High blood pressure (hypertension) is the major risk factor for cardiovascular disease. Hence, in 2002, it was named 'the number one killer' by the World Health Organization (WHO) in The World Health Report.
In short, the risk of stroke is four times greater and the risk of myocardial infarction (a heart attack) two times greater if you have high compared with normal blood pressure. This risk increases the higher the level of a person's blood pressure.
Hypertension is very common indeed and hence a major public health issue. The prevalence is expected to increase considerably in the coming years. In 2000, the estimated number of adults living with high blood pressure globally was 972 million. This is expected to increase to 1.56 billion by 2025! Lifestyle factors, such as physical inactivity, a salt-rich diet with high processed and fatty foods, and alcohol and tobacco use, are reasons for this increased disease burden, which is spreading at an alarming rate from developed countries to emerging economies, such as India, China and African countries.
Adequate treatment of high blood pressure lowers this cardiovascular risk towards normal levels. However, the biggest problem for controlling hypertension is compliance with treatment. Despite very effective and cost-effective treatments, target blood pressure levels are very rarely reached, even in countries where cost of medication is not an issue. Sadly, many patients still believe that hypertension is a disease that can be 'cured', and they stop or reduce medication when their blood pressure levels fall to normal levels. Despite the availability of effective and safe antihypertensive drugs, hypertension and its related risk factors (obesity, high blood lipids, and diabetes mellitus) remain uncontrolled in many patients. One often talks about 'the rule of the halves': Only one half of the patients with high blood pressure in a population have been diagnosed, only half of those detected have been treated, and only half of those treated have been adequately treated to a normal blood pressure.
The members of the International Society of Hypertension (ISH), founded some 50 years ago, have worked hard to improve these sad results, and there has been some progress. However, physicians and practitioners worldwide need to convey the message better to the public that high blood pressure is the first sign that many organs in the body are under attack. This message should make people think more carefully about the consequences of an unhealthy lifestyle and give preventative measures a real chance by staying on treatment.
Control of high blood pressure in the population is very important indeed and the benefit for the public is very large! Lifestyle changes that individuals can make for themselves to improve their blood pressure include:
- Losing weight if they are overweight
- Eating more polyunsaturated fat
- Reducing the salt content of their diet
- Taking regular exercise
- Making sure that they are sensible about their alcohol intake
To reach patients with high blood pressure worldwide, the ISH cooperates with many organizations and societies such as the World Health Organization (WHO), World Hypertension League (WHL), National Societies of Hypertension, Councils of High Blood Pressure and other related organisations.