High blood pressure, the silent killer

By Carol Aloysius

High blood pressure (Hypertension) is one of the leading causes of Non Communicable Diseases which have overtaken communicable diseases in many countries including Sri Lanka. If not controlled, it can lead to strokes and cardiac arrests diminishing the quality of life of the victims and eventually leading to premature deaths.

According to Health Ministry sources, the percentage of adult Lankans with High blood pressure is nearly 42 percent , with about 41.9 percent of Lankan men and 37 percent of women suffering from the disease. The disease now regarded as one of the main health issues in the country, has also prompted the Health Minister to request the Ministry of Non Communicable Diseases a country-wide survey of people suffering from High Blood pressure.

The main causes of hypertension stem from unhealthy lifestyles which include smoking, drinking alcohol and consuming excessive quantities of salt. Whereas in western countries processed foods, such as hamburgers, potato chips, and other fast foods are the main causes for hypertension, in Sri Lanka and other countries in the region, salt in our daily meals is one of the chief culprits.

Today, in its global message to people everywhere, on World Health Day, the World Health Organisation (WHO) has focussed special attention on blood control, highlighting the fact that the responsibility lies entirely on the individual.

Community Physician, Ministry of Health Dr Usha Perera who recently met WHO representative Dr F.R. Mehta and also spoke to other health experts, has this to say on this debilitating non communicable disease which affects thousands of Lankans without them even being aware they have the disease.

Excerpts

It sneaks up the path to your house and hides in close proximity to it but you don’t see it because you don’t look for it. It stays patiently lurking in the shadows and listening to your footsteps and watching your movements and closing upon you step by step until one day catches hold of you to rob you of your precious health and if it could, to also take your life away from you.

High blood pressure or hypertension has been ominously described as the silent killer as it hides undetected and then emerges explosively as a heart attack, stroke, kidney failure or blindness.

It is for this reason that the World Health Organisation has chosen Blood Pressure as its theme for World Health Day 2013. World Health Day is celebrated on April 7 every year to mark the anniversary of the founding of WHO in 1948.

“Each year the WHO focuses on a theme of Public Health importance to bring the issue into highlight and advocate governments and policy makers to recognise that issue and to take positive action.

The theme for 2012 is High Blood Pressure and the slogan for the South East Asian region is, Blood Pressure - Take Control”, says Dr. Firdosi Rutom Mehta, the World Health Representative for Sri Lanka.

Blood Pressure is a normal clinical measure that describes the force of which the heart pumps blood into vessels which is similar to the force of which a pump drives fluid into its piping.

It is commonly described by two numbers, the upper being systolic which represents the blood vessels when the heartbeats and the lower as diastolic when the heart rests between the beats which is always lower in value than the systolic. Hypertension or high blood pressure is defined as a systolic pressure equal to or above 140mmHg and / or a diastolic pressure equal to or above 90mmHg.

“High Blood Pressure is a component of Non Communicable Diseases (NCDs) that came into focus of the world and in April 2011 at a WHO ministerial meeting in Moscow followed by a UN General Assembly meeting in New York where it was taken up for further discussion. This had been only the second time a health issue was discussed at this level the first one being HIV/AIDS. This was a key milestone in the international campaign to curb the impact of NCDs consisting of cancers, cardiovascular diseases, diabetes and chronic lung diseases.

The modifiable risk factors of all NCDs that have been proved to be cost effective are tobacco use, harmful use of alcohol, improper diet and physical inactivity” explains Dr. Mehta.

It has been shown that that as much as 36 million people worldwide die every year of these NCDs and of which 9.4 million are due to high blood pressure.

Also over one billion people are living with high blood pressure and according to WHO statistics in 2008, globally; the overall prevalence of high blood pressure including those on medication in adults aged 25 and above was around 40 percent.

In the South East Asian region where we live, high blood pressure is a leading risk factor for death claiming 1.5 million lives yearly and among these deaths almost 25 percent occur prematurely below the age of 60 when they are at the peak of their lives which not only contributes to personal tragedies but also reducing a workforce of a country.

“Blood Pressure is a metabolic risk factor and not a behavioural risk factor and as such if people can take positive steps to control it, all risks associated with it can be reduced. As a diet modification, salt reduction has been found to be a key factor in reducing blood pressure. WHO recommendation of daily salt consumption is 5mg, but studies done in Sri Lanka by Dr. Renuka Jayatissa shows that the average daily intake of salt in the country is around 10mg and even going up to 12 mg. This is not due to fast foods as Sri Lanka consists mainly of a rural population, but because Sri Lankans add salt into their staple diet rice when cooking it as well as into the curries. So the message is, don’t add salt to rice and reduce the quantity adding into curries”, says Dr, Mehta. Studies have shown that persisting in high salt consumption also negates the desired effect of drug therapy.

Also it has been found that high cholesterol diets aggravate hypertension while low cholesterol diets conversely reduce it.

Exercise alone reduces blood pressure to some degree although it may be difficult to be consistent in people who are extremely busy. So, it pays well to watch the diet by limiting salt and cholesterol intake and to exercise regularly to facilitate achieving blood pressure goals.

The final goal of management of hypertension is reducing the risk of developing heart attacks, kidney disease, strokes and eye damage.

Controlling the blood pressure is actually an intermediate step towards this. “According to statistics available a Sri Lankan sees a doctor on average about five times a year.

Therefore, a high index of suspicion is important for everyone and it is important to get one’s blood pressure tested when seeing a doctor.

One reading is not enough to be conclusive and it is necessary to get tested more than once for diagnosis.

Once diagnosed with High Blood Pressure lifestyle modifications such as cessation of smoking, reducing alcohol intake, reducing salt intake and daily physical exercise should be undertaken and still if blood pressure remains uncontrolled a person should be started on medication”, says Dr. Mehta.

According to the WHO it is also extremely important to adopt lifestyle measures to not only control blood pressure but also to prevent all NCDs as prevention is always better than a cure.

Increasing compassion through meditation

Scientists have mostly focused on the benefits of meditation for the brain and the body, but a recent study by Northeastern University's David DeSteno, published in Psychological Science, takes a look at what impacts meditation has on interpersonal harmony and compassion.

Several religious traditions have suggested that mediation does just that, but there has been no scientific proof - until now.

In this study, a team of researchers examined the effects meditation would have on compassion and virtuous behaviour, and the results were fascinating. This study invited participants to complete eight-week trainings in two types of meditation.

After the sessions, they were put to the test.

Sitting in a staged waiting room with three chairs were two actors. With one empty chair left, the participant sat down and waited to be called. Another actor using crutches and appearing to be in great physical pain, would then enter the room.

As she did, the actors in the chair would ignore her by fiddling with their phones or opening a book.

The question DeSteno and Paul Condon - a graduate student in DeSteno's lab who led the study - and their team wanted to answer was whether the subjects who took part in the meditation classes would be more likely to come to the aid of the person in pain, even in the face of everyone else ignoring her. “We know meditation improves a person's own physical and psychological wellbeing,” said Condon. “We wanted to know whether it actually increases compassionate behaviour.”

Among the non-meditating participants, only about 15 percent of people acted to help.

But among the participants who were in the meditation sessions “we were able to boost that up to 50 percent,” said DeSteno.

This result was true for both meditation groups thereby showing the effect to be consistent across different forms of meditation.

“The truly surprising aspect of this finding is that meditation made people willing to act virtuous - to help another who was suffering - even in the face of a norm not to do so,” DeSteno said,

“The fact that the other actors were ignoring the pain creates as ‘bystander-effect’ that normally tends to reduce helping.

MNT

The five-second rule

If you’re reading this while eating breakfast and you happened to drop your food on the floor, you might want to stop (eating, that is, not reading).

A BBC investigation has proved that the five-second rule, followed so slavishly by so many of us, is not only hokum, but also potentially dangerous. For those not familiar with it, the five-second rule states that one is allowed to eat something that has dropped on the floor, provided that it has stayed there for no longer than five seconds (and has been given “a bit of a wipe” afterwards).

It might sound a bit dodgy when spelled out, but in residences up and down the land (where it is sometimes reduced to a mere three seconds) it is held as a quasi-scientific fact, self-justification that greed is more important than health risks and a reminder not to be fussy.

To test the theory, the Beeb sent reporter Sophie van Brugen to meet Dr Ronald Cutler at his laboratory. Pizza, toast (butter side down) and an apple that were dropped on a kitchen floor, a carpet and a street, respectively, were taken to the lab for testing.

A day later, all three items showed themselves to be covered in bacteria. Even the pizza that ended up on the kitchen floor had evidence of “faecal bacteria” on it.

It’s not the first examination of its kind. In 2004 a study by a American student, Jillian Clarke, at the University of Illinois, won the year’s Ig Nobel prize (a sort of satire on the real Nobels) in the field of Public Health. And in 2007, a team from Clemson University in South Carolina published its findings on the prevalence of bacteria found on food dropped on the floor in the Journal of Applied Microbiology.

While the evidence is unlikely to phase the old-matronly types who are fond of bleating lines such as “a little bit of dirt is good for you”, it could make those who pick up food thrown from children’s plates to the floor and give it back to them think twice about doing so.

And it should also disavow people of the notion that bacteria somehow respect superstition.

- The Independent

DNA transistors pave the way for living computers

Computers made from living cells, anyone? Two groups of researchers have independently built the first biological analogue of the transistor - an integral element of modern electronics.

It should make it easier to create gadgets out of living cells, such as biosensors that detect polluted water.

A transistor acts as a switch, converting electrical inputs into output signals via logic gates. Now, Drew Endy at Stanford University in California and colleagues have designed a transistor-like device that controls the movement of an enzyme called RNA polymerase along a strand of DNA, just as electrical transistors control the flow of current through a circuit.

A different enzyme acts as the input, which depending on the sequence of the logic gates, either stops or starts the flow of polymerase. The device can also amplify its flow, another important function of transistors, allowing them to power other components in the circuit. Because combinations of transistors can carry out computations, this should make it possible to build living gadgets with integrated control circuitry.

A similar device has been built by Timothy Lu at the Massachusetts Institute of Technology, but amplification gives Endy's device the edge.

For example, bacterial cells are good at detecting pathogens or chemicals, such as heavy metals, says Freemont. By redesigning the circuitry that a bacterium uses to sense things, we could produce cheap biosensors that monitor water quality. “Underpinning all of that will be these foundational components, like in electronics,” he says. For Endy, the applications are limited only by our imagination. He suggests we could one day have living bridges or buildings constructed by the self-directed growth of their natural materials, controlled by internal biological circuits, or even tiny medical “submarines” with on-board DNA computers navigating the inside of our bodies.

- NewScientist