that subject our people to the mercy of Native practitioner and various religious interventions that reinforce the lack of awareness of the dangers of hypertension, continuing the vicious cycle of hypertensive deaths in every family in our community.

The best preventive approach is mixing diet. Every hypertensive should seek expert advice from their doctor and dietician about the best dietary approach to lose weight and see what target weight loss will help with control of their hypertension and help reduce the number of anti-hypertensive medications. Diets rich in vegetables, low salt, and less of western diet is the key to prevention, and treatment. A well-balanced vegetable diet promotes good intestinal bacteria that prevent obesity, while diets rich western foods promote bad intestinal bacteria that promote obesity, and consequently hypertension. Small serving in people's diet will help with weight loss and prevent and treat hypertension. Appropriate diet portion size can be discussed with any licensed dietician. Other dietary factors include moderation in alcohol consumption to about 1-2 drinks daily.

Adequate daily exercise of about 30 minutes daily can help prevention, and control of hypertension. However, dietary discipline is superior to any kind of exercise.

Compliance with medical therapy, good follow ups to check blood pressure, compliance with anti-hypertensive medications, combined with diet and exercise are keys to good cardiovascular health.

In conclusion, diet based on mainly vegetables, low salt, less western food, alcohol consumption in moderation or avoidance, less sedentary lifestyle, exercise, and avoidance of cigarette smoking, are associated with good blood pressure and absence of the typical increase in blood pressure with age. Practicing these will help prevent sudden hypertensive deaths in our young community.

References

• Frank M. Sacks et al. N Engl J Med, 2010:2102;12. Dietary Therapy in Hypertension.
• Okechukwu S. Ogah et al. World J cardio, 2012;4(12):327-340.
• Obinna Ikechukwu Ekwunife et al. Prevalence, Awareness, Treatment, and Control Of Hypertension in a Nigerian Population.
• Noah Voreades et al. imicb 2014

Dr. Valentine Enemuo, MD,is a Pediatric Medicine Gastroenterologist based in Kansas, United States. He graduated with honors in 1994. Dr. Enemuo has more than 26 years of diverse experiences, especially in PEDIATRIC MEDICINE, GASTROENTEROLOGY. Dr. Enemuo is a meber of the American Society for Gastrointestinal Endoscopy and the American Academy of Pediatrics.