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Iqra Mazhar

Understand the nuances of hypertension in women with Meri Sehat. Gain insights and support for proactive cardiovascular health.

Hypertension In Women

Madeeha Syed

This article or video has been vetted and verified by Meri Sehat’s specialists. It contains citations and research from validated sources.

Beat The Heat: What Happens When Heat, Sweat And Skin Collide

Overview

The summer months can be a fun time for outdoor activities and spending time with friends. But if you&rsquo;re prone to chafing or rashes, they may not be so enjoyable.&nbsp; 
&nbsp;

effect of heat on skin

Chafing and rashes are a common problem, especially during the summer months. The main cause of these annoying conditions is sweat. When your skin gets wet and rubs against itself or another surface, it can become inflamed and tender to the touch.

When you put on clothes that are too tight or made with synthetic materials like lycra, they can act like a glue trap for sweat, which contributes to chafing and rashes by trapping moisture between your skin and clothing. Sweat can also irritate sensitive skin as it evaporates off of your body &mdash; this is why you should always wear breathable fabrics such as cotton when exercising outdoors or in an air-conditioned room on hot days. 
&nbsp;

Sweat is the main cause of chafing, but it&rsquo;s not the only one. Friction is also a major factor in causing irritation and soreness that can make you unable to enjoy your day-to-day activities. 
&nbsp;

There&rsquo;s a rash for every occasion:

<ul>
	<li>Boob Rash: It&rsquo;s the bane of many a lady&rsquo;s existence, especially during sweaty summers and strenuous workouts. The friction of your bra rubbing against your skin causes irritation, which leads to red bumps and rashes.</li>
	<li>Thigh Chafing: Similar to boob rash but on your legs instead of chest, thigh chafing is caused by the constant rubbing of clothing against bare skin as you walk or run around all day long &mdash; especially if you&rsquo;re wearing shorts or skirts!</li>
	<li>Nipple Chafing: This is one particular type of nipple rash that can happen during pregnancy or breastfeeding when there&rsquo;s excess fluid flowing through those delicate glands in addition to sweat from exercise! 
	&nbsp;</li>
</ul>

Sweat itself doesn&rsquo;t cause chafing, but it can make things worse. If your skin is already sensitive to friction or susceptible to rashes and blisters, then sweat will make it even more sensitive.

&nbsp;

When you&rsquo;re trying to keep cool in the summer heat, it&rsquo;s easy to over-hydrate and end up with a gush of liquid dripping down your back as you walk around. When that happens, you might start thinking that all this sweat must be causing me some discomfort &mdash; but in reality, we just need a little bit more salt!

&nbsp;

These rashes could cause serious health problems if left untreated

Cuts and scrapes can lead to infections. Chafing can lead to blisters, and, in turn, those blisters can become infected.

Infections in the skin can cause damage that leaves you vulnerable to infection by other germs and even viruses like <a href="https://merisehat.pk/disease/hepatitis-b-113">Hepatitis B</a> and C or <a href="https://merisehat.pk/disease/hiv-61">HIV</a>, which can be fatal if left untreated.

To avoid these rashes in the first place, you need to keep the skin dry, reduce friction and stop rubbing your skin raw.

A rash is an uncomfortable, and sometimes painful, skin condition that can occur due to a variety of reasons. The most common cause of rashes is sweat and friction. To avoid these rashes in the first place, you need to keep the skin dry, reduce friction and stop rubbing your skin raw. 
&nbsp;

Avoiding Sweat And Friction: Using a lubricant between two surfaces that rub together without causing much wear (skin against fabric) will help prevent chafing and blisters caused by sweating under heavy loads or tight-fitting clothing like cycling jerseys or hiking shorts. Silicone-based lubricants work well because they stay slick longer than water-based lubricants; however, they&rsquo;re not as safe for use around water because silicone doesn&rsquo;t absorb into fabrics so it can be slippery when wet!

Keeping Skin Dry: You should apply sunscreen before you go outside since sun exposure makes you more susceptible to getting burned &mdash; especially if there isn&rsquo;t any breeze to cool down your body temperature during long runs outdoors (or even short ones). 
A good rule of thumb is that if it&rsquo;s hot outside but feels less humid than usual then put on sunscreen anyway just in case because humid conditions make it harder for sweat from evaporating off our bodies which means we need more frequent hydration breaks during long workouts outside in summer heat waves! 
Don&rsquo;t forget about protecting yourself against UV rays too because even though clouds may block direct sunlight from reaching us directly down here on earth&rsquo;s surface &mdash; they don&rsquo;t block UV rays which come through holes in them called &ldquo;glare points.&rdquo; These glares points are responsible for generating many different kinds of reflections including glare reflection off surfaces such as pavements when walking along city streets. 
&nbsp;

The first rule of treating any skin condition is not to try to rub it off. The rubbing can make it worse, and you may introduce bacteria into the area, which could cause inflammation and infection. The best thing to do is keep the area dry by using talcum powder or a non-oily moisturizer with a high water-content like Vaseline or Petroleum Jelly. 
&nbsp;

<h4>&quot;Most rashes will clear up within a few days after you adopt prevention techniques that keep your skin dry and limit friction&quot; 
&nbsp;</h4>

If you&rsquo;re at risk of developing a rash, it&rsquo;s best to take the following precautions:

<ul>
	<li>Use a towel to dry off immediately after swimming or sweating.</li>
	<li>Apply a moisturizer with an SPF of at least 30 every morning and reapply in the afternoon if you plan on being outside for longer than an hour.</li>
	<li>If you are wearing clothes that rub against your skin, use an anti-chafing product such as zinc oxide paste until your rash clears up and then switch to a heavier formula like dimethicone which will protect against future rashes. You may also want to try tea tree oil or aloe vera gel if those options appeal more strongly than using medication prescribed by a healthcare professional. 
	&nbsp;</li>
</ul>

The best way to prevent chafing while running is to take steps before your run. You can start with a good exfoliating shower and apply some body lotion or cream to dry areas. Then, wear the right clothes. Make sure they fit you well and aren&rsquo;t too tight or too loose where it counts &mdash; the thighs and crotch area are particularly susceptible to chafing.

Lastly, you should use products like Vaseline on dry spots before you hit the road. These products will help protect against rubbing and chafing during exercise so that when it&rsquo;s time for your next long run, all of those miles won&#39;t be spent dealing with embarrassing rashes instead of crossing finish lines! However, this is not just limited to the girlies who are active. Even when you are going on with your daily life, you can always incorporate these hacks to make summers more comfortable for you. 
&nbsp;

Bottom Line

We know that dealing with these rashes can be frustrating. We want you to know that there is hope, though! They are all preventable, and it&rsquo;s not just about following the rules of hygiene either. You need to keep your skin dry and limit friction by wearing loose clothing and changing out of sweaty clothes as soon as possible after an activity ends. If you find yourself with a rash or chafing, don&rsquo;t try rubbing it off&mdash;that will only make things worse! Instead let your body heal naturally by keeping the affected area clean and dry until the symptoms subside on their own.

Umna Salah

Getting Back To Working Out After Giving Birth

The weeks after one&rsquo;s delivery can be as stressful as they are joyous. Newborn babies need constant attention and it&rsquo;s difficult to take out time to care for oneself. When the baby is down for a nap, it&rsquo;s our chance to get some sleep too or catch up on chores. Naturally, there&rsquo;s very little time or mental space for fitness and physical activity. Plus, there&rsquo;s the physical exhaustion that comes with long nights and breastfeeding. 
However, taking care of our bodies is essential to recovering quickly from pregnancy and childbirth. Taking time out for fitness enables us to better manage the stressors that come with a newborn baby, both physically and emotionally. This, in turn, ensures that we are able to enjoy the joys of new motherhood as well.

<div>&nbsp;</div>

time to recover body

As a new mother, it&rsquo;s important to ensure that you are consuming all of the nutrients that are essential to your health and recovery. If you are breastfeeding, it is even more important that you consume a nutritious diet.&nbsp;

Try to include a good amount of protein in your diet, as well as good fats and essential fatty acids. Eating a sufficient amount of carbs will give you the energy you need to keep up with your baby. Make sure to include fruits and nutrients in your diet as they are an important source of <a href="https://merisehat.pk/article/a-guide-to-essential-vitamins-and-micronutrients-and-should-you-be-taking-them">micronutrients and fibre</a>.&nbsp;

If you have a straightforward vaginal delivery, you can start with gentle movement in the form of short walks as soon as the day you deliver; however, you will have to wait till your epidural has been taken out. If you delivered via a caesarean or faced postpartum complications, you may have to wait a few extra days to give your body time to recover.&nbsp; 
&nbsp;

<h5>Moderate Walking</h5>

Easy to moderate walking is the best way to start moving after childbirth. You can start with just 20 minutes a day and gently build up to half an hour over the course of four to six weeks. Consider breaking up your walks into several walks a day to avoid tiring yourself out and being able to fit them in more easily into your newborn&rsquo;s routine. You could start with two 10-minute walks a day, build that up to two 12-minute walks after a few days and so on. Walking burns calories, while also strengthening muscles and joints, and improving blood circulation. 
&nbsp;

<h5>Postpartum Exercises</h5>

Incorporate gentle postpartum exercises and stretches into your routine in the first few weeks after a delivery. There is a lot of information online about safe postpartum exercises. You can look some up and aim to do them for five minutes a day. YouTube videos focused on postpartum exercises can also be easy to follow along, and if you&rsquo;d like the opportunity to get out of the house, a postpartum exercise or yoga class might just be the thing for you. As with walking, start with just a few minutes a day and slowly build up as your body adjusts.

Your pelvic floor and core tend to be particularly weak after childbirth. Before you move onto high-impact exercises, it is important to build some strength in these parts of the body. You can start doing gentle pelvic exercises, like kegels and pelvic tilts in the first week after your delivery. Aim to do them for about five minutes at a time, up to three times a day. Again, there&rsquo;s no need to do long sessions and tire yourself out. Fitting in smaller movement sessions throughout the day will ensure that you are able to be consistent and don&rsquo;t end up pushing yourself too much.

About a month after childbirth, you can start exercising core exercises into your routine. Again, this also depends on what kind of delivery you&rsquo;ve had and whether you faced any complications during or after. Once again, incorporate a few minutes of core work into your daily movement sessions and break it up into two to three sessions a day.&nbsp; 
&nbsp;

<h5>As A Rule Of Thumb</h5>

You should wait at least six weeks after childbirth to get into high-impact exercises. It&rsquo;s important to prepare your body in the preceding weeks and to also take it slow when you do start with higher impact movement. Make sure to consult your doctor and get their okay beforehand. Even at this stage, start slowly and listen to your body. There&rsquo;s no need to push forward from the get go. What&rsquo;s important is that you maintain consistency and build up in a manner that is doable for you. 
&nbsp;

It&rsquo;s easy to forget to take care of ourselves in the first few months after childbirth. But we need to remember that we need as much love and care as our newborn babies do. Being kind to yourself and patient with your body is especially important after a delivery. Remember, the healthier you feel, the better you&rsquo;ll be able to enjoy the time you get with your newborn!

Ayesha Binte Rashid

Humza Khizer

This article or video has been viewed by many visitors, and is popular.

How Can I Better Support A Breast Cancer Survivor?

Introduction

In 2020, <a href="https://merisehat.pk/disease/breast-cancer">breast cancer</a> accounted for 28.7% of new cancer cases in Pakistani women of all ages<a href="#accordion">[1]</a>. With the highest incidence in Asia, the country continues to struggle with increasing morbidity and mortality rates, especially among young females<a href="#accordion">[2]</a>.&nbsp;

As per a Pakistani study, 89% of breast cancer patients are diagnosed at a later stage while 59% present at an advanced stage<a href="#accordion">[3]</a>. This delay in diagnosis can reduce survival rates and cause an increased mortality rate among patients. Researchers believe that a lack of awareness and a combination of sociocultural and personal factors contribute to the delay. Furthermore, a delayed diagnosis also translates into a poor prognosis and the need for more aggressive treatments.&nbsp;

Treatments such as chemotherapy, radiation, and mastectomy can affect an individual&#39;s physical and mental health. The fear of side effects of chemotherapy such as loss of hair and eyebrows often causes women to delay seeking help. Moreover, mastectomy is often associated with body image issues that can be extremely challenging in a world where a woman&#39;s attractiveness is solely based on her physical appearance.&nbsp;

However, <a href="https://www.merisehat.pk/disease/breast-cancer">breast cancer</a> can have an implication on the lives of both survivors and their friends and family. Thus, it is important to identify the challenges they face and effectively address them to improve their overall quality of life.&nbsp;

&nbsp;

Understanding How To Support A Breast Cancer Survivor

A UK study looked at more than 50,000 breast cancer survivors and a control group consisting of over 200,000 women with no history of cancer. The results revealed a higher risk of anxiety, depression, fatigue, pain, and sexual dysfunction among the survivors<a href="#accordion">[4]</a>. This is similar to the results of a Pakistani study in which 74% of survivors reported feeling varying levels of anxiety. Moreover, 83% complained of fatigue, 75% of body pain or headache, 77% had reduced appetite, 63% had weight loss, and 77% reported sleep disturbances<a href="#accordion">[5]</a>. The fear of the recurrence of cancer is believed to further add to the anxiety. Thus, breast cancer can take a physical and psychological toll on the survivors.

In a society where physical beauty is often given preference over everything else, it is no surprise that breast surgery can elicit depression and anxiety in breast cancer patients. Across all cultures and countries, including Pakistan, a woman&#39;s breasts are considered a symbol of femininity, sexual beauty, and motherhood. Thus, the physical change associated with breast surgery or mastectomy can significantly lower a woman&#39;s self-esteem<a href="#accordion">[5]</a>. They may develop a negative image of their bodies, leading to lowered self-confidence and mental health problems. Furthermore, hairlessness, loss of eyelashes and eyebrows, and skin discoloration associated with cancer treatment also take a toll on the person&#39;s mental health.&nbsp;

The combination of all these factors may lead to the survivors feeling stigmatized. This can lead to many women never seeking help or talking about their concerns and self-isolation in some cases.&nbsp;

&nbsp;

The following are some of the ways one can help breast cancer survivors with their physical and mental health:

<ul>
	<li>
	<h5>Breast Reconstructive Surgery </h5>
	</li>
</ul>

Many women opt for reconstructive surgery following mastectomy or lumpectomy. A plastic surgeon may use an implant, a flap tissue from another part of the patient&#39;s body, or both to create a breast shape. However, if you don&#39;t want to go for reconstructive surgery, there are other options such as a breast form or prosthesis that one can wear under the bra.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Wigs And Accessories</h5>
	</li>
</ul>

​​​​​​​Women dealing with hair loss can wear a wig, hat, or scarves while they wait for the hair to grow back. Or you may feel comfortable flaunting the baldness which is just a reminder of the challenges you&#39;ve overcome as a survivor.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Cognitive Behavioral Therapy (CBT) </h5>
	</li>
</ul>

​​​​​​​CBT can prove beneficial in treating mental disorders among breast cancer survivors. It can also help them deal with the fear of recurrence.&nbsp;

&nbsp;

<ul>
	<li>
	<h5>Acceptance And Commitment Therapy (ACT)</h5>
	</li>
</ul>

​​​​​​​Unlike CBT which aims to change one&#39;s unhealthy thoughts and feelings, ACT teaches skills that help people accept their realities and live with them.

&nbsp;

<ul>
	<li>
	<h5>Mindfulness-Based Therapy</h5>
	</li>
</ul>

​​​​​​​Mindfulness meditation helps people become aware and accepting of their thoughts and feelings, without any judgment. In breast cancer survivors, it can help improve fatigue, stress, and symptoms of depression and anxiety.

&nbsp;

<ul>
	<li>
	<h5>Medication</h5>
	</li>
</ul>

​​​​​​​Some patients may also benefit from anti-anxiety pills and anti-depressants. However, professional help should be sought before starting any medication.

&nbsp;

<h4>"Supporting cancer survivors can lower their stress levels. Head on over to the <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan</a> to monitor your stress level today!" </h4>

While cancer is a challenging time for the patient, it also takes a toll on one&#39;s family and friends who are helping them through the disease. Moreover, it can often put a strain on people&#39;s relationships with their partners. According to research, anxiety, and depression more commonly affects long-term cancer survivors and their spouses compared to healthy controls<a href="#accordion">[6]</a>.&nbsp;

If a friend or family member is a breast cancer survivor, the following can help you deal with the emotional and psychological toll:

<ul>
	<li>Support Groups - Online or in-person support groups can help people realize that they are not alone. It allows you to talk about your feelings in a safe space and trade advice with others going through similar experiences. There are also many support groups for family members of survivors on social media.&nbsp;</li>
	<li>Couples Therapy - Cancer can often affect one&#39;s personal relationships. Many partners may benefit from couple&rsquo;s therapy to improve their family and marriage relationships.&nbsp;</li>
</ul>

&nbsp;

Conclusion

While a cancer diagnosis and going through treatment is emotionally and physically exhausting, the post-cancer period is often what really tests the person. Both cancer survivors and their family members go through a period of psychological distress. Therefore, there is a need for programs and interventions that target both patients and their caretakers and family. Moreover, early screening breast cancer patients for mental health disorders can also help provide timely intervention and reduce the disease burden.

Key Points

<ul>
	<li>A combination of physical, cultural, and social factors contributes to a delayed diagnosis of breast cancer among women. This leads to a poor prognosis and the use of aggressive treatments.</li>
	<li>Breast cancer survivors often report fatigue, pain, sleep disturbances, <a href="https://merisehat.pk/disease/depression">depression</a>, and <a href="https://merisehat.pk/disease/anxiety">anxiety</a>. Moreover, post-mastectomy or breast surgery, women report lower self-esteem and body image issues as breasts are considered a symbol of femininity, beauty, and womanhood.&nbsp;</li>
	<li>Breast reconstructive surgery, cognitive behavioral&nbsp;therapy, mindfulness meditation, acceptance and commitment therapy, and medications can help breast cancer survivors improve their overall quality of life.</li>
	<li>Partners of breast cancer survivors also report similar levels of anxiety and depression as them. Therefore, there is a need for effective programs that target both survivors and their families to help provide them timely support.&nbsp;</li>
</ul>

&nbsp;

[1] International Agency for Research on Cancer, 2021. Pakistan Globocan 2020. [Online]

[2] Sohail, S. & Alam, S. N., 2007. Breast cancer in pakistan - awareness and early detection. Journal of the College of Physicians and Surgeons Pakistan, 17(12), pp. 711-2.

[3] Gulzar, F. et al., 2019. Identifying the reasons for delayed presentation of Pakistani breast cancer patients at a tertiary care hospital. Cancer management and research, Volume 11, pp. 1087-1096.

[4] Carreira, H. et al., 2021. Associations between breast cancer survivorship and adverse mental health outcomes: A matched population-based cohort study in the United Kingdom. PLOS Medicine, 18(1).

[5] Azam, M. et al., 2021. An empirical study on quality of life and related factors of Pakistani breast cancer survivors. Scientific Reports, Volume 11.

[6] Mitchell, A. J. et al., 2013. Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: a systematic review and meta-analysis. The Lancet Oncology, 14(8), pp. 721-732.

Nimrah H. Sattar

Ismail Munir

This article or video has been recorded by a subject / domain specialists with a proven track record of excellence in their area. 

Know Your Blood Pressure Numbers

Blood pressure refers to the force applied by the flowing blood against the walls of the body&#39;s arteries<a href="#accordion">[1]</a>.&nbsp;Not only does this force help supply organs with oxygen and nutrients but also white blood cells and antibodies for immunity, and hormones like insulin<a href="#accordion">[2]</a>. Moreover, along with transporting oxygen and nutrients, blood pressure also plays a role in removing harmful metabolic end products, including carbon dioxide and other toxins cleared from the liver and kidneys.&nbsp; 
&nbsp;

Understanding blood pressure readings

When blood pressure exceeds the normal range, it is called <a href="https://www.merisehat.pk/disease/hypertension-57">hypertension</a>. Blood pressure is composed of a pair of numbers. The first (systolic) number represents the blood vessels&#39; pressure when the heart contracts. The second (diastolic) number is associated with the pressure in the vessels when the heart rests in between the beats<a href="#accordion">[1]</a>.&nbsp;The combination of the two allows doctors and health professionals to gauge the overall well-being of an individual. 
&nbsp;

Mild and temporary fluctuations in blood pressure are normal and can be triggered due to a myriad of reasons. However, if an individual deviates from the normal range for a chronic period, then that may indicate a deeper and more complex medical condition, and should be further explored by a licensed practitioner. To analyze quantitively, blood pressure has been categorized into five categories<a href="#accordion">[3]</a>. 
&nbsp;

<h5>Normal Range</h5>

The first range of blood pressure is defined as the normal range and is expected from every healthy individual. Numbers under 120/80mmHg are viewed as normal<a href="#accordion">[4].</a>&nbsp;Activities that encourage and support the heart&rsquo;s rhythmic motions, such as a well-balanced healthy diet and physical activity can help maintain the blood pressure in the normal range<a href="#accordion">[4]</a>. 
&nbsp;

At birth, the blood pressure stays at 64/40mmHg and then rises to 120/80mmHg as one reaches adulthood<a href="#accordion">[3]</a>. Several factors, both natural and human-induced, can then cause the blood pressure to fluctuate. For example, checking the blood pressure after delivering a fervent speech or running a marathon will likely give a high reading. This is perfectly normal as the increased adrenaline levels cause the body to increase the blood pressure, and supply the heart with more oxygen for fight or flight events<a href="#accordion">[3]</a>.&nbsp;

&nbsp;

<h5>Elevated Levels</h5>

This is a warning stage to alarm patients and usher them into hypertension treatment before it is exacerbated. Elevated levels are denoted by persistent high blood pressure readings. A doctor is likely to investigate for differential diagnosis if the systolic blood pressure is in the range of 120-129mmHg and the diastolic is less than 80mmHg<a href="#accordion">[3]</a>.&nbsp; 
&nbsp;

Individuals who constantly have elevated levels of blood pressure are more vulnerable and at risk of developing various coronary diseases early in their life<a href="#accordion">[5]</a>. An aneurysm is an abnormal bulge in the blood vessel wall that can result from prolonged and unattended elevated levels of blood pressure. Elevated blood pressure levels also increase the risk of cardiovascular failure. Moreover, damage to the renal vessels can affect healthy kidney functioning. Since little veins in the eyes are particularly defenseless against harm, hypertension can also prompt vision issues and even visual impairment<a href="#accordion">[4]</a>.&nbsp; 
&nbsp;

<h5>Hypertension Stage I</h5>

If not addressed, then elevated levels can deteriorate to advanced stages of hypertension. Stage 1 is defined by consistently high blood pressure levels of systolic 130-139mmHg and diastolic 80-89mmHg<a href="#accordion">[3]</a>. At this phase of hypertension, specialists endorse and stress a reconsideration of routine activities and life changes. They may also prescribe blood pressure medications based on the individual&#39;s risk of developing an atherosclerotic cardiovascular disease (ASCVD), such as a heart attack or a stroke<a href="#accordion">[3]</a>.&nbsp;&nbsp; 
&nbsp;

<h5>Hypertension Stage II</h5>

If treatment for hypertension stage 1 does not prove to be successful, then the individual is likely to progress to hypertension stage 2. Hypertension stage 2 is defined as blood pressure readings of 140/90mmHg or higher<a href="#accordion">[3]</a>. At this stage, specialists will probably recommend lifestyle changes and alternatives to the previously prescribed blood pressure prescriptions While treating a patient with stage 2 hypertension, the clinician should decide on the proper blood pressure (BP) objective, select the underlying anti-hypertensive routine, and change that routine, as required, to accomplish the objective BP. Likewise, the clinician ought to think about the effect of the treatment routine on both the patient&#39;s consistency with treatment and long-term risk for cardiovascular disease (CVD)<a href="#accordion">[6]</a>.&nbsp;

&nbsp;

If an individual has a history of high blood pressure, then they may be more likely to develop a hypertensive crisis. This phase of hypertension necessitates immediate and proper medical assistance. Therefore, it is important not to delay treatment. If during a routine blood pressure check, the readings out of nowhere surpass 180/120mmHg, try not to panic. Take a deep breath, wait for five minutes, and afterwards test the blood pressure once more. However, if the readings are bizarrely high twice in a row, immediately contact a hospital or a doctor<a href="#accordion">[3]</a>. Such high levels could indicate that the person is going through a hypertensive crisis.&nbsp; 
&nbsp;

Moreover, with the blood pressure reading being higher than 180/120mmHg the individual might witness other alarming and distressing symptoms. These suggest signs of conceivable organ harm<a href="#accordion">[7]</a>. They may range from chest pain to difficulty in breathing, body numbness and pain (especially in the back), visible change in vision, and communication problems. If these accompany the blood pressure readings, then an individual should not hesitate or wait for the shortness of breath to pass away, and immediately call for medical help<a href="#accordion">[7]</a>.

&nbsp;

<h4>"Stay on top of your blood pressure reading with our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan</a>!"</h4>

To maintain the blood pressure (BP) goal according to the individual&rsquo;s age, health, and stage, the patient must regularly monitor their readings for comparison and to confirm if the advised treatment is leading to any progress or not. Realistically, it is neither economical nor feasible to expect an individual to travel great lengths, and pay hefty consultation fees for a quotidian blood pressure reading. Therefore, a doctor may suggest investing in a home blood pressure monitor. 
&nbsp;

A home blood pressure apparatus is a more accessible and economical alternative than rushing to the hospital each day. Moreover, a patient does not require a doctor&#39;s prescription to purchase one. Thus, increasing its prevalence in every home. However, it should be stated that home blood pressure observation is not a substitute for visits to the primary care physician for more serious concerns and complications that might arise due to hypertension. Additionally, home blood pressure apparatuses might have a few shortcomings of their own<a href="#accordion">[7].</a> However, these can be avoided if the individual makes an informed purchase.&nbsp; 
&nbsp;

Don&#39;t hesitate to venture onto the world wide web and gather all necessary specifications before buying a home blood pressure monitor. You can even bother a doctor for suggestions for a reliable and approved gadget. Make sure to be diligent with the yearly check-ups of the apparatus. For the inauguration, bring it to the doctor&#39;s office and request a doctor or nursing staff to teach you the proper method of checking blood pressure at home. This will help guarantee correct readings<a href="#accordion">[7]</a>.&nbsp;

&nbsp;

Hypertension is a gateway to permanent damage and life-long complications. Therefore, it is important to understand the different stages of high blood pressure and the method to monitor it. The predominance of hypertension with increasing age is a result of the gradual rise in systolic blood pressure. 
&nbsp;

Systolic hypertension is the most common type of hypertension in people older than 50 years and reflects the pathologic decline in the blood vessel and arterial compliance<a href="#accordion">[6]</a>. The increase in systolic blood pressure is a more significant risk factor for cardiovascular disease than diastolic blood pressure rise. However, both should be regulated through prescribed treatments and lifestyle changes.

&nbsp;

While hypertension covers a range of sub-topics, it is important to remember that: 
&nbsp;

<ul>
	<li>Hypertension results from the normal blood pressure rising consistently. Blood pressure is measured through a pair of readings: systolic and diastolic.</li>
	<li>Systolic blood pressure results from the heart contracting, while diastolic pressure develops when the heart relaxes.</li>
	<li>The normal range of blood pressure is less than 120mmHg for systolic, and less than 80mmHg for diastolic.</li>
	<li>Elevated levels are defined as a systolic reading of 120-129mmHg and diastolic pressures of less than 80mmHg.</li>
	<li>Hypertension Stage 1 has blood pressure readings of 130-139mmHg and 80-89mmHg for systolic and diastolic respectively.&nbsp;</li>
	<li>Hypertension Stage 2 has blood pressure readings of 140mmHg or higher for systolic and 90mmHg or higher for diastolic.&nbsp;</li>
	<li>During a hypertensive crisis, systolic readings soar above 180mmHg while diastolic readings are higher than 120mmHg. This requires immediate medical attention.</li>
</ul>

&nbsp;

[1].World Health Organization (WHO). (2021, August 25). Hypertension. Retrieved from World Health Organization (WHO)

[2].Weatherspoon, D. (2022, March 20). What is a normal blood pressure reading? Retrieved from Medical News Today:

[3].American Heart Association. (2022). Understanding Blood Pressure Readings. Retrieved from American Heart Association:

[4].Jaret, P. (2021, September 17). High Blood Pressure. Retrieved from WebMD:

[5].Chobani, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., IzzoJr, J. L., . . . Rocella, E. J. (2003). Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension, Vol. 42, No. 6, 1206-1252

[6].Giles, T. D., & Materson, B. J. (2005). Treating stage 2 hypertension. Journal of clinical hypertension (Greenwich, Conn.), 7(8), 464–470.

[7].Mayo Clinic. (2021, July 1). High blood pressure (hypertension). Retrieved from Mayo Clinic:

Zarlish Kazmi

Check Yourself Before You Wreck Yourself

&ldquo;A checkup can tell your inside story&rdquo; is something we have seemed to have forgotten over time. Sometimes it is due to a family commitment, and sometimes it is because of a work commitment. We have reached a point when we won&rsquo;t go for a checkup even when we are not feeling well!

&nbsp;

But did you know there is a list of diseases that can be prevented, or caught on early, if proper routine <a href="https://merisehat.pk/page/sehat-scan/">health checkup</a> is done? For starters, a routine <a href="https://merisehat.pk/page/sehat-scan/">health screening</a> would allow you to track any mild symptoms that might not seem dangerous initially. It also allows your health care practitioner to look for diseases that are notoriously asymptomatic.&nbsp;

&nbsp;

People nowadays have honestly started to take their health for granted. They only visit their doctors once a disease has settled in. Some of us even want to challenge the illness and see how far we can take it before we need to get admitted!

&nbsp;

Like any other medication a healthcare practitioner may prescribe for treating the disease, a <a href="https://merisehat.pk/page/sehat-scan/">health checkup</a> is necessary for preventing it. And as many of us will agree, &ldquo;prevention is better than cure&rdquo;.&nbsp; &nbsp;&nbsp; 
&nbsp;

&nbsp;

Understanding The Importance Of Regular Medical Check Ups

It is important to understand that males and females have different types of bodies physiologically. Hence, screening is essential for a range of different diseases, and, in some cases, it is solely dependent on the gender or age.

<h5>Blood Pressure</h5>

If you are a male aged between 18 and 39, you should control your blood pressure by getting it checked once every 2 years. If during these checkups your upper pressure (systolic) is above 120 and the lower pressure (diastolic) is more than 80, the monitoring has to be on a yearly basis<a href="#accordion">[1]</a>.

&nbsp;

<h5>Cholesterol</h5>

Due to dietary and lifestyle habits, cholesterol monitoring becomes crucial, particularly for men. The recommended age for cholesterol screening is 35 for men with no known risk factors for coronary heart disease, and 20 for men with known risk factors for coronary heart disease. If there are any comorbidities involved, you should get it checked more often. However, if the results are normal, the screening could simply be repeated after a span of 5 years<a href="#accordion">[1]</a>.&nbsp;

&nbsp;

<h5>Diabetes</h5>

Diabetes and hypertension often go hand in hand. So, if you are a known hypertensive patient, you are more likely to be screened for diabetes. HbA1c is usually tested along with the oral glucose tolerance test (OGTT).&nbsp;

&nbsp;

For OGTT, blood sugar levels between 141 mg/dL and 200 mg/dL (7.8 - 11.1 mmol/L) is considered impaired glucose tolerance, whereas a result above 200 mg/dl (11.1mmol/L) means the person is diabetic. A normal HbA1C level is below 5.7%, levels of 5.7% - 6.4% indicates pre-diabetic condition, and 6.5% or more is a strong indicator of diabetes<a href="#accordion">[2]</a>. After obtaining your medical history in detail, your healthcare practitioner will decide whether screening for certain infections, like syphilis, chlamydia, and HIV is important or not.

&nbsp;

<h5>Prostate Cancer</h5>

Regarding malignancies, there are some horrific statistics seen in men, which makes it all the more necessary for them to be screened on a routine basis. According to the American Cancer Society&rsquo;s estimates for prostate cancer in the United States, in 2022, 268,490 new cases were reported and 34,500 people lost their lives due to the disease. This is equivalent to 1 in 8 men, with increasing risk once they turn 65<a href="#accordion">[3]</a>.&nbsp;

&nbsp;

The Prostate Cancer Early Detection Guidelines established by the National Comprehensive Cancer Network urges men above 45 years of age to get a screening done, and then plan a routine checkup according to the results.&nbsp;

&nbsp;

Prostate Specific Antigen (PSA) along with a digital rectal examination (DRE) is done to screen you for prostate cancer<a href="#accordion">[5]</a>. The PSA is a blood test to check for prostate specific chemicals, whereas the DRE is the insertion of a finger in the anus to feel the physical aspects of the prostate<a href="#accordion">[4]</a>.&nbsp;

&nbsp;

<h5>Bladder Cancer</h5>

Even though it&rsquo;s a disease of elderly, with the mean age being 73, bladder cancer is another malignant disease that is four times more prevalent in men compared to women<a href="#accordion">[5]</a>.&nbsp;

&nbsp;

Data collected by GLOBOCAN in 2018 estimated that 550,000 people were diagnosed with bladder cancer<a href="#accordion">[6]</a>. The screening method for bladder cancer is done by a basic urine detailed report and urine cytology which helps detect abnormalities.&nbsp;

&nbsp;

<h5>Colorectal Cancer</h5>

Colorectal cancer is yet another cancer which takes around 27,000 lives in the US alone each year.&nbsp;

&nbsp;

It is recommended that a colonoscopy be done as a screening method in men at the age of 45 years. A family history of malignancies makes the screening even more crucial<a href="#accordion">[5]</a>.&nbsp;&nbsp;

&nbsp;

<h5>Sexually Transmitted Infections&nbsp;</h5>

Men who have sex with women should get screening for:&nbsp;

<ul>
	<li>Chlamydia, gonorrhoea, syphilis, herpes, HIV, and hepatitis B and C&nbsp;</li>
</ul>

&nbsp;

Men who have sex with men should get screening for:&nbsp;

<ul>
	<li>Chlamydia, gonorrhoea, syphilis, herpes, HIV, HPV, anal cancer, and hepatitis B and C&nbsp;</li>
</ul>

&nbsp;

Women also need to be screened for their overall health. Reason being that a woman has to go through menstruation, pregnancies, and then post-menopause, all of which can cause multiple relevant health condition like dysmenorrhea, premature delivery, and increased risk of malignancies, respectively.&nbsp;

&nbsp;

Following are a few vitamins and minerals, and their recommended daily allowance which a woman can take to ensure optimal health<a href="#accordion">[7]</a>:

<ul>
	<li>Iron: For those aged 19-50 years, it&rsquo;s 18 mg/day whereas for those aged 51 and up, it&rsquo;s 8 mg/day</li>
	<li>Magnesium: If aged 19-30, then 310 mg/day; if aged 31 years and above, then 320 mg/day</li>
	<li>Vitamin D:&nbsp;If aged 1-70 years, 15 mcg/day (600 IU or international units)</li>
	<li>Vitamin C: 75mg/day</li>
	<li>Vitamin E: 15mg/day</li>
</ul>

&nbsp;

<h5>Lung Cancer</h5>

If you smoke one pack a day, it is necessary for you to be screened for lung cancer.&nbsp;Screening is done by a Computed Tomography (CT) and has to be done annually.&nbsp;

&nbsp;

<h5>Cervical Cancer</h5>

Cervical cancer is the 4th most common malignancy found in women worldwide. Around 604,000 new cases and 342,000 deaths were reported in 2020, with 90% of this data being sourced from low and middle income countries<a href="#accordion">[8]</a>.&nbsp;

&nbsp;

In order to screen a woman with cervical cancer, a Pap test is recommended every 3 years for women aged 21-65 years. A Pap smear test is one in which your health care practitioner takes samples from your cervix and evaluates them under a microscope.&nbsp;

&nbsp;

<h5>Breast Cancer</h5>

Another alarming malignancy in females is breast cancer. A total of 7.8 million cases, diagnosed between 2015-2020, made it the most prevalent cancer worldwide. In 2020 alone, there were 2.3 million women who were diagnosed and 685,000 deaths worldwide that occurred due to breast cancer<a href="#accordion">[9]</a>.&nbsp;

&nbsp;

Screening for breast cancer is done through mammography (an x-ray of your breast) every 2 years from the age of 50 years onwards<a href="#accordion">[10]</a>.&nbsp;

&nbsp;

<h5>Sexually Transmitted Infections&nbsp;</h5>

Women who are 24 years and older and sexually active should get screened for sexually transmitted infections like chlamydia, gonorrhoea, herpes, trichomoniasis, HIV, HPV, cervical cancer, hepatitis B, hepatitis C, and syphilis. Chlamydia screening particularly should be done every year once girls turn 24.&nbsp;

&nbsp;

Pregnant women should be screened for chlamydia, gonorrhoea, herpes, HIV, HPV, cervical cancer, hepatitis B, hepatitis C, and syphilis.&nbsp;

&nbsp;

Screening for diseases in children is another ball game and one that&rsquo;s quite important too.&nbsp;

&nbsp;

<h5>Severe Acute Malnutrition</h5>

Severe acute malnutrition (SAM), also known as severe wasting, is the most crucial form of undernutrition and has a mortality rate of 10-30%.&nbsp;

&nbsp;

Studies show that children in developing countries have a strong correlation of undernutrition and development outcomes. It should be noted that even if the child survives the undernutrition at the moment, it would have a drastic effect on adulthood, especially with regards to physical and cognitive development.&nbsp;

&nbsp;

According to the Pakistan Demographic Survey (2017&ndash;18), 37.6% of children under 5 years were stunted, with 17% severely stunted. Furthermore, 7.1% were found to be wasted, with 2% severely wasted and 23% were underweight<a href="#accordion">[11]</a>. Hence, it becomes necessary to monitor a child who is 5 years or under, to counteract any existing deficiencies .&nbsp;

&nbsp;

Developmental Screening Test II (Denver), also known as DDST II, is used to screen a child for his or her development. DDST II has 4 components: personal-social behavior development, fine motor development, language, and gross motor development.&nbsp;

&nbsp;

Apart from this, anthropometric measurements are also taken to check for physical development. Anthropometric measurements include height, weight, head circumference, body mass index (BMI), body circumferences to assess for adiposity (waist, hip, and limbs), and skinfold thickness.

&nbsp;

It can be settled from the statistics mentioned above that some diseases are silent killers and need to be identified as early as possible. Anything could happen to anyone, so the best way to look out for yourself is to give yourself a fair opportunity. Just going to your doctor reduces your risk by 50%. Some diseases like pancreatic cancers are usually symptomatic at advanced stages. However, if routine blood work is done, it can warrant for early on imaging and, hence, diagnosis. There can be a lot of examples like this, but the main question remains, “do you love yourself enough?”&nbsp;&nbsp;

<ul>
	<li>A health screening routine allows to track any mild symptoms that might not seem dangerous initially.</li>
	<li>Screening is important for different diseases and in some cases it&rsquo;s solely dependent on the gender or your age.</li>
	<li>If you are a male, aged between 18 and 39, you should keep your blood pressure in check by getting it checked once every 2 years.</li>
	<li>The recommended age for cholesterol screening is 35 for men with no known risk factors regarding coronary heart disease, and 20 for men with known risk factors for coronary heart disease.</li>
	<li>Blood sugar levels between 141 mg/dL and 200 mg/dL (7.8 to 11.1 mmol/L) is considered impaired glucose tolerance, whereas above 200 mg/dl (11.1mmol/L) is diagnostic of diabetes in an OGTT.</li>
	<li>A normal HbA1C level is below 5.7%, whereas a level of 5.7-6.4% indicates pre-diabetes. 6.5% or more is a strong indicator of diabetes.</li>
	<li>2022 studies show 268,490 new cases were reported and 34,500 people lost their lives due to prostate cancer in the US.</li>
	<li>Prostate Specific Antigen (PSA) along with a digital rectal examination (DRE) are done to screen one for prostate cancer</li>
	<li>Bladder cancer is 4 times more prevalent in men compared to women.</li>
	<li>Data collected by GLOBOCAN in 2018 estimated that 550,000 people were diagnosed with bladder cancer.</li>
	<li>The screening method for bladder cancer is a basic urine detailed report and urine cytology.</li>
	<li>Colorectal cancer is the 4th most common cancer in the US which takes around 27000 lives each year.</li>
	<li>Colonoscopy should be done to screen men around 45 years.</li>
	<li>Women need to tend to their overall health as vigilantly as possible, to ensure proper menstrual cycle and pregnancies.</li>
	<li>Lung cancer screening is done by a Computed Tomography (CT) and has to be done on an annual basis.</li>
	<li>Cervical cancer is the 4th most common malignancy found in women worldwide. Around 604,000 new cases were reported in the year 2020 and 342,000 deaths, with 90% of this data being sourced from low- and middle-income countries.</li>
	<li>Pap test is recommended every 3 years for women aged 21-65 years, for screening for cervical cancer.</li>
	<li>In 2020 alone, there were 2.3 million women diagnosed with breast cancer and 685,000 deaths globally.</li>
	<li>Screening for breast cancer is done by mammography every 2 years from the age of 50 years.</li>
	<li>Sexually active men (included males who have sex with males) and women (including pregnant women) should get screened for sexually transmitted infections.</li>
	<li>According to the Pakistan Demographic Survey (2017&ndash;18), 37.6% of children under 5 years of age were stunted, with 17% severely stunted. Furthermore, 7.1% were found to be wasted, with 2% severely wasted, and 23% were underweight.</li>
	<li>Developmental Screening Test II (Denver), also known as DDST II, and anthropometric measurements are used to screen a child for his or her development.</li>
</ul>

&nbsp;

[1] Health screenings for men ages 18 to 39: Medlineplus Medical Encyclopedia. MedlinePlus.

[2] All about your A1C. Centers for Disease Control and Prevention.

[3] Key statistics for prostate cancer: Prostate cancer facts. American Cancer Society.

[4] What is screening for prostate cancer? Centers for Disease Control and Prevention.

[5] 5 most common cancers in men. Roswell Park Comprehensive Cancer Center.

[6] Saginala K, Barsouk A, Aluru JS, Rawla P, Padala SA, Barsouk A. Epidemiology of Bladder Cancer. Med Sci (Basel). 2020;8(1):15. Published 2020 Mar 13. doi:10.3390/medsci8010015

[7] Vitamins and minerals: How much should you take? WebMD.

[8] Cervical cancer. World Health Organization.

[9] Breast cancer. World Health Organization.

[10] What is a mammogram? Centers for Disease Control and Prevention.

[11] Saleem, J., Zakar, R., Bukhari, G.M.J. et al. Developmental delay and its predictors among children under five years of age with uncomplicated severe acute malnutrition: a cross-sectional study in rural Pakistan. BMC Public Health 21, 1397 (2021).

Arbaz Ansari

Hypertension And Heart Attack

Your heart is responsible for pumping blood around your body. The pressure with which your blood pushes against the walls of the blood vessels continually changes. When your heart is relaxed, this pressure will be low. When your heart is squeezing the blood into arteries, this pressure will increase.

Your blood pressure reading is a measurement of the highest (systolic) and lowest (diastolic) recorded pressure. Normal blood pressure is less than 120/80 mmHg<a href="#accordion">[1]</a>. 
&nbsp;

High blood pressure or hypertension occurs when:

<ul>
	<li>Either the first number (systolic pressure) is above 140 mmHg</li>
	<li>Or the second number (diastolic pressure) is above 90 mmHg</li>
	<li>Or both 
	&nbsp;</li>
</ul>

Your blood pressure may vary at different times of the day depending on your activity and general health. Generally, high blood pressure is diagnosed if your readings on two separate days are higher than 140/90 mmHg.

It&rsquo;s important to monitor your blood pressure on a regular basis as high blood pressure can affect your blood flow to the organs. The higher the pressure, the greater the risk of complications. Often, it continues to damage the body quietly, without any symptoms. 
&nbsp;

Note: This limit (140/90 mmHg or higher) is based on 2003 guidelines. Some doctors diagnose high blood pressure when a patient consistently presents a reading of 130/80 mmHg or higher, as per the 2017 Guideline For The Prevention, Detection, Evaluation, And Management Of High Blood Pressure In Adults by the American College of Cardiology/American Heart Association<a href="#accordion">[1]</a>. 
&nbsp;

Understanding Hypertension and its risks

A heart attack occurs when the blood supply to your heart is blocked. The lack of oxygen causes the heart muscle to die. The longer the blood flow is blocked, the more damage it causes to your heart.

And where does hypertension fit in the picture? 
&nbsp;

A heart attack is basically a medical emergency due to high blood pressure. If your blood pressure is consistently high, you&rsquo;re at a higher risk of developing cardiovascular problems than those who don&rsquo;t.

<ul>
	<li>Additional Strain: Hypertension forces your heart to work harder to pump blood throughout your body. It weakens the heart muscle, contributing to the development of multiple heart-related conditions, including heart attack. 
	&nbsp;</li>
	<li>Atherosclerosis: Hypertension also causes the thickening of the walls of your blood vessels. The damage makes them more susceptible to blockages. A buildup of plaque (composed of cholesterol, fat, and other substances) in the artery causes the hardening or thickening of the arteries. This puts you at a higher risk of developing conditions like vascular dementia, kidney failure, heart attack, and stroke. 
	&nbsp;</li>
	<li><a href="https://merisehat.pk/disease/aortic-aneurysm">Aneurysm</a>: The increased pressure of the blood causes a section of the artery wall to enlarge and bulge out. While aneurysms can develop in any artery, they usually develop in the aorta. 
	&nbsp;</li>
	<li>Coronary Thrombosis: When the plaque ruptures, it can cause blood clots to form and block the blood flow. If it blocks the coronary arteries, it can trigger a heart attack. 
	&nbsp;</li>
</ul>

A heart attack is a life-threatening emergency. While symptoms vary from person to person, common warning signs include:

<ul>
	<li>Unexplained shortness of breath, with or without chest discomfort</li>
	<li>Chest discomfort (angina)</li>
	<li>Pain and discomfort extending beyond the chest to one or both arms, neck, jaw, teeth, stomach, and back</li>
	<li>Nausea or vomiting</li>
	<li>Anxiety</li>
	<li>Lightheadedness</li>
	<li>Cold sweats</li>
	<li>Indigestion</li>
	<li>Unexplained fatigue</li>
	<li>Coughing or wheezing</li>
	<li>Swelling in hands or feet 
	&nbsp;</li>
</ul>

Note: Seek medical attention immediately if you or a loved one has any of these symptoms. 
&nbsp;

Not all people who have a heart attack will experience intense pressure or pain to think they&rsquo;re having an episode and show due concern. In fact, some people have no symptoms at all. According to the American Heart Association, silent heart attacks make up about 20% of all heart attacks<a href="#accordion">[5]</a>.

They&rsquo;re pretty much the same as a heart attack, i.e., the heart muscle is deprived of oxygen and nutrients due to blockage, causing the person to feel pressure or pain, except that this time the problem goes unnoticed. 
&nbsp;

A general feeling of unease, for instance, that causes sleep disturbance at night should not be overlooked. Similarly, pain in the arm or shoulder should not be mistaken for simply an orthopedic issue. Sometimes, a pacemaker can disguise a heart attack as chest pain as well.

Rule of the thumb here is to see if this pain can be manipulated in some way. For instance, do you feel better if you change your position? If you experienced discomfort while you were sitting in a chair, does getting up and walking around improve or aggravate it? 
&nbsp;

The earlier this condition is identified and targeted, the better. According to a study, a silent heart attack is connected to a greater risk of heart failure<a href="#accordion">[5]</a>. 
&nbsp;

<ul>
	<li>Gender &ndash; Women have a greater risk because of high blood pressure during pregnancy, birth control pills containing estrogen, and depression. Women are thrice at risk of heart failure due to high blood pressure while men are twice as likely to get it<a href="#accordion">[3]</a>.</li>
	<li>Age &ndash; Men aged 45 or above and women aged 55 or above are at risk of having a high attack.</li>
	<li>Ethnicity &ndash; At least 3 out of 5 African American women have high blood pressure (&ge; 130/80 mmHg).</li>
	<li>Diet &ndash; Consuming more than the recommended amounts of salt and unhealthy fat raises blood pressure.</li>
	<li>Lifestyle &ndash; An unhealthy lifestyle choice, like not getting enough physical activity every day or smoking, also increases the risk of developing high blood pressure.</li>
	<li>Health &ndash; Certain health conditions, like obesity, sleep apnea, and diabetes, are major risk factors. A family history of heart disease may cause it, too. 
	&nbsp;</li>
</ul>

To reduce your risk of heart attack, you need to prevent and/or manage hypertension. This includes lifestyle changes mainly:

<ul>
	<li>Not smoking</li>
	<li>Relieve stress through meditation or yoga</li>
	<li>Quitting alcohol and smoking</li>
	<li>Maintaining a healthy weight</li>
	<li>Getting at least 30 minutes of physical activity every day</li>
	<li>Eating a healthy diet</li>
	<li>Monitoring cholesterol and diabetes closely and keeping their levels under control 
	&nbsp;</li>
</ul>

Your doctor may prescribe some medication (e.g., diuretics, vasodilators, beta-blockers, and calcium channel blockers) depending on your condition to help you control your blood pressure<a href="#accordion">[3]</a>. Do not change or stop medications without talking to your doctor. 
&nbsp;

Important!

All adults aged 18 and above should get their blood pressure checked every year. In case of the presence of risk factors, more frequent checkups may be needed<a href="#accordion">[2]</a>. 
&nbsp;

The global prevalence of hypertension is 26.4%. In particular, 1 in 3 US adults have hypertension with only 54% of these patients having adequate blood pressure control<a href="#accordion">[4]</a>. It requires constant surveillance to identify and slow the development of complications.

Always consult a healthcare professional if you think you have high blood pressure or a heart-related condition. They can recommend the appropriate preventive measures and treatment options to reduce your risk of heart attack. 
&nbsp;

[1] High blood pressure symptoms and causes. Centers for Disease Control and Prevention. May 18, 2021

[2] Hypertensive Heart Disease. Pennmedicine.

[3] Hypertensive heart disease: Symptoms, causes &amp; treatment. Cleveland Clinic.

[4] Tackling G, Borhade MB. Hypertensive Heart Disease.

[5] Nania R. How to recognize the signs of a silent heart attack. AARP.

Shermeen Zuberi

Medilink Consultant clinic

ZAKA CLINIC GULBERG LAHORE

Saad Ullah Siddiqui

Nocturnal Hypertension Explained

You&rsquo;re probably familiar with the term &lsquo;hypertension,&rsquo; which refers to blood pressure that is consistently higher than normal. However, this high blood pressure lowers when the patient is asleep. 
&nbsp;

Now, let&rsquo;s talk about the other condition which reverses this situation. In this scenario, you have normal blood pressure throughout the day, but it shoots up as soon as you fall asleep. It is known as &lsquo;nocturnal hypertension&rsquo;.&nbsp; 
&nbsp;

Understanding Nocturnal Hypertension

It is believed to be a complication of essential and secondary hypertension<a href="#accordion">[1]</a>. The increased blood pressure during sleep has been identified as an elevated risk factor for several cardiovascular issues, including heart failure and cerebrovascular diseases<a href="#accordion">[2]</a>. Several studies have revealed that nocturnal hypertension may be an initial symptom of later target organ damage.&nbsp; 
&nbsp;

There are 2 types of blood pressure patterns in nocturnal hypertension: 
&nbsp;

<h5>1. Non-Dipping Blood Pressure</h5>

During sleep, the body is not doing a lot of work; it is at rest and the person feels calm. It&rsquo;s why the blood pressure is also lower than what it is during the day time. This phenomenon is called dipping. Normally, there is at least a 10-20% dip expected from daytime to nighttime while sleeping. 
&nbsp;

However, when the dip in blood pressure at night time is less than 10%, it is then considered as non-dipping blood pressure. People with essential hypertension are more exposed to it and it is highly associated with target organ damage<a href="#accordion">[5]</a>. 
&nbsp;

<h5>2. Reverse Dipping Blood Pressure</h5>

Also known as inverted dipping, this phenomenon refers to blood pressure that is higher during the night time as compared to the daytime. People with hypertension, diabetes type 2, sleep apnea, and chronic kidney disease usually suffer from reverse dipping blood pressure<a href="#accordion">[3]</a>. This pattern of nocturnal hypertension is most common among old people and smokers.&nbsp; 
&nbsp;

Reverse dipping pattern is further considered a risk factor for <a href="https://merisehat.pk/disease/atherosclerosis">atherosclerosis </a>and is believed to promote the formation of carotid plaque<a href="#accordion">[4]</a>. 
&nbsp;

The WHO reported the number of adults suffering from hypertension in 1975 was 594 million. According to their assessment in 2015, the number has gone up to 1.13 billion<a href="#accordion">[7]</a>. The increased instance of hypertension has also led to better controlling therapies. There is new research and newer concepts being proposed every other day.&nbsp; 
&nbsp;

The latest direction in the management of high blood pressure is to target the problem earlier and aim towards lowering the blood pressure throughout the day<a href="#accordion">[8]</a>. According to the 2017 guideline by American College of Cardiology (ACC), all blood pressure readings taken during the awake period of a patient must be less than 130/80 mm Hg. It is now considered a universal blood pressure goal.&nbsp; 
&nbsp;

Despite these measures, the risk of masked nocturnal hypertension remains and poses an increased risk for cardiovascular diseases<a href="#accordion">[7]</a>. 
&nbsp;

Sleep apnea and obstructive sleep apnea in particular, has been closely related to hypertension. Nocturnal hypertension is very commonly found in patients of sleep apnea. Coexistence of these two issues tend to increase the chances of the development of other cardiovascular issues.&nbsp; 
&nbsp;

Continuous positive airway pressure, which is the main therapy for sleep apnea, has little to no effect on the elevated blood pressure experienced in nocturnal hypertension and thus goes unnoticed<a href="#accordion">[9]</a>.&nbsp; 
&nbsp;

While there is no specific treatment targeted towards nocturnal hypertension, it is believed that taking blood pressure medications even during the day keeps the pressure at bay at night.&nbsp; 
&nbsp;

Other approaches towards the treatment would mainly include lifestyle changes, like taking potassium supplements, monitoring and reducing sodium intake, and avoiding any sleep-interrupting stimulants like alcohol or caffeine. Regulating sleep and following a proper sleep hygiene routine is a crucial fix to nocturnal hypertension<a href="#accordion">[9]</a>.&nbsp; 
&nbsp;

Considering that nocturnal hypertension is closely linked to diabetes, maintaining blood sugar level and even overall sugar intake is very important to the process. Lastly, it helps to keep a check on and maintain the other underlying health conditions<a href="#accordion">[10]</a>. 
&nbsp;

<ul>
	<li>Nocturnal hypertension refers to high blood pressure of a person while they are asleep.</li>
	<li>It has been related to several health conditions and is believed to increase the chances of several cardiovascular issues, including heart failure and stroke.</li>
	<li>There are no targeted medicines that work specifically for nocturnal hypertension. The ideal way to combat it is through lifestyle changes.</li>
</ul>

[1] Vij R, Peixoto AJ. Management of nocturnal hypertension. Expert Review of Cardiovascular Therapy. 2009;7(6):607-618. doi:10.1586/erc.09.42

[2] Tadic M, Cuspidi C, Grassi G, Mancia G. isolated nocturnal hypertension: What do we know and what can we do? Integrated Blood Pressure Control. 2020;Volume 13:63-69. doi:10.2147/ibpc.s223336

[3] Cuspidi C, Sala C, Tadic M, et al. Clinical and prognostic significance of a reverse dipping pattern on ambulatory monitoring: An updated review. The Journal of Clinical Hypertension. 2017;19(7):713-721. doi:10.1111/jch.13023

[4] Yan B, Peng L, Han D, et al. Blood pressure reverse-dipping is associated with early formation of carotid plaque in senior hypertensive patients. Medicine. 2015;94(10). doi:10.1097/md.0000000000000604

[5] Routledge F, McFetridge-Durdle J. Nondipping blood pressure patterns among individuals with essential hypertension: A review of the literature. European Journal of Cardiovascular Nursing. 2007;6(1):9-26. doi:10.1016/j.ejcnurse.2006.05.001

[6] Hypertension. World Health Organization.

[7] Whelton PK, Carey RM, Aronow WS, et al.. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Hypertension. 2018; 71:e13–e115. doi: 10.1161/HYP.0000000000000065

[9] Kario K. Nocturnal hypertension. Hypertension. 2018;71(6):997-1009. doi:10.1161/hypertensionaha.118.10971

[8] Kario K, Hettrick DA, Prejbisz A, Januszewicz A. Obstructive sleep apnea–induced neurogenic nocturnal hypertension. Hypertension. 2021;77(4):1047-1060. doi:10.1161/hypertensionaha.120.16378

[10] Vij R, Peixoto AJ. Management of nocturnal hypertension. Expert Review of Cardiovascular Therapy. 2009;7(6):607-618. doi:10.1586/erc.09.42

Link Between Diabetes And Hypertension

According to the World Health Organization (WHO), diabetes and <a href="https://merisehat.pk/disease/hypertension-57">hypertension</a> are major public health concerns worldwide. The prevalence of both conditions has been increasing over the past few decades.

Data from the International Diabetes Federation (IDF) indicates that around 547 million adults have diabetes, which translates to 10.5% of the adult population<a href="#accordion">[1]</a>. The number is expected to rise to 783 million by 2045; this would be an increase of 46%<a href="#accordion">[1]</a>. Type 2 diabetes continues to be the predominant type of diabetes affecting people worldwide. The increasing prevalence of obesity, a sedentary lifestyle, and an aging population are all believed to be contributing factors to the rise in the prevalence of type 2 diabetes. 
&nbsp;

Approximately 3 in 4 adults with diabetes reside in middle- and low-income countries, such as Pakistan. As per estimates, 26.7% of Pakistani adults suffer from diabetes<a href="#accordion">[2]</a>. The country currently ranks third in the world in terms of diabetes prevalence.

Hypertension, on the other hand, affects an estimated 1.28 billion people globally, as reported by the WHO[3]. More than two-thirds of these people reside in middle- and low-income countries. 
&nbsp;

In Pakistan, the prevalence is 18%<a href="#accordion">[4]</a>. However, 70% of patients are unaware of their disease and only less than 3% have controlled hypertension<a href="#accordion">[4]</a>. This is quite alarming considering hypertension is a leading cause of mortality worldwide and accounts for 45% of deaths due to heart attacks<a href="#accordion">[5]</a>.

With the prevalence of both diabetes and hypertension increasing worldwide, the question arises - is there a link between the two chronic conditions? Is one leading to the other? Let&rsquo;s find out! 
&nbsp;

Understanding the link of Diabetes and Hypertension

Both diabetes and hypertension are common chronic diseases that often coexist in individuals, and their interaction can significantly increase the risk of cardiovascular complications and other health issues. Hypertension is twice as common in diabetics as in people who do not have diabetes<a href="#accordion">[6]</a>. Moreover, hypertension exacerbates the occurrence of cardiovascular disease in people with diabetes, which is a major cause of mortality and morbidity. 
&nbsp;

However, the two chronic conditions are interlinked in several ways<a href="#accordion">[6][7]</a>.

<ul>
	<li>Shared Risk Factors - Several risk factors contribute to the development of both diabetes and hypertension. Lifestyle factors such as unhealthy diet, physical inactivity, and obesity play a significant role in the development of these conditions. The &quot;Diabesity&quot; concept, which combines diabetes and obesity, emphasizes the strong connection between the two conditions and their mutual association with hypertension. Studies have shown that overweight and obesity increase the risk of developing both diabetes and hypertension. 
	&nbsp;</li>
	<li>Insulin Resistance And Hypertension - Insulin resistance is a key feature of type 2 diabetes, where the body&#39;s cells do not respond properly to insulin, leading to high blood sugar levels. Insulin resistance also has implications for blood pressure regulation. Research demonstrates that insulin resistance is linked to increased sympathetic nervous system activity, sodium retention, and altered vasodilation, all of which can contribute to hypertension. 
	&nbsp;</li>
	<li>Endothelial Dysfunction - Endothelial cells line the inner surface of blood vessels and play a crucial role in vascular health. In both diabetes and hypertension, there is evidence of endothelial dysfunction, which can lead to impaired blood flow regulation and promote the development of atherosclerosis. 
	&nbsp;</li>
	<li>Renin-Angiotensin-Aldosterone System (RAAS) - The RAAS is a hormonal system that regulates blood pressure and fluid balance. It has been implicated in the pathogenesis of both diabetes and hypertension. Hyperactivation of the RAAS can lead to vasoconstriction and sodium retention, contributing to increased blood pressure. Studies have demonstrated that components of the RAAS are dysregulated in both diabetes and hypertension. 
	&nbsp;</li>
	<li>Cardiovascular Complications - The combination of diabetes and hypertension significantly increases the risk of developing cardiovascular complications, such as coronary artery disease, stroke, and heart failure. Individuals with diabetes and hypertension had a substantially higher risk of cardiovascular events compared to those with either condition alone. 
	&nbsp;</li>
</ul>

Managing both diabetes and hypertension together requires careful consideration of treatment strategies. Some antihypertensive medications, such as thiazide diuretics and beta-blockers, may adversely affect glucose metabolism and insulin sensitivity. Therefore, individualized treatment plans that address both conditions while minimizing potential side effects are essential. 
&nbsp;

In conclusion, diabetes and hypertension share common risk factors and pathophysiological mechanisms, which contribute to their frequent coexistence in individuals. Their interaction significantly increases the risk of cardiovascular complications and underscores the importance of comprehensive management for individuals with both conditions. Regular medical check-ups, lifestyle modifications, and appropriate medications are crucial in effectively managing these two chronic diseases together. 
&nbsp;

[1] Facts & Figures. International Diabetes Federation.

[2] Azeem S, Khan U, Liaquat A. The increasing rate of diabetes in Pakistan: A silent killer. Ann Med Surg (Lond). 2022;79:103901. Published 2022 Jun 3. doi:10.1016/j.amsu.2022.103901

[3] Hypertension. World Health Organization.

[4] Akram M, et al. (2023). Prevalence of Hypertension and Associated Co-Morbidities in Pakistan. Mathews J Nurs. 5(1):11.

[5] Riaz M, Shah G, Asif M, Shah A, Adhikari K, Abu-Shaheen A. Factors associated with hypertension in Pakistan: A systematic review and meta-analysis. PLoS One. 2021;16(1):e0246085. Published 2021 Jan 29. doi:10.1371/journal.pone.0246085

[6] Petrie JR, Guzik TJ, Touyz RM. Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms. Can J Cardiol. 2018;34(5):575-584. doi:10.1016/j.cjca.2017.12.005

[7] Berbari, A.E., Daouk, N.A., Nasr, E.M. (2023). Coexistence of Diabetes Mellitus and Hypertension. In: Berbari, A.E., Mancia, G. (eds) Blood Pressure Disorders in Diabetes Mellitus. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. doi:10.1007/978-3-031-13009-0_1

Does Postpartum Hypertension Go Away?

Bringing a new life into the world is an incredible journey, but sometimes unexpected challenges can pop up, like postpartum hypertension.

In simple words, postpartum hypertension is high <a href="merisehat.pk/disease/blood-pressure">blood pressure</a> that shows up after you give birth. 
&nbsp;

Understanding postpartum hypertension

However, it doesn&#39;t stick around forever. It&#39;s like the body&#39;s way of saying, &quot;Hang on, I need a little more time to get back to normal.&quot;

The duration and severity of postpartum hypertension varies from woman to woman. Factors such as pre-existing health conditions and the presence of risk factors may influence the resolution of postpartum hypertension.

A recent study found that the condition was more commonly present in mothers who smoked, had delivered via C-section, were aged 35 and above, and were Black Americans.<a href="#accordion">[1]</a> 
&nbsp;

Other risk factors include:<a href="#accordion">[2]</a>

<ul>
	<li>Obesity</li>
	<li>Family or individual history of preeclampsia</li>
	<li>High blood pressure during pregnancy</li>
	<li>Multiple births</li>
	<li>Diabetes</li>
	<li>Autoimmune conditions 
	&nbsp;</li>
</ul>

High blood pressure usually peaks within 48 hours after delivery, which is when most women leave the hospital.

Call your doctor immediately if you have a reading of 140/90 mm Hg or higher or postpartum hypertension symptoms, such as changes in vision, shortness of breath, persisting and severe headache, abdominal pain, nausea or vomiting, and decreased urination.

Delayed treatment can lead to serious complications, including pulmonary edema, seizures, strokes, blood clots, and even death. 
&nbsp;

For a new mom, postpartum hypertension can be scary. Will it go away on its own? Will I need medications?

Postpartum hypertension treatment often revolves around a healthy lifestyle. Eating well, staying active, and catching those precious zzz&#39;s all contribute to your body&#39;s speedy recovery.

Regular check-ups with your healthcare provider ensure that any lingering high blood pressure is noticed and managed. Sometimes, they may prescribe blood pressure medicine, antiseizure medicine, and anticoagulant medications to treat it.

It could take several days to a few weeks for the blood pressure to return to a safe or manageable level. Remember, you&rsquo;ll also be recovering from childbirth itself during this time, too. So, you may experience physical and emotional changes, such as fatigue, tender breasts, cramping or vaginal discharge, and mood swings. 
&nbsp;

Your body has this remarkable ability to self-regulate and heal, ensuring that postpartum hypertension often resolves on its own. However, regular monitoring and doctor check-ups during this period can further help with a smooth transition back to pre-pregnancy blood pressure levels. 
&nbsp;

Key Takeaways

<ul>
	<li>Postpartum hypertension, or high blood pressure after giving birth, is a rare condition that affects some women during the weeks or months following delivery.</li>
	<li>Postpartum is a healing period for the body, and as it recovers from the stress of childbirth, blood pressure levels often return to normal.</li>
	<li>However, it&#39;s important to monitor postpartum hypertension through regular check-ups with a healthcare provider to ensure that it does not persist or lead to complications.</li>
	<li>Maintaining a healthy lifestyle, including a balanced diet, regular physical activity, and sufficient rest, helps blood pressure levels return to normal.</li>
	<li>In some cases, medical intervention, such as medication, may be required to manage postpartum hypertension.</li>
</ul>

[1] Sullivan K, Rauf D, Welch A, et al. New moms at risk of developing high blood pressure 6 weeks after childbirth, study finds. EverydayHealth.com. Accessed January 26, 2024.

[2] Postpartum preeclampsia: Causes, symptoms & treatment. Cleveland Clinic. Accessed January 26, 2024

Pediatric Hypertension: Emerging Challenges And Treatment Strategies

In recent years, pediatric hypertension has become a growing concern among healthcare professionals and parents alike.

At least 1 in 25 kids ages 12 to 19 have hypertension, more commonly seen in boys, those older than 12 years, and Hispanic or non-Hispanic Black ethnicity.<a href="#accordion">[2]</a>

Despite its relatively low prevalence compared to adult hypertension, the implications of high blood pressure in children can be severe and long-lasting. 
&nbsp;

Understanding The Evolving Nature Of Pediatric Hypertension

While the exact causes may vary, factors such as genetics, obesity, poor diet, teen pregnancy, smoking, and a lack of physical activity play significant roles in its development.

A family or personal history of conditions like hypertension, cholesterol, kidney disease, and diabetes should be considered as well.

Certain drugs and medications, including decongestants, caffeine, NSAIDs, and steroids, may also increase blood pressure.<a href="#accordion">[4]</a> 
&nbsp;

Pediatric hypertension can be classified into primary (essential) and secondary types.<a href="#accordion">[4]</a>

<ul>
	<li>Primary Pediatric Hypertension: Also known as essential hypertension, this type occurs when a child&#39;s blood pressure is consistently elevated without an identifiable cause. It often results from a combination of genetic, lifestyle, and environmental factors.</li>
	<li>Secondary Pediatric Hypertension: Secondary hypertension in children arises due to an underlying medical condition or external factor. Conditions such as kidney disease, heart defects, hormonal disorders, and certain medications can lead to elevated blood pressure in children. 
	&nbsp;</li>
</ul>

Diagnosing pediatric hypertension can be challenging since its symptoms often go unnoticed. Symptoms may include headaches, fatigue, vision problems, and difficulty breathing.

Accurate blood pressure measurement is crucial for diagnosing pediatric hypertension. Healthcare providers use age, height, and gender-specific norms to interpret blood pressure readings in children.

In addition to blood pressure measurement, laboratory tests such as urinalysis, blood tests, ECG, and renal ultrasound may be conducted to identify underlying conditions.

Some doctors suggest ambulatory monitoring to check if the child has high blood pressure. This means the child wears a special device for a short time to track their blood pressure all day, even while sleeping and playing. It ensures that high blood pressure isn&#39;t just because the child feels nervous at the doctor&#39;s office. 
&nbsp;

The new Clinical Practice Guidelines (CPG) released by the American Academy of Pediatrics (2017) state:[1]

<table cellspacing="0" class="1" style="border-collapse:collapse; border:none; width:464px">
	<tbody>
		<tr>
			<td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:36px; vertical-align:top; width:99px">
			&nbsp;
			</td>
			<td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; height:36px; vertical-align:top; width:182px">
			Systolic and/or Diastolic BP
			</td>
			<td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; height:36px; vertical-align:top; width:182px">
			Systolic and/or Diastolic BP
			</td>
		</tr>
		<tr>
			<td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top; width:99px">
			Age category
			</td>
			<td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:182px">
			&lt;13 years
			</td>
			<td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:182px">
			&ge;13 years
			</td>
		</tr>
		<tr>
			<td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top; width:99px">
			Normal BP
			</td>
			<td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:182px">
			&lt;90th percentile
			</td>
			<td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:182px">
			&lt;120/80 mmHg
			</td>
		</tr>
		<tr>
			<td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top; width:99px">
			Elevated BP
			</td>
			<td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:182px">
			&ge;95th &lt;95th percentile + 12

			or

			120-130/&lt;80 mmHg
			</td>
			<td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:182px">
			120-130/&lt;80 mmHg
			</td>
		</tr>
		<tr>
			<td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top; width:99px">
			Hypertension Stage 1
			</td>
			<td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:182px">
			&ge;95th &lt;95th percentile + 12

			or

			130-140/80-90 mmHg
			</td>
			<td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:182px">
			130-140/80-90 mmHg
			</td>
		</tr>
		<tr>
			<td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; vertical-align:top; width:99px">
			Hypertension Stage 2
			</td>
			<td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:182px">
			&ge;95th + 12 or &ge;140/90 mmHg
			</td>
			<td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:182px">
			&ge;140/90 mmHg
			</td>
		</tr>
	</tbody>
</table>

The new method helped with accurate diagnosis and understanding of the impact of different criteria on estimating high blood pressure prevalence and associated health risks:

<ul>
	<li>The approach lowered the levels used to define high blood pressure by 1&ndash;3 mmHg for children and over 4 mmHg for adolescents.</li>
	<li>It led to more children being identified as at risk of high blood pressure compared to the old criteria, sparking debates among scientists, especially with European researchers involved in setting guidelines.</li>
	<li>It resulted in higher estimates of high blood pressure prevalence compared to the old criteria.</li>
	<li>It identified that the prevalence of high blood pressure varied based on factors like age, weight, and the study setting. For instance, some children may experience higher blood pressure readings initially due to stress (white coat hypertension), which could lead to overestimation of high blood pressure prevalence.</li>
	<li>Studies show that children identified as hypertensive under the new criteria had a higher risk of cardiometabolic problems compared to those classified under the old criteria. 
	&nbsp;</li>
</ul>

Early intervention helps prevent the progression of pediatric hypertension and reduces the risk of complications later in life.

Untreated pediatric hypertension can lead to heart disease, stroke, kidney damage, and cognitive impairment.

<ul>
	<li>Lifestyle Modifications &ndash; Lifestyle modifications such as adopting a healthy diet, increasing physical activity, reducing sodium intake, and managing stress are essential to pediatric hypertension treatment.</li>
	<li>Medications &ndash; In some cases, medications such as ACE inhibitors, calcium channel blockers, angiotensin II receptor blockers, and diuretics may be prescribed to help lower blood pressure levels in children and adolescents. These medications are typically used in conjunction with lifestyle changes.</li>
</ul>

Note: Regular monitoring and follow-up appointments are necessary to track the effectiveness of treatment and make adjustments as needed. 
&nbsp;

Coping with a child&#39;s diagnosis of hypertension can be challenging for parents. Seeking support from healthcare professionals and connecting with other parents facing similar challenges can be helpful.

Moreover, collaboration among healthcare providers, parents, schools, and community organizations is important to promote a supportive environment for children and adolescents to effectively manage the condition. 
&nbsp;

Preventing pediatric hypertension involves promoting healthy lifestyle habits early on, including proper nutrition, regular physical activity, and stress management techniques. Make sure that they get quality sleep and avoid vaping, smoking, or even exposure to secondhand smoke.

Other precautions include:

<ul>
	<li>Children (aged 2-3 years) &lt;1200 mg of sodium a day</li>
	<li>Older children &lt;1500 mg of sodium a day</li>
	<li>All children 60 minutes of physical activity a day</li>
</ul>

Also, children should have their blood pressure checked at least once a year as part of their routine healthcare visits, starting at age 3. 
&nbsp;

<ul>
	<li>Pediatric hypertension refers to elevated blood pressure levels in children and adolescents. Stage II hypertension is diagnosed if a child&#39;s BP is greater than the 99th percentile plus 5 mm Hg.</li>
	<li>Symptoms of pediatric hypertension include headaches, fatigue, vision problems, and difficulty breathing.</li>
	<li>Diagnosis involves measuring blood pressure and conducting laboratory tests like urinalysis and blood tests to assess kidney function and identify underlying conditions.</li>
	<li>Causes and risk factors include genetics, obesity, poor diet, lack of physical activity, family history, excess weight, sedentary lifestyle, high-sodium diet, and certain underlying medical conditions.</li>
	<li>Treatment of pediatric hypertension includes lifestyle modifications such as diet and exercise changes, and medications may be prescribed in some cases.</li>
	<li>Untreated pediatric hypertension can lead to heart disease, stroke, kidney damage, and cognitive impairment.</li>
	<li>Promoting a healthy lifestyle from an early age through proper nutrition, regular physical activity, and stress management techniques can help prevent pediatric hypertension.</li>
</ul>

[1] Di Bonito P, Di Sessa A. New Diagnostic Criteria for Hypertension in Children and Adolescents: Lights and Shadows. Children (Basel). 2020;7(11):196. Published 2020 Oct 24.

[2] High blood pressure in children. Cleveland Clinic. Accessed February 23, 2024.

[3] Ashraf M, Irshad M, Parry NA. Pediatric hypertension: an updated review. Clin Hypertens. 2020;26(1):22. Published 2020 Dec 1.

[4] High blood pressure in children. Mayo Clinic. Accessed February 23, 2024.

This is because most people with high blood pressure have no symptoms at all, at least not until the condition has become severe. Even then, it may not be visible.<a href="#accordion">[1]</a>

A common misconception is that this &ldquo;silent killer&rdquo; affects men only. On the contrary, the American Heart Association states that almost half of the adult population with high blood pressure are women.

Moreover, according to the Centers for Disease Control and Prevention, the number of women dying from stroke is greater than the figure for men. Additionally, the number of women dying from heart disease every year in the US is almost the same as men<a href="#accordion">[2]</a>. 
&nbsp;

Hypertension occurs when the force with which blood pushes against the inside lining of the arteries increases and stays high for a period. High blood pressure means:

<ul>
	<li>The diastolic pressure is 80 or above</li>
	<li>The systolic pressure is 130 or above</li>
	<li>Both systolic and diastolic pressures are high 
	&nbsp;</li>
</ul>

Gender usually does not influence how the condition affects an individual. However, the onset of menopause does increase the risk of developing high blood pressure in some women. 
&nbsp;

The risk increases further with increasing age. According to a study, this is also related to estrogen-only pills that women take to manage menopause symptoms. Those who prefer estrogen-only creams or patches are less likely to be diagnosed with high blood pressure than those who take pills<a href="#accordion">[3]</a>.

The condition remains undiagnosed and untreated because of the myth that hypertension affects only men. Doctors assuming that women are healthy or immune to high blood pressure don&rsquo;t check it then while measuring other vitals during an examination, leading to delays in proper care. 
&nbsp;

Understanding the Hypertension in Women

When symptoms occur, they may include:

<ul>
	<li>Red spots in front of the eyes</li>
	<li>Flushing</li>
	<li>Dizziness 
	&nbsp;</li>
</ul>

The only way to know the person has high blood pressure is consistently high blood pressure readings, which is why regularly monitoring blood pressure helps with early diagnosis. If not treated or controlled, hypertension can lead to serious health issues, including:

<ul>
	<li>Stroke</li>
	<li>Heart attack</li>
	<li>Dementia</li>
	<li>Kidney failure</li>
	<li>Vision problems</li>
	<li>Amputation 
	&nbsp;</li>
</ul>

High blood pressure is responsible for 8.5 million deaths globally from ischemic heart disease, stroke, and renal diseases<a href="#accordion">[4]</a>. 
&nbsp;

High blood pressure during pregnancy can be dangerous for both mother and the baby. Whether it&rsquo;s a preexisting condition (chronic hypertension) or pregnancy-induced hypertension (gestational hypertension), it can cause preeclampsia, which is one of the major causes of maternal and infant mortality.

Preeclampsia, a critical blood pressure condition that develops during pregnancy, usually presents itself after the 20th week of pregnancy. However, it can occur earlier or during postpartum as well. It is characterized by headaches, nausea or vomiting, and abdominal pain. In some cases, it also causes swelling, sudden weight gain, and kidney, liver, and brain damage. 
&nbsp;

The risk of developing high blood pressure during pregnancy increases if the mother is:

<ul>
	<li>Obese</li>
	<li>Under 20 or over 40</li>
	<li>On a diet high in fat and salt</li>
	<li>Living with chronic stress</li>
	<li>Not physically active</li>
	<li>Pregnant for the first time</li>
	<li>Had preeclampsia during a previous pregnancy</li>
	<li>Pregnant via IVF</li>
	<li>Have chronic kidney disease, hypertension, diabetes/gestational diabetes, and an immune system disorder like lupus</li>
	<li>Have a history of thrombophilia</li>
	<li>Certain medications, including some pain relievers and birth control pills</li>
	<li>Having multiple pregnancies (twins, triplets, etc.)</li>
	<li>Have a family history of hypertension or preeclampsia</li>
	<li>Environmental factors 
	&nbsp;</li>
</ul>

High blood pressure during pregnancy is dangerous for the mother because it can cause complications, such as seizures, blood clotting problems, stroke, liver problems, and temporary kidney failure. It can also necessitate a c-section delivery. 
&nbsp;

Moreover, it prevents the placenta from receiving enough blood. This restricts the food and oxygen supply for the fetus, causing:

<ul>
	<li>Labor induction before the baby is full-term</li>
	<li>Premature birth</li>
	<li>Low birth weight</li>
	<li>Stillbirth 
	&nbsp;</li>
</ul>

The risk of these serious complications increases if the condition is not diagnosed in the early stage. As such, it&rsquo;s important that women are screened for hypertension during pregnancy just like any other condition. 
&nbsp;

A woman taking medicine, as advised by the doctor throughout the pregnancy, should take it during labor, too.

In the case of mild-moderate hypertension, the blood pressure is to be monitored closely every hour during labor. Blood pressure within the acceptable range increases the chances of a natural birth. 
&nbsp;

In the case of severe hypertension, the blood pressure is to be monitored every 15-30 minutes during labor. Also, doctors may suggest using forceps or opting for a cesarean section to deliver the baby.

Post-delivery, the mother&rsquo;s blood pressure will be monitored again. If they had hypertension before pregnancy, the doctor may need to review their treatment program again two weeks after delivery.

Postpartum preeclampsia is typically diagnosed within two days after delivery and treatment proceeds accordingly. 
&nbsp;

If the doctor approves it, it&rsquo;s okay to breastfeed while taking hypertension medicine. That said, some medications are not recommended for pregnant or breastfeeding women. It&rsquo;s best to always check the warnings mentioned in the manufacturer&rsquo;s information provided<a href="#accordion">[5]</a>. 
&nbsp;

Understanding the individual risk and warning signs of high blood pressure is important to prevent it. Additionally, women should:

<ul>
	<li>Eat a healthy diet and reduce the salt intake</li>
	<li>Maintain a healthy weight</li>
	<li>Quit smoking and alcohol</li>
	<li>Be active</li>
	<li>De-stress</li>
	<li>Get plenty of rest 
	&nbsp;</li>
</ul>

Excess fat, particularly abdominal fat, can raise blood pressure. Losing just 7.7 pounds can reduce this risk by 50%<a href="#accordion">[6]</a>.

Exercising and other forms of physical activity not only help shed the extra weight but also help keep the arteries flexible. According to the American Heart Association, regular exercise can lower the numbers by 8-10 points<a href="#accordion">[6]</a>. 
&nbsp;

Moreover, fat-free dairy products, dried beans, and fresh produce have a high content of calcium, potassium, and magnesium and help regulate blood pressure. However, evidence is needed to validate the effectiveness of dietary supplements (e.g., fish oils, folic acid) in preventing hypertension in women.

Besides, it pays if the individual avoids high amounts of sodium and saturated fat. Also, a 2017 report showed that a moderate intake of coffee is safe for consumption in case of high blood pressure<a href="#accordion">[7]</a>. 
&nbsp;

Meditation and other relaxation techniques, like breathing exercises, warm baths, and yoga, are also beneficial since stress hormones raise blood pressure. And while sleep alone cannot treat hypertension, poor sleep quality or sleeping less than five hours a night increases the risk of high blood pressure. 
&nbsp;

Important!

Women aged 30-60 should monitor their blood pressure even when their levels generally remain low. Compared to men, women have lower blood pressure but it increases earlier and also progresses faster. One reason could be that their blood vessels age faster than men&rsquo;s, making them more susceptible to developing hypertension and related problems<a href="#accordion">[8]</a>. 
&nbsp;

It&rsquo;s normal for blood pressure to fluctuate throughout the day. For instance, blood pressure is different while sleeping or relaxing compared to when a person is under stress or excited. However, when the resting blood pressure level is too high, it can stiffen, scar, or weaken blood vessels. A person may not necessarily feel unwell if they have hypertension or high blood pressure. 
&nbsp;

Do not start or stop any medication without first talking to a doctor. Women who are already taking medicine to lower their blood pressure and trying to get pregnant should consult their doctor first. If they&rsquo;re pregnant already, it&rsquo;s important to inform the doctor immediately. This is so the doctors can change the medication as soon as possible because some medicines are simply not safe to take during pregnancy.

Other than medications, lifestyle changes like eating a balanced diet and physical activity (e.g., walking or swimming) are important to reduce high blood pressure. 
&nbsp;