Transcript HYPERTENSION IN SPECIAL OCCASIONS

HYPERTENSION IN
SPECIAL OCCASIONS
Prof. YOUSEF Abdullah AL TURKI
Professor and Consultant FAMILY MEDICINE
Family and community medicine department
COLLEGE OF MEDICINE
KING SAUD UNIVERSITY
CONTENTS
 HYPERTENSION
DURING FASTING IN
RAMADAN
 HYPERTENSION DURING HAJJ
PERIOD
 HYPERTENSION DURING TRAVEL
 CONCLUSION
 FURTHER READINGS
CASE SCENARIO
 Ahmed
52 years, recently diagnosed to
have hypertension, he is on diet and
life style modification. Started on
Atenolol 50 mg once daily two month
ago, his BP 140/95.
Ahmed ask you if he can fast during
Ramadan safely?
HYPERTENSION AND FASTING

STUDY: The effect of the fast of Ramadan on
ambulatory blood pressure in treated
hypertensives. Perk G, etal. J Hum
Hypertens. 2001 Oct;15(10): 723-5
 Conclusion: Treated Hypertensive patients
may be assured that with continuation of
previous medications, fasting during the
month of Ramadan can be safely undertaken.
HYPERTENSION AND FASTING

STUDY: Variation of blood pressure during
the month of Ramadan. Habbal R, etal. Arch
malcoeu vaiss1998 Aug;91(8):995-8
 Conclusion: We can confirm that in patients
with essential hypertension without
complications, the fast is well supported. The
variations of BP are minimal and are related
to the variations of sleep,activity and eating
pattern.
HEART DISEASES AND
FASTING

STUDY: The effect of fasting in Ramadan on
patients with heart disease. Hassan Chamsipasha, Waqar H. Ahmed. Saudi Med J
2004;25(1):47-51
 Conclusion: The effects of fasting during
Ramadan on stable patients with cardiac
disease are minimal. The majority of patients
with stable cardiac disease can fast during
Ramadan without significant detrimental
effects.
HEART DISEASES AND
FASTING

STUDY: Does hospitalization for congestive
heart failure occur more frequently in
Ramadan: A population based study(19912001). Al Suwaidi J, etal.Int J Cardiol
2004;96(2):217-21.
 Conclusion: This population- based study
demonstrates that no significant difference
was found in number of hospitalization for
CHF which fasting in Ramadan when
compared to the non-fasting months.
MEDICATIONS DURING
RAMADAN

Frequency and doses of medications
 Antihypertensive drugs
Examples: -Thiazides
- Beta blocker
- ACE inhibitor
- Angiotensin ii antagonist
- calcium channel blockers
PATIENT EDUCATION AND
FASTING

Life style modifications:
diet advise
dietary sodium reduction
weight reduction
physical activity
psychosocial aspect
‫ ( يا أيها الذين آمنوا كتب عليكم الصيام كما كتب على الذين‬:‫قال تعالى‬
183 ‫ اآلية‬،‫ سورة البقرة‬.)‫من قبلكم لعلكم تتقون‬
CASE SCENARIO
 Ibrahim
65 years old, known
Hypertensive patient for the last 10
years on treatments.His BP 150/90.
He want to perform Hajj this year.
He ask you for health advise regarding
his hypertension before performing
Hajj?
HYPERTENSION AND HAJJ


Medical reports
Medications: drugs availability
Compliance
 Avoid physical exhaustion
 Proper utilization of health services
 Elderly patients
،‫ ( يريد هللا بكم اليسر وال يريد بكم العسر) سورة البقرة‬:‫قال تعالى‬
185 ‫اآلية‬
‫ اآلية‬،‫ ( وما جعل عليكم في الدين من حرج) سورة الحج‬:‫قال تعالى‬
78
HYPERTENSION AND HAJJ
 STUDY:
Pattern of admission to
hospitals during muslim pilgrimages
(Hajj). AL Ghamdi SM, etal. Saudi Med J
2003; 24(10):1073-6.
 Conclusion: Hospital admission during
Hajj is related to old age and occurs in
patients with associated co-morbid
conditions.
HYPERTENSION AND TRAVEL
 Medical
report
 Medications: Compliance
 Travel advise
 Control BP
 Pre travel stable status
 Control hypertensive patients can
travel safely
HYPERTENSION AND TRAVEL

STUDY: Toleration of high altitude by
patients with heart and pulmonary
diseases.Fischer, MMW fortschr Med 2003
Feb 20;145(8):36-8.
 Conclusion: It is, however, still possible for
patients with coronary heart disease, high
blood pressure or bronchial asthma to
tolerate high altitudes without having to
experience health problem.
 Prerequistes, optimal medications and pre
travel stable status.
CONCLUSION

HYPERTENSIVE PATIENTS CAN FAST
SAFELY DURING RAMADAN.
 HYPERTENSIVE PATIENTS CAN TRAVEL
AND PERFORM HAJJ WITHOUT HAVING TO
EXPERIENCE HEALTH PRBLEMS.
 PRE- TRAVEL STABLE STATUS IS
IMPORTANT.
 HEALTHY LIFE STYLES AND GOOD
COMPLIANCE TO ANTI HYPERTENSIVE
DRUGS WILL HELP TO MAINTAIN
CONTROLL BLOOD PRESSURE DURING
RAMADAN, HAJJ AND TRAVEL.
FURTHER READING

THE JOINT National Committee on Prevention,
Detection, Evaluation and Treatment of High
Blood Pressure
( seventh report)
http://www.nhlbi.nih.gov/guidelines/hypertension
 Clinical Evidence
www.clinicalevidence.org
 The Cochrane Collaboration
http://www.cochrane.org/
THANK
YOU