Tt HRB Centre for Health and Diet Research The burden of hypertension Ivan J Perry, Dept. of...
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Tt HRB Centre for Health and Diet Research The burden of hypertension Ivan J Perry, Dept. of Epidemiology and Public Health, University College Cork. Institute
tt HRB Centre for Health and Diet Research The burden of
hypertension Ivan J Perry, Dept. of Epidemiology and Public Health,
University College Cork. Institute of Public Health in Ireland
Hypertension Launch May 2012
Slide 2
t HRB Centre for Health and Diet Research Overview What do we
mean by hypertension and why is it important ? Global burden of
hypertension Overview of current hypertension prevalence estimates
and recent trends in Ireland Importance of hypertension in framing
our response to the national and global Non-Communicable diseases
(NCDs) crisis
Slide 3
t HRB Centre for Health and Diet Research 3 Major causes of
death in Ireland, all ages in 2006 (N=27,479)
Slide 4
Approximate mean SBP (mmHg) Systolic Blood Pressure, Stroke,
and CHD CHD mortality 16 8 4 2 1 120125135148168 Relative risk of
CHD mortality
Slide 5
Major Underlying Factors causing Death - Worldwide Ezzati et
al. Lancet 2002:360:1347-60. Underweight Unsafe water, sani &
hygiene Alcohol Physical inactivity High BMI Low fruit &
vegetables intake Unsafe sex High cholesterol Tobacco Raised Blood
Pressure 0 1234567 Millions of Deaths 7 million Developing region
Developed region
Slide 6
t HRB Centre for Health and Diet Research International
mortality trends in CHD in men aged 35 to 74 years from 1968 to
2002
Slide 7
t HRB Centre for Health and Diet Research Population weighted
average risk factor changes between 1985 & 2006 Risk
factors19852006% Change Smoking Prevalence (%)32.328.2-12.7 Mean
Total Cholesterol (mmol/L)5.885.39-8.3 Mean SBP (mm Hg)144136-4.9
Physical Inactivity (%)63.562.3-1.9 Mean BMI (Kg/m 2) 25.428.5+12.2
Diabetes Prevalence (%)1.83.2+78
Slide 8
t HRB Centre for Health and Diet Research 8 Distributions of
systolic blood pressure in middle-aged men in two populations Rose,
G. Int. J. Epidemiol. 2001 30:427-432;
doi:10.1093/ije/30.3.427
Slide 9
t HRB Centre for Health and Diet Research CHD mortality fall in
Ireland between 1985 and 2006 estimated impact of risk factor
trends and treatments
Slide 10
t HRB Centre for Health and Diet Research CHD and Stroke
mortality in Ireland
Slide 11
t HRB Centre for Health and Diet Research Overview What do we
mean by hypertension and why is it important ? Global burden of
hypertension Overview of current hypertension prevalence estimates
and recent trends in Ireland Importance of hypertension in framing
our response to the national and global Non-Communicable diseases
(NCDs) crisis
Slide 12
t HRB Centre for Health and Diet Research 12 Prevalence
estimates for hypertension in people aged 20 years and older by
world region and sex in 2000 (upper) and 2025 (lower)
Slide 13
t HRB Centre for Health and Diet Research 13 Estimates of
number of people with hypertension aged 20 years and older by world
region and sex in 2000 (upper) and 2025 (lower
Slide 14
t HRB Centre for Health and Diet Research Overview What do we
mean by hypertension and why is it important ? Global burden of
hypertension Overview of current hypertension prevalence estimates
and recent trends in Ireland Importance of hypertension in framing
our response to the national and global Non-Communicable diseases
(NCDs) crisis
Slide 15
t HRB Centre for Health and Diet Research SLN 2007 - National
Health & Lifestyle Study 10,364 adults from 400 clusters
nationally
Slide 16
t HRB Centre for Health and Diet Research 16 Hypertension
prevalence estimates: Ireland SLAN 2007
Slide 17
t HRB Centre for Health and Diet Research Obesity,
Hypertension, Hypercholesterolemia & Smoking in adults aged 45
years and older SLAN 2007 Obese Above normal BP Above normal
cholesterol Current smoker All 3 biological risk factors Any 2 of 3
risk factors Any 1 of 3 risk factors
Slide 18
t HRB Centre for Health and Diet Research Mitchelstown Cohort
Study Based in a single large primary care centre (LivingHealth
Clinic) in Mitchelstown, Co Cork Baseline data collected in
2010-2011 2047 participants aged 45 to 74 years and response rate
of 67%. Standard dietary, lifestyle, and anthropometric measures
Measurement of 24 hour ambulatory BP in over 50% of participants
and triaxial accelerometry data over 7-days from a sub-sample of
over 400 participants
Slide 19
t HRB Centre for Health and Diet Research 19 Baseline
prevalence of hypertension by age and gender in the Mitchelstown
Cohort study in 2010
Slide 20
t HRB Centre for Health and Diet Research 24-hour ambulatory BP
measurement 20
Slide 21
t HRB Centre for Health and Diet Research 21 Prevalence of
hypertension defined by ABPM by age and gender in the Mitchelstown
Cohort study in 2010 Mean 24 hour Ambulatory BP > 130/80 mmHg or
on anti-hypertensive therapy
Slide 22
t HRB Centre for Health and Diet Research 22 Overview of blood
pressure data in Irish men and women aged 50 years and older (TILDA
Study)
Slide 23
t HRB Centre for Health and Diet Research Overview What do we
mean by hypertension and why is it important ? Global burden of
hypertension Overview of current hypertension prevalence estimates
and recent trends in Ireland Importance of hypertension in framing
our response to the national and global Non- Communicable diseases
(NCDs) crisis
Slide 24
t HRB Centre for Health and Diet Research What causes high
blood pressure in the population? Salt intake Lack of fruit and
vegetables Obesity Lack of exercise Alcohol excess
Slide 25
t HRB Centre for Health and Diet Research Priority
cost-effective, affordable, feasible interventions to tackle the
global burden of Non- Communicable diseases Accelerated
implementation of the Framework Convention on Tobacco Control with
the goal of a tobacco-free world, where less than 5% of people
smoke, by 2040 Reduced salt intake with the goal of 5 g per person
per day, by 2025 Promotion of diets low in fats and sugar,
increased physical activity, and less alcohol Generic multidrug
treatment in primary care settings targeted to people at high risk
of an NCD
Slide 26
t HRB Centre for Health and Diet Research Summary Elevated
blood pressure is an important and preventable cause of suffering
and death in Ireland and globally In more than 50% of the
population of middle-aged adults BP is at a level that requires
treatment Need for ongoing, regular and standardised risk factor
surveillance in the general population, including BP measurement
Problem of hypertension requires specific evidence based
interventions in both the clinical and policy arena Public policy
measures are vital in tackling the problem of hypertension as the
impact of health services (at best) is marginal
Slide 27
t HRB Centre for Health and Diet Research CVD prevention moving
into public policy arena
Slide 28
t HRB Centre for Health and Diet Research 28 Thank you
