World Hypertension Day (WHD) is aimed at raising attention on the importance of a better hypertension control. This important worldwide activity, started by the World Hypertension League (WHL), was first held on May 14, 2005, and since then World Hypertension Day has been an ever-expanding yearly event.
World Hypertension League is an umbrella of organisations from 85 countries dealing with hypertension societies and leagues. World Hypertension League introduced World Hypertension Day on May 14, in the year 2005. From 2006, World Hypertension Day has been observed on May 17.
For this year, the theme of World Hypertension Day (WHD) is “Measure your blood pressure accurately, control it, live longer”. The low awareness of hypertension among people creates the space for the condition to get more serious. When Hypertension is regularly measured and kept under check, the risk of other chronic illnesses also reduces significantly. This day helps in promoting public awareness about hypertension, and seek for treatment methods to overcome it. World Hypertension Day also helps in creating awareness about the healthy lifestyle choices that we can adapt to avoid hypertension, complications, and to provide information on its prevention, detection, and management.
According to the World Health Organisation (WHO), globally cardiovascular disease accounts for approximately 17 million deaths a year. Hypertension accounts for 9.4 million deaths worldwide every year. Hypertension is responsible for at least 45 per cent of deaths due to heart disease and 51 per cent of deaths due to stroke.
In 2008, worldwide, approximately 40 per cent of adults aged 25 and above had been diagnosed with hypertension; the number of people with the condition rose from 600 million in 1980 to one billion in 2008 (3). The prevalence of hypertension is highest in the African Region at 46 per cent of adults aged 25 and above.
Hypertension is more prevalent in low- and middle-income countries. Additionally, because of weak health systems more people with hypertension are undiagnosed, untreated and uncontrolled in low-and middle-income countries.
The increasing prevalence of hypertension is attributed to population growth, ageing and behavioural risk factors, such as unhealthy diet, harmful use of alcohol, lack of physical activity, excess weight and exposure to persistent stress. The risk factors include tobacco use, obesity, high cholesterol and diabetes mellitus. Tobacco use increases the risk of complications among those with hypertension. The global prevalence of high cholesterol was 39% and prevalence of diabetes was 10 per cent in adults over 25 years.
Nearly 80 per cent of deaths due to cardiovascular disease (CVD) occur in low- and middle-income countries. They are the countries that can least afford the social and economic consequences.
Hypertension is among the leading causes of admissions and deaths in Ghana. It was the third leading cause of admission and the leading cause of deaths, accounting for 4.7 per cent of the total admissions and 15.3 per cent of the total deaths in Ghana in 2017 (Bosu et al. (2021) Prevalence, awareness and control of hypertension in Ghana: A systematic review and meta-analysis. PLoS ONE 16(3): e0248137. https://doi. org/10.1371/journal). Patients are admitted for one to 91 days, with 22.7 per cent staying for four or more days. Hypertension is a common cause of medical emergencies such as heart failure and renal failure in Ghana. It is the main determinant of stroke in Ghana. Besides genetic factors, behavioural risk factors such as eating foods high in salt and fat, inadequate intake of fruit and vegetables, harmful use of alcohol use, tobacco smoking, low physical activity and poor stress management contribute to the development of hypertension.
According to the Ghana Demographic and Health Survey (GDHS) in 2014, hypertension has a prevalence of 13 per cent amongst adults with 40.5 per cent on treatment and only 23.8 per cent of hypertension under control. A study revealed that in the middle belt of Ghana, less than half of hypertensives were aware of their condition with an overall hypertension prevalence of 28.1 per cent.
In Ghana, the May Measurement Month initiative (MMM), led by the International Society of Hypertension (ISH) and endorsed by the World Hypertension League (WHL) targets to screen one per cent of the population in each participating country for hypertension. The prevalence of hypertension amongst participants determined during the global MMM campaign in 2018 was 33.4 per cent. Again, the prevalence determined during the global 2019 MMM campaign was 34 per cent amongst participants with 23 per cent of participants having untreated or poorly treated hypertension.
Analysis of household survey data in five sub-Saharan Africa countries (Benin, Burundi, Ghana, Kenya and Lesotho) showed that women with overweight or obesity were 2.4 and 5.3 times as likely as those with normal body mass index (BMI) to have hypertension. Overweight/obesity, physical inactivity, older age and family history of diabetes are also significantly associated with adult diabetes in Ghana.
Ghana is one of the few Sub- Saharan Africa (SSA) countries undergoing nutrition transition, along with South Africa, Cabo Verde and Senegal. The prevalence of women with overweight and obesity in women is not only among the highest in SSA, but increased significantly in surveys conducted between 1991 to 2014.
The foregoing clearly underscores the theme of this year’s World Hypertension Day (WHD)- ““Measure your blood pressure accurately, control it, live longer”.
A nutraceutical approach is been proposed to counteract the increasing burden of cardiovascular disease (CVD). The consumption of polyphenol-rich foods is linked to a lower risk of cardiovascular events (cardiovascular mortality, myocardial infarction, and stroke) both in the general population and in patients with cardiovascular risk factors (Ludovici et al. Cocoa, BP, and Vascular Function. Frontiers in Nutrition. August 2017 | Volume 4 | Article 3).
Polyphenols are to a large extent linked to this protective role. Fruits, vegetables, tea, and cocoa contain a high number of polyphenols. Cocoa is an excellent source of polyphenols. Several studies link cocoa consumption, (and vegetables and fruit intake) to several beneficial effects on cardiovascular health, including lowering of BP, improving vascular function, reducing of platelet aggregation and adhesion, having anti-inflammatory properties, and improving glucose and lipid metabolism. These positive effects have been found in healthy subjects as well as in patients with risk factors (arterial hypertension, diabetes, and smoking) or established CVD (coronary heart disease or heart failure). Polyphenols have several anti-atherogenic properties including anti-inflammatory, anti-aggregating, and vasodilatory effects, the ability to lower blood pressure (BP), to prevent oxidation of low-density lipoprotein (LDL), and to improve glucose and lipid profiles.
As we observe (WHD), get screened against hypertension. If you are diagnosed as having hypertension, take your medications every day to control the condition and live longer. Consume polyphenol-rich cocoa everyday in addition to all the interventions recommended for you. If you do not have hypertensive, still consume polyphenol-rich cocoa everyday for its protective function.
2023 is the 50th anniversary of Cocoa Clinic. Management of hypertension is one of the several services we provide at Cocoa Clinic.
BY DR EDWARD O. AMPORFUL
CHIEF PHARMACIST
COCOA CLINIC
