Title: Regional Health Forum
Year of Publication: 2013
Author: WHO South-East Asia Region
Subject: Blood pressure-take control
Summary: Globally, cardiovascular disease accounts for nearly one third of the total global deaths . Hypertension is responsible for at least 45% of deaths due to heart disease, and 51% of deaths due to stroke. Currently, 80% of deaths due to cardiovascular disease occur in low- and middle-income countries, where the burden of hypertension has increased over the past decade due to population growth, ageing and increase in behavioural risk factors. If appropriate action is not taken, deaths due to cardiovascular disease are projected to rise further. The cost of inaction may be very high. In low- and middle-income countries, many people do not seek treatment for early stage hypertension because it is unaffordable. Households then spend a substantial share of their income on hospitalization and care of complications of hypertension, and may be driven to poverty. The annual loss of approximately US$ 500 billion due to major noncommunicable diseases amounts to approximately 4% of gross domestic product for low- and middle-income countries. Cardiovascular disease accounts for nearly half this cost. On the other hand, there are significant health and economic gains attached to early detection, adequate treatment and good control of hypertension. These approaches can significantly reduce the need for costly interventions such as cardiac bypass surgery and dialysis. The estimated cost of scaling up highly cost-effective interventions that address major noncommunicable diseases in all low- and middle-income countries is less than US$ 1 per head in low-income countries, less than US$ 1.50 per head in lower–middle-income countries and US$ 2.50 in upper–middle-income countries. Although such cost-effective interventions are available, there are major gaps in implementation, particularly in resource-constrained settings. Public health policy must address hypertension because it is a major cause of disease burden. A combination of affordable, sustainable and effective interventions targeted at the whole population through multisectoral actions and partnerships is needed to address the implementation gap. Salt reduction initiatives can also make a major contribution to the prevention and control of high blood pressure by shifting the blood pressure distribution of the whole population to a healthy level. Health systems need to be strengthened to deliver cost-effective integrated programmes, particularly at the primary care level, and use hypertension and diabetes as entry points. The prevention and control of hypertension requires political will on the part of governments and policy-makers. The World Health Organization is coordinating the development of a global action plan for the prevention and control of noncommunicable diseases for the period 2013–2020 and a global monitoring framework. Together, they will provide a road map to operationalize the commitments of the United Nations Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases.