A killer disease that hits over a billion

The revelation by the World Health Organisation on blood pressure is alarming, to say the least. It said on Wednesday that nearly 1.3 billion people globally suffer from hypertension.

Blood pressure is a silent killer often driven by obesity that increases the risk of heart disease, stroke and kidney problems.

Hypertension can be easily diagnosed by monitoring blood pressure, and treated with low-cost drugs, but half of affected people are unaware of their condition which is left untreated, the WHO and Imperial College London said in a joint study published in The Lancet.

The issue is one over money. The disease is a disease of the poor. The rich countries have managed to keep the disease in check, but the poor are the ones who bear the brunt of the suffering. While hypertension rates have changed little in 30 years, the caseload has shifted to lower-income countries.

“It is far from being a condition of affluence, it’s very much a condition of poverty,” Majid Ezzati, professor of global environmental health at Imperial College London, told a news briefing.

“Many parts of sub-Saharan Africa, parts of South Asia, some of the Pacific island nations, they are still not getting the treatments that are needed,” he said.

Over 17 million people died in 2019 from cardiovascular diseases, accounting for one in three global deaths, with hypertension a major factor, according to the WHO.

“We know that the treatment is cheap, it’s low cost medicines. But there is a need to include them in the UHC (universal health coverage) so this is not a cost for the patient, it has to be covered by the insurance system,” said Bente Mikkelsen, director of the WHO’s department of noncommunicable diseases.

Apart from genetic risk factors for hypertension, there are “modifiable risk factors” linked to lifestyle, Mikkelsen said.

These include unhealthy diet, physical inactivity, tobacco and alcohol consumption, uncontrolled diabetes, and being overweight, she said. Referring to obesity, she said: “This is really the tsunami of the risk factors.”

Last year, two blood pressure-lowering drug classes, called ACE inhibitors and ARBs, came under scrutiny after the US Centers for Disease Control and Prevention reported in April that 72% of hospitalised COVID-19 patients 65 or older had hypertension.

Researchers at Oxford University had recommended some patients stop the drugs until the risks were better known, while others argued patients should stay on the medications.

The new study made publicly available on Friday found no clinically significant increased risk of either a diagnosis or hospitalisation of COVID-19 with ACE or ARB use compared with other first-line drug treatments for hypertension.

Early life changes in brain activity and blood flow may be the reason why people tend to develop abnormally high blood pressure, or hypertension, researchers said.

High blood pressure is a condition in which the force of the blood against the artery walls is too high.

It is also often called the silent killer because it typically has no symptoms until after it has done significant damage to the heart and the arteries. In 90-95 per cent of people, high blood pressure has no identifiable cause, yet it is a risk factor for diseases of the brain, kidneys, heart, eyes, and other parts of the body.

Changing your lifestyle can help control and manage high blood pressure.

But sometimes lifestyle changes aren’t enough. If diet and exercise don’t help, your doctor may recommend medication to lower your blood pressure.

According to the Mayo Clinic, the type of medication your doctor prescribes for high blood pressure depends on your blood pressure measurements and overall health. Two or more blood pressure drugs often work better than one. Sometimes finding the most effective medication or combination of drugs is a matter of trial and error.