World Health Day: highlighting blood pressure

World Health Day, marking the establishment of the World Health Organisation (WHO) is celebrated on 7 April each year. It was on this day that the WHO was established in 1948. To mark World Health Day, the WHO nominates a priority area of global public health as the theme for World Health Day: this year the theme is controlling high blood pressure. According to WHO, high blood pressure (also called hypertension) affects more than one in three adults worldwide. Complications from high blood pressure—including heart attack and stroke—account for more than 9 million deaths worldwide every year.

Blood pressure is the force exerted by blood on the walls of arteries. It is commonly expressed as a ratio of two measurements, systolic and diastolic pressure. Normal blood pressure sits around a reading of around 120 mmHg over 80 mmHg. A reading higher than this can indicate high blood pressure. High blood pressure is sometimes called a silent killer, because patients may not experience any symptoms.

Until recently, up-to-date national data on the prevalence of high blood pressure was lacking. First results from the 2011-12 Australian Health Survey found that  just over 3.1 million adults (or 21.5%) had measured high blood pressure. Baseline data from the 1999–2000 Australian Diabetes, Obesity and Lifestyle Study, which measured blood pressure among other indicators, showed that around 30 per cent of adult Australians had high blood pressure or were on medication for that condition. High blood pressure is also more common among Indigenous Australians, with some studies suggesting it is 1.5 times more common.

Although a decline in average blood pressure levels has occurred since the 1980s, it remains a major risk factor for coronary heart disease, stroke, heart failure, peripheral vascular disease and renal failure.

High blood pressure has been attributed to both genetic and lifestyle factors. Dietary and lifestyle modifications can play a large part in controlling blood pressure. National guidelines prepared by the Heart Foundation recommend moderate physical activity of 30 minutes duration on most, if not all, days of the week (except for patients with angina, diabetes or other disease symptoms). Reduction in salt intake and alcohol is also recommended, as is weight reduction, while cessation of smoking will help reduce overall cardiovascular risk. Antihypertensive drugs may also be prescribed. These may include angiotensin II receptor antagonists (or ACE inhibitors), calcium channel blockers, or low-dose thiazide diuretics, alone or in combination.

Other health interventions associated with high blood pressure are hospitalisations due to complications and GP visits—high blood pressure is one of the most common problems managed by GPs.

The cost of treating high blood pressure with medications is substantial and growing. In 2011–12, the cost of ACE inhibitors listed on the Pharmaceutical Benefits Scheme (PBS) was over $567.3 million, and for calcium channel blockers the cost was over $124.8 million (see PBS Expenditure and Prescriptions, Table 7b). A recent report from Access Economics on the economic impact of stroke found that ‘even a small blood pressure reduction (5 to 6 mmHg systolic, 2 to 3 mmHg diastolic) would result in 40% fewer strokes’. Worryingly, the report also highlighted that nearly half of those who participated in a National Stroke Foundation blood pressure awareness exercise called Know Your Numbers, did not know their blood pressure level. This indicates there is considerable scope to improve blood pressure awareness.

It has been estimated that 2 in 5 people could lower their blood pressure by making adjustments to their lifestyle, including adopting a healthier diet, smoking cessation, maintaining a healthy weight and increasing exercise. This suggests there is some room for a greater focus on lifestyle modification programs to reduce high blood pressure.

Image Source: Better Health Channel Victoria 


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