by Philemon kwizera, RN

Hypertension is the leading driver of cardiovascular disease deaths in Africa. Its prevalence is highest in older populations, Uncontrolled hypertension can affect various body organs and can lead to impaired vision, kidney failure, stroke, paralysis, heart attack and brain damage. Across all WHO regions, including the Americas, Africa has the highest prevalence of hypertension where 46% of the entire population over 25 years of age is estimated to be hypertensive.

A normal blood pressure reading is less than 120/80 mm Hg. Blood pressure that’s 130/80 mm Hg or more is considered high.

Systolic blood pressure :The top number represents the pressure in your blood vessels when your heart beats.
Diastolic blood pressure:The bottom number represents the pressure in your blood vessels between beats, when your heart is resting.
Hypertension is often called the “silent killer”: people with hypertension can be asymptomatic for year and then have a fatal stroke or heart attack, Hypertension has no cure, But it is easily detected and usually controllable!
Risk factors for Hypertension
• High salt (sodium chloride) intake
• High blood cholesterol
• Too much fat, saturated fatty acid, Trans -unsaturated fatty acids
• Overweight/obesity
• High levels of low density lipoprotein (LDL) cholesterol
• Physical inactivity
• Smoking cigarettes
• Excessive alcohol intake
• Family history

Reduced sodium intake
It can prevent CVD in persons at risk and can facilitate CVD control in older age persons on medication. Sodium should be limited to 6g per day, an equivalent of 100mmols of sodium (2400mg) per day. To achieve this, choose food low in sodium and limit the amount of salt added to food.
Consumption of diets that include a wide variety of fruits and vegetables:
These are high in nutrients and fibre and relatively low in calories and hence are nutrient dense. In addition, consuming a variety of fruits and vegetables (especially those that are dark green, deep orange or yellow) helps ensure adequate intake of micronutrients normally present in these foods.
Micronutrients that play a role in controlling high blood pressure include, potassium, magnesium, calcium and vitamin especially vitamin C.
Dietary patterns high in grain products especially whole grains
Grain products provide complex carbohydrates, vitamins, minerals and fibre. Foods high in starches (polysaccharides e.g. bread, pasta, cereals and potatoes) are recommended over sugars. A high complex carbohydrate diet is rich in fiber, minerals, vitamins and essential fatty acids. It is rich in antioxidants E, ascorbic acids and carotenoid especially lutein and zeaxanthin, which are important in preventing heart disease and delaying aging.
Diet high in fiber (Fibre)
Fiber is found exclusively in plant based foods. Animal foods such as milk, eggs, fish, meat and their derivatives contain no fiber. Insoluble fibres are found in higher concentration in vegetables such as carrots, green leafy vegetables, wheat and cereals. The insoluble fiber is found primarily in grain bran. Other sources of insoluble fiber include brown rice, rice bran, wheat bran, corn bran,
whole grain bread and cereals, cabbage family, cauliflower, green beans, green peas, legumes, mature vegetables, root vegetables, tomatoes, nuts, fruits such as pears, peaches, plums, seeds, strawberries, apples and bananas. High concentration of soluble fiber occurs in fruits, oats, barley and legumes such as peas, beans and lentils. High carbohydrates based on whole plant foods prevent obesity.
Consumption of diet that lower LDL (harmful) cholesterol:
polyunsaturated fatty acids which include fish and fish oils, soybeans, wheat germ, canola oil, sunflower oil, corn oil, cotton seed oil, walnut, some vegetables for example spinach, lettuce and broccoli, monounsaturated fatty acids such as avocado, cashews, canola oil, peanuts and poultry. The polyunsaturated and monounsaturated fatty acids lower BP, the level of
triglycerides and LDL cholesterol and consequently lead to increase in HDL cholesterol that carries cholesterol in the blood back to the liver for recycling or disposal. Fish and fish oils help prevent the development of atherosclerosis and heart disease. It is believed that fish oil exert their protective effect by lowering BP levels, blood triglycerides and LDL. Fish oils are also believed to reduce platelets and suppress the growth of smooth muscle cells in the arterial walls.

Potassium causes increased excretion of sodium by the kidney. also reduces secretion of rennin which operates to conserve sodium and blood fluids.
Dietary sources of potassium include foods such as blackstrap molasses, soybeans, wheat germ, pumpkins, bananas, almond, avocado, spinach, potatoes, sweat potatoes, carrot juice, tomatoes, whole grain bread, melon, cucumber, prune juice, beans, oranges, mangoes. Others from animal sources include salmon, cod, beef steak, cheese, cow’s milk and fresh eggs.
High consumption of magnesium reduces the production of prostacyclin which is vasodilating and increases the release of thromboxane. It also stabilizes calcium channels. Low blood magnesium lowers potassium level and leads to hypokalemia.
The food sources of magnesium ranked by milligram of magnesium per standard amount include bran, pumpkin and squash seeds kernel roasted, sesame, nuts, wheat germ, whole wheat flour, soybeans, molasses, spinach, white bean, green leafy vegetables, potatoes and oranges.
It increases sodium excretion. It also alters the vascular smooth muscle reactivity. Milk and dairy products are well known as the best sources of calcium.
Vitamin C
Vitamin C acts as a potent water soluble antioxidant in humans thus preventing oxidative damage to tissues and the genesis of atherosclerosis.
Vitamin C is found majorly in plant sources such as sweet red pepper, guava, black currant, broccoli, orange, lemon, cassava, peas, tangerine, tomatoes, potatoes and water melon. It may also be found in small amounts in animal sources such as beef, liver, oyster, trout and chicken.
Physical activity
Physical activity has measurable biological effects affecting cholesterol levels, insulin sensitivity and vascular reactivity. Moderate physical activity means 30 minutes brisk walking (3-4 miles) per hour, walking upstairs, dancing, bicycling and any exercise that will expend 200 calories per day.
Prevent and control obesity:
Limitation of dietary fats and alcohol (7kcal/g) is effective means to reduce both energy density and total energy.

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