Regular checking of blood pressure a must — Dr Efua Commeh

World Hypertension Day is celebrated every year on May 17 to communicate to the lay public issues on hypertension and its serious medical complications, as well as provide information on prevention, detection and treatment.

This year’s celebration is on the theme, ‘Measure Your Blood Pressure Accurately, Control It, Live Longer’. 

The acting Programme Manager of Non-Communicable Diseases of the Ghana Health Service, Dr Efua Commeh (DR EC), as part of the commemoration of the day spoke to Daily Graphic’s Augustina Tawiah (AT) on hypertension in Ghana and why it is important for people to measure their blood pressure. Below are excerpts of the interview:

Augustina Tawiah (AT): What is hypertension?
Dr Efua Commeh (DR EC): When one’s blood pressure is measured, it can either be low, high or normal. Averagely, the blood pressure for most people is around 120 / 70.  However, when one is going about their routine activities, the blood pressure can go up or can come down. 
Whichever way it goes; it should be able to come back to normal. If it is not able to come back to normal but rather continues going higher, higher and higher without it being controlled, we call it hypertension. So hypertension is high blood pressure that is not coming down over a long period of time. 
Unfortunately, as a result of diseases, age, unhealthy lifestyles, among others, some people are not able to control their blood pressure or the blood pressure is not able to come down to normal levels. It keeps rising. 
It is this rising blood pressure that is dangerous for our health, because the higher the blood pressure, the more complications you are going to have. Sometimes, we hear that some people have developed stroke, heart failure, kidney damage, heart attack, etc. 
They come about because the vessels that your heart is pumping blood through burst because the blood pressure is too high. You can only find out you have hypertension when your blood pressure is checked. 

(AT): Which age group is worst affected by hypertension?
DR EC: Generally, for young people, it’s between 30 to 40 year olds, while for the older age group, 50 and above. It is not limited only to people in these age groups but they are the most reported. We also keep seeing more and more young people sometimes even in their 20s, who would report hypertension, but the numbers are not as those of the older age groups. 

Causes

(AT): What predisposes people to hypertension?
DR EC: The causes are wide. For hypertension, being a black person is a predisposition because when you compare blacks to other races, we are more likely to retain salt. So the more salt you take, the higher your blood pressure. 
Apart from that we, as a community, love to take in a lot of salt in our diets. Almost all our diets have very high salt content – koobi, momoni, processed meat, everything has high salt content. So when you compare us blacks generally with other races, our blood pressure is much higher.
In addition, generally, our lifestyles have changed as a people. As part of our changing lifestyles, we are consuming more and more unhealthy diets. For others too it is a family history of the condition, while for others, they develop it because they take alcohol and smoke cigarettes. 
All these contribute to raise the blood pressure and it’s important that we get a firmer grip on these things in order to ensure that we don’t develop hypertension much earlier than it used to be previously.

(AT): How can people detect they have hypertension?
DR EC: You need to screen for it. For hypertension, if you don’t screen, it cannot be detected. You need to measure your blood pressure. Once you do that, you will know whether it is going up or not. If you measure and it is going up then, you do something about it. 
Hypertension is a silent killer. It is so silent that you will not know you have it unless you screen for it. For a lot of people, the first time they know they have hypertension is when they suffer a stroke. They just collapse, are brought to the hospital and we check their blood pressure and we realise it is not normal.

(AT): What are the treatment options?
DR EC: The treatment options are a lot but generally, medicines are important to ensure that blood pressure can be brought under control quickly and it doesn’t get out of hand. In addition to taking the medicine, persons with the condition are given lifestyle counselling, where they are taught how to undertake exercises, how to eat healthily, how to ensure that they reduce their salt and sugar intake, which are the things that trigger hypertension. Sometimes, it is just stress and so you need to identify that particular stress and do something about it. 

Hypertension in Ghana

(AT): Is hypertension a serious health issue in Ghana?
DR EC: It is a very serious health problem in this country. For us, we tend to look at numbers and within the GHS, the primary healthcare facilities have a health information system that collects information from all health facilities across the country including teaching hospitals, Christian health facilities, among others. 
Averagely, every year, we record around 600,000 cases of people with hypertension visiting hospitals. These are people who have hypertension and have come to hospital. What we have realised is that in Ghana, people don’t go to hospital unless they are sick. So, there are a lot more people in the community that have the condition but have not been diagnosed. 
For us, we look at both the population and then the individual cases. Within the population generally, the undiagnosed cases are much more. People who don’t know they have high blood pressure are much more than people who know, so its important we continue to create awareness and check blood pressure.

(AT): What measures or programmes have your outfit put in place to reduce hypertension cases in Ghana?
DR EC: We have multiple programmes. We provide people the opportunity to screen and as part of the screening, we train health workers to undertake the screenings. We also link up with partners to provide the machines used for the screening and we distribute them to health facilities. 
We have programmatic activities such as developing cardiovascular guidelines for health workers. These are used in hospitals and guides the kind of care health workers should give to people with the condition.
This year we are going to have the national survey, which looks at the risk factors in all the regions of the country. It will give us more hindsight of the risk factors around the country. This survey is done every five years.

(AT): What message do you have concerning the global theme for this year?
DR EC: Just like the global theme is saying, we need to measure our blood pressure accurately. People have different machines that they use to measure blood pressure but we are not too sure if the machines have been calibrated. 
There are a lot of questions as to how people are measuring their blood pressure but if they are able to go to a pharmacy shop or walk into a clinic, their blood pressure can easily be checked with the right machines so that they get accurate report. 
The theme says, let’s control it. This is the heart of everything we are trying to do because the lack of control of blood pressure is what give us the stroke, kidney failures, heart attacks, etc.  When your blood pressure is not controlled then, it can threaten your life. 
If you are not careful, the person collapses and that is it. So, even if you are diagnosed of hypertension, it is important you get your blood pressure under control. As much as possible, those who have been diagnosed of hypertension should stick to the medicine that has been provided. Sometimes, alternatives cause more harm than good.
Live longer: Live longer in the theme means that while putting up all these measures in place, it will help us to live longer because now the blood pressure is well controlled and so you can live a healthier life and live longer.
So, let us all measure our blood pressure. If you haven’t been diagnosed, at least once a month, just walk into a clinic and check it. Once a year, let us have a full medical check up – check for malaria, blood pressure, hypertension, etc. 
For women, once every three years, you should screen for cervical cancer and breast cancer. Routine screening is very important.