World Health Day is observed on 7 April every year to mark the anniversary of the founding of WHO in 1948 and each year a theme is selected that highlights a priority area of concern for the agency.
This year’s theme “Measure your blood pressure, reduce your risk” focuses on preventing hypertension in people over 25 years of age.
Researchers estimate that high blood pressure contributes to nearly 9.4 million deaths from cardiovascular disease each year.
The high-income countries have a lower prevalence of hypertension (35% of adults) than low -and -middle income groups (40% of adults).
According to the World Health Organization’s website, over 40% of adults over the age of 25 had raised blood pressure in 2008. 17.3 million people died from cardiovascular diseases in 2008.
80% of deaths related to blood pressure occur in low and middle income countries.
The proportion increases with age, from 1 in 10 people in their 20 years to 30 years, 5 in 10 people in below 50 years.
With the aforementioned statistics, it is no wonder why high blood pressure was chosen as this year’s public health issue.
The World Health Organization also offers numerous suggestions for reducing your risk of developing high blood pressure. kindly see the enclosed file.
Download the leaflet by WHO on Hypertension : https://files.secureserver.net/0s2Y5Nw5rcfh3H
Some Facts regarding Hypertension:
The hypertension is a multifactorial or polygenetic disorder; which besides multifactorial inheritance, manifestly emerges into vulnerable individual entity with substantial participation of some non-genetic causes. It’s a most common silent killer in the contemporary world today. Nowadays, hypertension is ‘unimmunañopathically’ treated with the varieties of antihypertensive drugs; single or in combinations with two or more drugs at a time; whilst each of them operates onto the organism of sufferer in a very different way.
Actually, the sustained increase in systolic blood pressure SBP ≥140 mmHg and/or diastolic blood pressure DBP ≥90 mmHg is considered as a hypertension; which causes to have major risk events of the coronary artery disease CAD and/or brain stroke and/or even feared death of the entity. The SBP and DBP both have independent risk, when crosses over the above said limit, for the CAD as well as brain stroke. But, after the age of 50 years, SBP has greater risk than that of DBP. The elasticity of vascular tree maintains the DBP; whereas SBP tends to continuous rising trends, which results into the elevation of pulse pressure; a very unfamiliar and less known term that technically called as isolated systolic hypertension ISH. The evolution of ISH demonstrated a great probability to have brain stroke and is a good predicator of CAD risk. In fact, below 50 years of the age, raised DBP is considered as a good predicator of CAD; whilst in-between the age of 50-60 years, SBP and DBP both; whereas, above the 60 years of age SBP; because, the pulse pressure plays a key role in the manifestation of CAD and mainly brain stroke. Therefore, regardless of mode of medication, while treating a case of hypertension, SBP and DBP both ought to be considered seriously.
Actually, the BP in older ones with ISH put them to a greater risk of brain stroke and CAD. The long acting thiazide/ tiazide-type of drugs and dihydropyridines CCBs are beneficial in the ISH. The ARBs are much better than ACEIs in ISH and, especially, than that of beta-blockers, because, the beta-blockers are found less-efficient in mitigating the BP and also less-efficient in preventing CAD events in older patients. But, the beta-blockers are indeed much better for the prevention of secondary CAD events, post MI and in heart failures. The risk of postural hypotension in older patients, especially, when they are taking combination of 2 or 3 antihypertensive drugs at a time, must be monitored before and during the treatment; because, it may call for the changes in medicine/s.
The major categories of anti-hypertensive drugs which utilized today. Such as: (A) Adrenergic inhibitors: 1. Alpha-1 Blockers (doxazocin, prazosin); 2. Beta-blockers (atenolol, metoprolol); 3. Combined (carvedilol, labetalol). (B) Angiotensin converting enzyme inhibitors ACEI,s: (enalapril, perindopril). (C) Angiotensin II receptor blockers ARB,s: (losarton, valsarton). (D) Calcium channel blockers: 1. Dihyropyridines (amlodipine, nifedipine); 2. Non-dihyropyridines: (diltiazem, verapamil). (E) Diuretics: 1. Loop (bumetanide, furosemide (fursemude)); 2. Potassium-sparing: (amiloride, spironolactone); 3. Thiazide: (bendrofluazide, hydrochlorthiazide); 4. Thiazide-type: (chlorthalidone, indapamide). (F) Imidazoline receptor agonists: (moxonidine, rilmenidine). (G) Vasodilators: (hydralazine, minoxidil).
For instance: The above mentioned each and every drug in addition to its advantages has its own side effects and contraindications; thus, relying onto the precise indications, lowest ever effective proper dose of the long acting drug ought to be prescribed as per need and tolerance of the patient. Initially, although it is thought to be preferable to prescribe thiazide or thiazide–type of drugs as a first-line of treatment in the hypertensive patient; yet, because of its metabolic side effects in the high doses, it causes to have gout, impotency (2%), hypocalcaemia and hypoproteineamia etc. This happens to be true because of the diuretics dwindle BP by increasing the renal excretion; which together with large amount of water (body fluids) contains calcium and protein besides Na+ ion, medicinal and other metabolites. In the cases of diabetes and/or heart failure and/or renal failure, the ACEIs and ARBs are mostly prescribed; when there is much more lowered target BP, like that of 125-30/75-80, has to be achieved and desired. And that, in combination with the diuretics, ACEIs and ARBs are preferred in the post MI, LV dysfunctions and systolic heart failure. The ACEIs can be considered as a first line of treatment in the high risk patients, but, even if it mitigates the progression of renal damage with microalbuminaria or proteinuria, it causes to have renal failure and totally contraindicated in pregnancy, PVD and renal artery stenosis, this cannot be given in such cases. The ACEIs in 10% of the patients turn out irritating dry cough but ARBs are not. All the CCBs cause to have vasodilatation by reducing the vascular tone (resistance) and thereby mitigate the hypertension; but, non-hydropyridines in addition to this also reduces heart rate and its contractility; and so that, it prevents the brain stroke also attributable to ISH. The non-hydropyridines CCBs should not be given with the beta-blockers, as it causes to have heart block, bradycardia and extreme hypotension. Seeing that, the beta blockers cardio-selectively decrease the rate and contractility of the heart; and so that, thereby, requirement of the oxygen is also get down. The beta-blockers shouldn’t to be utilized in the patients with history of asthma, COPD, heart failure and heart block. Moreover, as its side effect, this also concurrently impairs the natural sexual instinct in the males, which is most precious mental instinct relating to the will of entity; not only of the human beings alone but also of all the living creatures existing upon the earth. In so doing, along with BP this also deprives of a most natural instinct of the human being, relating to the will of entity, a most important general symptom. The Alpha-blockers, even if it helps in glucose intolerance and dyslipidaemia and improve them, but, as it (doxazosin) is in the elderly patients cause to have heart failure, postural hypotension and worsen the urinary stress incontinence, especially, in the over wt. women, it doesn’t employed anymore now. Usually, the arterial vasodilators are not utilized now, to mitigate hypertension; however, hydralazine at times employed in pregnancy related blood pressure; as well, minoxidil and diazoxide in those individuals who found noncompliant to the other medicines. The spironolactone is useful in the obstinate type of BP,s. The effects of utilized antihypertensive ought to be evaluated after a month or so; because, the thiazides may require more time to establish it affects; thus, it’s better to evaluate a case after one & half months later on or so.
There are several other combinations of the anti-hypertensive drugs often utilized in the combination of two or more drugs for the same purpose; however, with a long list of adverse consequences of such unimmunañopathic drugs. For example: beta-blokers + thiazide; calcium channel blocker + ACE inhibitor or ARBs and beta-blokers + IRA + thiazide etc. Notwithstanding, even after such Herculean efforts, while patient was taking his prescribed medicinal doses properly, ultimately the probability of CAD, brain stroke with paralysis, brain hemorrhage, retinal hemorrhage and/or even feared death of the organism cannot be and has not ruled out entirely.
After all, even if Meta-analysis has been revealed the fact that the modern antihypertensive treatment decreases the risk of stroke by 30% and heart failure by 40%; but it also has suggested a trend towards higher mortality rate. Within all such cases often we find that, the most of general physicians never consider to take care of pulse pressure, a most neglected parameter so far. Consequently, apparently though DBP gets down by proper ingestion of the prescribed medicines; but, because of the increasing SBP, the pulse pressure considerably up hills to a great extent and largely found increased; which actually causes to have such serious detrimental consequences. See also text ‘PREAMBLE’ for more details. The American Heart Association has also admitted the fact that some prescription drugs increase the risk of heart attack by 60%; i.e. many high blood pressure drugs multiply your risk of a heart attack.