Impact of high blood pressure on the main cause of death in Portugal: stroke

Fernando Pinto, senior graduate assistant in cardiology at CHEDV, member of the scientific committee of the Portuguese Stroke Society and former president of the Portuguese Society of Hypertension
Fernando Pinto, senior graduate assistant in cardiology at CHEDV, member of the scientific committee of the Portuguese Stroke Society and former president of the Portuguese Society of Hypertension. Photo: DR

Cardio-cerebrovascular disease (CVD) is the leading cause of death, premature death (ie death before the age of 70) and disability worldwide. Cerebrovascular accidents (CVA) and acute myocardial infarction (AMI) account for approximately 85% of all cardiovascular diseases.

In our country, cardiovascular diseases are responsible for more than 32,000 deaths per year and it is estimated that they can reduce life expectancy by 12 to 14 years. In addition, cardiovascular diseases are responsible for a high number of hospitalizations and are one of the most important causes of disability and dependence on others for basic daily activities (eating, dressing, personal hygiene, etc.).

Arterial hypertension (HTA), defined as blood pressure greater than or equal to 140/90 mmHg, is by far the main risk factor for stroke (the main cause of death in Portugal: approximately 2/3 of all death from cardiovascular disease) and is one of the strongest risk factors for AMI, heart failure, kidney failure, peripheral arterial disease, dementia, etc.

In the vast majority of patients, hypertension does not cause specific symptoms for many years, often only being discovered when the aforementioned diseases appear and it is well demonstrated that early diagnosis and correct and prompt treatment of the hypertension clearly and unequivocally reduce the risk. severity) of cardiovascular diseases and their disastrous consequences: disability and mortality.

Despite the fact that, especially in the last two decades, we have seen a very favorable evolution of cardiovascular diseases in Portugal, we continue to verify that approximately 42% of adults suffer from hypertension, of which almost 25% (1 out of 4) are unaware of the disease and of those diagnosed also about 25% do not take medication, which explains why less than half of hypertensive patients actually have their blood pressure controlled and only about 12% (1 out of 8) have their blood pressure blood pressure to ideal values.

What remains to be done?

In order to achieve the ultimate goal of increasing the number of years of life and the quality of life, i.e. to prevent the consequences of cardiovascular diseases and above all to reduce strokes and their dramatic sequelae , it is crucial to further and better diagnose hypertension and to initiate prompt treatment measures that lead to its treatment, including the adoption of healthy lifestyles, including the reduction of salt and alcohol consumption and increasing the consumption of vegetables and fruits, regular physical exercise, correcting any excess weight or obesity and completely stopping smoking. When these measures are insufficient, antihypertensive drugs may also be necessary.

The last 2 years have, in many cases, made it more difficult to access health care for the population very focused on the pandemic that has devastated us (and it still is…). It is up to all of us – users/patients, health professionals and not only – to contribute to catching up/minimizing this delay, which could have serious consequences in the medium term: the first regularly measuring blood pressure (which can in many places, even at home) and, in the event of hypertension, seek to seek health care as soon as possible, but starting immediately to correct inappropriate lifestyle habits; healthcare professionals actively encourage patients to monitor their blood pressure, making it easier for them to access their care and not unnecessarily delaying the correction of hypertension (and any concomitant risk factors). Learned societies, in partnership with the media, must alert the population to the importance of these measures, and it is up to political power and the State to outline and implement concrete measures to accelerate this mission, which is possible with the commitment of everything!

May 17 – World Hypertension Day

Author: Fernando Pinto, senior graduate assistant in cardiology at CHEDV, member of the scientific committee of the Portuguese Stroke Society and former president of the Portuguese Society of Hypertension

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