Terrifying night-time high blood pressure

FOR some Jamaicans, the thought of experiencing nocturnal hypertension — which is elevated blood pressure during sleep — is terrifying.

Abigail Atkinstall, 22, a final-year student at The University of the West Indies, Mona (UWI), is one such Jamaican.

She told the Jamaica Observer that after heading home from a doctor’s appointment in 2014, she went to sleep because she had been experiencing a severe headache. Her medical check-up was for her blood pressure.

“My hypertension got worse in the night. When I woke up and my parents checked the blood pressure readings, it was very high and I had to be rushed to the hospital. I was told that I suffered a minor stroke, as I was unable to move,” Atkinstall recounted for Your Health Your Wealth.

“There really should be more awareness about the issue [nocturnal hypertension],” she added.

According to the the Ministry of Health and Wellness’s July 2020 publication, Interim Guidelines for the Clinical Management of Hypertension in Jamaica, high blood pressure, or hypertension, is a condition in which there is sustained, non-physiologic elevation of systemic blood pressure. It is measured in millimetres of mercury (mmHg).

Mayo Clinic explains that it is a condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems.

“Most of the current guidelines define hypertension as systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg,” Jamaica’s interim guidelines read. “Normal blood pressure is defined as SBP < 120 mmHg and DBP

Data from the Jamaica Health and Lifestyle Survey 2016/2017 indicates that one in three Jamaicans 15 years and older has hypertension, and four of every 10 with hypertension are unaware of their status. Additionally, 70.2 per cent (63.3 per cent male, 73.2 per cent females) of Jamaicans 15 years and older with hypertension are on treatment, and of those on treatment only 31 per cent (26 per cent males, 33.1 per cent females) are controlled.

Atkinstall, who shared that her hypertension is now controlled, explained that she was diagnosed with the condition at age 12, after suffering her first stroke while attending Holy Childhood High School.

“One day during class, my pen fell out of my hand and my friend asked if I was okay, but I could not respond. My speech and vision were not clear. When my classmates took me to the nurse and she checked my pressure, it was 200/140 mmHg,” said Atkinstall.

The university student told Your Health Your Wealth that she is now eating less salty foods, drinking more water, and exercising regularly to help with the management of her hypertension.

Adelta Hilton, a 61-year-old retired certified nursing assistant who was diagnosed with hypertension 34 years ago when she became pregnant with her daughter, had never heard about nocturnal hypertension until a comment was sought from her.

“I am not aware of that type of hypertension. High blood pressure during sleep? That sounds very dangerous,” she said.

Family physician Dr Pauline Williams Green explained to Your Health Your Wealth that nocturnal hypertension is detected by using 24-hour ambulatory blood pressure monitoring.

She explained that the condition is common in people who have other underlying health issues with hypertension.

“Studies in the United States of America suggest that nocturnal hypertension has been seen in 20 per cent of whites and 40 per cent of blacks. It is more common in persons with diabetes and chronic kidney disease,” Dr Williams Green said.

She said, too, that in order to treat nocturnal hypertension, there should be consistent adherence to blood pressure-lowering medications and regular monitoring of blood pressure. The physician also recommended living a healthier lifestyle.

“Persons should avoid smoking, and reduce alcohol intake. They should also reduce salt content in meals by avoiding processed foods — fresh or frozen foods are preferred — and regular exercise for at least 30 minutes each day should be maintained,” Dr Williams Green said.

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