Being the most populous continent in the world, consisting of around 60% of the global population, Asia shoulders a big brunt of the hypertension and cardiovascular disease (CVD) burden in the world. Just as it is in the rest of world, hypertension remains a major modifiable risk factor in Asia for stroke, myocardial infarction, heart failure, atrial fibrillation, and peripheral arterial disease; and it is a dominant risk factor implicated for cardiovascular deaths causing premature death in the region. There is generally a stronger association between elevated blood pressure (BP) and stroke than with coronary artery disease (CAD), although CAD is reported as the most dominant cause of CVD deaths in Central, Western, and Southern Asia, while stroke deaths is more common than CAD deaths in Eastern and Southeastern Asia. Of the estimated 1.13 billion people worldwide with elevated BP, around 66% live in low and middle income countries, which consist the majority of countries in Asia. In Southeast Asia (SEA), the prevalence of hypertension in the adult population is nearing 35%, and to this has been attributed the close to 1.5 million deaths in the region annually. Hypertension awareness, treatment and control remain a challenge in Asia. Awareness level is less than 50% in most countries in Asia, though it is higher (56 70%) in the higher income countries in the region. Treatment rates are generally 25% to 30% of the hypertensive population, but control rates to BP levels below 140/90 mmHg, are still dismally low. The comparatively high dietary salt intake in the region, aggravating the salt sensitive phenotype characterizing Asian hypertension is implicated as a significant risk factor leading to poor hypertension control and a relatively increased rates of strokes in the region. Salt intake ranges from 10to17 grams a day, which is 2to3 times higher compared to the 5 grams (approximately 2 grams of sodium) recommended daily salt consumption by the World Health Organization. Because of the socioeconomic, educational and cultural heterogeneity of the countries comprising Asia, the region appears to be in different transition stages of the CVD epidemic. This highlights the challenge in mapping out a one size fits all strategy in curbing hypertension and CVD in Asia. Individualized prevention and treatment strategies factoring the differing capacities for management, prevalence of unhealthy diet especially increased salt intake, smoking, obesity, hypertension, dyslipidemia, and diabetes, as well as the impact of population aging must be considered.
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