Tag: hypertension

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Salty Advice About Dietary Salt

A spilled salt shaker. (iStockphoto/Thinkstock)
A spilled salt shaker. (iStockphoto/Thinkstock)

None of us are strangers to table salt. Everytime you eat something, you probably make a remark regarding the amount of salt in the food. Some people may think it is just right, some may find it too salty and some may feel extra salt is required.

Our body contains many salts. Table salt (sodium chloride) is a major one making up around 0.4 per cent of the body’s weight at a concentration pretty much equivalent to that in seawater. Somebody has calculated a 50 kg person would have around 200 gm of sodium chloride in his body. That makes around 40 teaspoons.

We continually lose salt when we lose water from our body as salt is in a solution. So when we are sweating, vomiting, having diarrhea or voiding water by act of urination, we are losing salt. Salt cannot be made in our body so we have to replenish it otherwise there can be serious consequences.

Salt is needed to maintain our blood volume and blood pressure. Sodium is also needed for nerves and muscles to work properly. Low levels of body sodium can make our brain swell and cause confusion.

Too much sodium is bad for us as well. Excessive consumption of sodium can increase blood pressure, and that salt is a major determinant of population blood pressure levels. Some research estimates suggest the numbers of deaths averted by moderate reductions in population salt consumption would be at least as many as those achieved by plausible reductions in population smoking rates (CMAJ June 12, 2012).

The fast food industry is making its own contribution towards increasing the general population’s salt intake. Fairly large population is relying on fast food industry to provide their daily food needs. Fast food tends to be more energy dense, contain more saturated fat and salt, contain fewer micronutrients and be eaten in larger portions than other foods, says the CMAJ article.

Fast food items such as fried potatoes, pizzas and sugar-sweetened soft drinks typically provide between one-third and one-half of daily energy intake but less than one-quarter of most micronutrients.

Now what? Too much or too little salt in the diet can lead to muscle cramps, dizziness, or electrolyte disturbance, which can cause neurological problems, or death. Generally, more emphasis is given to the evidence showing an association between salt intakes and blood pressure among adults. We also know reduced salt intake results in a small reduction in blood pressure. Evidence suggests that high salt intake causes enlargement of the heart and swelling of the legs.

There is a clear scientific evidence that a modest and long term reduction in population salt intake can result in a lower population blood pressure, and a reduction in strokes, heart attacks and heart failure.

Then what are we waiting for? Most of us consume more salt than we need. General recommendation is no more than six grams (about one teaspoon) of table salt a day. This includes salt used in cooking and at the table. If you have high blood pressure or heart disease then less than two grams of table salt per day will be helpful. Are you willing to try that?

So, how is your food tasting today?

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Regular Physical Activity Can Reduce Your Blood Pressure and Prevent Stroke

When was the last time you had your blood pressure checked?

There are many things you can do to prevent stroke. One of the most important things you can do is to keep your blood pressure under control. It is also important to learn to recognize early signs of stroke because if you receive clot busting medications within three to 4.5 hours then your chance of survival and living without disability is considerably improved.

Stress and anxiety can raise your blood pressure. We know that anxiety does not cause permanent high blood pressure but it can cause dramatic temporary spikes of high blood pressure which can cause damage to our blood vessels and vital organs like heart and kidneys. It can damage the brain and retina. Persistent or recurrent anxiety can make us prone to picking up bad habits like smoking, drinking or eating too much unhealthy food. Combination of these factors can increase our risk of high blood pressure.

Nearly two-thirds of all cases of stroke and one-half of all cases of coronary heart disease are directly related to hypertension. What is scarier is that most cases of hypertension either go undiagnosed or untreated. That is why it is called a silent killer. You may have high blood pressure but may not have any symptoms.

World Health Organization says that hypertension causes seven million premature deaths worldwide each year. Hypertension affects 22 percent of Canadians. It is estimated that 25 percent of the 42 million people with high blood pressure in the United States are unaware that they have hypertension. It is a ticking but silent time bomb ready to explode any time.

The incidence of hypertension increases with age. Most elderly Canadians have high blood pressure – probably due to thickening of blood vessels. No cause is identified in 80 to 95 percent of people with hypertension. This is known as idiopathic or essential hypertension. Others have hypertension due to primary disease of kidneys or due to certain hormonal disorders.

We eat too much and we do not exercise enough. Our blood vessels become harder and less compliant with age. When the blood is pumped out of the heart into less compliant blood vessels, the blood pressure goes up. So the heart has to work harder – and eventually it becomes tired, weak and fails. It silently causes damage to our vital organs and eventually results in heart attack, congestive heart failure, stroke, kidney failure and blindness.

Normally, systolic blood pressure should be less than 140 mm Hg (mercury) and diastolic pressure of less than 90 mm Hg. Blood pressure is lowest in the early morning, rises as the day progresses, and then dips down during the night and earliest hours of the morning.

Hypertension can be prevented and treated with lifestyle changes – with or without medication. Eat a healthy diet, lose weight if you are overweight, do not smoke, limit alcohol intake, eat a low salt diet, minimize sugar intake, do regular exercise, relax and learn to manage stress with laughter and meditation.

If your doctor wants you take pills to control your blood pressure then make sure you take it regularly. Research has shown that 50 per cent of the patients with high blood pressure discontinue their antihypertensive medications by the first year. This is no good.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Controlling Hypertension Means Preventing Stroke

When was the last time you had your blood pressure checked?

Last week, I wrote in my column that we should learn to recognize early signs of stroke because if you receive clot busting medications within three to 4.5 hours then your chance of survival and living without disability is considerably improved.

So, what can you do to prevent stroke?

There are many things you can do to prevent stroke. One of the most import things you can do is to keep your blood pressure under control. Especially, in the current worsening economic situation.

We know that anxiety does not cause permanent high blood pressure but it can cause dramatic temporary spikes of high blood pressure which can cause damage to our blood vessels and vital organs like heart and kidneys. It can damage the brain and retina. Persistent or recurrent anxiety can make us prone to picking up bad habits like smoking, drinking or eating too much unhealthy food. Combination of these factors can increase our risk of high blood pressure.

Nearly two-thirds of all cases of stroke and one-half of all cases of coronary heart disease are directly related to hypertension. What is scarier is that most cases of hypertension either go undiagnosed or untreated. That is why it is called a silent killer. You may have high blood pressure but may not have any symptoms.

World Health Organization says that hypertension causes seven million premature deaths worldwide each year. Hypertension affects 22 percent of Canadians. It is estimated that 25 percent of the 42 million people with high blood pressure in the United States are unaware that they have hypertension. It is a ticking but silent time bomb ready to explode any time.

The incidence of hypertension increases with age. Most elderly Canadians have high blood pressure – probably due to thickening of blood vessels. No cause is identified in 80 to 95 percent of people with hypertension. This is known as idiopathic or essential hypertension. Others have hypertension due to primary disease of kidneys or due to certain hormonal disorders.

We eat too much and we do not exercise enough. Our blood vessels become harder and less compliant with age. When the blood is pumped out of the heart into less compliant blood vessels, the blood pressure goes up. So the heart has to work harder – and eventually it becomes tired, weak and fails. It silently causes damage to our vital organs and eventually results in heart attack, congestive heart failure, stroke, kidney failure and blindness.

Normally, systolic blood pressure should be less than 140 mm Hg (mercury) and diastolic pressure of less than 90 mm Hg. Blood pressure is lowest in the early morning, rises as the day progresses, and then dips down during the night and earliest hours of the morning.

Hypertension can be prevented and treated with lifestyle changes – with or without medication. Eat a healthy diet, lose weight if you are overweight, do not smoke, limit alcohol intake, eat a low salt diet, minimize sugar intake, do regular exercise, relax and learn to manage stress with laughter and meditation.

If your doctor wants you take pills to control your blood pressure then make sure you take it regularly. Research has shown that 50 per cent of the patients with high blood pressure discontinue their antihypertensive medications by the first year. This is no good.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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The Silent Killer – Hypertension on the Rise

“The number of adults with hypertension more than doubled from 1995 to 2005. The age- and sex-adjusted prevalence increased from 153.1 per 1000 adults in 1995 to 244.8 per 1000 in 2005, which was a relative increase of 60 per cent,” says an article in the Canadian Medical Association Journal (CMAJ).

The article was discussing public health strategies to prevent and manage hypertension and its consequences in Ontario, the most populous province in Canada. I think the problem of hypertension is no different in the rest of Canada and the U.S.

Articles in the CMAJ reported marked improvement in the diagnosis and treatment of high blood pressure. This may explain the increase in the prevalence of hypertension which may represent an increase in the detection of hypertension rather than a true increase in its incidence.

It is estimated that a middle-aged man with normal blood pressure has 90 per cent risk of becoming hypertensive. That is scary.

The consequences of high blood pressure are severe. Nearly two-thirds of all cases of stroke and one-half of all cases of coronary heart disease are directly related to hypertension. What is scarier is that most cases of hypertension either go undiagnosed or untreated. That is why it is called a silent killer. You may have high blood pressure but may not have any symptoms.

For example, in U.S., studies show that only 37 per cent of hypertensive patients were treated and adequate control of blood pressure achieved. Comparative studies from Europe indicate that less than 25 per cent of people with hypertension receive adequate treatment. In Canada, 1985–1992 Canadian Heart Health Survey reported a treatment and control rate of only 13 per cent.

One of the most important findings reported in one of the studies from Ontario is the remarkable improvement in hypertension management. The study reported hypertension awareness rate of 87 per cent, treatment rate of 82 per cent and treatment and control rate of 66 per cent. These numbers are by far the highest from any population-based study, says one of the CMAJ article.

The study also revealed that South Asian and female black Canadians had a disproportionately high prevalence of hypertension. This means intervention programs should be targeted to such groups at community and individual levels. They also found that one in three adults with hypertension did not have blood pressure control.

Diabetic patients with hypertension have a high risk for cardiovascular disease. Unfortunately, two-thirds of these patients did not have blood pressure control and that over one-quarter had received no treatment. If these patients receive intensive treatment for high blood pressure then this actually saves the health care system money as well as prevents death and disability, says one of the articles.

As they say, prevention is better than cure. You can reduce the risk of hypertension by 50 per cent by maintaining healthy weight and exercising daily. Eating a healthy diet with lots of fruits and vegetables also helps. Have your blood pressure checked when you visit your doctor. Common symptoms of hypertension to look out for include recurring headaches, dizziness, confusion, unexplainable nosebleeds, and vision problems.

Bare your arm for blood pressure measurement next time you visit your doctor.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!