Hypertension in the Asian Pacific region: the problem and the solution

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Cardiovascular and cerebrovascular diseases are the most common cause of death in the developed world and causes major morbidity. These diseases impose a major burden on the individual, family, community and governments. This burden is social and economic. Hypertension and nonoptimal blood pressure levels are the most important contributors to cardiovascular and cerebrovascular disease. Hypertension is common in the Asian Pacific region with prevalence similar to that in developed countries. Hypertension can be treated and this reduces the mortality and complication rates. Programs can be devised to detect, start and maintain treatment of hypertension. These programs are cost effective and can reduce the economic and social burden. Institution of drug therapy needs to be based on the patient's cardiovascular risk profile. Treatment should consider and treat all risk factors. Many people have an elevation of blood pressure that worsens prognosis but is below the level at which drug treatment would be started. Lifestyle changes will benefit these people. The requirement is to improve the risk profile of the entire community. Most risk factors (blood pressure, obesity, diabetes, cholesterol and smoking) can be reduced by lifestyle interventions. For blood pressure reduction this involves dietary reduction of salt intake and an increase in potassium intake coupled with obesity reduction and increased activity. Successful implementation would reduce the social and economic burden of blood pressure-related damage. Implementation requires education of the individual, the community, the food industry, the government, the medical and the health service profession. Implementation may require government legislation or regulation. Only with an integrative programme involving all sections of the community can the epidemic of cardiovascular disease be overcome. Governments need to act now introducing programmes to prevent, detect and treat elevated blood pressure.