World Health Day�April 7 : Is yours white coat or masked hypertension?

In white coat hypertension, blood pressure shows an increase in doctor's office and becomes normal at other places. In masked hypertension, except at office, the candidate's BP levels are highly elevated due to stress, anxiety and other factors. One in 10 people in their 20s and 30s, five in 10 people in their 50s suffer from hypertension. Take charge before it is too late

Naga Sundari

Experts of hypertension felt 24 hour home blood pressure monitoring (24 hr ABPM) service is regarded as the gold standard for blood pressure measurement. It helps identify different patterns of blood pressure like white coat hypertension, masked hypertension etc. They said proper measuring of blood pressure is not followed by number of medical practitioners in the hospitals. And repeat blood pressure measurement provides more accurate readings for administering accurate treatment procedures for the patients.

Startling facts

• Nearly half of patients with hypertension do not take medications as prescribed by their physicians.
• Majority do not know they suffer from hypertension until they visit the clinic for some other illness leading to more deaths every year.
• 95% patients with hypertension have primary hypertension � one that develops with age. Secondary hypertension, which develops at a young age, is attributed to tumours, arterial disease like renal artery stenosis etc.
• The theme of World Health Day this year is 'Preventing Hypertension.' As per World Health Organization data, High Blood Pressure (HBP) affects every third person above the age of 18 years. The number of patients in India with high blood pressure is likely to rise about 140 million in 2008 to nearly 215 million by 2030. The proportion increases with age, from 1 in 10 people in their 20s and 30s, 5 in 10 people in their 50s.

"Among senior citizens especially at the age of 75, almost 95 per cent of people suffer from hypertension. Stiffening of arteries can lead to hypertension and result in heart or stroke attacks also. High intake of salt , cholesterol and smoking can cause stiffing of the arteries. Hence low fat food, low salt intake, plenty of fruits and vegetables, avoiding red meat and processed food, regular physical exercises (daily walk of at least 45 minutes per day) can help control hypertension, obesity and diabetes In one word, lifestyle modifications make our lives go on a healthy track� " said Dr Mohammed A Rafey, renowned hypertension specialist and nephrologist.

"Repeated blood pressure measurement provides more accurate readings of the individual. At least once a week, measure your blood pressure at home in the morning and night. Keep a record of the readings and show it to your physician for review. It is the correct way to come for an understanding of blood pressure levels of any patient in their body accurately. Patients should remember that while high blood pressure is bad, very low blood pressure is even worse.

Especially in summer, dehydration or starvation can also lead to low blood pressure," warned Dr Rafey. There are two types of hypertension - primary and secondary. 95 per cent of hypertensives have primary hyper tension. It occurs as the arteries stiffen and kidneys are not able to maintain optimal blood pressure. Many diseases can occur due to secondary hypertension in which blood pressure levels get highly elevated. Different patterns of blood pressure can be observed. In normal blood pressure, BP is normal when measured in physician's office as well as at other places. Whereas in white Coat hypertension, BP shows an increase in doctor's office and becomes normal at other places.

In masked hypertension, except at office, the candidate's BP levels are highly elevated everywhere due to stress, anxiety and other factors. A "Many young men in their 20s approach us with complaints of high blood pressures and high cholesterol which happens because they are into junk food, sit for prolonged hours either at workplaces or at home. Another starling fact is that nearly 60 per cent of hypertensive patients stop their BP medication after one year of treatment assuming that the BP is under control. This can be dangerous," he warns.