Health Essentials
Measure your blood pressure accurately, control it, live longer
May 17 is World Hypertension Day and please do not panic. This is not a stress-filled day that aims at increasing your blood pressure but rather it’s a day set aside to increase awareness of a serial yet silent killer. That is exactly what Hypertension it; its killing the young and old at an alarming rate yet in most instances people with high blood pressure may feel absolutely well.
The theme for this year is “Measure your blood pressure accurately, control it, live longer”
Do these when you take your blood pressure since the accuracy of the reading matters:
• If you have been walking or running rest for at least 5 to 10 minutes
• No caffeinated drinks or alcohol two or three hours before checking blood pressure
• Sit (sometime you may need to stand or lay in bed) comfortably with your back rested/supported and your arm for the cuff resting on a table of firm surface
• Have your feet flat on the floor and not legs crossed
• Ensure the cuff is the right size for your arm
• If using an electronic monitor ensure battery is working well
• If clothing covering arm is thick remove
• Loosen your neck-tie or belt if uncomfortable
• If you are not conversant with checking blood pressure, get the appropriate training
Global statistics show that only 50 per cent of those with hypertension are actually aware and that awareness in some areas may be as low as 10 per cent while awareness may exceed 75 per cent in a few areas.
The bitter truth is some people do not have enough information about the condition, a significant number do not have easy access to measuring their blood pressure and a few stubborn ones think it is better not to know if something is going wrong.
What do we need to understand about our blood pressure numbers? There are ALWAYS two numbers in a blood pressure reading such as 120/80mmHg. The top figure represents the force of the blood against the artery (blood vessel) walls as your heart beats and the lower value represents the force on the walls in between beats or while the heart rests. Both numbers are important.
Essentially when your blood pressure is higher than it should normally be all organs in the body are exposed to elevated pressures since arteries supply blood to every part of the body. These sustained high pressures will be causing harm gradually every minute of the day.
Prevention of high blood pressure is based mainly on adopting the appropriate lifestyle, while having regular medical check-ups to pick up conditions that can may lead to hypertension if not tackled early. Management of hypertension on the other hand requires a three-pronged attack in most situations;
• Lifestyle modifications
• Regular medical checks to pick up other conditions that be worsen our hypertension or general wellbeing
• Use of appropriate physician prescribed medication
Age and our genes may have a way of increasing our blood pressure or predisposing us to hypertension, but since we have no control over the choice of our family and years rolling by, it may be worth focusing on the above three that we can control to a large extent.
Lifestyle Modification
• Exercise adequately
• Do not smoke
• Limit or avoid alcohol
• Aim at fat (weight) loss
• Manage stress appropriately
• If you have sleep apnoea (intermittent snoring during sleep and feeling tired and sleepy on waking up) seek medical intervention
• Adopt the DASH (dietary approaches to stop hypertension) diet; low sodium (salt), increased potassium from fruits and vegetables, low or no saturated fats and increased fibre.
• Control conditions such as diabetes, cholesterol challenges and kidney disease.
Exercise need not be rushing to the gym to sweat out only, but taking walks, gardening, cleaning your home, using the stairs and many others. Exercise increases heart function and lowers blood pressure but there is a little hitch: the benefits of exercise on blood pressure do not last beyond 72 hours.
In short frequency is the watch word. Do not be a once a week or once a month exercise fan. The effect of exercise on the heart does not rely on past glory so if you were an athlete years ago but you have now become one with your sofa, I am sorry to disappoint you but you need to get moving NOW!
All types of exercises will benefit you and lower your blood pressure but a word of caution here;
• When your blood pressure is not controlled DO NOT lift weights above your head
• Do not overdo exercises of the upper body but lower body exercises such s squatting will enhance lowering of your blood pressure.
• Breathe properly especially while you train with weights; breathe out during the exertion phase as you lift a weight and breathe in while you relax.
• Of course brisk walking, swimming, use of the treadmill and other exercises that target heart function are also a must
When all is said and done, you can never know our blood pressure without measuring or checking it. Take a few minutes to check your blood pressure and ensure at least one other person checks their blood pressure before the end of the month.
Associations, companies and all identifiable groups should ensure they check their blood pressure and go an extra mile and as a corporate social responsibility help to check the blood pressure of hundreds or even thousands of people. You will be saving lives.
AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)
Dr. Kojo Cobba Essel
Health Essentials Ltd/ Mobissel
(dressel@healthessentialsgh.com)
This week I bumped into Deborah, one of my avid readers and I promised her I will be writing this weekend. So Deborah, this is for your reading pleasure and to pick some golden nuggets for the future.
The quest to find the best way to make one’s golden years, happy, exciting, healthy and a time most people look forward to continues unabated. One factor that keeps popping up is the need to grow friendships with people more than 20 years younger than yourself.
Do not take this for granted. It is a form of “social security” since these close friends who are much younger than you will step in to support you in more ways than you can ever imagine.
Some conditions may make life challenging for older adults but knowing these Geriatric Giants helps us to take the necessary steps to reduce our risk.
“Geriatric Giants” refers to a group of chronic health conditions that are common in the elderly, typically 65-year-olds and older.
These conditions quite often co-occur and can impact on the independence, dignity and overall wellbeing and quality of life of an elderly person.
These Geriatric Giants include:
- Impaired Intellect/ Memory (e.g. Dementia)
- one of the major battles we need to deal with is challenges with memory
- Exercise, adopt the Mind Diet, build a great social network and enjoy time outdoors
- Keep reading and solving puzzles for as long as possible
- Instability – leading to much feared falls
- A good reason to indulge in Balance Training and Core Strengthening exercises from today
- Ensure your home is safe; avoid clutter such as cables crisscrossing floors, toys etc. These are all trip hazards and should be avoided
- Many healthy, happy and fun-loving older adults have died soon after a fall with its attendant complications.
- Do whatever it takes to avoid falling
- Immobility (opening the doors to pressure sores, joint stiffness)
- Even when you are unable to move about on your own it is important to get support to change positions as often as possible or get an appropriate mattress or bed that prevents prolonged pressure over any single point.
- Make sure you passively or actively move joints daily.
- Incontinence (urine, faeces or both)
- This is one of the reasons older adults prefer to stay at home and avoid going out to meet friends etc.
- Iatrogenic Disorders – adverse effect of medication
- Quite often most older adults are on several medications and some side effects such as drowsiness may seem to cause more unhappiness and may even lead to falls.
- Inappetite – this may result in poor nutrition
- This may also be linked to loss of teeth thus making chewing very difficult or limited.
- The loss of smell and taste may also reduce the amount of food one may willingly eat.
The power to reduce the impact of the Geriatric Giants starts now and should be a lifetime commitment. It is never too early to start making the appropriate lifestyle modifications, nor is it too late to reduce the impact of the giants on one’s life.
Other conditions that significantly impact on the lives especially of the elderly are:
- Sleep Disorders
- Good sleep has the power to give us energy, improve our thought pattern and even helps us to make good choices.
- Good sleep sets the tone for a healthy life
- Constipation
- This is a challenge that confronts quite a number of older adults.
- Movement, fibre and lots of water go a long way to reduce the stress that frequent constipation generates.
- Fraility
- Muscle loss is real and as we age, we lose a significant percentage of our muscle plus our bones also become brittle.
- Make sure strength training is part of your exercise schedule
- Polypharmacy
- Another headache that needs to be confronted head-on
- Everyone especially older adults need a good primary care physician or a general practitioner who can coordinate all medicines from the different Specialists who may be attending to an elderly person. This ensures that unnecessary medicines are dropped
The goal of care at all times is to optimise the quality of life. As family, professional caregivers and friends we should always show respect so that the dignity of the elderly is preserved at all times. For those of us who are not yet in the age group with such challenges, we need to start the conversation about the type of care we will prefer and take steps to stay healthy and independent for as long as possible. The goal should be a long Healthspan and not just a long Lifespan.
AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)
Dr. Kojo Cobba Essel
Health Essentials Ltd (HE&W Group)
(dressel@healthessentialsgh.com)
*Dr. Essel is a Medical Doctor with a keen interest in Lifestyle Medicine, He holds an MBA and is an ISSA Specialist in Exercise Therapy, Fitness Nutrition and Corrective Exercise. He is the author of the award-winning book, ‘Unravelling The Essentials of Health & Wealth.’
Thought for the week – “There is no magic formula to being happy but making a conscious effort to be happy goes a long way.” – Dr. Kojo Cobba Essel
By Dr. Kojo Cobba Esse
The call to action
We must move beyond the cycle of temporary outrage. I propose a four-point blueprint for the Ministry of Health and the government:
1. A Digital Bed-Tracking Command Centre: Legally mandate all public and major private hospitals to update a live, digital bed-registry every hour. The NAS must be able to see a vacancy before they move. This must be matched with the available resources and services so that the right patient will be sent to the right facility.
2. Strategic Capacity Expansion: We must stop building “prestige projects” and start building high-volume stabilisation centres. We need a targeted investment to triple the ER bed count in Accra and Kumasi within 24 months. This should then be extended to other regional capitals.
3. Specialised Emergency Hubs: Designate specific hospitals as “Centres of Excellence” for Cardiac and Stroke care (and for other health emergencies), ensuring they have 24/7 imaging and intervention capabilities as well as the requisite expertise to manage these conditions. Policy makers must incentivise public-private partnerships to ensure that a heart attack in Accra or Kumasi can be treated with the same urgency as one in New York.
4. Develop a nationwide trauma system: This is extremely important because trauma is a major cause of deaths in Ghana. In the US, each state has a statewide trauma system with three levels. Level 1 trauma centres are usually University Teaching hospitals that provide comprehensive trauma care and also play an important role in local trauma system development, regional disaster planning, increasing capacity and advancing trauma care through research. Level II trauma centres are expected to provide initial definitive trauma care for a wide range of injuries and injury severity.
Level III centres provide definitive care to patients with mild trauma. Having such systems is imperative to ensure proper treatment of trauma patients.
Even for those who survive trauma, disability is a major assault on economic potential and viability. Importantly all this cannot happen with a cash and carry system. Emergencies should be managed under a different model to save life and limb first. Obviously, there is a need to ensure that healthcare facilities will be able to recover their investments in emergency care, and that balancing act needs careful consideration.
Frontline clinicians are often forced to bear the public’s anger for infrastructure deficits they did not create and cannot fix. This is a failure of governance, not a lack of clinical care. Responsibility lies with the policy makers who manage the nation’s resources.
The “No Bed Syndrome” is a systemic disease. It cannot be cured with a directive from the Ministry of Health, parliament or a lecture on ethics. It requires a blueprint, a budget, and the political will to treat this like the menacing threat it is.
It is safe to say that non-emergent healthcare is excellent in Ghana for the most part if you can afford it. However, emergency care is suboptimal. We had a sitting president die from an emergency health issue and a former vice president also die from an emergency. If that is not enough warning, it is clear that anyone can be a victim of an emergency.
If we do not act, the next ambulance driving aimlessly through the streets of Accra could be carrying anyone, including the very people who have the power to fix this issue.
Prof. Jonathan Laryea is a Professor of Surgery at the University of Arkansas for Medical Sciences in Little Rock. Arkansas. He is board certified in General Surgery, Colorectal Surgery and Clinic Informatics.
He is a graduate of the University of Ghana Medical School (Class of 1997)
