“Measure Your Blood Pressure Accurately, Control It, Live Longer”
Author: Prof Ye Myint, General Secretary, Myanmar Society of Hypertension
WORLD Hypertension Day is an annual event that takes place on 17 May. It is dedicated to raising awareness about hypertension or high blood pressure, a common medical condition that affects millions of people around the world. An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, among these, two-thirds are in low- and middle-income countries. An estimated 46 per cent of adults with hypertension are unaware that they have the condition. Less than half of adults (42 per cent) with hypertension are diagnosed and treated. Approximately 1 in 5 adults (21 per cent) with hypertension have it under control. In Myanmar, the prevalence of hypertension was 30.1 per cent in males and 29.8 per cent in females (1). Despite its prevalence, many people are unaware of its dangers, as it often has no obvious symptoms. That is why it is often called the “Silent Killer”.
The establishment of a dedicated day
The origins of World Hypertension Day can be traced back to the World Hypertension League (WHL), an organization established in 1984 with the goal of combatting the global health burden of hypertension. Hypertension is responsible for an estimated 7.5 million deaths worldwide, which amounts to approximately 12.8 per cent of all deaths (2). In 2005, the WHL launched World Hypertension Day as part of its efforts to raise awareness about high blood pressure. The inaugural celebration took place on 14 May 2005. Since then, the day has been observed annually on 17 May. Each year, World Hypertension Day focuses on a specific theme related to hypertension. The themes often highlight different aspects of hypertension prevention, control, and management. For example, some past themes have included “Measure Your Blood Pressure, Control It, Live Longer” and “Know Your Numbers”. These themes aim to encourage individuals to monitor their blood pressure, seek appropriate medical advice, and adopt a healthier lifestyle.
Understanding the blood pressure
The measurement of blood pressure is expressed as two numbers – systolic and diastolic pressure. The systolic pressure is the force when the heart beats, and the diastolic pressure is the force when the heart rests between beats. Hypertension is defined as systolic blood pressure (SBP) of 140 mm Hg and higher or diastolic blood pressure (DBP) of 90 mm Hg and higher (3). Hypertension is diagnosed when the blood pressure consistently measures above 140/90 mm Hg. The exact cause of hypertension is unknown, but several factors can contribute to the development of high blood pressure. Lifestyle factors such as obesity, physical inactivity, excessive alcohol consumption, and a diet high in salt can all contribute to hypertension. These are the modifiable risk factors. Medical conditions such as diabetes mellitus, kidney diseases and sleep apnea can also increase the risk of hypertension. Genetics also play a role in developing high blood pressure, and the risk increases with age. Non-modifiable risk factors include a family history of hypertension, age over 65 years and co-existing diseases.
People with very high blood pressure (usually 180/120 or higher) can experience symptoms including severe headaches, chest pain, dizziness, difficult breathing, nausea, vomiting, blurred vision or other vision changes, anxiety, confusion, buzzing in the ears, nosebleeds, and abnormal heart rhythm.
Accurate measurement of blood pressure is essential
Diagnosing hypertension is typically done through blood pressure measurement. Accurate measurement of blood pressure is essential to the diagnosis and management of hypertension. Ambulatory and home blood pressure measurements can be useful in diagnosis and monitoring. Blood pressure can be measured in a doctor’s office, at home using a blood pressure monitor, or through ambulatory blood pressure monitoring, which involves wearing a device that measures blood pressure at regular intervals throughout the day. Diagnosis requires two or more blood pressure readings on two or more occasions that meet the criteria for hypertension. If hypertension is diagnosed, further testing may be done to determine the underlying cause.
The ultimate objective of treating hypertension
The goal of treatment is to reduce morbidity and mortality while minimizing the risk of harm from medical intervention. There are several treatment options available for hypertension, including lifestyle changes and medications. These lifestyle changes can help prevent and control hypertension.
Do
• Eat more vegetables and fruits
• Sit less
• Be more physically active, which includes walking, running, swimming, dancing or activities that build strength, like lifting weights
• Get at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity
• Do strength-building exercises two or more days each week
• Lost weight if you are overweight or obese
• Take medicines as prescribed by your healthcare professional
• Keep appointments with your healthcare professional
Don’t
Eat too much salty food (try to stay under two grammes per day)
• Eat foods high in saturated or trans fats
• Smoke or use tobacco
• Drink too much alcohol (one drink daily max for women, two for men)
• Miss or share medication
If lifestyle changes are not sufficient, medications may be prescribed.
The perils of ignoring hypertension
If hypertension is left untreated, it can cause serious damage to the heart in the following conditions, chest pain, heart attack, heart failure, irregular heartbeat which can lead to sudden death, cerebral haemorrhages and infarction which can also lead to sudden death. In addition, hypertension can cause kidney damage, leading to kidney failure.
World Hypertension Day aims to raise awareness about the importance of blood pressure checks, encourage people to make lifestyle changes to manage high blood pressure, and promote access to affordable, effective treatment options. It also aims to reduce the number of deaths and disabilities caused by hypertension and related conditions. One of the global targets for non-communicable diseases is to reduce the prevalence of hypertension by 33 per cent between 2010 and 2030 (International Society of Hypertension World Hypertension Day, 2023). The theme of this year, “Measure Your Blood Pressure Accurately, Control it, Live Longer” highlights the importance of measuring blood pressure in the correct way, and taking proactive measures to control it to promote longevity and good health. It is aimed to increase awareness of the hazards of hypertension and encourage people to have their blood pressure measured regularly.
The Ministry of Health taking proactive steps to control hypertension
In Myanmar, community health clinics (Wednesday Clinics), encompassing a total of 7,476 rural health centres (RHC) and Sub-rural health centres have been implemented under the guidance of the Ministry of Health since 2018 (4)the World Health Organization (WHO. The clinics aim to provide accessible quality healthcare to the people and to reduce the mortality rate from non-communicable diseases, especially hypertension.
In order to fulfil the third social objective of the State Administration Council which is “to further strengthen basic healthcare services of the nation and to emerge the health system for enhancement of longevity and health of the entire national people”, the Ministry of Health is implementing abovementioned non-communicable clinics (community health clinics) which are providing affordable (free-of-charge) quality healthcare, especially focusing on prevention, effective management and referral services on hypertension. The Myanmar Society of Hypertension is actively engaging with the Ministry of Health in a collaborative effort to combat hypertension and improve the health of the population.
In conclusion, World Hypertension Day is an important initiative to raise awareness about hypertension and its associated risks as well as its impact on public health. With continued efforts to raise awareness and promote effective management of high blood pressure, we can reduce the burden of hypertension and related diseases. With increasing awareness about hypertension, blood pressure should be checked regularly in systematic situations and taking further prompt actions will prevent complications so that people may live longer and healthier. A bountiful array of information pertaining to hypertension can be readily accessed at online domains such as the Ministry of Health website, www.moh. gov.mm, as well as Myanmar Society of Hypertension (MMSH), www. myanmarsh.org, replete with a plethora of resources and insights for those seeking to deepen their understanding of hypertension.
References
1. Bjertness MB, Htet AS, Meyer HE, Htike MMT, Zaw KK, Oo WM, et al. Prevalence and determinants of hypertension in Myanmar - a nationwide cross-sectional study. BMC Public Health. Dec 2016; 16 (1):590.
2. Noncommunicable and Health Promotion Unit The WHO. Indicator Metadata Registry Details [Internet]. (cited 10 May 2023). Available from: https://www.who.int/data/gho/indicator-metadata-registry/imr-details/3155
3. Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension. 2020 Jun;75(6):1334–57.
4. Than Lwin Tun, Kyaw Kan Kaung, Nan Nai Nai Shein. Community health clinics combat hypertension, and diabetes in rural areas once a week across the nation (Internet). MDN - Myanmar DigitalNews. (cited 11 May 2023). Available from: https://www.mdn.gov.mm/en/ community-health-clinics-combat-hypertension-diabetes-rural-areas-once-week-across-nation
