Hypertension in the South-East Asia Region: an overview

Raised blood pressure or hypertension is the single most important risk factor for mortality worldwide as well as in the South-East Asia (SEA) Region. In the globally agreed list of indicators and targets for noncommunicable diseases, three are directly relevant to hypertension. These include age-adjusted prevalence of hypertension among adults, salt intake levels, and availability of diagnosis and medicines for hypertension at public and private health facilities. We reviewed the burden of hypertension, status of response to this burden in countries of the Region, and the barriers to effective blood pressure prevention and control. In the South-East Asia Region, approximately 35% of the adult population has hypertension, which accounts for nearly 1.5 million deaths annually; 9.4% of the total deaths are attributable to hypertension. National data from some countries indicate an increasing trend in the prevalence of hypertension. In four of the eight countries where information was available, less than 50% of the subjects were aware that they had hypertension and in four other countries, awareness ranged from 56% to 70%. Among those who were aware that they had hypertension, about half were on treatment, except in the Maldives and Thailand, where higher rates of treatment were reported. However, less than half of those who were on treatment had their blood pressure levels controlled to below 140/90 mmHg. Ten countries in the Region have strengthened their surveillance systems to measure risk factors including hypertension, though more needs to be done to establish a regular, sustainable national-level surveillance system for risk factors. Equipment and drugs for the diagnosis and management of hypertension were widely available in all Member States of the Region. However, in 2010, only eight countries had standard national guidelines for the management of hypertension. Only three countries in the Region have initiated efforts at population-level reduction of salt intake. Lack of an enabling environment for healthier lifestyles, cultural norms that promote unhealthy behaviours, lack of access to health services for early detection and treatment, including counselling, are among the major barriers to prevention and control of hypertension in the Region. Despite these barriers, the potential for health benefits makes continued efforts to prevent hypertension an important public health goal for these countries.