Global Burden of Hypertension and Strategic Approach to Overcome It

Md Zakir Hossain
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Abstract

Globally an estimated 1.28 billion people have hypertension, most (two thirds) living in low and middle income countries. It is the leading cause of preventable death and is responsible for 10-20% of all death worldwide. Moreover, untreated hypertension can lead to a number of serious health consequences like stroke, heart disease, renal failure, dementia, vision loss etc. Antihypertensive treatment substantially reduces incidence of stroke (35-40%), myocardial infarction (20-25%) and heart failure (>50%). But hypertension remains undiagnosed in about 46% cases and only about 21% hypertensive individuals have adequately controlled blood pressure. There are several misconceptions regarding hypertension among people that hinders diagnosis or leads to false diagnosis and impair proper management of hypertension. In attempt to reduce burden of hypertension awareness generation is the first necessary step. To create awareness among people several seminar, free blood pressure check-up campaigns etc can be conducted, billboard placement and leaflet distribution can be done in different public gathering sites like bazaar, fairs, mosques, school, college, hospital etc, and necessary knowledge on hypertension can be circulated through primary or secondary school textbooks and printing and electronic media. The next essential step is to provide quality service for hypertensive patients at an affordable cost through dedicated hypertension centers or hypertension corners. These centers should be designed to provide proper training for the stuff and proper education or counseling for patients and to perform necessary research works. Government initiatives to distribute free antihypertensive drugs should be enhanced and non-government aids can be added to it. National policy to control price of antihypertensive medications is also necessary. Finally, regular follow-up is necessary to ensure regular intake of medications, adherence to lifestyle advices, adequate titration of medications and early detection and treatment of any target organ damage. Proper counseling at each visit and reminder through phone calls or mobile SMS can improve follow-up tendency. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 185
高血压的全球负担和克服它的战略方法
全球估计有12.8亿人患有高血压,大多数(三分之二)生活在低收入和中等收入国家。它是可预防死亡的主要原因,占全世界死亡总数的10-20%。此外,未经治疗的高血压可导致许多严重的健康后果,如中风、心脏病、肾衰竭、痴呆、视力丧失等。降压治疗可显著降低卒中(35-40%)、心肌梗死(20-25%)和心力衰竭(>50%)的发生率。但约46%的高血压病例未被确诊,只有约21%的高血压患者血压得到了适当控制。人们对高血压有一些误解,这些误解阻碍了诊断或导致错误诊断,损害了高血压的适当管理。要想减轻高血压负担,提高认识是必要的第一步。为了提高人们对高血压的认识,可以举办一些研讨会、免费血压检查等活动,在不同的公共集会场所,如集市、集市、清真寺、学校、大学、医院等,放置广告牌和散发传单,并通过中小学教科书、印刷和电子媒体传播必要的高血压知识。下一个重要步骤是通过专门的高血压中心或高血压角为高血压患者提供价格合理的优质服务。这些中心的设计应该为工作人员提供适当的培训,为患者提供适当的教育或咨询,并进行必要的研究工作。应加强政府免费发放降压药的举措,并可增加非政府援助。控制降压药价格的国家政策也是必要的。最后,定期随访是必要的,以确保定期服用药物,遵守生活方式建议,适当的药物滴定和早期发现和治疗任何目标器官损伤。每次就诊时进行适当的咨询,并通过电话或手机短信提醒,可以提高随访倾向。孟加拉国J医学2023;第34卷,第2(1)号补编:185
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