By Saima Wazed, WHO Regional Director for South-East Asia
Hypertension, in the words of the World Hypertension League (WHL), is ‘a driving force in the global epidemic of non-communicable diseases (NCDs) and the leading risk factor for death and disability globally.’ World Hypertension Day, initiated by WHL in 2005, aims to increase awareness of this silent killer, and galvanise global action to combat high blood pressure. This year, the theme is a call to ‘Measure Your Blood Pressure Accurately, Control It, Live Longer.’
It is estimated that more than 294 million people are living with hypertension in our South-East Asia Region. High intake of salt, tobacco and alcohol use, unhealthy diets, physical inactivity, stress, and air pollution are key risk factors for the rising prevalence for hypertension.
Early detection and control are crucial. Amongst adults with hypertension, half are unaware they have it, and nearly 1 in 6 do not have their blood pressure under control. Uncontrolled, it can lead to heart attacks, strokes, kidney failure, and early death. Limited access to affordable healthcare services for hypertension is one of prime reasons for the low Universal Service Coverage Index for most countries in our Region and impacts access to quality health services.
Our Region has identified the prevention and control of hypertension as one of our priorities. “SEAHEARTS: Accelerating Prevention and Control of Cardiovascular Diseases in the South-East Asia Region” is an initiative endorsed by the Seventy-sixth Regional Committee in 2023. This can be considered as the world’s largest expansion of cardiovascular diseases prevention and control in primary health care. The “Dhaka Call to Action – Accelerating the control of cardiovascular diseases in a quarter of the world’s population” provides guidance on how to achieve the SEAHEARTS milestone of placing 100 million people with hypertension and diabetes on protocol-based management by 2025.
Countries across our Region are implementing evidence-based strategies to mitigate the associated risk factors. Encouragingly, trends indicate a decline in tobacco use, and in exposure to household air pollution. Notably, four countries have initiated measures to eliminate trans-fatty acids from their national food supply chains. Two countries have implemented standards for labelling and marketing to give consumers the information needed to make healthier dietary choices.
Several countries have established national targets to improve hypertension and diabetes management within primary healthcare settings. These efforts involve revising evidence-based clinical protocols to align with the WHO HEARTS technical package, introducing team-based care approaches, and enhancing the availability and accessibility of essential medicines and equipment. Notably, over 24 million individuals with hypertension are estimated to be on treatment within public health facilities across the region.
Nonetheless, efforts to prevent and control hypertension need to be further strengthened to meet global and national targets, including those outlined in the Sustainable Development Goals (SDG) and SEAHEARTS milestones.
Our Region advocates for action in five key areas:
First, reducing hypertension risk factors by implementing WHO Technical packages for tobacco control, salt reduction, elimination of trans-fatty acids, promoting physical activity, and reducing air pollution.
Second, accelerating the coverage and management of hypertension within primary healthcare by strengthening interventions outlined in the WHO HEARTS and WHO Package of Essential Noncommunicable Disease interventions.
Third, establishing and regularly monitoring national targets and indicators for hypertension, to enhance accountability and track progress towards SEAHEARTS milestones.
Fourth, ensuring convergence of hypertension prevention and management services with other national programs, including maternal and child health, tuberculosis, and HIV programs.
Fifth, empowering communities and individuals for self-care management of hypertension, incorporating measures such as low sodium diets, reducing tobacco and alcohol use, regular physical activity, and conducting periodic blood pressure assessments.
Improving hypertension prevention and control should be an integral part of every nation’s journey towards Universal Health Coverage. Not only can this potentially save countless lives, it also carries significant economic advantages and advances progress towards SDG targets.
On World Hypertension Day 2024, let us confront this silent killer, and motivate all to ‘Measure Your Blood Pressure Accurately, Control It, Live Longer’.
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