Number of people living with hypertension

Wednesday, 8th August 2012

Number of people living with hypertension, often undiagnosed, expected to increase dramatically.

The Institute of Public Health in Ireland (IPH) recently published new research which suggests that by 2020 the number of adults aged 45+ years in the Republic of Ireland with hypertension (high blood pressure) is expected to rise to more than 1,220,000 people (63.1% of the population aged 45+ years).

The research was conducted by IPH in collaboration with the HRB Centre for Diet and Health Research at University College Cork and the Centre of Excellence for Public Health Northern Ireland at Queen's University Belfast. It is based on an analysis of the latest national health survey, SLÁN, that was conducted in 2007.

IPH's Research Analyst, Steve Barron, explained that hypertension occurs when blood pressure is constantly higher than the pressure needed to carry blood through the body. High blood pressure is a major risk factor for several fatal conditions including stroke, coronary heart disease and heart failure.

Mr Barron outlined some of the key findings from the research including:

In 2010 it is estimated that 12.7% of adults aged 18+ years in RoI had been told by a doctor in the previous 12 months that they had hypertension (diagnosed hypertension). This increases from 3.7% among adults aged 18-44 years to 23.3% among adults aged 45+ years.

A subset of those aged 45+ years were clinically examined. Those examinations revealed that a further 38.9% of all adults aged 45+ years who had not been told by a doctor in the previous 12 months that they had hypertension had undiagnosed hypertension.

Undiagnosed hypertension among adults aged 45+ years exceeds the broad ‘rule of halves' that states that approximately half of hypertension cases are undiagnosed.

The percentage of adults with undiagnosed hypertension increases with age: 33.8% of adults aged 45-54 years had undiagnosed hypertension compared with 47.8% of adults aged 75+ years.

Rates of diagnosed hypertension are similar among men (3.7%) and women (3.7%) aged 18-44 years and among men (23.0%) and women (23.5%) aged 45+ years. However, undiagnosed hypertension among adults aged 45+ years is more common among men (47.0%) than women (31.5%).

By 2020 the rate of clinically diagnosed hypertension for all adults aged 18+ years is expected to rise to 14.6% (526,000 people). This represents a 24% (103,000 adults aged 18+ years) increase in just ten years.

By 2020 the number of adults aged 45+ years with (diagnosed and undiagnosed) hypertension is expected to rise to more than 1,220,000 (63.1%). This represents a 28% (270,000 adults aged 45+ years) increase in just ten years. Commenting on the findings, Mr Barron said that the fact that large numbers of adults are living with hypertension and that this number is expected to increase has significant implications for the individuals concerned, their families, as well as the health and social care system and Ireland's economies.

Department of Health Chief Medical Officer, Dr Tony Holohan said: "World Hypertension Day draws attention to the many preventable diseases caused by high blood pressure such as stroke, heart and kidney disease. The IPH report on hypertension has made a valuable contribution in determining the levels of this condition and it is important that adults should know their risk factors for cardiovascular diseases. Your GP can provide advice in these risk factors such as hypertension and cholesterol levels. I would also advise on the dangers of tobacco smoking which is a leading cause of preventable mortality."

Professor Ivan Perry HRB Centre for Health and Diet Research, UCC said: "More than 50% of the population aged over 50 years in Ireland have high blood pressure which places them at significantly increased risk of heart attack and stroke. This is a mass epidemic and there is no magic bullet that will solve this problem overnight. Most people are now well aware of the importance of weight control, healthy diet and regular exercise in the prevention and management of hypertension and related conditions and the promotion of positive health and wellbeing. Action is now needed at the public policy level. We need to persuade the food sector to reduce the amount of salt added to processed food through regulation and taxation if necessary. We also need dedicated public policy involving all Government departments focused on the prevention of obesity in children and adults and on the promotion of physical activity in the population. We know what needs to be done and it is now time to get on with it."

Dr Angie Brown, Medical Director, Irish Heart Foundation, outlined the steps needed to tackle the growing levels of hypertension: "A greater focus on prevention of risk factors such as obesity, by promoting healthier lifestyles, and by identifying and treating other risk factors will help moderate these increases. Prevention programmes for population health should address social, environmental and other issues that influence the development of hypertension. At individual level, it is important for adults to know their blood pressure by having it checked regularly with their GP, this includes people already diagnosed with hypertension to ensure it is being well managed."

The researchers also highlighted the substantial limitations in the data available on hypertension and its risk factors at subnational levels. "Better data at local levels would allow policy-makers and service providers take a more targeted approach in tackling hypertension," said Mr Barron.