You could feel perfectly healthy and still have high blood pressure upping your stroke or heart disease risk.

When a Vitality Health Check done in early 2021 showed blood pressure readings that were higher than they should have been, 38-year-old Nikash Bagirathi got proactive and went to see his GP.

After more investigation, Nikash was shocked to be diagnosed with hypertension (persistent, elevated blood pressure). "I took comfort in knowing I was with the right doctor and on the right medicine. Many people have chronic conditions that are well-managed, and they are fine. I realised that checking blood pressure often is so important, as most people who have hypertension have no symptoms.”

“I hope people will make time on World Hypertension Day – 17 May – to book a simple blood pressure check with a nurse or GP. The test is cheap, simple, non-invasive, takes less than a minute and can literally save your life.”

Billions of people have hypertension

World Health Organization data show that around 1.28 billion adults aged 30-79 years have hypertension, most (two-thirds) living in low- and middle-income countries. Yet 46% of these individuals are unaware that they have the condition. And, The Heart and Stroke Foundation of South Africa shares that more than a third of adults in South Africa live with high blood pressure - responsible for half of all strokes and 40% of heart attacks.

Regular screening is lifesaving!

"If hypertension is picked up early enough, it is relatively easy to manage," says Dr Noluthando Nematswerani, Head of the Centre for Clinical Excellence at Discovery Health. "This is why we encourage everyone to go for general health screenings - like a Vitality Health Check - at least once a year, where blood pressure measurements and other important, simple, and quick tests will be done. Also check your blood pressure anytime you see a doctor or nurse for any other reason. Don’t miss those opportunities for a quick check too as you can then pick up any trends towards persistent, elevated blood pressure."

“Most people who have hypertension don't have any symptoms”

Dr Nematswerani adds, "Hypertension, is a major risk factor for heart diseases, strokes, kidney disease and even eye diseases. As Nikash has rightly pointed out, most people who have hypertension don't have any symptoms. For most people hypertension is therefore called a ‘silent killer’.”

• Those who do have symptoms may experience headaches, shortness of breath, dizziness, chest pain, heart palpitations and nose bleeds.

“Regular health checks are the only way to know if we are really healthy. High blood pressure develops over years with constant damage to the blood vessels which eventually results in a stroke or heart attack or being diagnosed with a serious illness like kidney disease.”

• Every year, the number of Discovery Health Medical Scheme members diagnosed with hypertension increases. In 2019, when 377 784 members were registered for this condition. By 2021 there were 405,000 registered members, an increase of 27 216 people over two years. And, last year, Discovery Health Medical Scheme claims related to cardiovascular (heart disease) and circulatory condition treatment amounted to R6.1 billion, a 7% increase on claims paid out in 2020.

Understand your blood pressure numbers

“Blood pressure can be checked quickly and easily by a nurse at a pharmacy or clinic, or by your GP. A device called a sphygmomanometer, a cuff that is placed around the upper arm. The cuff gets tighter as it is inflated to give the blood pressure reading,” says Dr Nematswerani.

Blood pressure is measured in millimetres of mercury (mm Hg). The measurement is recorded as two numbers, one "over" another - for example 120/80 mm Hg or ‘120 over 80’. The top number refers to systolic pressure, which is the pressure in your arteries when your heart contracts. The bottom number refers to diastolic pressure, which is the pressure when your heart is resting between beats (this is when pressure is at its lowest).

"A normal blood pressure reading is 120/80 mm Hg and below," explains Dr Nematswerani. "Hypertension is usually defined as when either number (or both numbers) are equal to or above 140/90 mm Hg, when measured on two different days. You will need emergency medical care if your blood pressure measurement is 180/120 mm Hg or higher."

The lifestyle habits putting you at risk of high blood pressure

• Age: The risk of high blood pressure increases as you age.
• Race: High blood pressure is particularly common among people of African heritage, often developing at an earlier age than it does in Caucasian people.
• Being overweight or obese: The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues and as blood volume goes up so too does pressure on your artery walls.
• Physical inactivity: People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction and the stronger the force on your arteries.
• High stress levels: High levels of stress can lead to a temporary increase in blood pressure.
• Smoking: Not only does smoking or chewing tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls.
• Excessive alcohol intake: Having more than one drink a day for women and more than two drinks a day for men.
• Making unhealthy food choices: eating too much salt, too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.
• Certain chronic conditions. Certain chronic conditions also may increase your risk of high blood pressure, such as kidney disease, diabetes, and sleep apnoea.

It’s important to take your medicine as prescribed, and refilling your prescription as needed too.

For people who are diagnosed with hypertension, healthy lifestyle habits and the right medicine are key to getting the condition under control.

Dr Oliver received a Discovery Foundation Award in 2019 to conduct a study of 170 stable hypertensive patients at the Prince Mshiyeni Memorial Hospital hypertension clinic in Umlazi, one of the largest, most in-demand government hospitals in Durban. He looked at why patients take their blood pressure medicine incorrectly or stop taking it. His research found that among study participants (who come from low socio-economic settings), the cost and logistics of travel often got in the way of their filling prescriptions on time. Second, language barriers, patient education and counselling – all key components of the doctor-patient relationship that need to be in place to ensure compliance (patients taking their medicines on time and at the right dose).

Dr Oliver says the right lifestyle habits should be followed to manage hypertension effectively. This includes:

1. Staying at a healthy weight
2. Exercising regularly, aiming for a minimum average of 20 to 30 minutes a day
3. Eating plenty of low glycaemic index (GI) fruits and vegetables
4. Reducing the salt intake
5. Reducing fat and sugar intake
6. Stopping smoking
7. Reducing caffeine intake
8. Avoiding consuming excessive alcohol
9. Very importantly, finding ways to relax and consciously dealing with stress in healthy ways.

Supporting medical scheme members who live with heart disease

“Research shows that when people living with the same chronic illness connect with and learn from each other, health outcomes improve,” says Dr Nematswerani. “That’s why Discovery Health has partnered with myHealthTeam, to give Discovery Health Medical Scheme members access to the myHeartDiseaseTeam online patient community. Here patients, caregivers, and others can share real-world health experiences and stories; offer support, access medically approved resources, news, and live Q&A sessions with experts; and more.”

“Secondly, members also have access to Discovery Health’s Cardio Care programme designed to offer those living with cardiovascular disease cover for and access to the best quality care, for better outcomes.”

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