The number of people suffering from high blood pressure has doubled in the last 30 years to nearly 1.3 billion. More than half do not receive the treatment they need, and nearly one in two is unaware of their condition. This is despite the fact that diagnosing hypertension at home is relatively easy, maintaining normal blood pressure is relatively inexpensive, even in developing countries, and the typical complications of hypertension – stroke, heart attack, and heart and kidney failure – are among the leading causes of death, claiming about 18 million lives annually.
These are the conclusions of the most comprehensive study ever conducted in this field, published Wednesday morning in the Lancet. The authors of the study collected and analyzed a colossal amount of data: the results of blood pressure measurements in patients from around the world, from 1990 to 2019.
Statistics show that men are significantly more likely to suffer from high blood pressure than women (51% and 41% respectively), but they are much less likely to seek medical help. According to the study, nearly two-thirds of men with high blood pressure (62%) do not seek treatment. The situation is worst in Eastern Europe, where seven of the top 10 countries with the highest rates of hypertension are located. In Hungary, Poland, Lithuania, Romania, Belarus, Croatia and Serbia, at least half of men aged 30 to 79 have high blood pressure.
“The problem of arterial hypertension (its high prevalence) traditionally remains more acute in Eastern European countries than, for example, in the United States and the United Kingdom,” explains Yulia Balanova, senior researcher at the National Medical Research Center for Therapy and Preventive Medicine and one of the co-authors of the landmark study. According to her, such a rapid increase in the number of hypertensive patients worldwide is largely explained by the gradual aging of the population: “With age, the incidence of arterial hypertension increases, and the increase in the number of elderly people increases the burden on the healthcare system.”
Russia appears to be quite wealthy compared to its Eastern European neighbors. In reality, however, the number of hypertensive individuals among adult and elderly Russians is not much lower, at about 45%. Only one in five women and one in seven men have their blood pressure under control. Yulia Balanova cites three main reasons for this situation. “Our data show that, first, those who are unaware [of their condition] are not treated – often these are poorly educated men,” she lists. “Second, hypertension is called the silent killer because it often has no symptoms. And third, it is often people who drink too much alcohol.
According to Julia Balanova, Russians’ awareness of the problem leaves much to be desired. For example, practically everyone can name the normal body temperature without mistakes. But what about normal blood pressure? They differ slightly in different countries, but according to the criteria of both the European and Russian Society of Cardiology, hypertension begins when the patient’s blood pressure exceeds 140/90 mm Hg in the normal state. This is a “so-called tipping point, after which there is a significant increase in the number of undesirable events. To better explain the nature of the problem to a hypertensive patient, British doctors often compare his cardiovascular system to a boiler that gradually builds up scale (which inevitably increases the water pressure), or to an overinflated car tire that is much more likely to burst. In order to prevent the onset of the disease and prevent irreparable damage to the body, most middle-aged people simply need to be aware of the danger and measure their blood pressure regularly. After all, it is much easier to stop any disease in its early stages – and in the case of hypertension, the patient can often help himself without medication.
“It is important to remember the expression ‘risk factors do not hurt’. Lack of physical activity, insufficient consumption of fruits and vegetables, excessive salt intake – these are just some of the risk factors for hypertension. It is very important to note that these are modifiable risk factors, which means that a person can eliminate them from his or her life”.
Salt – probably the biggest enemy of hypertensive patients, as it has long been convincingly proven that the development of the disease is closely related to the amount of salt consumed in the daily diet. According to WHO recommendations, the total amount of salt consumed should not exceed one teaspoon (5 grams) per day. In reality, the global average exceeds the norm by a factor of two. “Eastern wisdom says that the journey of a thousand miles begins with a single step,” Julia Balanova reminds us. “In our case, it is a step toward reducing the risk of cardiovascular disasters. And at the family level, that first step is as simple as taking the salt shaker off the table.”