World Health Day is celebrated on the 7th April to mark the anniversary of the founding of WHO in 1948. This year’s theme is high blood pressure. With one in three adults worldwide having the condition, this ‘silent killer’ puts huge numbers of individuals at risk for heart disease and stroke, and represents one of the most important challenges facing public health today. It is estimated there will be a staggering 1.56 billion adults living with high blood pressure in 2025.
Objectives of World Health Day 2013 include:
- raising awareness of the causes and consequences of high blood pressure
- providing information on how to prevent high blood pressure and related complications
- encouraging self-care to prevent high blood pressure
- making blood pressure management affordable to all
Prevention and treatment of the condition has brought about a reduction in deaths from heart disease in developed countries but nearly two-thirds of the global hypertensive population live in low- and middle-income countries.
Sandra C Fuchs, an Associate Editor of BMC Public Health is an Associate Professor and Program Coordinator of Graduate Studies in Cardiology at the Universidade Federal do Rio Grande do Sul in Brazil. Her main areas of research interest are obesity, hypertension and translational research in cardiovascular diseases and her research activities are currently focused on the PREVER study; two randomized trials which aim to prevent hypertension with low doses of antihypertensive drugs and to control hypertension in patients who do not respond to lifestyle changes.
“High blood pressure is a public health problem worldwide, mostly in developing countries. By the year of 2025, about 1.17 billion people with blood pressure equal to or greater than 140/90 mmHg or on blood pressure lowering medication will be living in emerging nations. Although hypertension is a major risk factor for cardiovascular morbidity and mortality, most developing countries lack reliable estimates of nationwide prevalence. In Brazil, a pooled analysis of population-based studies with more than 120 thousand individuals, representative of adults aged 18 to 90 years, shows that 30.7% (95%I: 26.6–35.1) have hypertension. This figure is higher than the estimate obtained by telephone interviews [21.4% (95%CI: 20.3–22.6)] during the decade of the 2000s. Even though efficacious anti-hypertensive medications are available, a large fraction of the population does not know they have high blood pressure and one-third of hypertensive individuals have controlled hypertension. Lifestyle changes including weight control, diet with reduced sodium, vegetables, fruits, and fat-free or low-fat dairy products, and exercise are effective interventions to control hypertension. Since hypertension is incurable, long-term strategies such as educational interventions should be implemented to prevent its development.”
Epidemiological research on hypertension is therefore a high priority in developing countries. Research published in BMC Public Health highlights the urgent need for strategies to improve high blood pressure prevention in these regions:
Skin color is unrelated to mean blood pressure or hypertensive status in Cuba, a country with a persistent policy of social inclusion over the last 5 decades. The pattern observed here contrasts with other Western Hemisphere nations where evidence suggests a more pronounced racial disparity.
One fifth of participants report having never heard the term ‘blood pressure’, with the lack of basic health knowledge associated with male gender, younger age, lower levels of education and unemployment. While Mongolians are aware of common prevention and treatment methods, these are perceived to be generally ineffective.
Angola’s recent fast economic growth and consequent impact on risk factors for cardiovascular disorders suggests hypertension is likely to become an increasingly important public health problem in the country.
Obesity is rapidly reaching epidemic proportions in developing countries. Higher prevalence of hypertension in children is associated with higher body mass index (BMI) or waist circumference, the latter appearing to be a more sensitive risk factor associated with the risk of hypertension than BMI.
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Developments in this field are strongly supported by our academic Editorial Board such as Associate Editor Sandra C Fuchs who adds:
“Low- and middle-income developing countries must tackle hypertension as a public health priority.”