Case

Jamal is a 53 year old father of three children. He has been diagnosed over 15 years ago with high blood pressure and takes his medication whenever he eats too much salt or feels his blood pressure is high. In addition, he drinks garlic boiled water to help lower his blood pressure. He feels otherwise well.

Learning points

• High blood pressure is very common in the Caribbean and there are many barriers to effective control.
• There are often no symptoms of high blood pressure so patients should visit their doctor whenever possible to get it measured.
• It is associated with many complications later on in life and therefore persons must take their medication as prescribed to prevent these problems.
• It is an illness which is well managed well through lifestyle changes.
• There are many ways to control high blood pressure and whilst there is evidence that suggest that certain garlic preparations (not boiled garlic water) may reduce your blood pressure, there is not enough evidence to use instead of prescribed medications.”

Definition

Hypertension, or high blood pressure or pressure is a common medical condition which increases a person’s risk for heart and kidney diseases as well as strokes. (1) High blood pressure is abnormally high blood pressure with no known cause.  

Systolic pressure is the higher number when blood pressure is measured and a normal reading is in the region of 120 millimeters of mercury (mmHg). Diastolic pressure is the lower number and a normal reading is in the region of 80 mmHg. High blood pressure is defined as systolic pressure greater than 140 mmHg and/or diastolic pressure greater than 90 mmHg.

High blood pressure increases the work required by the many organs in the body and over time, damage them.

Causes

As many are aware, for most persons with hypertension, no cause would be found if further investigations were done. (2)

Modifiable Risk factors:

• Being Overweight
• Drinking large amounts of alcohol.
• Smoking
• Non-active lifestyle
• High-salt diet
• Stress

Symptoms

High blood pressure usually does not cause symptoms. But, the condition can still damage your organs and tissues. Only if blood pressure is extremely high (> 200/120) are persons likely to get symptoms.

Further information on “feeling high blood pressure” can be found at Link 1

Management

Garlic and high blood pressure

Whilst there is evidence that suggest that certain garlic preparations (not boiled garlic water) may reduce your blood pressure, there is not enough evidence to use instead of prescribed medications.” There have been several research studies which have found that garlic-only preparations can reduce your blood pressure better than a placebo. However, there is not adequate research to recommend that garlic preparations are more effective than current medications.

Further information could be found at Link

Non-Pharmacological treatment

Here are some tips:

• Maintain a healthy weight.
• Begin a safe exercise program with the advice of your doctor.
• If you smoke, make plans to stop or cut down.
• Eat a healthful diet, one that is low fat, low salt, and rich in fiber, fruits, and vegetables. Your doctor may recommend the DASH diet, which is designed to reduce blood pressure.
• Drink alcohol in moderation. Moderate is two or fewer drinks per day for men and one or fewer drinks per day for women and older adults.
• Manage stress and cutting down on caffine

Further tools to help curb high blood pressure risk factors: Link

Pharmacological treatment

There is a lot of different medications which can help manage high blood pressure. (3) Your doctor would recommend medications which he believes is best for you. If you believe the medication you are taking is too expensive, or you are unsure why you need to take it, are having side effects, or simply would not like to take the medication, please discuss this with your health practitioner. You have the right to refuse treatment and doctors must respect this. By being open with your doctor, you help them effectively manage your health.

More information can be found at Link, Link_2 or Link_3

References

1. Chadee, Derek, et al. “Prevalence of self-reported diabetes, hypertension and heart disease in individuals seeking State funding in Trinidad and Tobago, West Indies.” Journal of epidemiology and global health 3.2 (2013): 95-103.
2. Alexander, Miranda. “Awareness, knowledge and life style modification practices of hypertension among women.” (2012).

3. Clement, Y. N., et al. “Drug prescribing for hypertension at primary healthcare facilities in Trinidad.” The West Indian medical journal 61.1 (2012): 43-48.