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A new study reflects that those with hypertension need to be mindful of their condition and avoid risk factors such as stress and lack of sleep.
According to the study, stress at work and poor sleep can triple the risk of cardiovascular death in patients with hypertension.
Each year on May 17, World Hypertension Day is marked to raise awareness of how to manage or prevent the condition. One-third of the working population has hypertension or high blood pressure, and according to the World Health Organisation (WHO), nearly 1.13 billion people across the world suffer from the condition.
The study, published in the European Society of Cardiology last month, said it is the combination of stress and poor sleep that causes the increase in risk.
Author Karl-Heinz Ladwig, a professor at the German Research Centre for Environmental Health and the Medical Faculty, Technical University of Munich, said in the study: "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."
This study is the first to examine the combined effects of work stress and impaired sleep on death from cardiovascular disease in hypertensive workers, and the follow-up took place for nearly 18 years.
It included nearly 2,000 hypertensive workers aged 25 to 65, without cardiovascular disease or diabetes. Compared to those with good sleep and no work stress, people with both risk factors had a 'three-times-greater likelihood of death from cardiovascular disease'.
People with work stress alone had a 1.6-fold higher risk, while those with only poor sleep had a 1.8-fold higher risk.
During an average follow-up of nearly 18 years, the absolute risk of cardiovascular death in hypertensive staff increased in a stepwise fashion with each additional condition.
In the study, work stress was defined as jobs with high demand and low control, and impaired sleep was defined as difficulties in falling asleep and/or maintaining sleep.
"These are insidious problems," said Ladwig. "The risk is not having one tough day and no sleep. It is suffering from a stressful job and poor sleep over many years that fade energy resources and may lead to an early grave."
The findings serve as a red flag for doctors, who should now consider asking patients with high blood pressure about sleep and job strain, said Ladwig.
"Each condition is a risk factor on its own, and there is cross-talk among them, meaning each one increases the risk of the other. Physical activity, eating healthy, and relaxation strategies are important, as well as blood-pressure-lowering medication, if appropriate."
Dr Sohail Rukn, consultant neurologist and head of stroke unit at the Rashid Hospital, said the study's focus on the risk factors does emphasise how lifestyle diseases should be addressed.
"This study reflects the combined effect that risk factors can have on lifestyle diseases. In general, lifestyle diseases need to be looked at holistically and, therefore, the first step is to follow a three-fold strategy: healthy food, enough sleep, and regular exercise that includes the mind and body, such as meditation techniques," he said.
Dr Rukn added that sleep is one of the fundamentals for good health and well-being.
"If a person suffers from poor sleep for more than three weeks, he or she should visit a medical practitioner or a sleep specialist. Usually, anxiety and poor sleep go hand in hand and, therefore, relaxation therapies are needed. Sleep deprivation can also be due to underlining medical issues, such as sleep apnea and, therefore, medical intervention is needed," he added.
Dr Rukn also said people with hypertension must keep an eye on their salt consumption and, in general, people should consume only the daily recommended amount of sodium.
According to the WHO, a decrease in salt consumption of three grammes per day would result in a reduction in high blood pressure, which in turn would lead to a reduction of 22 per cent and 16 per cent in stroke and ischaemic heart disease deaths.
"In order to lead a holistically healthy lifestyle, people - especially those with chronic diseases such as hypertension - need to build daily habits that support their health and eliminate ones that do not," said the doctor.
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