PEME advice: Hypertension

Hypertension is currently the second most frequent reason for PEME failure and the illness alone represents 8% of all unfit decisions.  Hypertension is a constant cause of crew illness incidents and can lead to heart disease, stroke, vascular dementia and chronic kidney disease.  In 2014 it was estimated that Hypertension cost the NHS in the UK over £2 Billion in health care services and medications.

Dr Marcus Brauer, a General Practitioner from one of the Clubs PEME approved clinics in South Africa provides us with valuable medical insight into one of the industry’s most concerning medical issues, Hypertension:

Hypertension is one of the most common conditions diagnosed during PEME examinations. Other commonly diagnosed conditions worthy of mention are obesity and diabetes. Obesity is often a precursor to both hypertension and diabetes and therefore the three conditions are intimately inter-related.

Hypertension is a major risk factor for heart disease, stroke, congestive heart failure and kidney disease. Hypertension is usually asymptomatic, meaning in most cases the patient is unaware of the condition. In most cases Hypertension is only discovered through routine blood pressure readings, such as those taken during the UK Club’s PEME examinations.

Hypertension is an elevation in blood pressure which leads to damaged blood vessels in the brain, heart and kidneys. The longer this process goes undetected, the more difficult it becomes to manage the condition with medication.

Some contributing causes of Hypertension; 

• Smoking
• Inactivity
• Stress
• Obesity
• Alcohol
• Poor diet

Measures for improvement:

Education of the benefits of a healthy lifestyle - How we live determines how healthy we are and consequently determines the quality of our later life.

• Stop smoking - or at very least reduce smoking 
• Achieve a healthy BMI of <25. If above this value to strive to continuously reduce your BMI.
• Healthy eating habits - With emphasis on eating fresh fruit, vegetables, salads and healthy protein. The consumption of starches and sugars should be reduced wherever possible and feasible
• Perform regular exercise - aim for a 30 minute workout at least three days a week.
• Avoid excess salt in food - This is of particular note when pursuing a healthy lifestyle. Remember that some products like Soy sauce have high salt contents.
• Manage any co-existing medical conditions such as diabetes and elevated cholesterol levels
• Manage stress - exercise, meditation, yoga and breathing exercises can all be beneficial.
• Avoid excess alcohol consumption –recommended consumption levels are less than 5 units of alcohol in a 24 hour time period, and not more than 14 units of alcohol per week. 

Ultimately the responsibility of a seaman’s health rests with the individual but encouraging a healthy, active lifestyle onboard would be a cheap and cost effective way to assist in preventing health issues such as Hypertension.

The Club’s PEME programme provides regular, quality pre-employment medical examinations in which seafarers are diagnosed and counselled in matters of health as part of the overall solution to raise health standards on Members vessels. For more information regarding the UK Club’s PEME programme ask for details contact the PEME team directly at: peme.ukclub@thomasmiller.com

Thanks to:

Dr Marcus Brauer MBChB (UCT), Dip PEC, DOH

Dr Brauer and Associates

Waterfront, Cape Town

E-mail: marcus@drbrauer.co.za