Back in 1999, researchers became aware that rates of hypertension and high blood pressure were trending upward. Hypertension and high blood pressure considered a blood pressure measurement above 140/90 mm Hg. At that time approximately, 50% of their study group had a blood pressure measurement greater than 140/90, men’s pressures were higher than women. Compounding the concern was that 17% were being treated, 40% were unaware of their condition, 28% received drugs that were ineffective and only 6% were using diet and exercise to combat the condition.
Hypertension is the largest single contributor to risk of disease and mortality globally. The number of people affected and the prevalence of hypertension worldwide are expected to continually rise, causing an estimated 9.5 million deaths annually. Preventive strategies are urgently needed, both in developed and less developed nations.
Managing the global rise of hypertensive populations requires strategies to optimize treatment. Three drug combinations can control hypertension in roughly 90% of the population, but only if resources allow identification of patients and the drugs are affordable. Drug therapies are not one size fit all treatments. Treatments need to be optimized for the ethnic population treated.
Between 1980 and 2008, the global prevalence of hypertension fell slightly in men and women. However, the incidence of hypertension has risen continually between 2008 and 2015 in all regions of the world.
Consequently hypertension is expected to affect over 500 million people in the coming decades. Overall, the prevalence of hypertension is higher in people of African descent than those of European origin. Socioeconomic status and BMI confound the relationship between hypertension and ethnicity. (Body fat is superior to the flawed BMI)
HYPERTENSION DEVELOPED NATIONS
Epidemiological data from Africa and India show lower rates of controlling hypertension incidents. Contrast that with England and Canada where awareness and treatments are controlling the rise of high blood pressure. The improved treatments of hypertension in England and Canada, have occurred despite those country epidemic of obesity, which affects larger numbers of younger adults and adolescents. Confounding the problem of hypertension in developed nations is the rise of type 2 diabetes.
Researchers observe that as a country’s development improves so does its increase incidence of hypertension, eventually affecting all populations evenly across socioeconomic levels. Blood pressure is an inherited trait; 30% of cases are related to genetic factors.
The link between develop nation status and hypertension is not surprising:
- As a country achieve develop nation status life expectancy increases
- Excess salt intake rise
- Alcohol consumption increase and consumption of saturated fats
- Physical activity diminishes and consumption of fresh fruit and veggies are reduced.
LINK BETWEEN DIET AND OBESITY
High salt intake is endemic worldwide and contributes to the formation and maintenance of high blood pressure. New research supports the claims that a salt reduction diets does lower blood pressure. The World Health Organization have set guidelines for daily salt intake at 5 grams per day.
The obesity epidemic is a complex global health problem (Fit and Fat and the Obesity Paradox). Hypertension and diabetes are often associated with obesity and increases an individual’s risk of disease as well as higher medical cost. People who are obese, hypertensive and diabetic have greater risk of developing coronary heart disease and kidney damage. An individual that has contracted all three substantially increase their risk of disease and mortality.
Here are several take away:
- High belly fat increase risk of hypertension and type 2 diabetes regardless of ethnicity
- Insulin resistance is a key factor in the development of hypertension and type 2 diabetes
- Calorie reduction and exercise to lose weight are essential in treating hypertension and type 2 diabetes
- Early detection is crucial, studies show younger patients experience more tragic outcomes from obesity complications.
Exercise often prescribed as a remedy for obesity, hypertension and type 2 diabetes. However, what works for one may not work the same for everyone. The research show that practitioners need to implement strategies which are more collaborative in nature. Specificity and specialization is essential. The first step is making individuals aware of their hypertensive condition, then optimizing treatments for their care.
Senior, K. (1999). Worrying trend in hypertension described for USA. Lancet, 354(9180), 747.
Poulter, N. R., Prabhakaran, D., & Caulfield, M. (2015). Hypertension. The Lancet, 386(9995), 801-812. doi:10.1016/S0140-6736(14)61468-9
Loenneke, J. P., Fahs, C. A., Abe, T., Rossow, L. M., Ozaki, H., Pujol, T. J., & Bemben, M. G. (2014). Hypertension risk: exercise is medicine* for most but not all. Clinical Physiology & Functional Imaging, 34(1), 77-81. doi:10.1111/cpf.12059
Kazuko, M., Michael L., T., & Gavin W., L. (2011). Hypertension and Diabetes in Obesity. International Journal Of Hypertension, doi:10.4061/2011/695869
Suckling, R. J., & Swift, P. A. (2015). The health impacts of dietary sodium and a low-salt diet. Clinical Medicine, 15(6), 585-588 4p.