A recently published study of 142,042 people from 17 countries (including Brazil) showed that throughout the world, only 46% of people with high blood pressure are aware of their condition, and, surprisingly, of the people being treated, only about 33% have their blood pressure under good control.
This lack of blood pressure control was prevalent throughout the world, in “poor” countries such as India, and in “rich” ones like Canada, although the worst performing countries were in Africa.
Globally, high blood pressure is the number one cause of cardiovascular disease, and when untreated or inadequately treated, hypertension leads to heart disease and heart failure, stroke, and kidney disease. These risks decrease if a person receives adequate treatment.
High blood pressure is generally defined as a systolic pressure greater than 140 and/or a diastolic pressure above 90. A healthy blood pressure is considered to be 120/80 or below.
The current research project divided the 17 countries into categories from “high income countries” such as Sweden, to “low income countries” like Bangladesh. Brazil was considered an “upper middle income” country, and 5549 Brazilians, from age 35 to 70, were examined in the study.
Interestingly, the percentage of people who were aware that they were hypertensive was greatest in South America (including also Chile and Argentina) at 57%, but of the South Americans being treated, only 36% had their blood pressure under “good control”. (Note the study did not publish separate statistics for Brazil versus Chile and Argentina.)
This report suggests that even among the people who are aware they are hypertensive, and who are being treated, are not adequately being monitored to see if the therapy is working. Part of the reason is that hypertension is generally a “silent disease”, as most people with high blood pressure have no symptoms—the only way to know they have the problem is to have their blood pressure checked (several different readings are needed).
Those people who are not diagnosed or not adequately treated have the health risks mentioned above, but almost everyone diagnosed can be adequately treated with oral medications. Also helpful is avoiding obesity and avoiding excessive salt intake. A good diet with plenty of fruits and vegetables is also valuable. Even owning a pet, particularly a dog, can help control blood pressure.
However, while these “non-medication” measures are useful, most people who are hypertensive need to take medication daily to keep under control. Many people require a combination of two or more medications for good control. The only way to know is to go back for blood pressure checks after treatment is started to see if medication should be changed or a combination of medicines is needed.
This report is a reminder to all of us, patients and doctors, that we are not overall performing well in blood pressure control. Don’t put off having your pressure checked. It’s painless and there is effective treatment available.
And then if you are found to have high blood pressure, it is vital that you don’t just start a medication and forget about it. You need to follow through with your doctor to see if the medication is working, and if not, change the medication to significantly lower your risk of long-term complications.
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