Understanding Hypertension: A Guide to Protecting Your Heart

By: Dr. Tirsit Tilahun Abebe

What Causes Hypertension?

In most cases, high blood pressure develops over time with no single identifiable cause; we call this 'primary hypertension'. It is often a combination of genetics, age, and lifestyle. In other cases, it can be caused by underlying conditions like kidney disease or hormonal imbalances (secondary hypertension).

Regardless of the cause, the result is the same: the force of blood against your artery walls is consistently too high, causing wear and tear on your internal organs.

The Situation Today

In Ethiopia, we are seeing a significant shift. Hypertension was once considered rare in our region, but current data from the Ethiopian Public Health Institute (EPHI) shows that nearly 1 in 4 Ethiopian adults now has high blood pressure. Most concerning is that many of these individuals are under the age of 40 and are unaware they have the condition.

How to Read Your Numbers

When you have your pressure checked, the results are categorized based on the risk they pose to your health. Use this table as a guide:

Category	Systolic (Top Number)	Diastolic (Bottom Number)	Action Required
Normal	Less than 120	Less than 80	Maintain healthy habits.
Elevated	120–129	Less than 80	Lifestyle intervention recommended.
Hypertension	130 or higher	80 or higher	Medical consultation required.

Am I at Risk?

Certain factors increase your chances of developing hypertension. Some we cannot change, but many we can:

• Non-Modifiable: Family history (genetics), increasing age, and certain ethnic predispositions.
• Modifiable: High salt intake, being overweight, physical inactivity, excessive alcohol consumption, and tobacco use.

How to Stay Safe

You can actively lower your risk by:

• Maintaining a diet rich in potassium (found in bananas, potatoes, and spinach).
• Managing stress through community, rest, or healthy coping mechanisms.
• Prioritizing consistent, quality sleep.

What Does it Feel Like?

This is the most critical point: Hypertension usually has no symptoms. You cannot "feel" your blood pressure rising. While some people may experience headaches, shortness of breath, or nosebleeds, these usually only occur when the pressure has reached a life-threatening level.

The only factual way to know your status is to have your blood pressure measured by a professional.

Prevention and Management

The goal of treatment is to protect your brain, heart, and kidneys from future damage.

1. Lifestyle as Medicine (Prevention)

• The "One Teaspoon" Rule: Limit your total daily salt to less than 5g. In Ethiopia, be mindful of added salt in Wot(stew) and snacks.
• Active Living: Aim for 30 minutes of brisk walking daily.
• Traditional Diet: Use Teff and legumes, which are excellent for heart health, and limit "white" foods like sugar and white flour.

2. Medical Management

If lifestyle changes are not enough, a physician may prescribe medication. Modern blood pressure medications are safe and highly effective at preventing strokes.

• Crucial Rule: Hypertension is a chronic condition. Even if you feel great, you must continue your medication as prescribed to keep your arteries protected.

Scientific Resources & Citations

• World Health Organization (WHO). (2023). Global Report on Hypertension.
• Ethiopian Public Health Institute (EPHI). (2024). National NCD Progress Monitor.
• International Society of Hypertension (ISH). (2024). Global Clinical Practice Guidelines.