Keep your BP in check

Hypertension or high blood pressure is becoming a major health concern in our modern lifestyle, and needs to be addressed with due care, writes Dr Nata Menabde.

Worldwide, hypertension or high blood pressure (see box) affects one in three adults and leads to more than nine million deaths worldwide every year. The number of people with high blood pressure globally rose from 600 million in 1980 to 1 billion in 2008. These are staggering figures.

Hypertension is a leading risk factor for cardiovascular disease, a major killer in India. In 2008, 24% of all deaths in India were from cardiovascular diseases (CVDs). High blood pressure is estimated to be responsible for nearly 10% of all deaths in India.

High blood pressure does not always have symptoms and therefore many people do not know that they have it. This adds to the complexity of the issue. It is also true that even though it is easily diagnosed and can be treated, many people do not have access to quality health services that would ensure that after being detected people receive necessary treatment, and that the treatment is followed up to ensure that blood pressure is continuously controlled over the long term.

Given that high blood pressure is a silent and invisible killer, increasing public awareness is key, as is early detection and treatment.

In light of this pressing need, the World Health Organisation (WHO) chose “High Blood Pressure” as the theme of World Health Day (WHD) 2013.

Risk factors

Different risk factors contribute to high blood pressure. These include: eating unhealthy diets (including diets high in salt and transfats, and low in fruits and vegetables), harmful use of alcohol, using tobacco products, not getting enough regular physical activity, and exposure to persistent stress.

These factors are highly influenced by the conditions in which people live and work. Ageing and genetic factors can also play a role in high blood pressure.

Consequences of high BP

High blood pressure has major implications. It increases the risk of heart attacks, strokes and kidney failure.

If left uncontrolled, high blood pressure can also cause blindness, irregularities of the heartbeat and heart failure.

The risk of developing complications from high blood pressure is higher in the presence of conditions like diabetes, obesity, high cholesterol etc.

 Preventable and treatable

Controlling high blood pressure, together with other risk factors, is the main way to prevent heart attack and stroke. Early detection is key; all adults should know their blood pressure. It is equally important that the health facilities are well-equipped to provide effective, affordable and quality services to prevent and eventually treat the condition.

The risk of developing high blood pressure can be minimized by cutting down on salt, eating a balanced diet, avoiding excessive consumption of alcohol, getting regular exercise; and saying a firm NO to tobacco in any form.

For many people, lifestyle changes are sufficient to control blood pressure. For others, medication is also required. Inexpensive medication exists, which is effective when taken as prescribed.

It is essential that detection and control of high blood pressure (measurement, health advice and treatment) are coupled with simultaneous efforts to reduce other risk factors that cause heart attacks and strokes, such as diabetes and tobacco use.

WHO’s role

Globally, WHO has increasingly played a critical role in efforts to address noncommunicable diseases (NCDs) including high blood pressure since 2000. At the country level, WHO has been providing support to the Government of India in the area of NCDs.

On the occasion of WHD 2013 campaign (which spans throughout the year), WHO’s focus is on highlighting how the health system in the country can be strengthened to provide comprehensive care and at all levels to address NCDs including high blood pressure. In this context, a key priority of WHO’s collaboration with the Government of India is universal health coverage – in other words that affordable, accessible and quality health care is available to all.

Time for action

Prevention and control of high blood pressure is complex, and it is imperative that all sections of the society are involved, including governments, civil society, academia and the many sectors including food and agriculture. In view of the enormous public health benefits of blood pressure control, now is the time for concerted action.

(The writer is WHO Representative in India)