Lack of treatment common in those with hypertension

A recent report by WHO (World Health Organization) focusing on hypertension found that while medications and care involved with treating the disease are easy and inexpensive, 80% of patients don’t get adequate treatment.

The paper also exposes that lack of access to diagnosis has a major effect on treatment access. High blood pressure impacts one in three adults globally, but almost half of people with hypertension are not aware of their illness.

Hypertension is linked with a multitude of cardiovascular issues including heart failure and stroke. It’s been dubbed the “silent killer” as initial symptoms for many patients are absent. In the report, Tedros Adhanom Ghebreyesus, PhD, Director‑General of the WHO, stated, "Hypertension can be controlled effectively with simple, low-cost medication regimens, and yet only about one in five people with hypertension have controlled it."

The report was addressed on September 19 in the 78th session of the United Nations General Assembly, which highlighted the organization’s progress of Sustainable Development Goals.

The report notes that "The world is not on track to meet the voluntary global target of a 25% reduction in the prevalence of raised blood pressure (uncontrolled hypertension) by 2025."

In addition, the report suggested that "High blood pressure causes more deaths than other leading risk factors, including tobacco use and high blood sugar."

The WHO advises better prevention and treatment programs to improve the outlook of those with hypertension. According to Ghebreyesus, "Hypertension control programs remain neglected, underprioritized, and vastly underfunded. Strengthening hypertension control must be part of every country's journey towards universal health coverage, based on well‑functioning, equitable, and resilient health systems built on a foundation of primary health care,".

According to the WHO, those with blood pressure >= 140/90 mm Hg or using blood pressure medication have doubled in 20 years from 650 million in 199 to 1.3 billion in 2019.

Brazil is one country where the prevalence of high blood pressure is higher than the global average, impacting nearly 45% of adults aged 30 to 79 years. Over 50 million adults have hypertension. While 62% are receiving treatment, only 33% have their blood pressure under control.

While high blood pressure can be exacerbated by family history and a patient’s age, lifestyle choices including a high-sodium, low-potassium diet, smoking, alcohol intake, tobacco use, and lack of physical activity are main contributors.

The report advises large-scale adoption of recommendations from the WHO HEARTS technical package, which sums up a series of approaches and strategies to improve cardiovascular health in global populations to be sure that diagnostic tools and appropriate care for those with hypertension are addressed.

The WHO states that increasing the number of people treated globally and repeating the successes of high-performing countries could dodge 76 million deaths due to cardiovascular disease, 120 million strokes, 79 million myocardial infarctions, and 17 million cases of heart failure from 2023 to 2050.

WHO believes that adequate community- and country-wide management of hypertension can be done in countries of all economic levels, stressing that "more than 40 low‑ and middle‑income countries, including Bangladesh, Cuba, India, and Sri Lanka, have strengthened their hypertension care with the HEARTS package, enrolling more than 17 million people into treatment programs."

Below are tips to share with your patients with hypertension:

1.   Encourage a diet low in sodium and saturated fat.

2.   Provide tips on how to prepare simple meals to reduce reliance on fast food and convenience food.

3.   Offer ways to season foods without high sodium condiments, salt, and sauces.

4.   Encourage high potassium fruits and vegetables. Those that are dark green or dark orange are good sources.

5.   Suggest ways to obtain adequate calcium in the diet though low-fat or non-fat dairy products or calcium-fortified non-dairy products.

6.   Discuss mild weight loss if patients are overweight or obese.

7.   Encourage regular physical activity.

8.   Refer patients for smoking cessation and stress reduction programs.

9.   Provide suggestions and low-calorie drink options to help reduce alcohol intake.

10.  Don’t forget the power of sleep on blood pressure control.

Lisa Andrews, MEd, RD, LD

This article was translated from the Medscape Portuguese Edition.