We live in a rapidly changing environment. Throughout the world, human health is being shaped by the same powerful forces such as ageing, rapid urbanisation and the globalisation of unhealthy lifestyles.
Increasingly, wealthy and resource-constrained countries face similar disease patterns with populations in low- and middle-income countries disproportionately affected due to weak health systems.
One of the most striking examples of this shift is the fact that non-communicable diseases (NCDs) such as cardiovascular disease, cancer, diabetes and chronic lung diseases have overtaken infectious diseases as the world’s leading cause of death.
Sixteen million cases of NCD deaths occur before the age of 70 with 82 percent of them occurring in low- and middle-income countries.
Globally, cardiovascular diseases account for most NCD deaths, or 17.5 million people annually, followed by cancers (8.2 million), respiratory diseases (4 million), and diabetes (1.5 million). Of these, complications of hypertension account for 9.4 million deaths every year.
Therefore, hypertension is a considerable public health threat. It has long been called the “silent killer” — and for good reason, in most cases, it has no obvious symptoms to indicate that something is wrong.
It is an independent predisposing factor for heart failure, coronary artery disease, stroke, renal disease, and peripheral arterial disease. It is the most important risk factor for cardiovascular morbidity and mortality.
Hypertension rarely causes symptoms in the early stages and many people go undiagnosed.
The Seventh Report of the Joint National Committee on the Prevention Detection, Evaluation and Treatment of High Blood Pressure (JNC7), categorises blood pressure in mm/Hg as follows: normal blood pressure is systolic <120 and diastolic <80, prehypertension is systolic 120-139 or diastolic 80-89. Stage one hypertension is systolic 140-159 or diastolic 90-99 and stage two hypertension is systolic ≥160 or diastolic ≥100.
Some of the risk factors to this disease include high levels of blood lipids, obesity, physical inactivity, smoking and excessive alcohol use, glucose intolerance/diabetes and age.
There are a significant health and economic gains attached to early detection, adequate treatment and good control of hypertension.
Treating the complications of hypertension entails costly interventions such as cardiac bypass surgery, carotid artery surgery and dialysis all of which drain individuals’ and governments’ budgets.
Hypertension can be prevented. Doing so is far less costly, and far safer for patients, than interventions like cardiac bypass surgery and dialysis that may be needed when hypertension is missed and goes untreated.
The best ways to protect oneself from hypertension are being aware of the factors and making changes that matter.
Therefore, engaging in healthy lifestyle behaviours at all stages of life, regardless of race or ethnicity, can help keep one’s risk of hypertension in check.
At the community level: preventive and promotive health education measures are required. Early and regular screening is invaluable through outreaches, school and workplace wellness programmes and. Salt reduction initiatives can make a major contribution to the prevention and control of high blood pressure.
At an individual level the following measures are useful in preventing hypertension: quitting smoking, limiting intake of all types of fats and replacing saturated with unsaturated fats such as nuts, vegetable oils and fish; limiting cholesterol intake; increasing fibre intake as it can speed up the removal of cholesterol from the blood-fibre is found in oats, oat bran, barley, fruits, vegetables, legumes and whole grains.
Keeping Body Mass Index (BMI) between 18.5kg/m² and 23kg/m². BMI is a measure of a person’s weight in relation to his height and reducing excess weight helps lower one’s cholesterol levels.
Exercising for 150 minutes per week also comes in handy. Regular exercise lowers blood pressure by keeping the heart and blood vessels in good condition; limiting alcohol intake to two standard drinks per day-a standard drink is 220ml of beer, 100ml of wine, or 30ml of spirits.
For those already diagnosed with hypertension, blood pressure should be monitored frequently. If a patient does not achieve goal blood pressure readings, then alterations to the pharmacological management of hypertension should be made.
All members of the healthcare team (such as physicians, nurses, and pharmacists) should work together with the patient to promote lifestyle change and blood pressure control and ultimately taming this silent killer.
The writer is Health and development expert in the Horn of Africa.