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

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

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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