Charlie was unbeatable. Charlie was unconquerable. Charlie was indomitable. But Charlie is now dead. Dead with many unanswered- How unbeatable, unconquerable and indomitable could’ve been so vulnerable?
Thus the beginning, whence two newly medical school liberated, of confidence high, sought a conquest anew- Muscles. Which meant eyes were inevitably Kingsrow directed, where Charlie was proposed, to scrutinise our aspirations. And with aspirations scrutinised, individualised
1. Charlie collapsed unconscious in the gym.
2. Thus had an emergency CT brain
3. Which revealed ruptured blood vessels.
4. Indicative that the Blood Pressure was deadly high.
5. Counting Charlie another victim of the silent killer.
Hypertension
The fact is, the silent killer has taken millions of lives, nevertheless it’s dismissed as benign, to the peril of millions more. For there is much disinformation, myths, fictions and old wives’ tales, that this column is task at deconstructing. However, first is the language, to reaffirm that name medical is hypertension, but with Blood pressure known, Blood Pressure it shall remain.
Wherefore the myths are exposed- Headaches indicate blood pressure. In fact, very false this is, since Blood Pressure rarely causes symptoms, unless a catastrophic event is imminent. Then this- A Blood Pressure of 120/80 is normal. Firstly, there is nothing like a normal blood pressure, rather there is an acceptable Blood Pressure, based on age, underlying health conditions etc. And the third- Bush tea is good for Blood Pressure. Truth be told, take this path and the bushes of Le Repentir cemetery, will be the last bush you ever see. And- hypertension medications make you impotent. Yet another falsity, like the Champion’s marriage. For rarely such medications are listed in the cause of impotence.
Now the unanswered- What causes Blood Pressure? An admission, the list is longer than PPP rap sheet, but generally it could hormonal, structural, or age related. Thus, this is to share, with ageing the only thing that effortlessly goes up and stays up, is the Blood Pressure. Where narrowing of the blood vessels, known as arteriosclerosis, mean a greater pressure is required to overcome the narrowing. In fact, this can be compared to blowing into a watering hose and then a much narrower drinking straw, where it will be discovered, a greater effort it takes, blowing into the narrower straw. And for this reason, the narrower atherosclerotic blood vessels, will require greater pumping pressure from the heart, to facilitate blood circulation. However, in an attempt to facilitate blood flow, the increased heart pressure leads to Blood Pressure with ageing.
Complications
Having said that, Blood Pressure and Diabetes are the two most common non-communicable diseases, not only in Guyana but also worldwide. And with this recognition, along with the potential for serious complications, most imperative it’s that Primary Healthcare is invested in, to optimally manage these chronic but deadly conditions. However, this is reality, PPP being clueless haven’t made such investments, which mean thousands are unknowingly walking Blood Pressure bombs, while those known, aren’t optimally managed.
Having said that, this is a known medical fact, Blood Pressure has unique clinical course in Blacks, with us having a greater propensity to severe Blood Pressure, complications, and death. Where this is the underlying reason, we have greater salt sensitivity, critical in the hypertensive process. As a result, we are at greater risk of, hence do develop, serious complications of the brain, eyes, kidneys and blood vessels.
Treatment
What’s more, not dissimilar to diabetes, this is known, a marriage to Blood Pressure literally means till death do us part. As a result, once the dotted lines are signed, controlling Blood Pressure deadly instinct is paramount;
1. Education: Understanding it’s impact on the body etc.
2. Lifestyle modifications: Weight loss, reduce alcohol, excercise, reduce salt etc, aiming to be butcher’s dog fit, in surviving this black widow.
3. Medications: Necessary to keep the Blood Pressure in a Jagdeo’s Vice, where prescription should be guided by evidence, as shown below in the British Hypertension
Society recommendations.
For this reason, The British Hypertension Society recommendations, underpinned by research, could inform our guidelines, in the management of Blood Pressure. Where the flowchart, easy to follow, utilises the acronym ABCD to represent the Blood Pressure medications. Thus, the medication prescription follows an alphabetical ABCD order, where notably ACE inhibitors and the related ARBs {A} are ineffective against Blacks, thus shouldn’t be prescribed for hypertension in this group.
However, this is the reality, chronic diseases like Diabetes and Blood Pressure, should be managed in Primary Care. But with PPP having mismanaged the Health Sector for over 25yrs, there are only Health Centres rather than Primary Care Centres. As a result, chronic diseases like Blood Pressure, aren’t being adequately managed, leading to thousands of avoidable complications and deaths.
Conclusion
Thus, the message- Blood Pressure is a silent killer, that maybe causing you harm, even as you read this column. As a result, if you’re hypertensive, take it seriously, however with status unknown, get checked with the painless blood pressure apparatus. For this is the counsel, risking your life with a misplaced invincibility conviction,
