World Hypertension Day - Dr. Jarbas Barbosa, PAHO’s Director Remarks - 11 May 2023
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Washington, DC As prepared for delivery Hypertension, or high blood pressure, is a common condition which, if left untreated, can lead to heart attacks, heart failure, stroke, kidney failure and blindness. It is the main risk factor for cardiovascular disease, which is the principal cause of premature death in the Americas, responsible for around 2 million lives lost each year. Hypertension affects 18% of adults in the Americas, which means there are approximately 180 million people who require access to primary health care services and treatment to control their hypertension. The condition also becomes more common with age: Around 50% of all people aged 65 and older have hypertension. Hypertension rates vary between countries and subregions, with the highest rates in the Americas seen in the English-speaking Caribbean, where it affects a quarter of all adults. Yet despite the high levels of hypertension in our region, many of its risk factors – overweight and obesity, lack of physical activity, high sodium/salt intake, and alcohol use – can be prevented. This year, World Hypertension Day, observed on 17 May, focuses on the steps we can take to prevent high blood pressure, find out whether we have it and, if we do, what we need to do to keep our blood pressure under control. This is crucial because hypertension often has absolutely no symptoms nor signs and is therefore frequently undiagnosed and untreated. In the Americas, around 1 in every 6 adults has hypertension. Among those aged 30 to 79 years, over one-third of men and a quarter of women with hypertension are unaware they have the condition. Of those who are aware of their condition, only 60% receive treatment. And of these, only around a third (36%) are controlled. This is serious because undiagnosed and uncontrolled hypertension can lead to heart attack, heart failure or stroke. Lifestyle changes and lifelong use of antihypertensive medications are key to reducing and controlling this condition. To ensure this, PAHO recommends that people follow a healthy lifestyle, including 30 minutes of exercise per day, five days a week; reduce their sodium intake to less than 5g per day; increase their intake of fruit and vegetables, and work to achieve and maintain a healthy body weight of a BMI less than 25. Beyond individual actions, however, it is crucial that countries implement evidence-based measures to promote healthy lifestyles, including interventions to promote healthy diets, such as front-of-package warning labels on processed and ultraprocessed unhealthy food products, and measures to reduce salt intake and salt content of food. In fact, several countries are now debating regulations on front-of-package warning labels and I would encourage swift adoption. The theme of this year’s World Hypertension Day is Measure your blood pressure accurately, Control it, Live Longer Measuring your blood pressure is the only way to find out whether or not you have high blood pressure. Yet many primary health care clinics throughout our region lack clinically validated blood pressure measurement devices, significantly limiting their ability to accurately diagnose hypertension. To address this, the PAHO Strategic Fund, a pooled procurement mechanism for essential medicines and health technologies, now offers these devices to countries of our region, as well as quality-assured antihypertensive medications at competitive prices. However, this resource continues to be underutilized - In the past years only 6 countries have used the Strategic Fund for these essential medicines and only in small quantities. PAHO is also working with countries to intensify the scale-up and ensure equitable access to care for hypertension and other noncommunicable diseases at the first level of care, and to provide training and normative guidelines so that the latest, evidence-based approaches for hypertension diagnosis and treatment are practiced in primary health clinics across the Americas. This includes the PAHO HEARTS initiative, which is a model of care for cardiovascular risk management, with an emphasis on the control of hypertension and the prevention of complications. Approximately 3000 clinics in the Americas are implementing the recommended hypertension treatment guidelines and over 100,000 primary health care providers have been trained on evidence-based hypertension management. Estimates suggest that if the control of hypertension could be increased from current levels (36%) to 50%, around 420,000 deaths could be averted in the Region every year. As Director of the Pan American Health Organization, I am pleased to join the global public health community in observing World Hypertension Day and call on countries:
Dr. Jarbas Barbosa |