Risk factors

Call to action: Australian roadmap for hypertension control released


A three-step roadmap could mobilise the nation against hypertension and help save around 83,000 lives, Australian cardiac researchers hope.

The bid to prioritise blood pressure awareness, treatment and control comes after University of New South Wales Principal Theme Lead of Cardiac, Vascular and Metabolic Medicine Professor Aletta Schutte and her team noted serious gaps in Australia’s hypertension literacy and management and “a significant degree of complacency” in cardiovascular research and the public health agenda.

The roadmap, published in the Medical Journal of Australia, calls for the creation of a national taskforce of cardiologists, GPs, pharmacists, nurses and other key stakeholders, “with a remit to improve [blood pressure] to at least 70%”.

It also highlights the need for increased funding to support blood pressure research and help implement and scale proven strategies that improve blood pressure management and control across the life course.

Professor Schutte and colleagues also call for a range of measures to increase awareness, training and screening programs for hypertension. These might including courses on the latest evidence-based BP measurement, better access to “affordable and validated [BP] devices”, patient coaching for home-monitoring and further promotion of lifestyle changes to tackle hypertension.

“Adequately treating and managing people currently living with hypertension would save 83,000 lives over the working lifetime and save $91.6 billion in gross domestic product,” they write.

Only 1 in 3 have BP controlled

The roadmap notes that as of 2017-18, only 32% of Australian hypertensive patients have controlled blood pressure (<140/90 mmHg) — less than the 44% it took for the US to take national action on the same issue.

“The question could be asked as to why Australia is not prioritising [blood pressure control]”, the authors write, noting that it could be the “linchpin” in reducing coronary artery disease, vascular dementia and cerebrovascular disease risk.

“Australian data have shown raised [blood pressure] to be responsible for 43% of coronary heart disease, 41% of stroke, 65% of the burden of hypertensive heart disease, 38% of chronic kidney disease, 32% of atrial fibrillation and flutter, and 3.6% of dementia,”

Further, a meta-analysis of 344,716 patients from 48 trials found that a 5 mmHg decrease in systolic blood pressure was associated with a 10% reduction in major cardiovascular events, regardless of baseline blood pressure level in those with and without known cardiovascular disease.

Despite blood pressure’s role in disease development, the authors feel Australia is doing little in prevention and focussing too much on management — even with the Medical Research Future Fund Cardiovascular Health Mission, which will see the Australian Government put $220 million to cardiovascular disease research over 10 years from 2019.

“While [established disease management] is undoubtedly important, a major public health impact is likely to be achieved most effectively by improving awareness of and screening for elevated [blood pressure] and improving control rates,” the authors say.

Australian hypertension awareness appears to have declined since the 199os and the 2018 blood pressure awareness campaign May Measurement Month revealed less than half the patients with high blood pressure were aware of their condition.

“With raised [blood pressure] leading to major cardiovascular outcomes, improving these conditions in Australia is not only critical but also possible, but only if improved health literacy, accompanied by better awareness, treatment and control of raised [blood pressure], is made a national priority,” the authors wrote.

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