Many of us are familiar with hypertension from quite early because it is so frequently spoken about in our homes. We grow up hearing our parents, older relatives, or family friends speak of having high blood pressure. We were scolded for eating salty foods, and now we do the same to our children. The admonishment remains the same: you’ll “raise your blood pressure.”

Sadly, scolding and warnings have done little to address the issue of hypertension in the Caribbean. The Pan American Health Organization (PAHO) reports that in the Americas, 35.4% of adults aged 30-79 are affected by the chronic disease. However, alarmingly, the Caribbean region is known to have the highest prevalence of hypertension in the Americas. As late as 2021, the Caribbean Public Health Agency (CARPHA) Executive Director, Dr Joy St. John, stated that the region’s above-average figures ranged from “a high of 27.1% to a low of 20.9%.”

Hypertension, often called the silent killer, should not be taken lightly. It is the foremost risk factor for illnesses and premature deaths caused by heart disease. Arguably, it is one of the most well-known non-communicable diseases. Still, more must be done to keep our numbers down. Although you’re potentially at greater risk if it runs in the family, it can be avoided with lifestyle changes.  

So, let’s talk about it in detail. Read on as we discuss what it is, its causes, treatment, the Caribbean’s stats, and more.

What is high blood pressure?

According to the World Health Organization (WHO), it is a condition that occurs when “the pressure in your blood vessels is too high.” Reading levels are measured in two values, placed one above the other. While the top figure represents the force your blood pushes against your arteries during your heartbeats (systolic), the bottom signifies the pressure your blood pushes against your arteries as your heart rests between beats (diastolic). The values are measured in millimetres of mercury (mmHg).

What are the typical readings for each stage?

An ideal or normal reading for an adult is less than 120 systolic and a diastolic below 80 (120/80mm Hg). Higher values are categorised as elevated, hypertension Stage I, hypertension Stage II, and hypertensive crisis. Such levels, if left untreated, can cause damage to blood vessels and organs, resulting in serious health complications. Here are examples of blood pressure readings for the four categories:

• Elevated: 120-129/80 or under
• Hypertension Stage 1: 130-139/80-89
• Hypertension Stage 2: 140 and up/90 and up
• Hypertensive Crisis: above 180

What causes high blood pressure?

There are two types of hypertension: primary and secondary. Primary hypertension, developed in adults, does not have an identifiable cause. Nevertheless, fatty deposits such as cholesterol can clog the arteries over time, increasing the risk of high blood pressure. On the other hand, secondary hypertension results from a preexisting condition. Usually, these levels are higher than those of primary hypertension.

What are the symptoms of high blood pressure?

This is where it gets alarming. We previously mentioned that it’s also called the ‘silent killer’ because there are no symptoms. It’s possible to have it for years and not be aware. Notably, some people may experience headaches, nosebleeds, or shortness of breath at life-threatening levels. However, this is not always the case. The only way you can truly know is to get tested. 

What are the risk factors of high blood pressure?

Several factors make some people more susceptible to elevated levels. Many of us are already aware that family history plays a significant part. If other family members have had it, we’re more likely to develop the condition. However, other factors are race, age, obesity, and lack of regular physical activity.  

How do you treat high blood pressure?

When dealing with high blood pressure, management is critical. PAHO reported in August 2024 that typically hypertension is not managed, although it affects an extensive number of people in their 30s and older. What does management or treatment entail? For both types, it requires lifestyle changes and/or medication. Now, when we speak of making lifestyle changes, it’s about more than lowering your sodium intake. Nonetheless, that’s a good place to start because salt causes the body to retain fluids, elevating blood pressure.

Lifestyle changes

Diet: You’ll need to revise your diet. The American Heart Association (AHA) recommends a Dietary Approach to Stop Hypertension (DASH) diet. The Dash plan emphasises the importance of consuming fruits and vegetables, whole grain foods, fat-free or low-fat dairy products, skinless poultry and fish, nuts, and legumes.

Physical activity: You can lower your blood pressure through regular physical activity. Maintaining an exercise routine, like walking, jogging, or running, helps your heart to beat faster and stronger, helping it to pump blood more efficiently.

Quit smoking: AHA Chief Medical Officer Dr Eduardo Sanchez warns that smoking negatively affects your blood pressure, as it accelerates your heart rate and narrows blood vessels. Furthermore, it increases the likelihood of plaque buildup on your blood vessels (atherosclerosis), making it more difficult for the heart to pump blood effectively. When this occurs, it can lead to other health conditions, including heart attack and stroke.

Medication

Medications are prescribed depending on the severity of your condition. They help reduce the chance of developing complications, avert organ damage, and improve your health.  

What are the statistics for the Caribbean?

We’ve already mentioned that our region has above-average figures for hypertension, but here are a few others to note:

• 37% of people with hypertension remain undiagnosed.

• 15% of people diagnosed fail to receive treatment.

• 47% of people treated for hypertension fail to control their blood pressure.

Although the Caribbean has incredibly high numbers of hypertension, we can control it. By maintaining a nutritious, low-sodium diet, exercising regularly, and not smoking, you can enjoy optimal health. It’s equally important that you get your pressure checked periodically. If, however, you have been diagnosed with hypertension, then commit to the type of treatment prescribed by your medical doctor. It will help you control your blood pressure.

This article is for informational purposes only and should not be relied upon as a professional opinion. Consult your medical practitioner for more information on hypertension risks, causes, tests, and treatment.

Sources: American Heart Association, CARPHA, Cleveland Clinic, Mayo Clinic, PAHO, and WHO.