14/01/2024
14/01/2024
In a recent interview with Dr. Rajesh Rajan, we delved into the new treatment targets and goals for preventing high blood pressure. Dr. Rajan, an esteemed figure overseeing various clinical research registries focused on heart failure, has played a pivotal role in this field.
The 2024 World Heart Federation Roadmap for Hypertension, which builds on the previous 2015 edition, serves as a vital reference document for individuals involved in planning, organizing, managing patients, and implementing strategies to alleviate the burden of hypertension.
This comprehensive roadmap offers evidence-based guidance on priority interventions for hypertension that can be adapted to different contexts. It summarizes the latest research in epidemiology, treatment, emerging technologies, health system strategies, and policies, providing valuable insights to enhance the detection and management of hypertension worldwide.
Bringing together the expertise of clinicians, researchers, allied health professionals, health systems experts, and patient representatives from around the globe, the roadmap presents an integrated approach to patient care.
Dr. Rajan emphasizes the urgent need for global awareness, treatment, and control of hypertension, which is the leading risk factor for death worldwide, affecting over 1 billion people. Often referred to as "the silent killer," hypertension often goes unnoticed until it leads to severe health complications such as heart disease and stroke.
Dr. Rajan highlights that while high blood pressure is a global concern, the most significant increases in its burden are currently observed in East Asia and the Pacific, Latin America and the Caribbean, South Asia, and Sub-Saharan Africa. Alarmingly, only about a third of individuals with hypertension are receiving treatment, and merely one in ten have their blood pressure under control, particularly in low- and middle-income countries.
The economic impact of uncontrolled hypertension is staggering, with direct healthcare costs and productivity losses due to disability and premature mortality. Approximately 10% of global healthcare spending is directly associated with hypertension and its complications.
Hypertension can be classified into primary and secondary. Primary hypertension accounts for over 90% of cases and is often caused by factors such as obesity, a high-salt diet, lack of exercise, and excessive alcohol consumption. On the other hand, secondary hypertension is caused by underlying conditions, most commonly kidney problems and endocrine disorders.
The insidious nature of hypertension is what makes it so dangerous. It does not exhibit any symptoms on its own, earning it the nickname "the silent killer." Regular blood pressure monitoring is therefore crucial. Hypertension increases the risk of heart, brain, and kidney diseases and affects more than 1 billion individuals worldwide.
Managing hypertension requires a comprehensive approach that combines lifestyle interventions and medication. Shockingly, it is estimated that less than 1 in 5 people with hypertension have it under control.
Dr. Rajan emphasizes the vital role of healthy eating in managing high blood pressure and reducing the risk of heart disease. A diet low in salt, with less than 5g of salt (2g of sodium) per day, is recommended. Increasing potassium intake can also help lower blood pressure.
Maintaining a healthy weight is another crucial step in reducing the risk of developing high blood pressure. Regular physical activity not only helps lower blood pressure but also provides numerous other health benefits.
Limiting alcohol consumption is essential, as excessive drinking can elevate blood pressure. Ideally, alcohol intake should be minimized or eliminated altogether.
Smoking is a major risk factor for hypertension and other cardiovascular diseases. Quitting smoking significantly reduces the risk of heart attack, stroke, and lung cancer.
In some cases, blood pressure-lowering medication may be necessary to effectively manage hypertension. These medications, known as anti-hypertensives, do not cure high blood pressure but aid in its control. It is important to note that once medication is initiated, it is typically a lifelong commitment.
The advancements in hypertension medication over the past five decades have been remarkable. There is now a wide range of cost-effective and safe options available to treat hypertension. However, global awareness, treatment, and control of hypertension still remain low.
Let us raise awareness about this silent killer and encourage individuals to take control of their blood pressure. Regular monitoring, lifestyle modifications, and appropriate medical intervention can make a significant difference in preventing the devastating consequences of hypertension. Together, we can combat this global health challenge and ensure a healthier future for all.
Dr. Rajan is a renowned Indian cardiologist at Al Amiri Hospital Kuwait and Chairman of the Indian Association of Clinical Cardiologists. Dr. Rajan also holds prestigious positions as the current President of the Association of MD Physicians and the managing editor of the esteemed Annals of Clinical Cardiology Journal by Wolters Kluwer. His contributions to the medical community are highly regarded, with notable achievements that include the invention of the RHF Risk Score calculator for heart failure patients and the development of Rajan's and Kotevski's modified Lipton's classification. Beyond his groundbreaking research, Dr. Rajan has garnered recognition through various Fellowships from esteemed institutions such as the Royal College of London, Edinburgh, Ireland, and Glasgow. Moreover, he has been honored as a Fellow of the American College of Cardiology, the European Society of Cardiology, and the American Heart Association, further highlighting his expertise and commitment to cardiovascular health.