Epidemiology of Hypertensive disorders

Question 1

Describe non-communicable diseases?

Answer 1

– tend to be of long duration
– are the result of a combination of genetic, physiological,
environmental and behaviours factors

Question 1

Describe non-communicable diseases?

Answer 1

– tend to be of long duration
– are the result of a combination of genetic, physiological,
environmental and behaviours factors

Question 2

What are the main types of NCDs?

Answer 2

1. cardiovascular diseases (like heart attacks and stroke),
2. cancers
3. chronic respiratory diseases (such as chronic obstructive
   pulmonary disease and asthma) and
4. diabetes.

Question 3

Describe the epidemiology of NCDs?

Answer 3

NCDs disproportionately affect people in low- and middle- income countries
- more than three quarters of global NCD deaths (32million) occur

Question 4

Describe the global burden of NCDs?

Answer 4

• NCDs kill 41 million people each year, equivalent to
71% of all deaths globally.
• Annual deaths: 15 million people aged 30-69 years
• Over 85% of these “premature” deaths occur in low- and middle- income countries.
• Cardiovascular diseases (CVD) account for most NCD
deaths (17.9 million people annually) followed by
cancers (9.0 million), respiratory diseases
(3.9 million), and diabetes (1.6 million).
• These 4 groups of diseases account for over 80% of all
premature NCD deaths

Question 5

What are hypertensive disorders?

Answer 5

heart conditions caused by high blood pressure.
• One of the Cardiovascular diseases
• Hypertension is the most important preventable cause of heart disease and stroke worldwide

Question 6

Increased heart pressure causes different heart

disorders including?

Answer 6

1. Heart failure
2. Coronary artery disease
3. Thickening of the heart muscle
4. And other related conditions
   - Hypertensive disorders are the leading cause of death
   from high blood pressure

Question 7

What are the types of hypertensive heart disease?

Answer 7

Are heart problems associated with high blood pressure in relation to heart’s arteries and muscles
1. Coronary heart disease (CHD)/Coronary artery disease
2. Thickening and enlargement of the heart
– ventricular hypertrophy

Question 8

What are the signs and symptoms of hypertensive diseases?

Answer 8

1. chest pain (angina)
2. tightness or pressure in the chest
3. shortness of breath
4. fatigue
5. pain in the neck, back, arms, or shoulders
6. persistent cough
7. loss of appetite
8. leg or ankle swelling
   - These vary depending on the severity of the condition
   and progression of the disease.
   - Others may experience no symptoms

Question 9

State complications of hypertensive heart disease?

Answer 9

1. Heart failure
2. Arrythmia
3. Ischemic heart disease
4. Heart attack
5. Cardiac arrest
6. Stroke and sudden death

Question 10

Describe the diagnosis of hypertensive disorders?

Answer 10

1. Review of medical history
2. Physical exam including blood pressure measurements
3. Lab tests to check kidney function, sodium, potassium, and blood count

Question 11

Describe other tests that could help determine the cause of hypertensive disorders?

Answer 11

1. Electrocardiogram monitors and records your heart’s
   electrical activity.
2. Echocardiogram takes a detailed picture of your heart
   using ultrasound.
3. Coronary angiography examines the flow of blood
   through your coronary arteries.
4. Exercise stress test looks at how exercise affects your
   heart.
5. Nuclear stress test examines the flow of blood into the
   heart.

Question 12

Describe the global burden of hypertensive disorders?

Answer 12

• > 1 in 5 adults worldwide have raised blood pressure
– causes around half of all deaths from stroke and heart disease.
• Complications from hypertension account for 9.4 million
deaths worldwide every year

Question 13

Describe the burden of hypertensive disorders in high-income countries?

Answer 13

• significant drop in the proportion of people with raised
  blood pressure, as well as the average blood pressure across
  populations
• and this has contributed to a reduction in deaths from heart disease
• this is due to:
  1. widespread diagnosis
  2. treatment with low-cost medication
  e.g. the prevalence of raised blood pressure in the WHO region of the Americas in 2014 was 18%, as compared to 31% in 1980.

Question 14

Describe the global burden of hypertensive disorders in low income countries?

Answer 14

• have the highest prevalence of raised blood pressure.
• In the WHO African region, more than 30% of adults in many
countries are estimated to have high blood pressure and this
proportion is increasing.
• The average blood pressure levels in this region are much higher than global averages.

Question 15

Why is the prevalence of HD highest in low income countries?

Answer 15

Many people with high blood pressure in developing countries

1. are not aware of their disease
2. do not have access to treatments that could control their blood pressure and significantly reduce their risk of death and disability from heart disease and stroke

Question 16

Describe the burden of HDs in Malawi?

Answer 16

• Age-standardised prevalence of hypertension (BP ≥140/90 mmHg) is ~ 33%
• Hypertension more frequent in
– males than females (37% vs 30%),
– alcohol drinkers than non-drinkers (41% vs 32%)
– overweight than non-overweight (42% vs 31%)
– increased with increasing age (21% in 25-34 years old vs 59% in 55-64 years old)
• 3 in 4 never had their BP measured before
• 95% found with hypertension were not aware that they had such a medical problem

Question 17

What is the main focus of the global action plan?

Answer 17

1. Four types of NCDs
   – Cardiovascular diseases
   – Cancer
   – Chronic respiratory diseases and
   – Diabetes
2. NCDs conditions that
   - make the largest contribution to morbidity and mortality due to NCDs
   - Have four shared behavioral risk factors
   > tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol

Question 18

What is the main risk factor for hypertensive heart disease?

Answer 18

high blood pressure

Question 19

State modifiable risk factors for HDs?

Answer 19

Risk increases if:

1. Overweight
2. Physical inactivity
3. Smoking
4. Unhealthy diet e.g food high in fat and cholestero

Question 20

What are unmodifiable risk factors of HDs?

Answer 20

genetics - runs in family

Question 21

State other determinants and risk factors that contribute to the development of HDs?

Answer 21

1. Rapid unplanned urbanization

2. Population ageing

Question 22

Six concrete steps to minimize the odds of developing high

blood pressure and its adverse consequences are?

Answer 22

1. healthy diet
2. avoiding harmful use of alcohol - one standard drink a day
3. physical activity
4. stopping tobacco use
5. managing stress in healthy way
6. disease screening

Question 23

Describe a healthy diet as prevention and control of development of HDs?

Answer 23

– promoting a healthy lifestyle with emphasis on proper nutrition for infants and young people
– reducing salt intake to less than 5 g of salt per day (just under a teaspoon)
– eating five servings of fruit and vegetables a day
– reducing saturated and total fat intake

Question 24

Describe physical activity as prevention and control of development of HDs?

Answer 24

– regular physical activity and promotion of physical activity for children and young people (at least 30 minutes a day).
– maintaining a normal weight: every 5 kg of excess weight lost can reduce systolic blood pressure by 2 to 10 points.

Question 25

How do you manage stress in a healthy way to prevent and control development of HDs?

Answer 25

1. through meditation
2. appropriate physical exercise and
3. positive social contact

Question 26

Describe disease screening in prevention and control of HDs?

Answer 26

1. Adults to have their blood pressure checked routinely
   - Targets all who are at-risk
   - WHO strategy for control focuses on reducing disease morbidity through periodic, targeted treatment with praziquantel.
2. People with high blood pressure that also have
   - high blood sugar,
   - elevated blood cholesterol
   - kidney damage face even higher risk of heart attacks and stroke.
   Therefore it is important that regular checks for blood sugar, blood cholesterol and urine albumin take place