Recognising World Hypertension Day

Hypertension (high blood pressure) often goes unnoticed but is among the leading modifiable risk factors for cardiovascular disease and premature death worldwide. The prevalence, consequences, disease risk and associated mortality of hypertension place a considerable burden not only on individuals and but on health service resources.

Despite being the leading modifiable risk factor for cardiovascular disease and premature death, research has shown that Ireland has one of the lowest rates of awareness, treatment and control of hypertension among 12 highincome countries. Indeed, a review of The Irish Longitudinal Study on Ageing (TILDA) in the Journal of Public Health in 2016 reported that 64% of over-50s had high blood pressure and, worryingly, 45% of those were unaware of their condition. Of those with high blood pressure, 59% were taking medication to reduce it, but almost half of those did not actually have their blood pressure controlled to normal levels.

World Hypertension Day is on 17 May. This year the Irish Heart Foundation is collaborating with the Irish College of General Practitioners (ICGP) and the Irish Pharmacy Union (IPU) on a campaign to raise awareness of the causes and impact of hypertension and motivate people to get their blood pressure checked regularly.

The Irish Heart Foundation’s campaign will remind the public that hypertension is a major risk factor for cardiovascular disease (including stroke and heart attack), cognitive decline (including dementia) and kidney disease. It will also inform people of common modifiable risk factors, namely a diet high in salt but low in fruit and vegetables, overweight, high alcohol intake and low physical activity.

Research shows there are significant benefits to hypertension treatment. A major systematic review in the Lancet found that in the populations studied, every 10mmHg reduction in blood pressure resulted in:

• a 17% reduction for coronary heart disease

• a 27% reduction for stroke

• a 28% reduction for heart failure

• a significant 13% reduction in all-cause mortality.

These striking figures point not only to the need for, but also the enormous benefit of, a campaign to help people take control of their blood pressure through regular checks and small changes to their lifestyle, if needed.

Targeted at undiagnosed adults aged 50 and over, the campaign will run for three years. It will comprise:

• radio and online ads to encourage people to get their blood pressure checked

• a range of health information on understanding and managing hypertension on irishheart.ie

• posters and flyers, which are being informed by focus groups with underserved communities and will be distributed to community organisations, pharmacies and health centres nationwide.

Another significant element of the campaign will be the availability of free blood pressure checks through the Irish Heart Foundation’s mobile health unit (MHU). The MHU, staffed by nurses, conducts about 10,000 opportunistic blood pressure checks a year in mainly disadvantaged, hard to reach community settings such as men’s sheds, family resource centres and Traveller groups around Ireland. In a three-year period up to 2019, almost one in three (31.6%) health check participants identified with high blood pressure were unaware of having this condition before attending the MHU.

An additional arm of the campaign will be a partnership with The Irish Longitudinal Study on Ageing (TILDA) to assess long-term awareness and behaviour change in relation to hypertension in TILDA’s next wave of research.

Fieldwork for this research will start in 2024 and results are anticipated to coincide with the final year of the three-year campaign.

Primary care is central to managing hypertension, with multiple opportunities to test and adjust treatment recommendations. Currently, initial blood pressure management and treatment decisions most frequently take place in general practice (involving GPs and wider practice staff), while wider primary care (in particular pharmacy) plays a role supporting adherence to medicines. Recently, there has been a major push to transform healthcare delivery with a focus on achieving better integrated, coordinated, high-value care. The campaign is timely given the recent publication of the HSE’s Second Report of the Structured Chronic Disease Management Programme, which demonstrated reduction in mean population blood pressure readings for those in the programme.

For hypertension in particular, high quality care requires patient awareness of preventive care, regular blood pressure screening, effective communication between healthcare providers and patients and active self-management by patients. The upcoming campaign, led by the Irish Heart Foundation and supported by the ICGP and IPU, presents an opportunity for NGO advocacy, medical expertise and health service engagement to join forces for long-term changes in awareness, behaviours and positive health outcomes.

For more information see www.irishheart.ie

Written by Clodagh McCarthy, Health Information Manager, Irish Heart Foundation