Anxiety can cause hypertension

Dr. Turin Chowdhury

Hypertension problem is very much associated with lifestyle. One of the major components of our lifestyle is our mental status.
   
   What is blood pressure?
   Before exploring the relationship of salt and hypertension let us understand what blood pressure really is. Blood flows through the blood vessels all around the body. The force blood creates against the inner walls of the arteries is called blood pressure.
   Let us take a simple example from our daily life. If we take a rubber-made hosepipe used for watering in the garden and then try to squeeze close the pipe by pressing it with our fingertips, we will be able to do it easily. Now connect the pipe to water tap and open the tap. Water will start running through the pipe. Now if we try to do the same as before it will be nearly impossible to squeeze the pipe with our fingertips. This is due to the pressure forced by the flowing water on the inner wall of the rubber hosepipe.
   If we close the water tap now and the water stops flowing through the hosepipe, then we will again be able to squeeze close the water hosepipe with our fingertips. As there is no flowing water so there is no pressure force. In the same way flowing blood also puts pressure in the walls of the arteries in the body and that.
   
   What is high blood pressure?
   When the blood pressure in our body is above the normal ideal level then it is defined as hypertension or high blood pressure. People having the problem of high blood pressure - also known as hypertension - are more likely to develop heart disease or have a stroke than people with normal blood pressure levels. Uncontrolled hypertension can also lead to kidney failure and eye damage.
   
   Anxiety disorders
   Feeling worried or getting nervous from time to time is a very normal in our day-to-day living. Everyone feels anxious during our everyday life. It can even be said that even mild to moderate anxiety can be effective in achieving material and mental goals. A little bit of anxiousness can help us focus our attention, energy, and motivation in our activities.
   However, there are times or situations when anxiety can be severe. At such times one may have feelings of helplessness, confusion, and extreme worry. In some people these feelings are out of proportion with the actual seriousness of the feared event. It is like responding to a small possibility with serious mental anxiety. Anxiety that becomes overwhelming and interferes with daily life is not normal. This type of anxiety can cause physical and emotional symptoms. Anxiety disorders occur when people have both physical and emotional symptoms. Anxiety disorders interfere with personal relationships with others and affect daily activities. The symptoms of anxiety can be considered in two aspects:
   1) Physical symptoms of anxiety: These physical expressions of the symptoms may include
   * Visible trembling, unintentional twitching, or shaking or hands, legs or whole body depending upon the severity of anxiety situation.
   * Feeling of fullness in the throat or chest.
   * Breathlessness or difficulty of breathing and very rapid heartbeat.
   * Feeling of lightheadedness or dizziness.
   * Profuse sweating or cold, clammy hands.
   * Feeling fatigue.
   * Complaints of inability to fall asleep or stay asleep, early waking, or restless, unsatisfying sleep, etc sleep problems.
   2) Mental symptoms of anxiety: The mental symptoms of anxiety make it difficult for a person to communicate with the surroundings effectively and reasonably. Emotional symptoms of anxiety include:
   * Unable to express him\herself due to uncontrollable restlessness.
   * Feeling of excessive worrying without any rational reason.
   * Always fearing that something bad is going to happen
   * Inability to concentrate
   * Constant irritability
   * Constant feeling of sadness
   
   Anxiety and high blood pressure
   The anxiety in regard to the blood pressure can be described in few different angles.
   1) Anxiety in hypertensive people can be terrible: Anxiety itself does not cause persistent high blood pressure. Rather it can cause dramatic, temporary spikes in high blood pressure levels leading to terrible consequences. If these temporary but sudden episodes occur frequently, they can cause just as much damage to the blood vessels, heart and kidneys as persistently high blood pressure can.
   2) Anxiety leading towards hypertension: Anxiety has not yet been identified to be a reason directly behind hypertension diseases. But when a person is anxious, he or she is more likely to incline towards other unhealthy habits, such as smoking, drinking or overeating, which, in turn, can increase risk of high blood pressure. It is truer for people who are already having the risk factors of hypertension problem among them.
   
   Salt & heart disease
   For people under medication for high blood pressure problem the high salt intake may reduce the effectiveness of medication regarding blood pressure control. People who already have hypertension, a diet high in salt may further increase their risk of heart disease, stroke, and kidney damage.
   
   Fighting the risk
   Self management, combined with professional treatment, can help relieve anxiety.
   Recognising the problem: First of all one has to recognise and accept that he or she has an anxiety problem about specific fears or situations, and then make a plan for dealing with them. For example, if one may have constant worrying about financial issues and have anxiety problem regarding to those issues. If the anxiety goes out of hand but he or she does not recognise the problem tan nothing can be done. The friends and family has a great role here to make the person understand that he or she is undergoing an anxiety problem and it should be taken care off and the care has to be special. Now here the person also should be involved in the anxiety management.
   Physical activity: Anxiety affects our body and in some sense our body also can contribute in anxiety management. We can relieve tension with exercise or massage on regular basis. There are quite a number of relaxation techniques which we can practise and be benefited from. Getting enough rest is also important. Sleep problems should be discussed with the specialists rather than just taking sleeping pills.
   Diet issue: Any sort of food or drinks causing stimulation should be avoided. Avoid alcohol, caffeine, chocolate, and nicotine. Smoking must be stopped. These can increase anxiety level. On the other hand a healthy balanced diet will help maintain a healthy body and mind.
   Engage your mind: Trying to refresh mind is also very important. Try to get out and do something enjoyable. Taking up a suitable hobby may prove to be handy. A good idea is to get involved in social groups, or volunteer to help others.
   One has to keep track of the anxiety symptoms. Frank discussion with friends or caregivers about fears and concerns may relieve some steam. If needed, one should not hesitate to seek help and advice from mental health professionals.

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South Asian fiction

Rayyan Kamal

I've started reading the much acclaimed A Golden Age by Tahmima Anam. An English book written about our independence by a Bangladeshi is long overdue. I'm told it's been getting glittering reviews. Although I don't know her, I can take pride in the fact that I graduated from the same high school as she did. So far the book has not only been a good read, but has also been giving me a sorely-needed history lesson on the Liberation War.
   South Asian fiction in English is a field dominated by Indians. Salman Rushdie, be it due to actual merit or ability to inflame, is probably the Big Daddy in terms of fame. There's also V S Naipaul, who has won the Nobel Prize, though he's arguably not even Indian. During the 90's I was introduced to Rohinton Mistry, Arundhati Roy, and Vikram Seth. And this decade I have come to know the likes of Vikram Chandra and a personal favorite, Kiran Desai.
   Mistry's A Fine Balance is probably my favorite novel of all time. Likened to Dickens and Tolstoy, Mistry's ability to mold realistic and three-dimensional characters is perhaps only second to his talent for depicting harsh realities without begging the reader to feel sorry for the characters. In fact, this unflinching, almost objective portrayal is more successful in arousing the reader's sympathy.
   No South Asian novel in recent history received as much praise from the West as The God of Small Things by Arundhati Roy. For me, the book was a difficult read. I prefer conventional narratives to the disjointed, un-chronological form that she chose. In addition, I often felt as if she was making inside jokes that only she, and perhaps the characters, could understand. But I cannot deny the unique beauty of her language or the distinct power of her voice.
   Monica Ali's Brick Lane left me feeling disappointed. I found the book too slow and was unhappy with the oppressed-South-Asian-woman-who-finds-liberation-only-when-she-embraces-Western-ideals formula Ali used. I realize I am probably being biased, but I am tired of books that simply praise the West and put down the "East." It makes things too black and white for my liking.
   That's probably why I loved Inheritance of Loss by Kiran Desai. Even though it has won the Booker Prize, I don't think it has received as much attention as it deserves. People complain that it's too slow, doesn't go anywhere, the characters are not sympathetic, Desai complains about anything and everything etc., etc. I like it because it's always honest and very often humorous. It's true that Desai spends much time describing the setting and philosophising, but she does it in such an original and entertaining way that I can't bring myself to dislike her for it. I can simply laugh and be in awe of her genius.
   Enough about Indian writers. I hope Ms. Anam, with her patriotic labor of love, has paved the way for more Bengalis writing in English to follow. It will be good a way to implant Bangladesh in the consciousness of those who read English. Presently, India is South Asia. This is a situation that must be rectified.
   Rayyan Kamal is a sophomore at Yale University.

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Recently some newspaper published exaggerated news about labour unrest in EPZs which created wrong impression among the people. Bangladesh Export Processing Zone Authority (BEPZA) in a press statement clarified the situation.
   It said, presently 91 industrial units are operating in Dhaka EPZ, among them labour unrest occurred in one factory Lenny Fashion Company unit-2, because 103 workers of the factory became temporally sick on 3 August after eating sub-standard food supply by the contractor. Of them 101 workers were released on the same day after giving primary aid from hospital and remaining 2 workers being released the next day.
   It maybe mentioned that, according to BEPZA instructions and company rules the enterprises are not bound to supply food to the workers. It is being provided as part of labour welfare as additional facilities.
   However, when this matter was raised by BEPZA Lenny Fashion company cancelled the work order of the food contactor and decided to pay cash for food till the recruitment of a new food contractor. The workers demanded Tk. 30 in cash everyday for lunch. The factory authority agreed to provide Tk. 24 instead of previous food which was costing them Tk. 20 and the workers agreed. But some unruly workers stuck to their demand Tk. 30 and vandalising the factory and later observed abstention from work which created a set back to the production planning of Lenny Fashion Unit-1. For this reason Lenny Fashion authority was forced to filed a case against the some disorderly workers.
   It may also be pointed out that from 20 August Lenny Fashion Unit-2 has restarted their production. This labour unrest was not due to salary or indiscipline. This labour unrest was created by some selfish workers to cause trouble.
   On the other hand on 31 July, 2007 another industrial unit of Dhaka EPZ Ring Shine terminated 1000 workers of Knitting unit with full benefits of termination as they diversified products into spinning (textile) instead of the knitting (sweater) unit and that was on the basis of both workers-owner's concord, there is no respite of labour unrest. It may be pointed out that a sum of Tk. 1,31,006 was given as termination benefit to each workers. Some workers were terminated only for products diversification, not for any movement or unrest and same number of workers would be employed in new spinning unit. With this purpose on last Friday self motivated workers of another unit of this factory submitted application to the factory owners for termination with full benefit and the authority fixed termination date on next 07-09-2007. Recently this matter was published in the some newspaper as "axes on workers" which is not rational and objective. Indeed this is a termination with full benefit by the agreement of both workers and owners.
   Meanwhile, among 135 operating industrial units of Chittagong EPZ labour unrest created on 16 August in one industrial unit that was just an isolated incident. In the same way two workers of Euromode Fashion in Chittagong EPZ quarrelled with DGM of the factory, later a rumor was spread that those two workers were confined in the factory's service building, which was wrong. In this reason workers were agitated and some unruly workers broken 3 window/doors of glass and some flower pots of EPZ office.
   Publication of this news in different newspapers may creat negative impact amongst the foreign investors. We may mention that, there is no problem over salary of workers in the factories of EPZs. that is published in last October in ILO report as 94 per cent compliance. At present BEPZA is trying to ensure 100 per cent compliance in all the factories. It may be mentioned that BEPZA is playing role as bridge to ensure both workers and owners interest.
   So labour unrest was involved only in 3 factories out of 270 operating industries of 8 EPZs of the country.

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