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Hypertension and kidney disease in Ghana

Hypertension, also known as high blood pressure is a very common condition worldwide and also in Ghana. It has been shown to occur in 4.5 per cent to about 50 per cent of people depending on the population. This means when you take a group of 100 people at any point in time, up to about 50 of them may have high blood pressure. This is a disturbing fact!

It is more common among the older population, urban dwellers, diabetics and in those with obesity as reported in some studies in Ghana. Men are more prone to hypertension at a younger age than women, though women have a higher rate of hypertension at older ages. Lifestyle modifications such as increased intake of dietary salt, excessive alcohol, low dietary potassium and physical inactivity all contribute to an increased risk of hypertension. Those with a family history of high blood pressure of the black race and with poorly managed stress are also at increased risk.

Hypertension is associated with increased occurrence of strokes, convulsions, heart attacks, heart failures and kidney diseases worldwide and in Ghana. Blood pressure always have two readings. Your blood pressure is considered high when the upper value is greater than 140 and the lower value is greater than 90mmHg. In children, blood pressure is considered high even at lower values which is graded according to the age of the child. I guess you are surprised, yes children can also get high blood pressure.

High blood pressure is very common in Ghana. In most (90-95 per cent) of cases, the cause of hypertension is unknown. It can however run in families and can also be acquired as a result of diseases such as diabetes, kidney diseases, hormonal abnormalities and even during pregnancy. The use of illicit drugs like cocaine and medication such as birth control pills and steroids taken by mouth or applied on the skin as skin bleaching creams have been described as a causes of hypertension.

Hypertensive patients are mostly without any symptoms. You could have it for years and even decades without knowing. Some may however present with headaches, feeling of your heartbeat or with complications of hypertension such as stroke, convulsions, confusion, coma, heart failure and kidney failure.

I see these complication on daily basis and it gets me worried. It affects both young and old, male and female and we are all at risk.

It is interesting to note that half of the people who are hypertensive are not even aware they have high blood pressure. Of those who are have high blood pressure, again half are not on medications and of those on medication, about half are not well controlled. Poor control of high blood pressure leads to complications. A study in Ghana revealed that about half of the people who are hypertensive have some form of kidney disease.

If diagnosed to have high blood pressure, you should always be interested in the cause of your hypertension more especially if your age is less than 40 years. You can enquire from your physician for investigations to look for the cause of your hypertension as the majority of such patients have some form of kidney disease.

High blood pressure is a very common cause of renal disease and renal diseases can also present with high blood pressure. It’s a ‘chicken and egg’ situation and sometimes clinicians do not know which came first.

I see patients diagnosed with hypertension for decades who have never checked their kidney functions. If you have been diagnosed as having hypertension, you should have your kidneys checked every six months or at worse yearly to pick up early any deterioration in kidney functions. I suggest you have your kidneys checked with urine sample for protein and blood sample for your creatinine (a substance produced by muscles in the body which helps measure kidney function).

Get your blood pressure checked if you have never had it checked and get interested in your health. You can prevent and manage hypertension by;

  1. Decreasing salt intake. No added salt at the table.
  2. Work to decrease your weight or maintain adequate weight at all times
  3. Exercise regularly at least 30 minutes three times a week
  4. Get into the habit of incorporating physical activity into your work schedules to get yourself fit. Walk more and sit less! Use the stairs instead of the lift. Walk across to your colleague in a nearby office instead of calling on phone.
  5. Please ensure you take your medications if you have been told you have high blood pressure
  6. Have regular appointment with your doctor to keep your blood pressure below 140/90mmHg at all times.
  7. Be careful about medications that promise to let your high blood pressure disappear overnight. There is no such thing!
  8. Ensure you have your kidneys checked regularly if you are told you have high blood pressure.
  9. Ensure your doctor puts you on medications that prevent worsening of kidney functions if you are hypertensive.
  10. Plan a visit with the dietician to plan for you a healthy dietary lifestyle, avoid excessive alcohol intake and smoking. These increase your risk of complications.

By Dr Elliot Koranteng Tannor

Physician Specialist and Nephrologist

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