50% of South Africans with hypertension are undiagnosed & untreated.

More people die from Hypertension - more commonly known as high blood pressure (BP) - than from any other illness¹ and all signs point to this global pandemic getting worse.

Worldwide, more than 11 million people die from this chronic illness every year¹, and in SA the picture is equally concerning. An estimated 53 men and 78 women over 30 die from the impact of hypertension every day.² A BP test is the fastest way to detect and help diagnose the illness and in so doing, prevent avoidable deaths.

Hypertension is acknowledged as the ‘silent killer’ because it’s just that; there are no symptoms, and you don’t feel ill until you have a cardiac event like a heart attack. Despite there being no indications or symptoms of ill health, this invisible illness can potentially, if left unchecked, lead to serious heart disease, stroke and even death. Proof of that – every three seconds someone dies from hypertension’s consequences.³ Other complications can include heart failure, peripheral vascular disease, kidney damage, retinal haemorrhage, and visual impairment. With relatively few people making the connection between raised BP and the devastating consequences of the illness – awareness levels need urgent attention to curb the exponential growth of the disease in SA.

Hypertension is affecting more and more young adults. In SA, nearly 50% of people over age 15 have high BP.⁴ Even more alarming is only 50% know they have it.⁵

Dr Martin Mpe a Gauteng-based Cardiologist and past-president of the South African Hypertension Society said, “If you don’t have your BP measured you won’t know you have the condition until it strikes. Detecting hypertension early also helps minimise the risks. A BP test is the only way to find out if your BP levels are elevated – a non-invasive and really quick measure that will immediately determine if levels are unacceptably high. A BP reading of 120-129/70-79 is considered normal. Patients with a BP higher than 140/90 should immediately seek further medical intervention.” Dr Mpe explained that with this kind of diagnosis, your doctor is likely to prescribe antihypertensive medication that’s taken every day. This is the only way to ensure that the treatment will effectively control blood pressure in the long-term and protect against the risk of cardiovascular events.

Concerningly, more than a third of people diagnosed and treated for hypertension, stop their treatment after only six months while 50% of people with hypertension stop their treatment completely after one year.⁶ Dr Mpe cautioned that this lack of adherence prevents BP from returning to normal and has very important and severe consequences, including an increased risk of a heart attack or stroke.⁷

Reinforcing this, Prof Brian Rayner, nephrologist and past director of the Hypertension Institute at the University of Cape Town said, “Elevated BP is subject to the rule of halves – 50% of the population is unaware of their condition, 50% of those who are aware do not take treatment, and 50% of those who take treatment are not controlled, leaving only 12.5% of the total population who are controlled.”

From this it’s clear that BP management is all about the numbers and these figures indicate that treatment goals are not being met and it’s time to retool.

Hypertension is most often caused by a combination of hereditary influences and poor lifestyle. Prof Rayner said, “You can do little about your parents or your age, but you can choose to live a healthy life and lifestyle changes should be sufficient to correct a BP of 130-140/80-90. This includes daily exercise, reducing salt intake, following a good diet high in fruit and veg, no excessive alcohol consumption, maintaining an ideal weight, managing stress and no smoking.”

The frightening truth of the hypertension disease burden is the number of people with raised BP is on an upward trajectory, particularly in low and middle-income countries in Africa, with no signs of slowing down. Globally, adults with raised BP grew from 594-million to 1.13-billion between 1975 and 2015.⁸ Of great concern is that over these four decades research has shown that the highest worldwide BP levels shifted from high-income countries to low-income, developing countries, and by 2015, sub-Saharan Africa joined central and Eastern Europe and south Asia as the regions with the highest global BP levels.⁸

SA’s hypertension figures support this and the country has the highest rate of high blood pressure reported among people aged 50 and over for any country in the world, at any time in history, with almost 8 out of 10 people in this age group being diagnosed with high blood pressure.⁹

Dr Mpe said, “When one considers that 28 000 people die every day from the consequences of hypertension – that’s the equivalent of 70 jumbo jets crashing and killing everyone on board, it clarifies the importance of collaborative public information campaigns. A simple BP test can be instrumental in avoiding these preventable deaths, and why we need to bolster awareness levels as a matter of urgency. Mobilising South Africans to get their BP screened has never been more important.”

REFERENCES 

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