Need for Better Blood Pressure Measurement in Developing Countries to Improve Prevention of Cardiovascular Disease

Abstract

Hypertension is now the foremost cause of disability and is responsible for the highest percentage of attributable death among risk factors. These global changes are mainly due to the increase in the prevalence of hypertension in most low- and middle-income countries (LMICs) as a consequence of relevant socioeconomic changes occurring during the last decades. Implementation of global prevention efforts urgently needs to be accelerated because of the increasing incidence of haemorrhagic stroke, renal failure, and hypertensive heart disease in developing countries. Blood pressure (BP) measurement has different implications in epidemiological studies performed in low-resource settings. First, the frequency of blood pressure measurement is a simple but reliable indicator of access to healthcare in epidemiological studies, which may disclose the favourable effects of urbanization; the opportunity to have BP measured increases hypertension awareness, facilitates drug treatment, and leads to better achievement of BP control. Second, BP measurement is a key element in cardiovascular risk stratification, focusing solely on the preferred strategy in low-resource settings where costs of biochemical tests might be less sustainable. Third, the issue of obtaining reliable estimation of BP values is crucial to achieve sound data on the burden of hypertension in LMICs, and some aspects of BP measurement, such as the use of reliable automated devices, the number of measurements/visits to achieve a consistent diagnosis of hypertension, and the possible confounding effect of environmental factors, must be closely considered.

Potential Drug Interactions in Hypertensive Patients in Liwa District Hospital, Lampung Barat, Indonesia

“…In that study, 71.5% prescriptions were potentially having at least one drug interaction, with a total of 918 potential drug interactions. Another study was conducted in Croatia in elderly patients with arterial hypertension [16] and this study found 90.6% patients would potentially have clinically significant drug interactions, with the median number of significant potential drug interaction, was 4 (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. A study in Brazil also showed high potential drug interactions (93%) in patients with arterial hypertension and/or diabetes [17].…”

“…Preventive efforts are crucial to decrease the risk of these cardiovascular diseases. Better blood pressure measurement can increase awareness towards hypertension, facilitate treatment, better hypertension control, and better outcomes [6].…”

The quality and characteristics of sleep of hypertensive patients

“…In 2010, hypertension was responsible for the highest percentage of attributable death (13%), and the leading cause of disability, accounting for over 20% of the world rate for life years adjusted for disability in adults of 70 years of age or more, and about 15% of those between 50 and 69 years (17) . The evidence that OSAS is a key risk factor in the development of hypertension and consequent development of cardiovascular diseases is clear (18)(19) .…”

Comparison of the acute effects of <i>Tulbaghia violacea</i> William Henry Harvey (Alliaceae) on blood pressure and heart rate of ageing male normotensive Wistar kyoto rats and adult male spontaneously hypertensive rats

“…However, the number of people with uncontrolled blood pressure is increasing, despite therapeutic advances [3]. Consequently, the prevalence of HTN is still on the rise in developing countries [4] and worldwide [3]. As a result of better management of both communicable and non-communicable diseases, the global population of the elderly is increasing, a trend that has been predicted to continue in the coming decades [3,5].…”

“…The direct and indirect costs of HTN are high [4,13], and the incidence of HTN is relatively high among the elderly. Also, the elderly are largely excluded from many clinical trials, as they belong to the upper age limits and/or do not present with age-specific results [5,14].…”