Management of Hypertension During Ramadan

Hypertension, commonly known as high Blood Pressure, affects 1 in 3 people globally and is the cause of 9.4 million deaths annually worldwide. Hypertension is rather rampant among Emiratis and approximately 40.8% of Emirati adults between the ages of 35-70 years suffer from hypertension, as revealed by a study conducted by the Dubai Health Authority.1

BP is the pressure of the blood in the blood vessels and is recorded as two figures, the first being the systolic pressure which is the pressure in the arteries when the heart contracts and the second number is the diastolic pressure which is the pressure in the arteries when the heart relaxes. An individual is said to have high blood pressure, if either of the two numbers, systolic/diastolic or both are higher than normal. An individual’s blood pressure reading varies from time to time and can be high at different times in a day depending on whether the person is anxious, angry, stressed or even working out and does not indicate high blood pressure. A person is said to have high BP when his/her readings are constantly high at different occasions and an individual is said to have hypertension when the readings are higher than 140/90.

Hypertension is also known as the ’silent killer’ because people may go on for years together without realising that they are suffering from this condition. People remain unaware of the condition until they experience symptoms like consistent headaches, fatigue or eye pain which they ignore by taking painkillers and multivitamins. Uncontrolled hypertension is the causative factor for various other health conditions like stroke, heart failure, renal failure and eye problems.

Causative factors of hypertension are multifactorial like genetic inheritance, unhealthy lifestyles including physical inactivity and consumption of unhealthy food items.

Fasting during the holy month of Ramadan is a spiritual practice which can get difficult for an individual with hypertension to manage. People fast during the day and have significant changes in their eating and sleeping patterns which can cause fluctuations in their blood pressure. There are numerous misconceptions about hypertension and fasting during Ramadan. One major myth is that fasting adversely affect their health and hence people with hypertension shouldn’t fast. Most studies of the recent times suggest that individuals with mild to moderate hypertension that is efficiently managed with healthy lifestyle practices and medication can successfully fast without harming their health. However, it is true that people with uncontrolled hypertension with multiple medications should refrain from fasting. There is always the risk of their blood pressure shooting high during Ramadan.

It is advisable to consult with a specialist to discuss and decide on medications to be taken during the course of one month. There is no permanent cure for hypertension, however, the symptoms can be managed and prevented from worsening.

Hypertensive patients must ensure to drink lots of liquids and avoid sweetened juices to escape dehydration. Reduce the intake of caffeine and caffeinated drinks as these can cause dehydration and other complications. Fresh fruits and vegetables help to control high blood pressure and must be made a part of Iftar and Suhoor meals. Avoiding high fat dishes and consuming low dairy products regulate blood pressure. People with hypertension should always be cautious about their health and watch for symptoms like a headache and dizziness. Exercise is a must to keep the body active even during Ramadan. Physical exercise reduces and controls the blood pressure. Smoking is also a causative factor for high BP and Ramadan is a great opportunity for smokers to quit smoking because it increases the systolic pressure which in turn increases the risk of heart diseases and stroke. Control of diabetes and cholesterol are extremely important in reducing the risk of cardiovascular diseases, even though they are not directly related to hypertension.

Consulting a specialist a few weeks or months prior to Ramadan is essential to curate a plan suitable health plan. There are also several home monitoring devices that function with the aim of improving chronic disease care through regular home monitoring, one being Aster Chronic Care@Home. This program enables patients to control diabetes and hypertension from home.through smart monitoring devices for monitoring blood glucose and blood sugar. The readings captured by the device are automatically updated to a mobile application on the patient’s phone and Aster Chronic Care health records. The readings are also closely monitored by paramedics through a contact centre. In a case of the fluctuations in the reading patterns, the patients receive SMS & calls from Aster care specialists.

Adopting a cleaner and healthier lifestyle helps to combat the onset of hypertension and its complications. It is always best to undergo regular checkups to ensure Hypertension is diagnosed early and further complications can be prevented. A healthy lifestyle includes weight reduction, regular exercise, and reduction of salt and alcohol intake. Lifestyle changes alone can help reduce the complications by a great extent if they are followed diligently.

Every year 17th of May is recognised as World Hypertension Day in order to raise awareness about the condition, complications and management. This year goes by the theme of ‘Know Your numbers’, to motivate people to check their blood pressure regularly and keep track of it. The World Hypertension League (WHL), in partnership with the International Society of Hypertension (ISH) and other organisations annually, hosts based on the global statistics, indicating that only 50% of those with hypertension were aware of their condition. In some populations, the awareness was lower than 10%. It is crucial to creating awareness among people about the condition to help them take control of their health and lead a better life.

Dr. Srinivasan Ravindranath

Specialist Cardiologist

Aster Clinic, Al Muteena (DMPC)