New efforts to curb high blood pressure in Asia

May 17, 2018, American Heart Association
Awareness, treatment and control rates of high blood pressure in Asian countries and regions. (NA indicates data not available.) Credit: Hypertension

The reality of treating high blood pressure in the world's most populated continent is trickier these days, experts say. After guidelines recently lowered the threshold for high blood pressure, about half of adults living in Asia now have the chronic condition.

That's why a group of Asian doctors has come together to study the effects of high and implement culturally specific education programs that can increase awareness of hypertension and its relationship to cardiovascular disease throughout Asia. It's called the HOPE Asia Network, short for Hypertension Cardiovascular Outcome and Prevalence Evidence in Asia.

Researchers are studying ways to improve the management of hypertension in Asia, where the link between and cardiovascular disease is stronger than it is in Western countries, according to a commentary published last month in Hypertension.

The commentary's coauthors, Dr. Jiguang Wang and Dr. Kazuomi Kario, said lack of health insurance, inability to access care, poor adherence to prescribed medications, and the use of herbs as medicines are significant barriers to diagnosing and managing hypertension throughout the region.

As a result, "hypertension is often diagnosed late in many hypertensive patients," said Wang, director of the Shanghai Institute of Hypertension. Even when it is diagnosed, because high pressure causes no symptoms, many don't perceive the condition as serious, he said.

Nearly 4 billion people live in Asia. Studies show rates of awareness, treatment and control of high blood pressure are generally low in Asia, vary widely among individual countries, and are impacted by regional, economic and cultural differences. In China, for example, 47 percent of people are aware of their blood pressure, and 14 percent had their hypertension controlled, compared with 74 percent awareness and 69 percent control rate in Singapore.

Lifestyle factors, including diet and stress, may be behind the high hypertension rates in Asia, the researchers said. One common problem is high salt intake. Asians not only tend to have diets high in sodium, but they are genetically more sensitive to sodium.

"If we want to bring the number of cardiovascular events to zero, we need a better approach that is not just medicine," said Kario, chairman of the Division of Cardiovascular Medicine at Jichi Medical University School of Medicine in Tochigi, Japan, and chairman of the HOPE Asia Network. He noted that lifestyle changes and the use of technology and telemedicine could help Asian patients better control their blood pressure round-the-clock, especially during the crucial morning hours when Asian patients are more likely than Westerners to experience a surge in blood pressure.

The researchers stressed the need to standardize hypertension treatment in Asia. Doing so could more immediately address treatment gaps, given the wide disparities in practice and health care delivery, Kario and Wang wrote.

Yet in doing so, doctors must not overlook young people, Wang said.

"The prevalence of obesity and hypertension in the young is increasing rapidly in the past years," he said. "If we would not control , stroke incidence will remain high in Asians in the decades to come." Unlike in the United States, stroke is more common among Asians than coronary artery disease.

Dr. Daniel Lackland, president of the World Hypertension League, said, "The earlier you do something to lower blood pressure that's too high, the more likely you are to prevent a stroke or heart attack." Lackland, a professor of epidemiology and neurology and Medical University of South Carolina, was not involved in the recent commentary.

"Even if your blood is fine," he said, "it's important to start making any lifestyle modifications that can help protect it as you get older."

Explore further: Blood pressure control best achieved with a multilevel, multicomponent approach

More information: Kazuomi Kario et al. Could 130/80 mm Hg Be Adopted as the Diagnostic Threshold and Management Goal of Hypertension in Consideration of the Characteristics of Asian Populations?, Hypertension (2018). DOI: 10.1161/HYPERTENSIONAHA.118.11203

Related Stories

Blood pressure control best achieved with a multilevel, multicomponent approach

December 25, 2017
Current clinical guidelines recommend lower blood pressure targets for the general population, yet control remains elusive for most. A new study suggests that patients with hypertension can best achieve blood pressure control ...

Preventing, controlling hypertension could reduce China's high stroke rate

February 20, 2018
While in the United States heart disease is the leading cause of death, in China it is stroke. People have speculated for years about why the Chinese are predisposed to stroke to a greater extent than heart disease. Some ...

Low sodium-DASH diet combination dramatically lowers blood pressure in hypertensive adults

November 13, 2017
A combination of reduced sodium intake and the DASH diet lowers blood pressure in adults with hypertension, according to preliminary research presented at the American Heart Association's Scientific Sessions 2017, a premier ...

Study reveals that South Africa has the highest prevalence of hypertension in southern Africa

June 16, 2017
A study by Wits scientists and peers has revealed that South Africa has the highest prevalence of hypertension in southern Africa.

Blood pressure better controlled with 'MAP' for doctors

September 17, 2017
A quality improvement program designed to better control hypertension in primary care practices notably improved hypertension control in six months, according to research presented today at the American Heart Association ...

For the first time in history, high blood pressure is more common in lower-income countries

August 8, 2016
For the first time in history, people living in low- and middle-income countries have a higher prevalence of hypertension - or high blood pressure - than people living in high-income countries, according to new research in ...

Recommended for you

Predicting leaky heart valves with 3-D printing

December 10, 2018
More than one in eight people aged 75 and older in the United States develop moderate-to-severe blockage of the aortic valve in their hearts, usually caused by calcified deposits that build up on the valve's leaflets and ...

Study points to optimal blood pressure treatment for stroke patients

December 10, 2018
Aggressive treatment of hypertension in stroke patients could do more harm than good in the long term, according to a new study from researchers at the University of Georgia.

Team uses gene editing to personalize clinical care for family with cardiomyopathy

December 10, 2018
A little over a year ago, a 65-year-old woman with severe hypertrophic cardiomyopathy—a condition in which the heart's muscle becomes abnormally thick, potentially causing dangerous irregular heartbeats—had her genes ...

Researchers explore what's behind Mediterranean diet and lower cardiovascular risk

December 7, 2018
A new study by investigators from Brigham and Women's Hospital, Harvard Medical School, and the Harvard T.H. Chan School of Public Health offers insights from a cohort study of women in the U.S. who reported consuming a Mediterranean-type ...

Increasing statins dose and patient adherence could save more lives

December 7, 2018
Thousands of heart attacks and deaths from cardiovascular disease could be prevented by patients taking higher doses of statins and taking the drugs as advised by doctors.

Progress made in transplanting pig hearts into baboons

December 6, 2018
A large team of researchers from several institutions in Germany, Sweden, Switzerland and the U.S. has transplanted pig hearts into baboons and kept them alive for an extended period of time. In their paper published in the ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.