Preventing Hypertension–an Exercise in Social Engineering (Commentary)
A large number of population surveys from different parts of the globe have consistently demonstrated hypertension to be a ubiquitous disease (1-5) encompassing all ethnic groups and geographic regions. The disease affects both sexes and more and more patients are turning up at younger ages. Hypertension is the leading member of the group of so called “non-communicable diseases” (NCD) and a leading contributory cause of death worldwide (6). Future growth in numbers is projected to outstrip population growth by a factor of 2 (7)! It is believed that hypertension contributes about 57 per cent towards all deaths from strokes and 24 per cent towards all deaths from coronary artery disease (5). The contribution towards morbidity from these crippling diseases, as also chronic renal failure, would be staggering indeed. The study by Dong and colleagues from China (8) in this issue supplements the earlier study of Gu and colleagues that reported on a nationwide survey of hypertension in China (9). Both publications reinforce the message that the disease is a serious health issue of global interest. Therefore, the need for sharpening focus on this disease that is contributing so much to human suffering, cannot be overemphasised. Since hypertension progresses so insidiously it seldom produces any symptoms unless a complication strikes either in the brain, heart or kidneys. Consequently the disease remains undetected for long. Further, even when detected, compliance with treatment is a major problem such that consequential damage continues to take a heavy toll.