Hypertension: Silent and/or ignored / L’hypertension silencieuse ou ignorée

Ignore this editorial. Hypertension is so banal—it’s really common, easily measured and assessed, the treatment is mostly pharmacologic. . . . Wait a minute! That should be very exciting for pharmacists. Consider these facts: Hypertension is the number 1 leading risk factor for death and disability globally.1 Infectious diseases, poor sanitation and HIV are important, too, but 13% of all deaths (9.4 million annually) and 7% of all disability are caused by increased blood pressure. The World Health Organization (WHO) has declared its World Health Day 2013 theme to be hypertension.2 Indeed, in terms of “doing the most good for the most people,” as a pharmacist, focusing on hypertension might be the most important thing you can do. As you know, when blood pressure increases above 115/70 mmHg, blood vessels are damaged, causing more than half of all strokes and cases of heart disease, as well as being a major risk factor for kidney failure, dementia and other vascular diseases.3 World Health Day in 2013 plans to focus attention on the causes and consequences of hypertension, the need for people to adopt healthy behaviours to prevent hypertension, the need for regular blood pressure checks and the need for governments to create healthy environments to assist in preventing hypertension.2 Canada is well advanced in efforts to prevent and control hypertension compared with many countries. About 1 in 5 adult Canadians have hypertension, while the rate in many countries is over 3 in 10. Canada also has the highest national rate of treatment and control of hypertension,4,5 possibly because it has had strong nongovernmental and governmental partnerships, an extensive interdisciplinary hypertension education program (CHEP) and a well-organized hypertension community, led by Hypertension Canada (www.hypertension.ca).6 Canada also has a recently updated Pan-Canadian Framework to help guide the effort to prevent and control hypertension.7 Further, a national committee of health care and scientific organizations (the Canadian Hypertension Advisory Committee), including the Canadian Pharmacists Association, is helping guide and prioritize actions for prevention and control of hypertension. Look for the updated hypertension guidelines for pharmacists in the next issue of CPJ. By the numbers: #1: Hypertension is the number 1 risk for death and disability around the globe. 1/5 of Canadians have hypertension. 90% of Canadians living an average life span will develop hypertension. 1/3 of Canadians with hypertension are not controlled. 44% of people with diabetes have poor hypertension control. Although much has been accomplished, far too many Canadians remain adversely affected by increased blood pressure. It is estimated that over 90% of Canadians living an average life span will develop hypertension and that close to 7.5 million adult Canadians have hypertension.8,9 Many Canadians are particularly vulnerable, including ethnic minorities and people with low incomes and education. Close to 1 in 3 Canadians have uncontrolled hypertension10 (as do 44% of people with diabetes)11 and lack of awareness of hypertension is common in young adults.10 Cardiovascular risk factors other than blood pressure are largely not well controlled in people with hypertension. And, because much of hypertension is caused by unhealthy diets, the Canadian Hypertension Advisory Committee is focused on advocating for the implementation of healthy food policies7 (see https://www.facebook.com/HypertensionTalk?ref=stream).

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