Locals not taking ailment seriously
BASSETERRE, St. Kitts – THE recent announcement by the American Heart Association (AHA) of new guidelines for diagnosing patients with Hypertension (high blood pressure) from 140/90 to 130/80 have found favour with popular medical practitioner Dr. Terrance Drew.
The new guidelines were recently outlined and are now expected to be fully implemented globally.
Dr. Drew believes that the changes would have been made based on research done a few years prior in the medical community, and the information is now reaching the masses.
The information has highlighted that by lowering the blood pressure to numbers below 130 and below 80 is beneficial to morbidity and mortality, Dr. Drew said.
“That means that you would have fewer complications from blood pressure, such as strokes and heart attacks and so forth, and also you can live longer,” he said.
The MD disclosed that the changes do not only apply to younger people but also to the elderly who could benefit significantly.
According to the AHA, this is the first comprehensive set since 2003, and they believe that by lowering the definition of HBP, it would allow for earlier interventions to mitigate or deal with complications at a lower level.
The new guidelines are:
• Normal: Less than 120/80 mm Hg;
• Elevated: Systolic between 120-129 and diastolic less than 80;
• Stage 1: Systolic between 130-139 or diastolic between 80-89;
• Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;and
• Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.
Dr. Drew stated that it was lowered because research evidence showed that people live longer and suffer less consequences or complications as a result of its lowering.
With the incidents of Non-Communicable Diseases being high in the Federation - of which Hypertension is one of the leading factors - the Medical Doctor explained that it was difficult getting people to be compliant with their treatment to lower the blood pressure to 140/90 before the announcement.
He also said that the changes would make it much tougher to get it below 130 and below 80 if those persons are not adherent.
“What I believe is that we have to keep insisting,” he said. “But it shows that Hypertension is a serious disease with serious life consequences, but it can be properly managed and controlled and allow people to live healthy and better lives.
“But here in St. Kitts and Nevis we have been having a lot of trouble controlling people’s blood pressure because they are noncompliant to treatment.”
As a result, he is calling on people to take the ailment seriously, as this new measure means that persons would have to make more lifestyle changes and might be placed on medications.
American Heart Association: “The guidelines eliminate the category of prehypertension, categorizing patients as having either Elevated (120-129 and less than 80) or Stage I hypertension (130-139 or 80-89). While previous guidelines classified 140/90 mm Hg as Stage 1 hypertension, this level is classified as Stage 2 hypertension under the new guidelines. In addition, the guidelines stress the importance of using proper technique to measure blood pressure; recommend use of home blood pressure monitoring using validated devices; and highlight the value of appropriate training of health care providers to reveal "white-coat hypertension." Other changes include:
“Only prescribing medication for Stage I hypertension if a patient has already had a cardiovascular event such as a heart attack or stroke, or is at high risk of heart attack or stroke based on age, the presence of diabetes mellitus, chronic kidney disease or calculation of atherosclerotic risk (using the same risk calculator used in evaluating high cholesterol).
“Recognizing that many people will need two or more types of medications to control their blood pressure, and that people may take their pills more consistently if multiple medications are combined into a single pill.
Identifying socioeconomic status and psychosocial stress as risk factors for high blood pressure that should be considered in a patient's plan of care.”
