WHF Roadmap to the Management and Control of Raised Blood Pressure

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The WHF Roadmap for Reducing Cardiovascular Mortality through Prevention and Management of Raised Blood Pressure identifies roadblocks and suggests potential solutions to improve cardiovascular health and help reach the target set out in the Sustainable Development Goals: achieve a 30% reduction in NCDs, including CVD, by 2030.

This WHF Roadmap has been written by seven experts from around the world: Alma J. Adler, Dorairaj Prabhakaran, Pascal Bovet, Dhruv S. Kazi, Giuseppe Mancia, Vash Mungal-Singh and Neil Poulter.

A Roadmap is a framework to identify roadblocks and suggest potential solutions on the road to 2030. Global Roadmaps have been developed by worldwide experts to detect the problems and offer solutions on specific topics impacting cardiovascular mortality.

This Roadmap was launched on 8th May 2015 at the WHO World Health Assembly, and published in Global Heart.

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Overview

WHF has developed this Roadmap on Raised Blood Pressure with experts and Members to focus on and help identify the roadblocks to treating hypertension, which are currently preventing the 25by25 targets being achieved. This Roadmap offers evidence based solutions which may be applicable to achieving an improved management of hypertension.

Challenges

A key challenge in effective raised blood pressure control is that most hypertensive individuals are usually asymptomatic for years prior to a significant cardiovascular event, but face an increased risk of stroke, heart attacks, and kidney disease. Raised blood pressure is one of the most frequent reasons for consultation in primary care and, left untreated, can lead to a range of complications including myocardial infarction, stroke, heart failure, renal failure and death. Despite international efforts to control the disease, its prevalence continues to rise, increasing from 600 million in 1980 to 1 billion in 2008.

Target

A relative reduction of the prevalence of raised blood pressure by 25 percent by 2025.

Definition

According to the Global Burden of Disease, ischemic heart disease is one of the biggest causes of morbidity and mortality across the world. Annually, there are over 17 million deaths due to cardiovascular disease worldwide, of which 9.4 million are attributed to raised blood pressure. Complications of raised blood pressure account for 45% of all heart disease deaths and 51% of all stroke related deaths. Blood pressure has a continuous relationship with the incidence of stroke, myocardial infarction, heart failure, peripheral artery disease, and end stage renal disease. Trials show that lowering blood pressure reduces the risk of subsequent cardiovascular events, including a 35-40% reduction in the risk of stroke and a 20-25% reduction in the risk of myocardial infarction. Raised blood pressure is either defined as blood pressure at or over 140 mmHg systolic or 90 mmHg diastolic or as receiving drug therapy for raised BP regardless which are their blood pressure values. Individuals considered to have “high normal” BP are defined as those with a systolic BP between 130-139 mmHg &/or diastolic BP between 80 and 89 mmHg.

Patient Story

“Finding out I had hypertension was a shock. I’d always thought I was fairly healthy for my age, and put anything out of the ordinary down to simply getting older.

My diagnosis was completely accidental. I thought I had an eye infection and had called my optician to cancel my annual eye test because of it. He insisted I came in, took a look and told me that it wasn’t an infection… it was burst blood vessels caused by high blood pressure. I called my doctor, had a blood pressure test straight away and was told that I had hypertension. It turned out that my cholesterol was also very high and the doctor said I could have a heart attack or stroke at any point.

My doctor prescribed some medications and told me to lose weight, get more active and eat healthily. In a few months I’d managed to lose around 5kg through diet and gentle exercise but my blood pressure and cholesterol were still too high. I bought myself a monitor so that I could keep track of what was helping to lower my blood pressure. The answer was exercise. I joined a gym and now, five year later, I’ve managed to get my blood pressure and cholesterol levels under control. If I stop exercising I know that my blood pressure goes up, so I’m determined to carry on so that my medicines can be kept at a low dose.

The fact that I’m still here and feeling better than before is all thanks to my optician for insisting on that eye test.”

 

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