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04 February 2014
High blood pressure 'runs rampant in SA'

MEDICAL experts may not agree on the exact prevalence of hypertension among older South Africans, but there was one simple message from researchers and the government alike yesterday: too many over the age of 50 have high blood pressure. The concern expressed extends to the fact that many sufferers are blissfully unaware of their condition, putting them at increased risk of heart disease, stroke and dementia. A study published today in the International Journal of Epidemiology (IJE) found that 78 percent of South Africans over the age of 50 have high blood pressure. This is the highest rate reported for "any country in the world at any time in history", according to its authors. Fewer than one in 10 of these people were effectively controlling their hypertension with medication.
The data was drawn from the 2003 Study on Global Ageing and Adult Health, conducted by the World Health Organisation. The study surveyed more than 35 000 people aged 50 and older in SA, China, Ghana, India, Mexico and Russia. The lowest rate of high blood pressure (32 percent) was recorded in India. Lead author Peter Lloyd-Sherlock, professor of social policy and international development at the University of East Anglia, said high blood pressure was not a disease of the privileged and affected rich and poor, old and young, men and women. The study found the biggest risk factor of having high blood pressure was being overweight or obese and in SA 72 percent of men and women over the age of 50 fell into one of these categories. In India, just 12.7 percent of the respondents were overweight or obese. Lloyd-Sherlock said in many countries, public awareness about hypertension remained very low, adding that the condition was not prioritised by national governments or development agencies. He said that unless this changed, avoidable deaths and disability resulting from hypertension were set to soar.
Lloyd-Sherlock said ideally, people should be persuaded to adopt healthier diets and lifestyles, but in the short run they should at least have access to effective treatment. But the data in the IJE study is at odds with previously published research, which found significantly lower prevalence of high blood pressure among older South Africans, according to the Health Department's head of non-communicable diseases Melvyn Freeman. He said the department was somewhat dubious of the figures because they were a lot higher than other studies suggested. He said it was not clear how they came to these results, but it did not mean they were not worrisome. Freeman said there was clearly a problem of severe magnitude and the department had been taking action to reduce hypertension with a number of initiatives. He cited programmes to regulate the salt content of processed food and encourage people to get tested for hypertension as part of its HIV counselling and testing campaign as some of the initiatives.
Freeman said the 2008 National Income Dynamics Study found high blood pressure among 50 percent of men aged between 45 and 54, 70 percent of men aged between 55 and 64, and 78 percent of men aged over 65. For women, the figures were 50 percent, 63 percent and 71 percent in the corresponding age groups. Wits public health professor and Medical Research Council scientist Steve Tollman said the figures showed the "enormous challenges" facing the health system. He said traditionally, poor countries had high disease burdens of infectious diseases such as tuberculosis and HIV. Richer countries had a burden of lifestyle diseases, such as stroke and cancer. The WHO study indicated that developing countries, including South Africa, were now dealing with a "colliding epidemic" of infectious and lifestyle diseases. This, Tollman said, placed pressure on health workers and budgets.
Tamar Kahn: Business Day, 4 February 2014
Katharine Child: The Times, 4 February 2014

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