KCSE RESULTS AND HYPERTENSION

 Two weeks of silence. I'm back! I have been extremely busy during the weekdays and a tourist by the weekends. No excuse, I have been lazy!!!! This week, KCSE results were released. It's also on Monday that my boss and I were anxiously going through our 'KCSE' results ; our weekly histopathological reports from Agakhan University Hospital. Each batch comes in large numbers of around 20-30.  We are always so anxious to know the diagnosis of strange conditions we encounter and mostly crossing our fingers and hoping that we have less cancers. It's painful learning that certain patients indeed have cancer. My boss is  usually very anxious to know if the margins of tissues he removed are cancer-free and beaming when he learns that he did a thorough excision. You should see us seriously scruffling through the pages and commenting. For instance you would hear things like ' Oh, this is the lady teacher who came in with abnormal bleeds' or ' This is the mzee I admitted from Kangeta and I was too curios to know his progress making me pop-in in the weekends' or 'this is the father of the adamant three sons' or 'I knew it, it had to be lymphoproliferative disorder with that abnormal hemogram' etc. We quickly discuss the conditions briefly and decide on the way forward when the patients come to pick the results. The patients are usually always very anxious about the results to the extent that others literally lose weight in the days awaiting the arrival of the reports. I remember one lady was seriously shaking outside my office and I actually thought that she had urinary retention but later learned that she was too curious to know the meaning of the jargon that was written on her report. I could see a sigh of relief when I informed her that what she had was a totally benign condition; non-cancerous.  Away from 'KCSE,' today I want to talk about Hypertension. It's a condition that is becoming so common. I actually diagnosed my parents with it a few weeks back. Each day I diagnose 5- 10 people with hypertension. Of these, 8 are usually at the exact age of 55 years old. I don't know the relation between the  number 55 and hypertension.   Most of the times, Hypertension doesn't have any specific symptoms unless the blood pressure is too high. Patients present with any of the following symptoms;  persistent headaches, neck pains, blurring of vision, nausea, malaise, dizziness,palpitations, some even come in convulsing,with stroke or in a coma.  Hypertension is a paradox of an illness. Very easy to diagnose, very easy to treat and manage yet thousands of people go undiagnosed, others get sub-optimal treatment, some develop life-changing complications and others die.  Hypertension is defined as blood-pressure above 140/90mmHg in both variables or in one as in isolated systolic hypertension.  I will not go into details about how to grade it but it's graded differently depending on the values  How can we avoid hypertension? By  lifestyle modification. This involves eating low salt and low fat diet, exercising( atleast 30 minutes of brisk walking daily), cessation of smoking, reducing on alcohol use, reducing stress, managing well any comorbid illness one may have and most importantly weight reduction.Sedentary lifestyle should be avoided. We should all strive to have atleast a monthly Blood Pressure check irregardless of our age. This mostly applies to people with a family history of hypertension.  Hypertension can also be secondary to another illness. Patients with Diabetes, Renal Conditions, Heart Problems, Hyperthyroidism  etc are more at risk of developing secondary hypertension.  Medication for hypertension depend  on the grade of the hypertension. Some patients are only counseled of lifestyle modifications, others are put on one type of drug, others a combination of 2,3 or more drugs. The bitter truth about hypertension is that it's medication has to be taken for life. Its very frustrating to hear of patients who have been misguided by clinicians that their hypertension is healed and that they stop treatment only for them to come in with stroke or in coma. The doctor may reduce the number or dosage of drugs but at no given time can medication be stopped. I don't believe that herbal treatments heal hypertension, I will  leave this for further discussion.  There's no shortcut in the treatment. If not treated well, hypertension can cause complications like Congestive Cardiac Failure, Renal Failure, Stroke e.t.c One of my parents was frustrated when I told them that the medication has to be taken for life but I joked to them that probably God was passing them a signal to get grandchildren to remind them of daily drug use. That joke has become  a reality and today I celebrate the birth of AbdulRahim Mutula, my first nephew. As he grows older, may he the one to remind his grandparents to take their daily hypertension drugs.  Have a great referendum anniversary week.