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Our Global Voices Posts

High blood pressure, also known as hypertension, has become a global crisis

Posted on by Pragna Patel, MD, MPH (CGH) and Barbara A. Bowman, PhD (NCCDPHP)
Patient at the Edgar Cochrane Polyclinic in Barbados having her blood pressure taken.
Patient at the Edgar Cochrane Polyclinic in Barbados having her blood pressure taken.

In the United States, 67 million or 1 in 3 adults have high blood pressure (>140/90 mmHg), and only about half of these adults have their condition under control. Worldwide, high blood pressure is estimated to cause 9 million preventable deaths, and is expected to increase. Commonly referred to as the “silent killer” because it often has no warning signs or symptoms, hypertension is a leading risk factor for cardiovascular diseases, such as heart attack and stroke.

The Department of Health and Human Services, co-led by the Centers for Disease Control and Prevention, Center for Medicare and Medicaid Services developed the Million Hearts® Initiative to address this challenge within the United States.  It has set an ambitious goal to prevent 1 million heart attacks and strokes by 2017.

Million Hearts® aims to prevent heart disease and stroke by:

  • Improving access to effective care
  • Improving the quality of care for the ABCS (Aspirin when appropriate, Blood pressure control, Cholesterol management, and Smoking cessation)
  • Focusing clinical attention on the prevention of heart attack and stroke
  • Activating the public to lead a heart-healthy lifestyle
  • Improving the prescription and adherence to appropriate medications for the ABCS

Million Hearts® may also be a framework to address global cardiovascular disease (CVD) and provide translatable approaches to reduce the global burden caused by CVD, including reducing hypertension. Country specific strategies can be cost-effective and sustainable, increasing the health and productivity of populations and economies.

Million Hearts® helps to create win-win situations for public and private entities by emphasizing a common message: Improve health and prevent disease, empower patients and providers, enhance and coordinate the systems of care, and leverage the strengths of public and private partners to positively impact CVD.

Global Standardized Hypertension Treatment Project

Recognizing the need to bolster efforts to improve hypertension control and prevention globally, the Centers for Disease Control and Prevention (CDC), in collaboration with the Pan American Health Organization (PAHO), recently launched the Global Standardized Hypertension Treatment Project (the Project). Using evidence-based interventions, the Project is focused on improving hypertension treatment, and reducing associated morbidity and mortality by developing and implementing a framework for standardizing the pharmacologic treatment of hypertension globally.   The GSHTP is currently being implemented in Barbados and Malawi.

Barbados – Leading the way in the Caribbean

The treatment results of people with hypertension in Barbados and throughout the Caribbean region remain at an unacceptably low level. To contribute to better blood pressure control the Healthy Caribbean Coalition (HCC) recently has led several collaborative initiatives. These include:

  • Community Blood Pressure Screening and Enhanced Treatment and Control of Hypertension in 5 Caribbean countries, supported by the Development Aid Program of the Government of Australia
  • Update of the Caribbean Public Health Association (CARPHA) Hypertension Guidelines for use throughout the Region
  • A social marketing population salt reduction program in 5 Caribbean countries supported by PAHO/WHO and the American Heart Association
  • Piloting the Global Standard Hypertension Treatment (GSHT) Project in Barbados which is led by CDC, USA, PAHO/WHO and aims to control hypertension using a core set of medications, identifying mechanisms to increase the availability and affordability of these medications, and strengthening key elements of health care delivery systems
Dr. Jamario Skeete and Maisha Hutton of the HCC team conducting training on community blood pressure screening in the Caribbean.
Dr. Jamario Skeete and Maisha Hutton of the HCC team conducting training on community blood pressure screening in the Caribbean.

Many people who have hypertension have no idea that they have it.

A friend didn’t know she had high blood pressure until she went to a routine dental appointment. The hygienist asked if she could take my friend’s blood pressure and was completely surprised when the hygienist told her it was 167/95 – stroke level! Luckily, my friend immediately made an appointment to see her physician. She’s now on blood pressure medication, monitoring her blood pressure, and dieting and exercising to prevent further health risks. Many persons with hypertension are at high risk for cardiovascular disease even if they do not have symptoms. Because hypertension is “silent”, often patients do not seek medical attention or are not adherent to their treatment regimens. Although hypertension can be life-threatening, the good thing is that it is fairly easy to treat. There are effective, affordable medications that are not difficult to take but in some settings are not widely available. The important thing to remember is that hypertension is preventable. If you have hypertension or are at risk for hypertension, maintaining a low –salt diet, exercising regularly, monitoring your blood pressure and adhering to a treatment regimen is essential and can mean the difference been life and death. Bottom line, know your numbers!

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Posted on by Pragna Patel, MD, MPH (CGH) and Barbara A. Bowman, PhD (NCCDPHP)Leave a commentTags , ,

CDC Innovations: Real-Time Data Strengthens Uganda’s Efforts to End Mother-to-Child HIV Transmission

PMTCT infant

Identifying opportunities to improve global health sometimes requires creative thinking and new collaborations. In Uganda, the Centers for Disease Control and Prevention (CDC) exemplified this approach in developing a strategy to use the Emergency Operations Center (EOC) in Kampala – established with CDC’s assistance in 2013 – to help eliminate mother-to-child HIV transmission (MTCT). “The Read More >

Posted on by Betty Kagoro and Erik Friedly, CDC-UgandaLeave a commentTags , ,

World Malaria Day 2015

Figure 2: An antique rug beater.

World Malaria Day falls on Saturday this year, so I’ll spend some part of the day catching up on household chores. I can sometimes find moments of inspiration in the mental space created by simple tasks like running the vacuum cleaner. This year, malaria endemic countries and their global partners are reflecting on the remarkable Read More >

Posted on by S. Patrick Kachur, MD, MPH, FACPM, Chief, Malaria Branch, Division of Parasitic Diseases and MalariaLeave a commentTags

What I Saw as a Child Led Me to Champion Vaccines Today

Young Afghan children playing after receiving their polio vaccines during vaccination campaigns in 2014. ©Misgina Suba Abraha/UNICEF.

This post is part of the #ProtectingKids blog series. Read the whole series here. Living as a child in Kabul, Afghanistan in the 1970’s meant going to the bazaar on the weekends with my parents. My two sisters and I would climb in the back of our Volkswagen Kombi and my father would drive us Read More >

Posted on by Rebecca Martin, PhD, Director, Global Immunization Division1 CommentTags , ,

Stopping Ebola by Land, Water and Air

Photo credit: Justin Williams/CDC

This blog was originally posted on Huffington Post on February 18, 2015. Speed is paramount in our response to the Ebola epidemic in West Africa as we continue to be vigilant in the fight to extinguish Ebola. The faster we get to communities with suspected cases, the faster we protect the people there. That gets us Read More >

Posted on by Dr. Tom Frieden, MD, MPHLeave a commentTags , ,

Food Safety: A changing landscape in a global world

World Health Day 2015

The food supply in the United States is constantly evolving. U.S. consumers want convenience, choice, and diversity in the foods they eat. The U.S. is importing more food than ever before in order to meet these demands. In 2009, imported food accounted for 17% of food consumed by Americans (up from 15% in 2004). [1] Read More >

Posted on by Laura Burnworth and Suzie Heitfeld2 CommentsTags , ,

Working collaboratively to support Ebola response efforts in Sierra Leone

Over 100 public health workers in Sierra Leone participate in a demonstration session on how to use personal protective equipment during the E

In late November 2014, during the peak of the Ebola outbreak in West Africa, I was deployed to Sierra Leone to support CDC’s Ebola response efforts. Like many of my colleagues, I wasn’t sure what to expect or where to begin, but I knew that we faced immense challenges, and my skills and expertise in Read More >

Posted on by Bao-Ping Zhu, MD, PhD, MS, CDC Epidemiologist and Uganda FETP Resident AdvisorLeave a commentTags , , ,

A Consequence of Conflict: The Spread of Multidrug-Resistant Tuberculosis

Somali pastoralists on their way to Dadaab refugee camp in search of food and care.  (Credit: CDC-Kenya, Ahmed Unhur, KEMRI)

For more than 20 years, Kenya has been providing asylum to people fleeing civil war and conflict from Somalia. Many first reach Dadaab refugee camp, located in Garissa County, Kenya, about 50 miles from the Somali border where the United Nations High Commissioner for Refugees (UNHCR) and partners provide humanitarian relief and protection assistance. In Read More >

Posted on by Nadine SunderlandLeave a commentTags , , , , ,

An Ounce of Prevention: Why we must strengthen basic TB control to defeat drug-resistant TB

Dr. Sujata Baveja and TB nurses provide patient information at the TB clinic of LTM Hospital in Mumbai, India. (Photo Credit: Susan Maloney, CDC)

To many, the idea of living in a world where there is no effective treatment for tuberculosis (TB) seems unthinkable. After all, we live in a modern era, with hospitals and drugs at our fingertips. TB is considered by some to be a disease of the past. But every year, more than 9 million people Read More >

Posted on by Thomas Kenyon, MD MPH, Director of CDC Center for Global Health1 CommentTags , , ,

CDC partners with Bloomberg Philanthropies to strengthen public health data collection in developing countries


Did you know that each year 35 million deaths go unrecorded worldwide, and that the causes of millions more deaths are never documented? Today, 80% of the world’s population lives in countries that do not collect reliable cause-of-death statistics. According to the World Health Organization, “When deaths go uncounted and the causes of death are Read More >

Posted on by Dr. Samira Asma, Division of Global Health Protection1 CommentTags ,