Poor sleep a death risk in hypertensive patients

Hypertension or high blood pressure is a condition that affects many people in Kenya.

The Health ministry estimates that about 50 percent - or five out of every 10 adults in the country are suffering from the disease. This is one of the highest prevalence rates across the world.

Management of the disease is very important to prevent its adverse impact on the body.

Aside from treatment, which involves the use of blood pressure control drugs, a majority of Kenyans lack awareness on the role that other factors such as stress and sleep play in the management of the condition.

Mercy Mumo, 40, was diagnosed with the disease in 2015. Despite taking recommended drugs, she struggled to control it as she was going through immense pressure at work while at the same time dealing with an abusive marriage.

"In my mind, I treated the disease and my life as two separate things. I knew that so long as I was popping the pills, all would be well. But that didn't seem to work well.

Thanks to advise from her doctor, Mercy sought psychological support to help with the stress she was undergoing. During the counselling sessions, she was also equipped with strategies for tackling job pressures.

"This really helped me. And after that, my health started improving. In fact, my drug dosage reduced. So, I don't take many tablets as I used to before."

Aside from increasing the severity of the disease, research also shows that stressful lifestyles can rapidly cause death in hypertensive patients.

Recently, a new study published in the European Journal of Preventive Cardiology found that work stress and reduced sleep are linked to a three-fold higher risk of cardiovascular death in employees with hypertension.

"Sleep should be a time for recreation, unwinding and restoring energy levels. If you have stress at work, sleep helps you recover. Unfortunately, poor sleep and job stress often go hand in hand, and when combined with hypertension the effect is even more toxic," said Prof Karl-Heinz Ladwig, lead author of the study from the German Research Centre for Environmental Health.

The study included 1,959 hypertensive workers aged between 25 and 65 without cardiovascular disease or diabetes.

Compared to those with no work stress and good sleep, people with both risk factors had a three times greater likelihood of death from cardiovascular disease.

Those with work stress alone had a 1.6-fold higher risk, while those with only poor sleep had a 1.8-times increased chance of death.

In the study, work stress was defined as jobs with high demand and low control — for example when an employer wants results but denies employees the authority to make decisions.

"If you have high demands but also high control and you can make decisions, this may even be positive for health," says Prof. Ladwig.

"But being entrapped in a pressured situation that you have no power to change is harmful."

During the study, impaired sleep was defined as difficulties falling asleep or maintaining sleep.

According to Prof Ladwig, maintaining sleep is the most common problem in people with stressful jobs.

“The risk does not entail having one tough day and no sleep. It involves suffering from a stressful job and poor sleep over many years, which fade energy resources and may lead to an early grave."

Breathing exercises

Some of the effective stress management strategies include the following; performing breathing exercises to calm the body, learning to open up and share problems with others, having a positive mindset, making time for hobbies or interests, getting enough sleep, accepting that certain things are beyond your control, engaging in regular physical exercise, spending enough time with friends or those whose company you enjoy, learning to say No to requests that would create excessive stress in your life and effective time management.

Consuming minimal or no alcohol, as well as getting help to stop smoking are also helpful techniques for managing stress.

People with hypertension have a blood pressure that is higher than 130 over 80 mmHg.

Some of the major symptoms of the disease include headaches, dizziness, chest pain, shortness of breath, nosebleeds, visual changes and blood in the urine.

The risk factors of the disease include obesity, advanced age, tobacco use, physical inactivity, family history of hypertension, high-stress levels, too much alcohol use, enhanced salt intake and minimal levels of potassium in diets.