I'am read from A global brief on HYPERTENSION book (WHO: World Health Organization), i just share what i read for everyone..
Why Hypertension is a major public health issue?
Globally cardiovasculer disease accounts for approximately 17 milion deaths a year, nearly one third one third of the total. Of these, complications of hypertension account for 9.4 million deaths worldwide every year. Hypertension is responsible for at least 45% of deaths due to heart disease, and 51% of deaths due to stroke.
In 2008, worldwide, approximately 40% of adults aged 25 and above had been diagnosed with hypertension; the number of people with the condition rose from 600 million in 1980 to 1 billion in 2008. The prevalence of hypertension is highest in the African Region at 46% of adults aged 25 and above, while the lowest prevalence at 35% is found in the Americas. Overall, high-income countries have a lower prevalence of hypertension -35% -than other groups at 40%.
Not only is hypetension more prevalent in low- and middle-income countries, there are also more people affected because more people live in those countries than in high-income countries. Further, because of weak health systems, the number of people with hypertension who are undiagnosed, untreated and uncontrolled are also higher in low- and middle-income countries compared to hig-income countries.
The Increasing prevalence of hypertension is attributed to population growth, ageing and behavioural risk factors, such as unhealthy diet, harmful use of alcohol, lack of physical activity, excess weight and exposure to persistent stress.
The adverse health consequencer of hypertension are compounded because many people affected also have other health risk dactors that increase the odds of heart attack, stroke and kidney failure. These risk factors include tobacco use, obesity, high cholesterol and diabetes mellitus. tobacco use increases the risk of complications among those with hypertension. In 2008, 1 billion pepole were smokers and the global prevalence of obesity has nearly doubled since 1980. The global prevalence of high cholesterol was 39% and prevalance of diabetes was 10% in adults over 25 years. Tobacco use, unhealthy diet, harmful use of alcohol and physical inactivity are also the main behavioural risk factors of all major noncommunicable disease, i.e. cardiovascular disease, diabetes, chronic respiratory disease and cancer.
If appropriiate action is not taken, deaths due to cardiovasculer disease are projected to rise further.
Not addressing hypertension in a timely fashion will have significant economic and social impact.
Nearly 80% of deaths due ti cardiovascular disease occur in low- and middle-income countires. They are countries that can least afford the social and economic consequences of ill health. Current age standardized mortality rates of low-income countries are higher than those of developed countries.
Early detection and treatment of hypertension and other risk factor, as well as public health policies that reduce exposure to behavioral risk factors, have contributed to the gradual decline in mortality due to heart disease and stroke in high-income countries over that last three decades. For example, in 1972, comprehensive preventive interventions were initiated in a community project in North Karelia, in Finland. At that time Finland had an extremely high mortality rate from heart disease. Within five years, many posistive changes were already observed in the form of dietary changes, improved hypertension control, and smoking reduction acordingly a decision was made to expand the interventions nationally. Now, some 35 years later, the unnual cardiovascular disease mortality rate among the working-age population in Finland is 85% lower compared to rates in 1977. Observed reduction in population risk factors (serum cholesterol, blood pressure and smoking) have been shown to explain most of the decline in cardiovascular mortality. Concurrent improvements in nearly detection and treatment of risk factors have also contributed to the decline in cariovascular disease mortality.
Premature death, disability, personal and family disruption, loss of income, and health care expenditure due to hypertension, take a toll on famillies, communities and natuonal finances. In low- and middle-income countries many pepole do not seet treatment for hypertension because it is prohibitively expensive. Households often then spend a substantial share of their income on hospitalization and care following complications of hypertension, including heart attack, stroke and kidney failure. Families face catastrophic health expenditure and spending on health care, which is often long term in the case of hypertension complications, pushing tens of millions of people into proverty. Moreover, the loss of familly income from death or disabilitiy can be devastating. In certain low- and middle-income countries, current health expenditure on cardovascular disease alone accounts for 20% of total healh expenditure.
Over the period 2011-2025, the cumulative lost output in low- and middle-income countries associated with noncommunicable disieases in projected to be US$ 7.28 trillion. The annual loss of approximately US$ 500 bilion due to major noncommunicable disease amounts to approximately 4% of gross domestic product for low- and middle-income countries. Cardiovascular disease including hypertension accounts for nearly half of the cost.
The increasing incidence of noncommunicable disease will lead to greater dependency and mouting costs of care for patients and their famillies unless public health efforts to prevent these conditions are intensified. The Political Declaration of the High-level meeting of the General Assembly on the Prevention and Control of Non-communicable Disease. adopted by the United Nations General Assembly in September 2011, acknowledges the rapidly growing burden of noncommunicable disease and its devastating impact on health, socioeconomic development and proverty alleviation. The Political Declaration commits goverments to a series of concreate actions.