From the earlier section, it can be seen that apart from factors outside our control such as kidney disease and genetics (and perhaps pregnancy), High Blood Pressure (HBP) is generally a direct consequence of our lifestyles – it is caused by what we choose to expose ourselves to.
By CHRIS CHAN
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File photo of potato chips. There is no doubt that humans enjoy food with added salt – and this is precisely why the food industry usually overloads processed foods with the stuff. Photo: Bloomberg
Not all the lifestyle items are always within our control, especially stress caused by work or other factors – but in general, if we are aware of what we are doing that can cause HBP, it could be a significant step in controlling the condition.
It’s mostly what we eat
Statistics derived from country testing of sodium levels in human urine between 1990 and 2010 indicate that the global average for salt consumption is a little under 10g a day, curiously rising to around 15g a day for the countries of Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan and Kazakhstan.
There is a reason for this Central Asian anomaly – these countries are along the ancient Silk Road. Communities along this old trade route relied heavily on food preserved with salt and this historical circumstance has left a legacy of high salt consumption.
Several South-East Asian countries fit in at around the average with unusual jumps for Thailand and Singapore which both come in at over 13g a day – a possible explanation is that people in these countries enjoy eating food cooked with local sauces (eg. oyster, fish, soy) and these sauces are very heavily laden with salt.
In fact, some sauces have as much as 2.5g of salt per tablespoon, and popular processed foods such as fish and meat balls lag not far behind.
Just to be clear, Malaysia probably also comes in at around the same level of salt consumption as Thailand and Singapore – however, we cannot be sure as there are no firm statistics available for the country.
Regardless, it is sobering to note that the maximum recommended daily limit set by the World Health Organisation (WHO) for salt consumption is actually only 6g – which means that many countries are exceeding the WHO daily recommendation by more than 100%.
Even in Western Europe, the average daily salt consumption is just over 8g, which is still some 33% higher than the recommended level. Some organisations such as the American Heart Association actually suggest even lower limits, at 4g a day.
Common sources of salt
There is no doubt that humans enjoy food with added salt – and this is precisely why the food industry usually overloads processed foods with the stuff. Examples of common, but often unsuspected foods where salt can be particularly high include breads, sauces, crisps, pizzas, canned/packaged meals, sandwiches, stock cubes, sausages, ketchup, mayonnaise, salad dressings, nuts, snacks, breakfast cereals and even ice creams.
Salt can often be disguised by including competing taste sensations such as sweetness, sourness or chilli heat.
Lower salt – but be wary
One simple, popular alternative to salt is to use potassium chloride – this compound is readily available in the supermarkets and has pretty much the same taste as sodium chloride but have rather less of the undesirable effects of salt.
However, please be wary as several research papers have indicated that consuming too little salt (or sodium) may have negative repercussions and potentially cause a condition known as hyponatremia (low sodium in the blood).
In particular, a study of over 3,600 people published in 2011 has found that participants with the lowest salt intake actually had the highest death rates from cardiovascular disease (CVD).
Why this is the case is not known – but a more recent study published in 2016 indicates that the curve for CVD deaths is a U-shape distribution plotted against sodium intake.
Too little salt is very bad and too much salt is also pretty bad – and in the end, the paper summed up its findings thus: “lowering sodium intake is best targeted at populations with hypertension who consume high sodium diets”.
In my view, this all confirms that sodium is an important electrolyte, but with a potential for significant, deleterious side effects – and therefore consuming not less than 4g and not more than 6g of salt a day is probably the optimal dietary option.
Sweet stuff and booze
Consumption of sugars and alcohol are clearly lifestyle choices – and there is a lot of evidence that suggests that persistent overconsumption of these items can directly lead to HBP.
Sugar (and/or fructose) is something that commercial food producers very often surreptitiously include copiously into processed foods – however, most food items now have labelling to indicate the amount of sugar present. So there is little excuse for claiming not to know about the amount of sugar in the diet.
My general take is that if one has been overdoing it, it should be worth cutting down a bit – or at least don’t encourage other people to have huge sugary desserts or open another bottle of wine. I appreciate that not opening another bottle of good wine is often a difficult concept to get your head around – but even I have managed it quite often.
Fags, drugs and other stuff
If you are intent on smoking or taking recreational drugs, then it is highly probable that HBP is not high on your list of health concerns. This is also likely to be true if you are particularly fond of fried, oily foods – especially those sold by fast food chains or street vendors.
But if you are compelled to work in polluted environments, it may be sensible to don some protective gear such as face masks or just generally avoid long exposures to chemicals and other pollutants – this is just common sense anyway.
The silent monster in the room
For many people, stress can be like a monster that won’t get off the chest. It suffocates them physically and mentally – and research has indicated that in addition to causing HBP, stress is likely to take several years off an expected lifespan.
The duration of stress is also significant. If a stressful event passes relatively quickly, then the impact of stress is much less than a prolonged struggle with an interminable problem. The reason is simply because the body would be pumping out stress-related hormones such adrenaline and cortisol for long periods of time.
A study of the police force in Buffalo, New York, published in 2013 showed that policemen there tend to have much shorter lifespans compared to the general population – around 21.9 years shorter in fact.
The possible reasons noted are stress, shift work, obesity and the somewhat hazardous working environment. It seems the type of stress is also relevant – and this is reflected in the lifespans of educated versus uneducated people in the workplace. Educated people tend to end up higher on the management ladder and also tend to live longer.
It appears that as long as people believe they can exert control over stressful situations, especially in the workplace, then there may be some benefit in terms of lifespan.
What about people who are not in control of stressful situations; for example, uneducated people working under an abusive boss? The prognosis is not quite so good in this instance and statistics indicate that prolonged workplace stress can reduce lifespan by several years.
There also appear to be other side effects of long-term sustained stress apart from HBP – research has shown that brain tissue can shrink, memory loss becomes more prevalent, and the immune system may be significantly compromised resulting in poorer health and even more stress.
Deal with it
As someone working in a rather stressful profession for many years, I can relate to research which indicates that a positive mental attitude can materially reduce the negative effects of stress. There are many positive approaches to stress and perhaps one personal example may be expressed as an analogy.
Imagine stress is like holding something out in an outstretched hand – for example a book. Initially, there is no effort at all, but after a short while it becomes tiring to keep the arm so extended. So naturally you would fold the arm to hold the book closer to the body – this might be seen as an attempt to manage or compensate for the stress.
That works until you realise that it is still too restricting to have to hold the book for so long (for example, you now cannot eat properly) – and then you think, is it worth holding up the book in this silly manner? The correct answer is: No – of course not, and then you put the book down and forget about it.
But this simple, rational decision to stop the stress is exactly what many people refuse to contemplate doing when they worry over situations they cannot control – hence they force themselves to keep reviewing and brooding over past and future events over which they have no influence, in effect painfully holding up an item they don’t need to hold up at all.
Degrees of stress incurred in life range from minor to extreme – frankly, it is based hugely on personal attitudes, but stressful events nevertheless have the negative effect of elevating blood pressure and it then becomes another subjective issue as to how well each person’s body can cope with prolonged exposures to stress.
From my individual viewpoint, it is just logical to go with the flow about things which one cannot change and to focus more effort on things one can actually influence.
No way back?
Why HBP is often difficult to reverse is because the condition very rarely has any visible symptoms – so it is extremely easy to let the condition become chronic before a sudden catastrophic health event announces itself.
But long before then, the damage would already have been done. The only way to detect HBP is through regular health screening – and one suggestion is to buy a sphygmomanometer (blood pressure monitoring device) for use at home to keep an eye on things.
This is what I have done for my family and it has helped me cut down on a few dietary excesses – and as a result, my blood pressure is now within a tolerable range.
File photo of a blood pressure monitor. The only way to detect HBP is
through regular screening. Photo: AFP/shutterstock
The battery-powered devices are not at all expensive, easy to use and testing takes less than two minutes. If you do find that you already have chronic HBP, there are drugs available to help manage the condition – better to know now and start doing something about it than ending up in hospital in a nasty condition.
Regarding my mother, she had rather a sweet tooth, was always fond of tasty, greasy, fried foods – and though she never drank alcohol, she also never did any exercise. Although she had a longer than average life span, the sad sobering truth is that the end for her was rather drawn-out and unsatisfactory. If only one person manages to avoid her fate as a result of reading this, then it would have been worth writing it.
As for myself, I am now somewhat allergic to long-winded Buddhist-Taoist funerals with protracted chanting and convoluted rituals that are rather hard on my back and knees. If I had known about them in detail beforehand, I would have firmly forbidden my mother from giving up the ghost.
http://www.star2.com/food/food-news/2017/03/26/the-pressure-of-blood-part-2/
