Breaking the Pressure: Hypertension Management for Lasting Health

Abstract

Hypertension, also known as high or raised blood pressure, is a global public health issue. It contributes to the burden of heart disease, stroke and kidney failure and premature mortality and disability. It disproportionately affects populations in low- and middle-income countries where health systems are weak. Hypertension rarely causes symptoms in the early stages and many people go undiagnosed. Those who are diagnosed may not have access to treatment and may not be able to successfully control their illness over the long term. There are significant health and economic gains attached to early detection, adequate treatment and good control of hypertension. Treating the complications of hypertension entails costly interventions such as cardiac bypass surgery, carotid artery surgery and dialysis, draining individual and government budgets. Addressing behavioural risk factors, e.g. unhealthy diet, harmful use of alcohol and physical inactivity, can prevent hypertension. Tobacco use increases the risk of complications of hypertension. If no action is taken to reduce exposure to these factors, cardiovascular disease incidence, including hypertension, will increase. Salt reduction initiatives can make a major contribution to prevention and control of high blood pressure. However, vertical programmes focusing on hypertension control alone are not cost effective. Integrated noncommunicable disease programmes implemented through a primary health care approach are an affordable and sustainable way for countries to tackle hypertension. Prevention and control of hypertension is complex, and demands multi-stakeholder collaboration, including governments, civil society, academia and the food and beverage industry.