Last Saturday of October on the 30th, a memorial service for the late Jessie Chibanda, who was an administrator with Ernst & Young, was held at her brother’s house in Mabelreign, Harare.
Chibanda died after she had collapsed on the morning of Thursday September 23, about eight months after she had started taking high blood pressure pills.
Two days later, a prominent Arcturus widow also died a few moments after she had arrived home from a social visit at one of Harare’s northern suburbs.
The widow had complained about pain and weakness in one of her left hands as she walked into the lounge and plunged herself into a chair.
A young relative at the house discovered that she was dead as he tried to crack a conversation with her.
Simply speaking, this is what we call a sudden death.
But medically, this is a stroke.
Sadly, however, there are so many people in Zimbabwe that are unknowingly living with either diabetes or hypertension, who die without much warning.
Chibanda’s death left her family so confused.
It was a shattering experience for them.
“I had spoken with Jessie the previous day and to me she sounded fine. But I learnt that she had been having her blood pressure checked twice a day and that she had been taking a drug called Nifedipine to control her blood pressure since early this year,” Jessie’s brother Lemmy Chibanda said.
Hypertension and diabetes, also known as silent killers, are the leading causes of stroke.
Although statistics were not available at the time of going to press, Minister of Health Henry Madzorera described diabetes and hypertension as a ticking health time bomb.
He said diabetes and hypertension belonged to a group of diseases called the emerging epidemics of non-communicable diseases.
“These two diseases are going to be worse than HIV and Aids in as far as morbidity is concerned,” Madzorera said in a telephone interview.
Hypertension, according to Harvard Health Publications, is the single most important risk factor for stroke.
It causes about 50% of ischemic strokes and also increases the risk of haemorrhagic stroke.
“The damage that hypertension causes happens over time and is often only diagnosed when considerable damage has already happened to the body’s blood vessels.
“If you have hypertension you are unlikely to have any obvious symptoms for a long time. Symptoms associated with hypertension include tiredness, confusion, vision changes, angina-like chest pain, and heart failure, blood in urine, nosebleed, irregular heartbeat, ear noise or buzzing.”
However, most hypertension patients interviewed in Harare complained that it was difficult to access urgent medical attention due to financial constraints.
“I can only manage to visit the clinic once a month. I urge government to introduce a walk-in medical service where people with chronic conditions like diabetes and hypertension can quickly get tested and offered medication,” Christabelle Chourombo Mudzamiri from Tynwald North said.
Mudzamiri has been on high blood pressure pills since 1992, but she spent almost two years without undergoing any test because she was unemployed and sometimes skipped medication for months.
Another person living with diabetes and hypertension said it was imperative for the government to declare these diseases a national disaster because of their prevalence rate.
“Everywhere I go around Zimbabwe I meet hordes and hordes of people living with these illnesses. I also need a glucometer to check my blood sugar levels daily and also constant blood pressure checks and yet I can’t afford them,” said Alfred Muzanenhamo from Chivhu.
A person will know that they are hypertensive when a systolic blood pressure is above 140 mmHg and/or a diastolic blood pressure is above 90 mmHg.
Systolic blood pressure is the maximum pressure in the arteries when the heart contracts.
Diastolic blood pressure is the minimum pressure in the arteries between the heart’s contractions.
When the figures are consistently above 140/90 mmHg that means that the person has high blood pressure.
The strain hypertension places on blood vessels predisposes them to damage.
The heart also has to work harder to keep blood circulating.
When blood vessels weaken they are more likely to block, leading to stroke.
Stroke symptoms include:
A numb or weak feeling in the face, arm or leg; trouble speaking or understanding ;
blurred or poor vision in one or both eyes;
loss of balance or an unexplained fall;
difficulty swallowing; headache (usually severe or of abrupt onset) or unexplained change in the pattern of headaches;
confusion and unconsciousness.
Hypertension and diabetes are a dangerous combination.
A local doctor says it is not uncommon for people who have diabetes to also have hypertension.
He said hypertension is twice as common among diabetics as it is among people without diabetes.
“Although the two conditions seem to be linked, the mechanism by which they interact is unclear.
“The common denominator may be problems stemming from the body’s production and use of insulin. Like hypertension, diabetes increases the chances of developing heart disease and stroke, as well as kidney disease and eye damage.”
He said having both diabetes and hypertension raises these risks even more.
A local female doctor said there was growing public health concern in Zimbabwe about underestimation of this problem due to poor diagnostic skills and poor reporting.
She said hypertension and diabetes had been overshadowed by newly emerging diseases such as HIV and Aids, and re-emerging disease such as tuberculosis.
“There is also an imbalance in resource allocation to curb the major non-communicable diseases that also include cancer, respiratory infections, injury caused by accidents,” she said.
According to a 2001 report in a journal of the American Heart Association, as many as 75% of the cases of cardiovascular disease in diabetics are the result of hypertension.
Thus, keeping blood pressure in check may be a vital factor in preventing heart disease and strokes among diabetics.
Not only are diabetes and hypertension linked to cardiovascular disease, but they can also lead to kidney disease and eye damage.