Blood Pressure

(Arshad Muneer Butt, Islamabad)

Worldwide, raised blood pressure is estimated to cause 7.5 million deaths, about 12.8% of the total of all deaths. This accounts for 57 million disability adjusted life years (DALYS) or 3.7% of total DALYS. Raised blood pressure is a major risk factor for coronary heart disease and ischemic as well as hemorrhagic stroke. Blood pressure levels have been shown to be positively and continuously related to the risk for stroke and coronary heart disease. In some age groups, the risk of cardiovascular disease doubles for each increment of 20/10 mmHg of blood pressure, starting as low as 115/75 mmHg. In addition to coronary heart diseases and stroke, complications of raised blood pressure include heart failure, peripheral vascular disease, renal impairment, retinal hemorrhage and visual impairment. Treating systolic blood pressure and diastolic blood pressure until they are less than 140/90 mmHg is associated with a reduction in cardiovascular complications.

Globally, the overall prevalence of raised blood pressure in adults aged 25 and over was around 40% in 2008. The proportion of the world’s population with high blood pressure, or uncontrolled hypertension, fell modestly between 1980 and 2008. However, because of population growth and ageing, the number of people with uncontrolled hypertension rose from 600 million in 1980 to nearly 1 billion in 2008.

Across the income groups of countries, the prevalence of raised blood pressure was consistently high, with low, lower middle and upper middle countries all having rates of around 40%. The prevalence in high income countries was lower, at 35%.

Prevention and control of high blood pressure

Detecting high blood pressure is the first step in preventing and controlling it. On this year’s World Health Day, WHO is calling on all adults around the world to get their blood pressure measured. When people know their blood pressure level, they can take steps to control it.

“Our aim today is to make people aware of the need to know their blood pressure, to take high blood pressure seriously, and then to take control,” says Dr Margaret Chan, Director-General of WHO.

People can cut the risks of high blood pressure by:

Consuming less salt
Eating a balanced diet
Engaging in regular physical activity
Avoiding tobacco use
Avoiding harmful use of alcohol.

Prevention and control of non-communicable diseases

In 2012, at the WHO World Health Assembly, governments decided to adopt a global target of a 25% reduction in premature death from non-communicable diseases by 2025.

“Global leaders have agreed preventing and controlling high blood pressure is an important step to achieving this target,” says Dr Oleg Chestnov, WHO Assistant Director-General for Non-communicable Diseases and Mental Health.

The WHO campaign to encourage people to measure their blood pressure is a response to the United Nations Political Declaration on Non-communicable Diseases, which was adopted by Heads of State and Government in September 2011.

The Declaration commits countries to make greater efforts to promote public awareness campaigns to further the prevention and control of non-communicable diseases such as heart disease and stroke, cancers, diabetes, and chronic respiratory diseases.

“Early detection of high blood pressure and lowering heart attack and stroke risk is clearly far less expensive for individuals and governments than heart surgery, stroke care, dialysis, and other interventions that may be needed later if high blood pressure is left unchecked and uncontrolled,” says Dr Shanthi Mendis, Acting Director of the WHO Department for Management of Noncommunicable Diseases.

Government Responsibilities:

Government supports national efforts to develop high-level policies and plans to prevent and control noncommunicable diseases, as well as programmes related to advocacy, community mobilization, environmental interventions, health system organization and delivery, legislation and regulation. WHO has guidance for Member States for implementing affordable and effective solutions to reduce health and financial burden linked to hypertension, such as putting in place tools to manage total cardiovascular risk approach in primary health settings.

World Health Day is celebrated on 7 April every year to mark the anniversary of the founding of WHO in 1948. Each year, a theme is selected to highlight a priority area of public health concern in the world.

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Arshad Muneer Butt
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