High blood pressure, the silent
epidemic

Over 4,000 delegates attended the 13th meeting of the Spanish Hypertension Society Spanish League against Hypertension (SEHLELHA in its Spanish initials) held in the Valencia Conference Centre. The event´s organisers put forward a distinctly multidisciplinary programme. One of the themes of the conference involved considering the treatment of high blood pressure from a global perspective of risks to cardiovascular health. Over four days, over 200 specialists in different areas of medicine related to high blood pressure presented the latest discoveries and trends in their field. The conference took in all areas of medicine related to conditions affecting cardiovascular health, including high blood pressure, primary health care, cardiology, internal medicine, endocrinology, neurology and nephrology.

High blood pressure is a major health risk due to the magnitude of the problem. However, among cardiovascular illnesses, it is the most frequently occurring modifiable cardiovascular disease risk factor. In economic terms, high blood pressure costs Spanish tax payers E1,200m. The cost of diagnosis, treatment and hospital admissions totals E480m and the cost of sick leave, loss of productivity and disability amounts to E721m.

30% of the population suffers from high blood pressure The Valencian Region has one of the highest levels of high blood pressure sufferers in Spain. Thirty percent of the population suffers from the complaint, a figure similar to that of other autonomous regions such as Andalusia, the Balearic Islands and the Canary Islands, which have the highest mortality rates for this particular cause of death. One of the main ways to reduce these rates is to combat obesity, which is becoming increasingly common in our society, even amongteenagers. In fact, one in four teenagers is overweight or affected by obesity. A study carried out by the SEHLELHA and presented during the meeting highlighted the fact that almost half of the people with high blood pressure in Valencia are affected by abdominal obesity and/or excess cholesterol and triglycerides. Twenty percent suffer from diabetes and 19% are smokers. This silent epidemic as the WHO refers to it because of the lack of symptoms causes major disorders, namely thrombosis, brain haemorrhages, kidney failure and vascular damage. According to specialists, one in four deaths in developed countries is due to cardiovascular illness.

The problem is on the increase Far from decreasing, the number of high blood pressure sufferers is on the rise. The forecast is alarming: in 2025 half the adults living in developed countries will suffer from high blood pressure. By then, high blood pressure will have become an epidemic of global dimensions unless strict means of controls are introduced. To that end, the SEHSELHA is preparing a report drawn up in collaboration with 20 scientific organisations entitled The statement on future strategies in health policy to prevent and control high blood pressure. The document aims to set up a global health plan which will only succeed if health authorities, medical professionals, patients and the public in general all work together. The report sets out four main ideas: controlling high blood pressure through health care; increasing the autonomy of professionals with regard to the prevention and control of high blood pressure; increasing the extent to which patients follow treatments; and effectively quantifying the expected economic savings that such a strategy would represent.

Are modern lifestyle habits more or less healthy than those of a couple of decades ago? Present-day lifestyles are based on food with a very high calorie content. We are a long way from the Mediterranean diet, which is so healthy and also very much within our reach. Life is increasingly sedentary and people do less and less exercise. And this is happening from a very early age. There are more and more cases of obesity among children and this implies a risk to cardiovascular health with short and long-term consequences. That is why it is essential that our children eat fruit, vegetables and fish and do more physical exercise. We must develop healthy habits from the outset.

Is the number of people suffering from high blood pressure in Spain and in the Valencian Region increasing or decreasing. It is on the increase. In fact it is rising faster and faster. One of the reasons why high blood pressure is so common is the high obesity rate. It is becoming ever easier and cheaper to buy calories and current eating habits are less healthy for the heart. In the past schools were close to home, children used to walk to school and play outside. Nowadays, most journeys are by car and children spend too much time sitting in front of the television and playing video games.

What is your assessment of the conference held in Valencia recently? The event brought together over 4,000 delegates for four days of intense work. The meeting reviewed the most important issues regarding high blood pressure and risks to cardiovascular health, from the earliest signs which appear during adolescence to the effects on old patients. Specialists were invited from 15 different countries from Europe, America and Australia.

Which aspects of high blood pressure did the conference concentrate on? Above all on aspects related to prevention from adolescence onwards, with the presentation of studies related to obesity in children. Activities were organised in collaboration with the Valencia City Council in order to promote physical activity among school children with a walk along the river. The General Hospital of Valencia played a fundamental role, as did the Club del Hipertenso (Hypertension Club), a part of the Spanish Hypertension Society which deals with educating patients. In addition to these activities, presentations were made of the latest innovations for treating high blood pressure and reducing cholesterol levels.

High blood pressure is known as the “silent epidemic”. In terms of the number of deaths, what position does it occupy in the ranking of illnesses? It is the number one cause of death worldwide, even above cancer. The most recent figures from the WHO, which are from 2003, place high blood pressure as the number one cause of death in the world, not only in developed countries, but also in developing countries.

What basic advice can you give people to keep the risks of suffering from high blood pressure down? The most important advice of all is that people should limit their intake of salt, reduce obesity or excess weight, do physical exercise and not smoke. Likewise, it is advisable to limit alcohol consumption to under 25 grams per day, which is the equivalent of one glass of wine.

What would be the identikit picture of a person at risk of suffering a heart attack?. It would be an overweight smoker aged between 50 and 60 with high blood pressure. This especially applies to people with excess abdominal fat.

What was it like to hold this conference in Valencia again five years on? Every year the conference is held in a different city in Spain, but due to the size of the event not every city can offer the infrastructure required to host such an event.