Hypertension is a major public health issue. It contributes to the burden of heart disease, stroke and kidney failure and premature mortality and disability. VICTOR OKEKE examines an expert’s view

According to the World Health Organisation, globally, cardiovascular disease accounts for approximately 17 million deaths a year. Of these, complications of hypertension account for 9.4 million deaths worldwide every year.

Hypertension which is also known as high blood pressure is a condition in which the arteries have persistently elevated blood pressure. Every time the human heart beats, it pumps blood to the whole body the arteries. Blood pressure is the force of blood pushing up against the blood vessel walls. The higher the pressure, the harder the heart has to pump.

Eneregbu Akunna Isobel, a practicing dietician at the Federal Capital Territory says most cases of hypertension have no known cause. According to Eneregbu, ‘such type of hypertension is called primary or essential hypertension. However, hypertension can also be caused by other disease condition such as kidney disease, sleep apnoea, endocrine disease, and malformations of blood vessel, also the use of oral contraceptive can lead to hypertension which is known as secondary hypertension.’

She said that the prevalence of hypertension increases with age so that the majorities of people over the age of 50 are at risk or are already hypertensive. The older the man or woman, the greater is the chance of having hypertension (essential hypertension) especially in Africans.

‘Men are more prone to hypertension than women, obesity, smoking, alcohol, unhealthy diets, physical inactivity, stress and family history could also predispose one to this disease,’ she added.

Dietician Eneregbu believes that hypertension if detected early can be treated using non drug therapy. ‘The dietary approach to the prevention and treatment of hypertension is an integral part of the lifestyle changes that are required to control BP.’

The lifestyle measures that are widely agreed to lower BP or cardiovascular risk, and that should be considered in all patients are smoking cessation, weight reduction in the overweight and obese/weight maintenance, alcohol severance, exercise/physical activity.

Healthy dietary choices include reduction of salt intake, increase in potassium intake through increase in fruit and vegetable consumption, decrease in saturated and total fat intake.

‘There is also evidence that increased salt intake during childhood may result in an increased probability of hypertension during adult life. The above together with the DASH diet is the best way to treat hypertension.

DASH means Dietary Approach to Stop Hypertension, it a healthy way of eating, designed to be flexible enough to meet the lifestyle and food preferences of most people. It lowers cholesterol and makes it easy to lose weight. Generally, DASH diet works within 14 days of initiation. It exerts a protective effect against blood pressure (BP) and can reduce systolic BP by 8–14 mmHg. DASH diet is rich in fruits and vegetable, grains and low dairy foods.’

Sample menu for hypertensive (uncomplicated) patient based 2000 calorie diet. Breakfast: 3 slices of bread sandwiched with 1 cup cut up raw vegetables, 3 tablespoons skimmed milk in tea or coffee (decaffeinated) and half a cup of orange juice.

Midmorning snack: 1 medium size apple and 3 salt less crackers or plain biscuits while lunch should be 1½ oz. meat (lean) 1 cup of prepared garri or 1 ½ cup jollof rice vegetable soup (okra) with 1teaspoon of oil Vegetable salad without salad dressing 2 small fingers of banana 1 medium size (50) pawpaw

Mid afternoon Snack is 1/3 cup groundnuts, 3-4 garden eggs. Supper is 1½ oz. fish, 1½ cups cooked pasta with 1teaspoon of vegetable Oil, 1 cup cooked vegetables and ½ cup of pineapple juice. Bedtime is 1 cup low fat yoghurt.

No salt should be used at the table. Avoid processed meat, cheese, tinned or canned foods. They contain high amount of salt. Also avoid fried food. Use only one teaspoon in cooking per day i.e. 1/3 teaspoon per meal. Chicken should be skinned before consumption. Use boiling, steaming, or baking method of cooking.

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