THE HYPERTENSION MANUAL
BY
DR. PATRICIA MUGISHA
DR. EMMANUEL MUGISHA
Table of Contents
WHAT IS HYPERTENSION? 3
NORMAL BLOOD PRESSURE 3
AMERICAN HEART ASSOCIATION – CLASSIFICATION OF HYPERTENSION 4
TYPES OF HYPERTENSION 4
WHO IS AT RISK? 4
Modifiable Risk factors; 4
Non-Modifiable Risk factors; 5
PREGNANCY – INDUCED HYPERTENSION. 5
PSYCHOLOGICAL STRESS AND HYPERTENSION 6
INADEQUATE SLEEP AND HIGH BLOOD PRESSURE. 7
WHAT ARE THE COMMON SYMPTOMS OF HYPERTENSION? 7
DIAGNOSIS 8
THE BLOOD PRESSURE MACHINE 9
Manual BP Machine 9
Digital BP Machine; 9
STEPS FOLLOWED TO TAKE BLOOD PRESSURE 10
WHAT ARE THE COMPLICATIONS OF POORLY CONTROLLED HYPERTENSION? 11
TREATMENT OF HIGH BLOOD PRESSURE 12
Adherence to Medication; 12
LIFESTYLE CHANGES YOU CAN MAKE TO MANAGE HIGH BLOOD PRESSURE 13
Benefits of Heart-healthy Eating 13
The DASH eating plan. 14
Tips on switching to the DASH eating plan. 14
Tips to reduce salt and sodium. 15
Know what to eat. 15
Sample Meal Time Table. 16
Lower your BP by being Physically Active 16
OXIDATIVE STRESS AND DIABETES. 18
THE BYAMAKA IMMUNOLOGICAL OPTIMIZING PROTOCOL 19
MIXTURE OF LIFE (MOL) 20
REFERENCES 21
WHAT IS HYPERTENSION?
Hypertension is when your blood pressure, the force of blood flowing through your blood vessels is consistently too high.
Blood is carried from the heart to all parts of the body through blood vessels.
Each time the heart beats, it pumps blood into the vessels. Blood pressure is created by the force of blood pushing against the walls of the blood vessels as it is pumped by the heart. The higher the pressure, the harder the heart has to pump.
NORMAL BLOOD PRESSURE
Blood pressure is written as two numbers. The first (Systolic) number represents the pressure in blood vessels when the heart contracts or beats. The second (Diastolic) number represents the pressure in the blood vessels when the heart rests between beats.
AMERICAN HEART ASSOCIATION – CLASSIFICATION OF HYPERTENSION
NOTE; ELEVATED = PRE – HYPERTENSION (BEORE HYPERTENSION)
TYPES OF HYPERTENSION
Primary Hypertension:
Accounts for about 95% of cases. It’s also called Essential hypertension and has no known cause.
Secondary Hypertension:
Accounts for 5% of all cases of hypertension. Causes include Diabetes, Kidney disease, Cushing’s disease, Prolonged use of steroids (such as dexamethasone).
WHO IS AT RISK?
Modifiable Risk factors;
• Unhealthy diets e.g Excessive salt consumption, a diet high in saturated fats, low intake of fruits and vegetables.
• Physical inactivity/sedentary lifestyle.
• Consumption of tobacco and alcohol. (Nicotine in Tobacco damages blood vessels)
• Stress e.g demanding job, sleepless nights, abusive relationships, extreme poverty
• Diabetes mellitus (High sugar levels damage blood vessels)
• Dyslipidemias (High level of fats in blood may lead to deposition of fatty material in the walls of blood vessels therefore reducing their lumen size.
• Being overweight or obese. (High BMI)
BMI = Weight in Kilograms
(Height in meters)2
Non-Modifiable Risk factors;
• A family history of hypertension.
• Age over 65 years. (The walls of blood vessels start “hardening”)
• Co-existing diseases such as diabetes or kidney disease.
• Previous stroke
• Sex; Males are at a higher risk during young and middle age but post-menopausal women are at a higher risk among the elderly population.
PREGNANCY – INDUCED HYPERTENSION.
A special type of hypertension that occurs during pregnancy.
Some women may have hypertension even before pregnancy. (Pre-existing Hypertension). However, for some others, a high blood pressure is only recorded after 20 weeks of pregnancy. In this case, it is referred to as Pre-eclampsia/Eclampsia.
Preeclampsia is therefore defined as new onset or worsening of existing hypertension with protein in urine after 20 weeks of gestation.
The problem arises due to insufficient blood flow to the placenta.
In preeclampsia, the mother’s high blood pressure reduces blood supply to the baby, which may get less oxygen and nutrients (food). Eclampsia is when the mother with preeclampsia develops unexplained generalised seizures.
Risks of preeclampsia include; organ damage/failure, preterm birth, very small baby, pregnancy loss, stroke, coma or death.
Symptoms of these disorders include; high blood pressure, protein in urine, hand/face swelling, headache, vision problems, abdominal pain, seizures, vomiting/nausea.
If a woman has had preeclampsia in earlier pregnancies, they can have it again in the following pregnancies. Other risk factors however include;
• Age less than 20 or more than 40.
• Being of African descent.
• Being pregnant for the first time.
• Having babies less than 2 years apart or more than 10 years apart.
• Pregnancy with a new partner instead of the father of your previous children.
• High blood pressure before getting pregnant.
• A mother or sister who has had preeclampsia
• A history of obesity.
• Carrying more than one baby.
• In-vitro fertilization.
• A history of diabetes, kidney disease, lupus, rheumatoid arthritis.
After delivery of the placenta (the after-birth), the blood pressure usually stabilizes but in some women, symptoms persist even upto 6 weeks following delivery.
PSYCHOLOGICAL STRESS AND HYPERTENSION
This is a question that most of our patients have been asking on multiple occasions and we are sure many more people out there are still asking if psychological stress is related to high blood pressure.
Stress may arise from a very demanding job to domestic violence/abusive relationships whether physical or psychological to social isolation, poverty, unemployment, failed business deals etc.
Several studies have suggested that chronic exposure to stress (both physical and psychological) may have an influence on increased blood pressure.
The two suggested theories are:
1. Long term exposure to stress leads to high levels of some hormones in the body called “stress hormones” or counter-regulatory hormones such as glucagon, epinephrine, cortisol and growth hormone. If these hormones stay long in blood circulation, they cause high blood glucose and also high blood pressure.
2. People that are under chronic stress usually engage in unhealthy lifestyles such as overconsumption of alcohol, excessive tobacco smoking and eating unhealthy foods. Scientific evidence exists to show that these themselves are risk factors for developing high blood pressure.
INADEQUATE SLEEP AND HIGH BLOOD PRESSURE.
Several studies suggest that there is a positive relationship between Inadequate sleep (Less than 6 hours a day) and Increase in blood pressure.
Sleep is important in maintaining an optimally functioning immune system, repairing damaged cells in the body, formation of memory, hormonal balance, energy conservation.
The suggested theory to development of high blood pressure in these individuals is that lack of sleep leads to release of certain factors into the blood (eg NF-Kb – Nuclear Factor kappa beta). These factors cause damage to the innermost lining of blood vessels and ultimately damaged vessels become narrower in size and this contributes to increase in blood pressure.
WHAT ARE THE COMMON SYMPTOMS OF HYPERTENSION?
Most people with hypertension/ high blood pressure are unaware of the problem because it may have no warning signs or symptoms. For this reason, it is essential that blood pressure is measured regularly.
However, some of the symptoms that occur include;
Early morning headaches
Vision changes
Buzzing in the ears
Severe hypertension can cause fatigue, nausea, vomiting, confusion, anxiety, chest pain and muscle tremors.
High blood pressure is a largely symptomless “silent killer.” If you ignore your blood pressure because you think a certain symptom or sign will alert you to the problem, you are taking a dangerous chance with your life.
DIAGNOSIS
Diagnosis for high blood pressure is made by analysis of risk factors, symptoms and taking a blood pressure reading.
Blood pressure is simply measured using a blood pressure machine.
Hypertension is diagnosed if, when it is measured on two different days, the systolic blood pressure readings on both days is ≥ 140mmHg and/ or the diastolic blood pressure readings on both days is ≥ 90mmHg.
If your blood pressure in not within normal range, your doctor may go ahead to request for additional tests to find out the cause. These may be blood tests or imaging studies. They include Renal function tests (kidney function), Lipid profile, Cardiac ECHO, Renal or carotid arteriogram, CT scan for the head or abdomen etc.
THE BLOOD PRESSURE MACHINE
A device used to measure blood pressure. (BP)
It’s important that once you re found to have hypertension, you should get a personal BP machine so that you monitor your BP by yourself at home. A digital machine is very easy to use.
Two major types of BP Machines exist
Manual BP Machine (Sphygmomanometer);
It requires that one uses a stethoscope to listen to the heart sounds while measuring Blood pressure. It’s mostly used in clinical settings, requires skill and is not favourable for using at home to measure and monitor one’s own BP. You need a skilled person to help you measure.
Digital BP Machine;
This one is the most favourable for measuring one’s own BP. It’s easy to use and doesn’t require skill. It is also portable. You can take your blood pressure reading anytime, anywhere.
WHAT ARE THE COMPLICATIONS OF POORLY CONTROLLED HYPERTENSION?
One may pose the question: What if I do not take my antihypertensive medication? What is the worst that can happen?
And here is what happens when one has high blood pressure but does not bother to keep it in the normal ranges;
– Excessive pressure can harden arteries therefore decreasing the flow of blood and oxygen to the heart and other organs all together eg the brain and kidneys.
This elevated pressure and reduced blood flow can cause;
o Severe chest pain
o Heart attack, which occurs when the blood supply to the heart is blocked and heart muscle cells die from lack of oxygen. The longer the blood flow is locked, the greater the damage to the heart.
o Heart failure, which occurs when the heart cannot pump enough blood and oxygen to other vital body organs.
o Stroke, when blood and oxygen supply to the brain is blocked.
o Kidney disease or failure, when the high blood pressure damages the blood vessels around thee kidney and interfere with their ability to filter blood.
o Vision loss, when the high blood pressure damages blood vessels in the eyes.
o Sexual dysfunction; hypertension can lead to erectile dysfunction in men and low libido in women.
To sum it all, high blood pressure does its most harm through the blood vessels. And once the blood vessels of any organ are damaged, the organ itself is compromised and so is its functionality.
TREATMENT OF HIGH BLOOD PRESSURE
At the centre of the treatment for high blood pressure is lifestyle modifications.
Drugs alone are not sufficient to effectively control high blood pressure.
Depending on how high your blood pressure is and what symptoms you have presented with, your doctor will start you on a given regimen of medications. And these are not constant and are not the same for every patient. They are exactly tailored to the patient. No patient therefore should take drugs belonging to another hypertensive patient and expect good control of blood pressure.
Drugs are of various classes but include Amlodipine, Losartan, Hydrochlorothiazide, Methyldopa, Spironolactone, Enalapril, Nebivolol etc.
Adherence to Medication;
Adherence is key in managing your blood pressure. Taking medications daily until the doctor changes your regimen or advises you stop.
Non adherence can lead to emergencies such as Hypertensive Urgency and Hypertensive Emergency (With evidence of damage to end organs like the Eyes, brain, heart, kidneys). These can occur with complications such as stroke.
LIFESTYLE CHANGES YOU CAN MAKE TO MANAGE HIGH BLOOD PRESSURE
While there is no cure, using medications as prescribed and making lifestyle changes can enhance your quality of life and reduce your risk of heart disease, stroke, kidney disease and more.
1. Know your numbers.
If you are diagnosed with high blood pressure, you should monitor your blood pressure regularly. Tracking your results over time will also reveal if the changes you have made are working.
2. Make changes that matter eg;
Eat a well-balanced diet that is low in salt.
Limit alcohol
Enjoy regular physical activity
Manage stress
Maintain a healthy weight
Quit smoking
Take your medications properly
Work together with your doctor.
Benefits of Heart-healthy Eating
Important for managing your blood pressure and reducing your risk of heart attack, stroke and other health threats.
The DASH eating plan.
The DASH (Dietary Approaches to Stop Hypertension) eating plan is designed to help you manage blood pressure.
Emphasising healthy food sources, it also limits;
• Red meat
• Sodium (Salt)
• Sweet, added sugars and sugar – containing beverages.
You can reduce your blood pressure by eating foods that are low in saturated fat, total fat and cholesterol and high in fruits, vegetables and low dairy products.
The DASH eating plan has more daily servings of fruits, vegetables and grains than you may be used to eating. (Those foods are high in fibre and eating more of the may temporarily cause bloating and diarrhoea. To get used to the DASH eating plan, gradually increase your serving of fruits, vegetables and grains)
A good way to change to the DASH eating plan is to keep a record of your current eating habits. Write down what you eat, how much, when and why.
Note whether you snack on high fat foods while watching television or if you skip breakfast and eat a big lunch. Do this for several days, you will be able to see where you can start making changes.
Tips on switching to the DASH eating plan.
Change gradually. Add a vegetable or fruit serving at lunch or dinner.
Use only half the margarine or butter you use now.
Get added nutrients such as the B-Vitamins by choosing whole grain foods, including whole wheat bread or whole grain cereals.
Spread out the servings. Have two servings of fruits and or vegetables at each meal or add fruits as snacks.
Have two or more meatless meals per week.
Use fruits or low fat foods as desserts and snacks.
Instead of snacking on chips or sweets, eat unsalted nuts, raisins, low fat or fat free yoghurt, frozen yoghurt, raw vegetables, unsalted plain popcorn.
Tips to reduce salt and sodium.
An important part of healthy eating is choosing foods that are low in salt (sodium chloride) and other forms of sodium. Using less sodium is key to keeping blood pressure at a healthy level.
Buy fresh vegetables instead of canned.
Use fresh poultry, fish such as tuna to remove sodium.
When available, buy low or reduced sodium or no-salt-added foods.
Know what to eat.
Potassium, magnesium and fibre, on the other hand may help control blood pressure. Fruits and vegetables are high in potassium, magnesium and fibre. They are low in sodium.
Stick to whole fruits and vegetables. Juice is less helpful because the fibre is removed.
Also, nuts, seeds, legumes, lean meats and poultry are good sources of magnesium.
To increase the amount of natural potassium, magnesium and fibre you take in, select from the following;
Fruits – Apples grapes Pineapples
Apricots Mangoes Strawberries
Bananas Melons Tangerine
Oranges Peaches
Vegetables- Broccoli Green peas Kale
Carrots Green beans Beet greens
Spinach Sweet Potatoes Pumpkin Butternut squash
Sample Meal Time Table.
Day of week Breakfast Lunch Supper
Monday Vegetable soup Green peas + Rice + dodo/spinach Mushrooms + Bugga + Avocado + Matooke/Pumpkin
Tuesday Green tea + Avocado Toast + Boiled eggs Meat + Matooke/Pumpkin + Nakati + Avocado Beans + Rice/Matooke + Cabbage
Wednesday Katogo + Green tea Fish + Rice + Cabbage + Avocado Chicken + Pumpkin/Yam + Broccoli + Green beans.
Thursday Eggs + Vegetables salad + Green tea Beans + Matooke/Pumpkin + Cauliflower + Carrots Beans + Rice/Quinoa + Sukumawiki + Avocado
Friday Katogo + Eggs + Green tea Chicken + Eggplant + Pumpkin/Yam + Avocado Groundnuts + Matooke/Pumpkin + Spinach + Avocado
Saturday Vegetable soup Green peas + Matooke/Sweet potatoes + Bugga Liver/Kidney + Matooke + Kalo + Cauliflower
Sunday Eggs + Smoothie Lentils + Pumpkin + Spinach + Avocado Fish + Matooke/Yam + Nakati
SAMPLE RECIPES!
1. Smoothies;
All you need for a smoothie is a good high power blender, the food produce and a glass. No sieving required. All you have to do is blend/puree to the smoothness of your liking and enjoy.
a) Green smoothie:
Milk – 1½ cups of milk or and nut milk
Spinach – 2 cups fully packed
Banana – 1 banana (frozen is best)
Apple – 1 apple sliced into pieces
Avocado – ¼ avocado
Add all of the ingredients to a blender and blend for 30seconds on high or till smooth, serve and enjoy.
b) Orange carrot smoothie:
Milk – 1.5cups dairy or nut milk
Orange – 1 orange
Carrot – 1/3 cup grated carrots
Seeds – 1 tablespoon flax or chia seeds
Cauliflower – ¼ cup blanched then frozen cauliflower
Add to a blender, blend till smooth and enjoy.
2. Vegetable soup
Ingredient list:
• Olive oil (1 Table spoon)
• 1 onion (large, chopped)
• 2 carrots (peeled, chopped)
• 2 garlic cloves (minced)
• 2 celery stalks (chopped)
• 1 sweet potato (large, about 2 cups, chopped)
• 1 butternut squash/pumpkin (peeled, chopped)
• 1 cauliflower (chopped)
• 1 small cabbage (sliced)
• 4 tomatoes (diced)
• 1 litre of vegetable stock
• 2 teaspoons of Italian seasoning
• ½ tsp. cracked black pepper
• 1 tsp. salt
• 2 tbsp. chopped parsley (fresh)
Instructions
i. Heat up a large pot over med-high heat and add olive oil
ii. Throw in onion, carrot and celery and cook for 3-5 minutes or until onions are translucent.
iii. Add in garlic and cook for 1 minute.
iv. Add in sweet potatoes, butternut squash and cauliflower and cook for 5 minutes
v. Top with cabbage, diced tomatoes, vegetable stock and spices and give it a stir.
vi. Bring to a boil and then let simmer uncovered over medium heat for 30 minutes.
vii. Top with fresh parsley and serve warm.
viii. Will keep for a week in refrigerator and freezes well for several months.
3. Lentil soup.
Ingredients.
• 1 tbsp. olive oil 1 medium onion, chopped
• 2 carrots, chopped 4 garlic cloves, minced
• 2 tsp. cumin 1 tsp. curry powder
• ½ tsp. dried thyme 4 diced tomatoes
• 4 cups vegetable broth 2 cups water
• Pinch of salt black pepper
• 1 cup brown or green lentils, picked over and rinsed
Instructions
i. Warm the olive oil in a large pot over medium heat. Add the olive oil.
ii. Once the oil is shimmering, add the chopped onion and carrot and cook, stirring often until the onion has softened and is turning translucent, about 5 minutes.
iii. Add the garlic, cumin, curry powder and thyme. Cook until fragrant while stirring constantly, about 30 seconds.
iv. Pour in the diced tomatoes and cook for a few more minutes, stirring often, in order to enhance flavour.
v. Pour in the lentils, broth and water. Add salt and black pepper. Raise heat and bring the mixture to a boil, then partially cover the pot and reduce the heat to maintain a gentle simmer. Cook until lentils are tender but still hold their shape.
vi. Optional: blend about 2 cups of the soup and add it back to the pot, this helps to thicken the soup,
vii. Add the chopped greens and cook for 5 more minutes.
viii. Serve while hot. Leftovers will keep well for about 4 days in the refrigerator, or can be frozen for several months.
Lower your BP by being Physically Active
Physical activity is one of the most important things you can do to prevent or control high blood pressure. It also helps reduce your risk for heart disease.
It doesn’t take a lot of effort to become physically active. All you need is 30 minutes of moderate-level physical activity on most days of the week.
Examples of Moderate – level physical activity.
Common Chores;
Washing your car for 45 – 60 minutes
Gardening for 30 – 45 minutes
Washing windows or floors for 45 – 60 minutes
Walking up and down the stairs for 15 – 30 minutes
Raking leaves for 30 minutes
Sporting activities;
Walking 2miles in 30 minutes
Playing volleyball for 45 – 60 minutes
Shooting basketball for 30 minutes
Bicycling 5 miles in 30 minutes
Jumping rope for 15 minutes
Running 2 miles in 15 minutes.
Swimming laps for 20 minutes.
You can even divide the 30 minutes into shorter periods of atleast 10 minutes each. For instance, use stairs instead of an elevator, get off the bus/taxi one or two stops early or park your car at the far end of the lot at work.
If you already engage in 30 minutes of moderate level physical activity a day, you can get added benefits by doing more. Engage in a moderate level activity for a longer period each day or engage in a more vigorous activity.
Most people don’t need to see a doctor before they start on moderate – level physical activity. You should check with your doctor first if you have heart trouble or have a heart attack, if you’re over 50 years old and not used to exercise.
OXIDATIVE STRESS AND DIABETES.
Both Clinical and Experimental studies have showed that oxidative stress plays a big role in the development and acceleration of the complications of Hypertension. (As stated above). There’s evidence to support the fact that the co-morbidities associated with high blood pressure such as obesity and diabetes induce the formation of free radicles and impairs the antioxidant defence system in patients with Hypertension.
The antioxidants in the body are part of the body’s defence and they counterbalance the toxic reactive oxygen species. Common anti-oxidants include; Vitamins A, C, E, Glutathione, and some enzymes such as catalase, glutathione peroxidase and superoxide dismutase.
The co-morbidities associated with high blood pressure however disturb the antioxidant system and in part will lower the body’s defences against disease and stress.
THE BYAMAKA IMMUNOLOGICAL OPTIMIZING PROTOCOL
This protocol is based on the principle that an optimally functioning immune system is capable of building up defence against disease and sometimes without need for drugs against this disease.
That supplying the body with antioxidants reduces the risk of oxidative stress and therefore reduce the occurrence of complications of diabetes (and other chronic illnesses). This ultimately improves on the health outcomes of these patients.
Drugs on the market under this protocol include MOL (Mixture of Life) and Absolut plus; containing scavengers and antioxidants such as; Hypoxis, selenium, colloidal silver, plant sterols, spirulina, beta carotene, Vitamins C and E along with the B complex vitamins.
We recommend that the hypertensive patient adds this product to their usual anti-hypertensive regimen and to take it for atleast 3months consecutively then every other month thereafter.
Adding a potent immune booster has been showed to improve health outcomes in patients with chronic illnesses because the body’s immune system is constantly under stress.
MIXTURE OF LIFE (MOL)
Mixture of Life – A product of Byamaka Pharmaceuticals Co. LTD, Mbarara, Uganda.
This product was formulated by Ph. Byamukama Aggrey, a senior pharmacist in Mbarara and is manufactured in by Farmos Health, Bultfontein, South Africa.
It has been in existence for over 20 years and has showed tremendous results in patients with illnesses such as;
• Infectious diseases such as; HIV/AIDS, Hepatitis B and C
• Autoimmune conditions such as Rheumatoid Arthritis, Lupus
• Metabolic diseases such as Diabetes Mellitus, Metabolic syndrome
• Malnutrition
• Chronic Liver and Kidney disease
• Hypertension
• Cancers
It’s important to note that this product is not to be used in isolation without the primary medications for the specific illnesses but rather as a supportive drug to improve outcomes in these patients.
Regardless of whether we have chronic illnesses or not, our body cells undergo constant wear and tear as we age.
Immunosenescence is a process of immune malfunction that occurs with age and is closely related to development of infections, autoimmune diseases and malignant tumors. Keeping our immune system well moderated is therefore important as we age.
This product therefore is not only restricted to use in chronic illness but can also be used by individuals without apparent disease, just to keep their immunity in check.
REFERENCES
World Health Organisation; www.who.int; Health topics; Hypertension.
American Heart Association; www.heart.org; Hypertension
Tanya M. Spruill; PMC Article; Chronic psychological stress and hypertension; National Institute of Health; 2010.
Daniela Gasperin et al; Pubmed.gov; Article; Effect of psychological stress on blood pressure increase: a meta-analysis of cohort studies; National Library of Medicine; April 2009.
Ian B. Wilkinson et Al; Oxford Handbook of Clinical Medicine; tenth edition; 2017.
Brooke Aggarwal et al.; Effects of Inadequate sleep on blood pressure and endothelial inflammation in women; journal of the American Heart Association: June 2018.
Antoinette T. Dulay; Preeclampsia and Eclampsia; Article, MSD Manual Professional version, October, 2020.
Mark R. Zielinski et al; Article; Functions and mechanisms of sleep; AIMS Neurosci. 2016;3(1) 67-104; 2016 April 21.
Ph. Happiness Aggrey Byamukama; Infectious AIDS, The Healing Power of Photosynthesis; Revelations and Visions; 2014.
Ph. Happiness Aggrey Byamukama; Infectious AIDS; The healing power of photosynthesis; Hypothesis and Nutraceuticals; 2016.
UBUNTU
“One of the sayings in our country is Ubuntu – The essence of being human. Ubuntu speaks particularly about the fact that you can’t exist as a human being in isolation. It speaks about our interconnectedness. We think of ourselves far too frequently as individuals, separated from one another, whereas you are connected and what you do affects the whole world. When you do well, it spreads out; It’s for the whole humanity.”
-Archbishop Desmond Tutu
“A river cuts through rock, not because of its power, but because of its persistence.”
-James N. Watkins
ABOUT THE AUTHORS
Dr. Patricia and Dr. Emmanuel Mugisha are medical doctors with Bachelor’s degrees in medicine and surgery from King Cesar University.
They are a happily married couple and are strong believers in God being at the centre of their marriage and their careers.
They have a special interest in the chronic diseases Hypertension, Diabetes and HIV/AIDS.
They strongly believe that health education is the core of patient care yet in most cases there’s usually very little time during the consultation, for the doctor to give fully detailed medical information to the patient about their condition in the easiest way they understand it. So many questions therefore remain unanswered in the mind of the patient.
They have interacted with Hypertensive patients and realised that most patients don’t fully understand their condition and how to live positively with it. This has inspired the content in this book and they hope it shall be of benefit to the patient, their families and friends.
Contacts;
Tel; 0774774042 / 0780813885 / 0700264048
Email; themugishalibrary@gmail.com
