International Society of Hypertension

WHO Meeting on Cardiovascular Prevention on a Global Scale

A global World Health Organization (WHO) meeting was held in Geneva from 28-30 October to address issues related to cardiovascular prevention. This was the last of four meetings on strategies to combat non-communicable diseases. I was pleased to represent ISH on this occasion and took the opportunity to argue for aspects on hypertension control as part of a more general strategy to control cardiovascular risk factors.

The WHO meeting was attended by approximately 30-40 people from all continents, and important contributions were made by Sir Richard Peto and Professor Salim Yusuf. The main topics of discussion were the simplification of the Cardiovascular Risk Predication Charts and the role of the PolyPill (PP), as well as the dissemination of information regarding the charts. A proposal to include the PP in the WHO list of essential medical drugs has been rejected twice. A new application will be made in 2017. Some people consider the use of the PP as strategic while others refer to it as a clinical tool for secondary prevention.

Group photo WHO October 2015 meeting, Geneva

The following statements were included in my presentation on behalf of the ISH:

  • The ISH is involved in all aspects of screening, diagnosing and treatment of hypertension taking into account local infrastructure and health care systems. Whenever possible, these activities are linked to research and focus on encouraging a young generation of leaders and researchers and women in hypertension research.
  • The ISH aims to improve the quality of hypertension care, and therefore the Society likes to see follow-up studies of hypertensive patients, quality analyses and in some cases recordings of BP control in registers, when this is feasible. Also here we see a link to research and a gender perspective as treatment may differ according to quality with many background factors, including gender. Improvement in hypertension control in women (if pregnant) will also benefit their offspring and the health of these offspring in adult life based on modern understanding of programming in utero of uncontrolled maternal risk factors.

In addition I voiced, as a personal reflection, that I would like to see more evidence for the PP solution, especially in many low-resource settings, but also in more advanced economies, for example within a specific region for appropriate implementation and evaluation. This kind of evidence is needed before PP is fully accepted.

A full report from the WHO Meeting is planned to appear in 2016.

Peter M Nilsson
Chair, ISH Eastern Europe and Middle East Regional Advisory Group (RAG)

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