Livadia Palace, in Crimea, Yalta, located in southern Ukraine, on the shores of the Black Sea, was the summer retreat of Russian Tsar Nicholas II. With 116 rooms, each furnished in different taste and design, it was the ultimate in opulence. It was here on February 4, 1945, that the big three world leaders — British Prime Minister Winston Churchill, American President Franklin D. Roosevelt, and Chairman of Russian Federation Joseph Stalin — met and decided to draw the curtain on one of the bloodiest human conflicts, the Second World War. While they conferred on ending the animosity, unknown to these three men, a common enemy was working silently, planning a sinister personal attack on each one of them, an attack of a different kind. Hypertension.

Exactly 68 days later, President Roosevelt died of massive cerebral haemorrhage. Joseph Stalin in 1953 and Sir Winston Churchill in 1965, died of cerebral stroke. All the three leaders succumbed to the complication of a totally preventable disease — high blood pressure, ‘hypertension’ in medical terms.

The most important strategy in a war is an early and clear understanding of the sting and reach of the enemy. Till recently, doctors failed to do so against ‘hypertension.’ As recently as 1931, the British Medical Journal (BMJ) editorial warned: “The greatest danger to man with high blood pressure lies in its discovery, because then some fool is certain to try and reduce it...”

For two long years preceding his death, Roosevelt’s physicians recorded his blood pressure as high as 200/110 many times (severe hypertension by today’s standards), but never felt alarmed. On April 13, 1945, the day after the President’s death, his physician issued a statement that “his death came out of a clear sky,” meaning there was no warning at all. At that time no one thought that this level of blood pressure was abnormal and could cause brain haemorrhage or stroke. This lack of understanding of its long-term complications is what makes high blood pressure unique.

Disease of 30%

Hypertension is often referred to as a disease of 30%! Actually, this denotes that only about 30% people with high blood pressure are aware of it; of those aware, only 30% are treated and among them it is controlled to the recommended goal only in 30%. In India, it is a dismal 50% instead of the western 30%. Stroke, brain haemorrhage, loss of vision, heart attack, bulging of vessels in the chest (aneurysm), kidney failure, are all listed as complications of hypertension.

One major problem of hypertension detection, unlike other diseases, is that it has hardly any symptom. A majority of patients with high blood pressure don’t have headache or vision problem nor do they get angry or annoyed soon, despite popular belief to the contrary. This means there are hardly any warning signs. The victim can be apparently healthy, you or me. So the only way out is to get our BP checked and know our numbers.

It takes less than five minutes for a medical professional to record blood pressure. Undetected high blood pressure can result in massive brain haemorrhage and kill a person instantly. Even if the victim survives, the social and economic implications of living with a stroke-related disability are even more painful. The December Issue of Lancet quotes the Global Burden of Disease (GDB 2010) database to show that high blood pressure ranks as the number one risk factor responsible for death and disability worldwide.

May 17, every year, is celebrated as World Hypertension Day (WHD). By spending just five minutes of your time, you might benefit by decades of healthy future. Call it a short cut to good health, if you wish.

(The writer is Head, Dept of Cardiology, PRS Hospital, Thiruvananthapuram. Email: tinynair@gmail.com)

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