New Health Report Exposes Serious Social And Economic Implications Of Emerging Global High Blood Pressure Crisis

Main Category: Hypertension
Also Included In: Cardiovascular / Cardiology
Article Date: 18 Apr 2007 - 8:00 PDT

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The rate of uncontrolled high blood pressure may increase by 60 percent over the next two decades1,2 and potentially trigger a global epidemic of cardiovascular disease, according to a report released today by three international health experts and endorsed or supported by 12 leading medical groups from around the world. High blood pressure can severely damage major organ systems and lead to fatal heart attacks, stroke, kidney disease and dementia.

The report, High Blood Pressure and Health Policy: Where We Are and Where We Need to Go Next, launched at the European Parliament, calls for all levels of government and healthcare policy-makers to take action to manage the threat of high blood pressure through targeted education, better management strategies, enhanced medical collaboration, and improved medications.

Report author Dr Panos Kanavos of the London School of Economics, commented, "High blood pressure is a condition whereby incidence increases with age, but this does not mean that it is a problem that only affects old people. Uncontrolled high blood pressure among people in their 30s, 40s and 50s will inevitably lead to an increase in cardiovascular disease and stroke that will strike down men and women at the height of their earning power, potentially turning them from drivers of economic growth and sources of public revenues to long-term recipients of extensive social benefits with increased healthcare needs."

"A concerted public policy effort to prevent cardiovascular disease through more aggressive high blood pressure diagnosis, treatment of high blood pressure and its underlying causes, and monitoring will save productive lives and cut healthcare costs among adults in the prime of their lives" he added.

The report warns that, without increased emphasis on modifying lifestyles as well as diagnosing and treating high blood pressure, late 20th century gains in treating cardiovascular disease may stagnate or reverse, putting both individuals and healthcare systems at unnecessarily greater risk.

Dr Michael Weber, State University New York Downstate Medical College, and one of the authors stated, "Over the past 40 years, focused efforts to diagnose and control high blood pressure have helped to achieve significant reductions in cardiovascular disease, stroke incidence and death. However, we have become complacent about these achievements. The rate of cardiovascular disease reduction has leveled off and the number of people with uncontrolled high blood pressure is once again on the rise. We cannot afford to ignore high blood pressure control at this critical point."

The report concludes that, while high blood pressure already affects one in four adults globally, by the year 2025 it is likely to affect 1.56 billion people.1,2 Cardiovascular disease, largely a consequence of uncontrolled high blood pressure, accounts for more than 30% of deaths worldwide.2 Since high blood pressure is a leading modifiable risk factor for premature death and disability, the authors argue that it is essential to take steps now to avert this mounting health crisis.

The report flags the need to improve current management of high blood pressure in Europe. A recent study shows that people diagnosed with high blood pressure in North America have lower blood pressure and better blood pressure control than those diagnosed in Western Europe, potentially as a result of lower treatment thresholds and more aggressive treatment in North America.3 Also highlighted is the need to drive adherence to therapy. Poor patient adherence to recommended lifestyle changes and prescribed medication has been identified as the main cause of failure to control high blood pressure; research suggests that over 50% of patients do not take all of their prescribed high blood pressure medicines.4,5

The report also notes that increased emphasis on addressing lifestyle factors such as smoking, high-salt and high-fat diets, excessive alcohol intake and obesity require immediate attention by the entire global community.

Dr Jan Ostergren, Karolinska Institute, explains "European public health officials are only now beginning to realise that we need to do a better job at reducing cardiovascular health risks and that controlling high blood pressure is a key means for doing this. The problem is also especially worrying in Eastern Europe and the rapidly westernising nations of the Middle East, Asia, Latin America and Africa. Uncontrolled high blood pressure is a public health dilemma that requires an urgent global and national response."

High blood pressure is a serious chronic condition which damages peoples' hearts, eyes, brains and kidneys. It leads to cardiovascular disease, kidney disease and stroke, all of which are associated with a high risk of disabling conditions and mortality. At present high blood pressure causes an estimated 7.1 million deaths from cardiovascular disease each year.6

High blood pressure is one of the foremost risk factors that contribute to chronic disabling conditions in people of 50 years and over.7 Blood-pressure related conditions, including dementia in the elderly, also increase the demand for long-term medical and residential care, which has serious implications on government spending and infrastructure needs within individual healthcare systems.

Improved management of high blood pressure is highly achievable through the use of better education, treatment strategies and new medications. If the commitment to strengthen the control of high blood pressure is not made, this report shows that its socio- economic and individual health consequences could destroy lives, families and burden health budgets unnecessarily.

About the Report

The authors, Dr Panos Kanavos, The London School of Economics, London, UK, Dr Jan Ostergren, Karolinska University Hospital, Stockholm, Sweden, and Dr Michael A. Weber, State University New York Downstate Medical College, New York, USA are global leaders in health economics and treating high blood pressure, respectively.

The report's Call to Action and Recommendations are endorsed by: American Society of Hypertension, Asian Hypertension League, International Council of Nurses, International Diabetes Federation Europe, International Federation of Kidney Foundations, International Society of Nephrology, National Kidney Foundation, World Hypertension League, World Stroke Organization, incorporating the World Stroke Federation and the International Stroke Society and Dr Georgs Andrejevs, MEP, and supported by: European Society of Hypertension and International Society of Hypertension.

The report was made possible by an unrestricted educational grant from Novartis. Novartis was not involved in the content or editing of this report in any way. www.novartis.com

References

1. National Institutes of Health; National High Blood Pressure Education Program. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (NIH Publication No. 03-5233). Bethesda, MD: 2003. (Cited 2003 December.) Available here.

2. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet 2005;365:217-23

3. Wang Y R, Alexander G C, Stafford R S,. Outpatient hypertension treatment, treatment intensification and control in Western Europe and the United States. Arch Intern Med 2007;167:141-7

4. Sackett D L, Haynes R B, Gibson E S, et al. Randomized clinical trial of strategies for improving medication compliance in primary hypertension. Lancet 1975;1:1205-7

5. Waeber B, Leonetti G, Kolloch, R et al. Compliance with aspirin or placebo in the Hypertension Optimal Treatment (HOT) study. J Hypertension 1999;17:1041-5

6. World Health Organization. The World Health Report 2002. Reducing Risks, Promoting Healthy Life. (Accessed 2007 Apr 10;cited 2002) Available here.

7. Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ. Selected major risk factors and global and regional burden of disease. Lancet 2002;360:1347-6

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