New survey reveals shortcomings in global battle against high blood pressure

7 April 2013

PRESS RELEASE: Strictly embargoed until 00.01am 7 April 2013

This World Health Day on 7 April 2013 will see doctors, students and army medics join older people's campaign groups around the world in a push for greater awareness of high blood pressure - also known as hypertension or raised blood pressure.

The theme for World Health Day 2013 is controlling high blood pressure, a condition which affects more than one in three adults worldwide. For millions of people, high blood pressure will lead to fatal heart attacks, debilitating strokes, and chronic heart and kidney disease. As the world's population ages and grows, unhealthy behaviours - an unbalanced diet, a lack of physical activity, smoking, harmful use of alcohol - together with stressful lifestyles, all increase the chances of developing high blood pressure. All regions of the world are affected.

HelpAge International, the network that improves the lives of older people, today publishes the results of its own survey of civil society organisations working with older people in 42 countries. The results reveal a shocking global picture of the work which still needs to be done to provide adequate information and screening for this easily treatable condition which affects one billion people around the world.

  • Older people's organisations in 70% of the countries that responded said there was no easily accessible programme of free screening for older people available in their countries.
  • The survey revealed a clear lack of information with 58% of countries saying there was no form of information campaign about the effects and importance of treatment.
  • Only 46% said free drugs were provided to older people for the treatment of high blood pressure - and of those, 70% said these free drugs were not easily obtainable in rural areas.

HelpAge International is calling for:

  • The introduction and improvement of information campaigns about hypertension to encourage people to get their blood pressure tested.
  • Free universal screening for all people over 60 for the detection of high blood pressure.
  • Free drugs for the treatment of hypertension.

Among the key points raised in WHO's global brief on hypertension, published to coincide with World Health Day, is the important role for civil society in garnering political support and mobilising society to address hypertension and other non-communicable diseases. In some countries, civil society institutions often fill gaps in services and training and are significant providers of prevention and health care services.

On World Health Day, HelpAge is coordinating Age Demands Action campaigns in at least 26 countries - all calling for better health services for older people, including better provision for dealing with hypertension. In at least six countries mobile clinics will be set up to provide screening and information:

  • Gaza - 100 Palestinian medical students will target 40 primary health care centres while medically trained HelpAge staff will focus on 5 poorly resourced areas near the eastern border. They will be checking the blood pressure of hundreds of older people and handing out 5,000 information booklets - specially produced for the event in collaboration with the Ministry of Health and WHO. A big information campaign will feature radio messages, 3,000 posters in public places and advertising billboards carrying key messages on Gaza's main highways.
  • Serbia - army doctors will be joining medical staff from the Red Cross to travel into the mountains to remote villages to check the blood pressure of older residents, recommend treatment and promote awareness about good diet and lifestyle. In Belgrade, hundreds of older people will attend a public discussion on hypertension, its consequences and healthy food habits related to its prevention.
  • Kyrgyzstan - medical staff will target older people in 15 rural communities to check for both hypertension and diabetes, while cardiologists will be lecturing to older people in Bishkek. 40-50% of older people in rural areas have high blood pressure and a delegation of older people will appear on national TV to raise awareness.
  • Sri Lanka - staff and students from the University of Kelaniya's faculty of medicine will join older campaigners to screen for high blood pressure among older people and present an exhibition in Vakarai, Batticaloa district. They will also be handing out a new brochure on hypertension. Campaigners will meet the Minister for Health and Nutrition to discuss the improvement of health services for the treatment of non-communicable diseases.
  • Moldova - campaigners will provide free blood pressure screening in target communities in collaboration with WHO and the Ministry of Health.
  • Albania - a mobile clinic in one of Tirana's parks will be a focal point for checking blood pressure and giving out information.

HelpAge International is working with governments in different countries and global regions to tackle hypertension and other non-communicable diseases. We are actively engaged with health ministries, health workers and local communities in countries such as Peru, Cambodia, Tanzania and Mozambique to increase awareness, screening and treatment of non-communicable diseases such as hypertension - conditions which disproportionately affect older people, since illnesses such as hypertension are in large part, diseases of older age.

Dr Paul Ong, Health Policy Advisor at HelpAge International, said:

"Current WHO data suggests that more than one in three adults worldwide has raised blood pressure, yet over half of them do not know they have the condition, meaning they are not receiving treatment that could significantly reduce their risk of heart disease and stroke. This year's World Health Day report highlights the fact that nearly 80% of deaths due to cardiovascular disease occur in low and middle-income countries.

"If no action is taken to tackle hypertension and other non-communicable diseases, economic losses stemming from high blood pressure and other non-communicable diseases are projected to outstrip public spending on health in all low and middle income countries for the period encompassing 2011-2025. A high degree of direct medical costs associated with hypertension stems from the complications that arise from its non- treatment such as heart attacks, stroke or kidney failure. Several academic studies have indicated that successful early prevention and control of high blood pressure may be cost effective in controlling the rising trends of health care expenditures within global health care budgets."

Many countries run health programmes that ostensibly offer free treatment for hypertension but in practice people find it extremely difficult or even impossible to benefit from that free assistance.

Peru

Peru is one such country where solutions are badly needed; the case of Juan highlighted some of the challenges. When HelpAge staff met him, Juan was being treated for hypertension in Chulucanas hospital even though he is not from the local area.

Juan, who had to travel out of his area for treatment for hypertension, said;

"Although in my own district I qualified for treatment under the Peruvian Ministry of Health's programme for poorer groups in the population, I was refused treatment in my own district because the hospitals said that recovering cost from ministry was both difficult and tedious. My local hospitals offer discounts to patients if they pay as private patients, but if we don't have the money, we must search for a hospital elsewhere that is prepared to recover the cost from the ministry of health. This is obviously an unfair and untenable situation, especially for older people.

-ENDS-

Notes to Editors

1. This World Health Day, 7 April 2013, WHO and partners focus on the global problem of high blood pressure. Though it affects more than one in three adults worldwide, it remains largely hidden. Many people do not know they have high blood pressure because it does not always cause symptoms. As a result, it leads to more than nine million deaths every year, including about half of all deaths due to heart disease and stroke. http://www.who.int/campaigns/world-health-day/2013/en/index.html

2. Gallery of photographs for those covering the story can be downloaded here: http://www.flickr.com/photos/agehelps/sets/72157633089074234/

3. Age Demands Action is a global grassroots campaign supported by HelpAge and led by activists who challenge age discrimination and fight for the rights of older people. Today's activities give older people an opportunity to engage with government officials, raise their voices and stand united for improved health access and treatment across the globe. The following 26 countries are taking part in this year's ADA on health: Haiti, Kenya, Sudan, Ghana, South Africa, Moldova, Kyrgystan, Pakistan, Nepal, Sri Lanka, Bangladesh, India, Slovenia, Bosnia, Albania, Serbia, Philippines, Fiji, Indonesia YEL, Vietnam, oPt, St Vincent, Jamaica, Ecaudor, Colombia, Peru and Bolivia.
HelpAge's website for ADA on Health: http://www.helpage.org/get-involved/campaigns/age-demands-action-on-health/

4. HelpAge International carried out its survey in February 2013. 58 organisations in 42 countries responded:
The full results of the HelpAge survey can be found here: https://helpage.box.com/s/2xstyl8n8znzp9mcwe6k

5. HelpAge International works with governments to ensure that the needs of older people are properly considered when developing national health policies.

Tanzania

Recent research carried out by HelpAge in collaboration with the Ifakara Health Institute into non-communicable diseases among older people in Tanzania has revealed that hypertension, previously considered to be a disease of the wealthy with sedentary urban lives, is now prevalent in rural areas at a rate similar to the incidence in high income countries. The treatment rate of hypertension was found to be particularly low among those with a lower socio-economic status. While one study in 2002 concluded that many older people died at home due to a lack of awareness of the symptoms and signs of hypertension, heart attack or diabetes (AMMP. Adult Morbidity and Mortality Report 1994 - 2002), HelpAge has found that d that hypertension is now one of the more easily recognised NCDs, with many lower level health facilities able to detect hypertension or chronic obstructive respiratory diseases alone among common NCDs.

6. In Peru, the Seguro Integral de Salud (SiS) (Comprehensive Health Insurance) is organised by the Ministry of Health, and aims to protect the health of Peruvians who do not have health insurance, giving priority to those vulnerable populations who are at poverty and extreme poverty.

The beneficiaries of the SIS, about 18% of the population, are mostly in rural and urban areas, where poverty is greatest. Additionally, SIS benefits pregnant women and men over the age of 17 who live in poverty and extreme poverty, both in rural and urban provinces, provided they do not have coverage of EsSalud or other social security schemes. Qualification for coverage of SIS is based on an individual's or family's economic level. SIS is funded almost entirely (94%) with regular resources from the general budget. The remaining 6% of its resources come from donations and contributions, international aid agencies, contributions from individuals, and public and private institutions.

About HelpAge International

HelpAge International helps older people claim their rights, challenge discrimination and overcome poverty, so that they can lead dignified, secure, active and healthy lives. Our work is strengthened through our global network of like-minded organisations - the only one of its kind in the world.

Contact Attila Kulcsar at HelpAge International's office in London on +44 (0) 20 7148 7623 (mobile: +44 (0) 7713 567624) or email akulcsar@helpage.org)

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