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86

VOLUME 15 NUMBER 2 • NOVEMBER 2018

DIABETES NEWS

SA JOURNAL OF DIABETES & VASCULAR DISEASE

Diabetes News

News from the 2018 Cape Town World Congress of Internal Medicine

Why hypertension matters: the silent killer

L

aunching the 2018 World Congress of

Internal Medicine (WCIM), the South

African Hypertension Society (SAHS)

hosted a media brief on the importance

and urgency of detection and management

of hypertension. ‘Findings from global and

South African cohorts show critically low

awareness of hypertension...’ This message

from Dr Martin Mpe, president of the SAHS,

underscores the fact that hypertension is

the most important preventable cause of

morbidity and mortality worldwide.

1

The importance of blood pressure as a

risk factor for cardiovascular disease is long

recognised. Hypertension is causally linked

to stroke, myocardial infarction, end-stage

kidney disease, congestive heart failure,

peripheral vascular disease and blindness.

Inadequate control of blood pressure is

responsible for 60% of strokes globally

and 30% of ischaemic heart disease.

1

Hypertension is also related to dementia

and sexual dysfunction.

Treatment adherence (medicine, diet,

lifestyle) to control hypertension is crucial

and Dr Mpe noted that ‘...poor adherence

is of no benefit and is the same as doing

nothing,’ with only one-third of treated

patients achieving target. It is, however,

problematic that the target population

that should benefit from advances in

hypertension treatment are not even aware

of their blood pressure levels.

There are no symptoms of hypertension,

‘the silent killer’, and this can hinder

diagnosis. Sub-Saharan Africa has a burden

of 73% undiagnosed hypertension.

1

In 2010, 40% of South African adults

older than 25 years showed measured

hypertension.

2

South African demographic

and health survey figures from 2016

indicate a prevalence of hypertension of

46% in women and 44% in men older

than 15 years.

3

Awareness is the gateway to improved

blood pressure control. The International

Hypertension Society (IHS) introduced May

Measurement Month in 2017, to raise

awareness of the importance of measuring

blood pressure. Prof Alta Schutte, president

of the IHS, elaborated on the survey

outcomes. Of 1.5 million people screened

from 89 countries (including South Africa)

during May 2018, 18.4% were found to

havehighbloodpressure thatwasuntreated,

and 40.4% of those on treatment were not

controlled to target (unpublished data).

South African data from the 2017 survey

shows that 56% of those on treatment are

not adequately controlled.

4

Our older population

While increasing age is a risk factor for

hypertension, and although the size

of the older population is increasing,

relative global prevalence of hypertension

continues to climb. Prof Neil Poulter,

Oxford, UK, points out that lifestyle is

key in the prevention and management

of hypertension. As populations develop,

there is a shift in lifestyle towards reduced

physical activity, an increase in alcohol and

tobacco consumption, unhealthy eating

habits, using too much salt and being

overweight, all of which are risk factors for

hypertension.

5

With 1.56 billion people predicted to

have hypertension by 2025, the urgency

to detect and manage this condition

is paramount for non-communicable

disease management. Prof Brian Rayner,

Hypertension Institute, UCT, recommends

that individuals be encouraged to know

their own blood pressure numbers. Blood

pressure monitoring is a simple procedure,

using many validated devices available

on the market. Servier Pharmaceuticals

sponsored

the

May

Hypertension

Awareness campaign and an educational

video for patients and practitioners on how

to correctly measure blood pressure.

Source: DeNovo Medica

www.denovomedica.com

References

1.

Chow CK, Teo KK, Rangarajan S,

et al

. Prevalence,

awareness, treatment, and control of hypertension

in rural and urban communities in high-, middle-,

and low-income countries.

J Am Med Assoc

2013;

310

(9): 959–968.

2. Day C, Groenewald P, Laubscher R,

et al

. Monitoring

of non-communicable diseases such as hypertension

in South Africa: Challenges for the post-2015 global

development agenda.

S Afr Med J

2014;

104

(10):

680–687.

3. National Department of Health, Statistics South

Africa, South African Medical Research Council.

South Africa demographic and health survey

2016: Key indicators

.https://www.statssa.gov.za/

publications/Report%2003-00-09/Report%20

03-00-092016.pdf.

4. Beaney T, Schutte A, Tomaszewski M,

et al.

May

Measurement Month 2017: an analysis of blood

pressure screening results worldwide.

Lancet Glob

Health

2018;

6

(7): e736–e743.

5. Poulter NR, Prabhakaran D, Caulfield M.

Hypertension.

Lancet

2015;

386

(9995): 801–812.