Hypertension is as prevalent in many developing countries as it is in developed countries and is an increasingly health issue worldwide. It is a major risk factor of heart attacks and strokes: approximately 62% of cerebrovascular disease and 49% of ischemic heart disease are attributable to suboptimal blood pressure. Worldwide, high blood pressure is estimated to cause 7.1 million deaths per year, with close to 4.2 million of these occurring in developing countries.

The treatment of hypertension has been associated with an approximate 40 % reduction in the risk of stroke and 15% reduction in the risk of myocardial infarction. However in developing countries, the detection of major cardiovascular risk factors, such as hypertension, is often missed. Failure to identify hypertension is largely due to the unavailability of suitable blood pressure measurement devices and the limited attention paid to obtain accurate blood pressure readings.

There are several barriers to accurate and affordable blood pressure measurement, particularly in developing countries. These include:

• The absence of accurate, easily-obtainable inexpensive devices for blood pressure measurement;
• The frequent marketing of non-validated blood pressure measurement devices;
• The relatively high cost of blood pressure devices given the limited resources available;
• Limited awareness of the problems associate with conventional blood pressure measurement techniques;
• A general lack of trained manpower and limited training of personnel.

To fulfill the requirements related to blood pressure measurement in low resource settings, a blood pressure measuring device should therefore be affordable and extremely simple to use, but at the same time be accurate and robust so that it can be easily used for repeated blood pressure measurements.

In July 2002, WHO held a meeting to develop a package of tools for integrated cardiovascular risk assessment and management.

The July 2002 meeting included deliberations on blood pressure measuring devices. The experts supported the use of affordable, independently validated electronic devices in clinical practice...

A meeting of experts was convened on December 3rd, 2003 in Geneva, Switzerland, to develop technical specifications for an accurate and affordable blood pressure measuring device for office/clinic use in low resource settings.

Affordable Technology: Blood Pressure Measuring Devices in Low Resource Settings, WHO, 2005.

Questions

Commentary

1. Is there any relation between heart diseases and high blood pressure in the text? (03 points)
2. What do the different percentages in the text tell us about heart diseases? (03 points)
3. According to the text, what are the obstacles to the prevention of heart diseases? (04 points)
4. What is being done to overcome these obstacles, in the text? (04 points)
5. Hypertension is a worldwide phenomenon. Suggest precautions to prevent it in your country. (06 points)