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MANAGING AND PREVENTING CHRONIC HEALTH CONDITIONS AT SEA
Published: 12 September 2024
WHAT IS A CHRONIC DISEASE?
Many seafarers suffer with a chronic disease, an illness that typically lasts for an extended period, often throughout a person’s life. There are many different types of chronic disease. Cardiovascular diseases such as hypertension and heart failure account for the largest disease burden resulting in 17.9 million deaths per year (WHO 2023), with other common diseases including cancer, chronic respiratory disease and diabetes.
When onboard, seafarers need to appropriately manage any chronic diseases they suffer from, to ensure their overall health and wellbeing and to protect against the risks of their medical condition worsening at sea, where there may be limited access to medical care.
WHAT IS HYPERTENSION?
Hypertension occurs when the pressure exerted by circulating blood upon the walls of blood vessels is consistently too high. According to the World Health Organization (WHO):
• An estimated 1.28 billion adults aged 30–79 years worldwide have hypertension
• Approximately 46% of adults with hypertension are unaware that they have the condition
• Only 21% of adults with hypertension have it under control.
It can be caused by a range of factors from diet to stress, genetics, age and lack of activity and when undiagnosed or incorrectly managed, hypertension can lead to serious and long-term medical consequences including:
• Heart attacks
• Strokes
• Heart failure
• Peripheral arterial disease
• Aortic aneurysms
• Kidney disease
• Vascular dementia (due to reduced blood flow to the brain).
Given the risks, it is very important for all seafarers to appropriately manage their own health onboard as well as they can.
RECOMMENDATIONS FOR HYPERTENSIVE SEAFARERS
Take any prescribed medications. Bring an adequate medication supply for your contract duration and remember to take medication every day, as instructed by your doctor:
• Consider setting a daily alarm as a reminder, if you often forget to take medication.
• Remember, having a normal blood pressure does not mean you can stop taking medication, it means the medication is working.
Health and lifestyle: This should apply to all seafarers and is especially important in controlling high blood pressure and other cardiovascular diseases. It should include:
• Avoid tobacco: Smoking increases blood pressure and damages blood vessels.
• Eat a healthy diet: Limit sodium (salt) intake. Eat a diet high in vegetables, fruits, whole grains, and low-fat dairy. Minimise saturated fats, cholesterol, and added sugars.
• Exercise regularly: Aim for at least 30 mins of moderate aerobic exercise most days of the week.
• Maintain a healthy weight: Weight loss in overweight or obese people can significantly lower blood pressure.
• Limit alcohol intake: No more than two drinks per day for men and one drink per day for women for people who choose to drink alcohol.
Check your blood pressure regularly (once a month or as instructed by your doctor): Tips for measuring blood pressure:
• Before: Avoid exercise, eating or taking medication. Do not drink caffeine or smoke for 30 minutes before. Empty your bladder and rest for five minutes.
• During: Sit quietly and do not talk while taking your reading. Have both feet placed flat on the ground and your back supported. Use a cuff that fits the top half of your arm properly (follow manufacturer guidelines for blood pressure machines). The cuff should be at the same level as the heart. Take 2 readings, 1-2 minutes apart.
Assessing results:
. Normal blood pressure: Less than 120/80 mm Hg
. Elevated blood pressure: 120/80 to 129/79 mm Hg
. Stage 1 hypertension: 130/80 to 139/89 mm Hg
. Stage 2 hypertension: 140/90 mm Hg and above
IF HYPERTENSION WORSENS
Uncontrolled hypertension can result in life-threatening conditions such as heart attacks or strokes, or a condition known as a hypertensive emergency. Some warning signs of a hypertensive emergency include: chest pain, shortness of breath, severe headache, confusion, blurred vision, nausea and vomiting.
Do not delay reaching out to your telemedical provider (i.e. MedSea), If your blood pressure remains high, or you have any of the symptoms listed above, contact a medical professional at the onset as this will allow them to provide you with medical advice, support and mitigation strategies. Early contact is essential to prevent serious and long-term consequences.