Undetected Hypertension Puts South Africans at Risk – May Measurement Month Calls on South Africans to Get Tested

This May Measurement Month, health experts are sounding the alarm on hypertension (HTN), a condition that affects billions worldwide yet remains dangerously underdiagnosed and undertreated¹. Alarmingly, a recent study found that 74% of patients are unaware that they are at risk of hypertension or are unaware of their hypertension status.¹

HTN stands as the most significant risk factor for cardiovascular disease (CVD) in South Africa.² With cardiovascular disease ranking among the top 10 causes of death worldwide, detecting and controlling blood pressure has never been more critical.^2.

Uncontrolled hypertension can lead to serious health complications, significantly increasing the risk of heart attack, stroke, kidney failure, and heart failure. It’s also linked to a higher likelihood of developing dementia and can drastically reduce overall quality of life. These consequences contribute to increased mortality and morbidity, underscoring the importance of early detection, treatment, and management of high blood pressure.¹

 May Measurement Month

A public health campaign “Because I Say So” is part of a global blood pressure screening initiative, May Measurement Month. Now in its ninth year, this collaborative campaign was initiated in response to the hypertension health crisis and is led by the International Society of Hypertension (ISH), in collaboration with the Southern African Hypertension Society and Servier – amongst other scientific societies. This is a public call for everyone to get their blood pressure (BP) checked. This non-invasive test takes just five minutes, is FREE during May Measurement Month, and can help save lives.

Professor Erika Jones, President of the Southern African Hypertension Society says, “Hypertension is often called the ‘silent killer’ because it typically has no symptoms until significant damage has occurred. It’s a leading cause of heart disease and stroke, accounting for nearly half of related deaths worldwide. Despite this, awareness, treatment, and control remain alarmingly low.”

The scale of the problem

The statistics as recorded in 2019 paint a concerning picture:

• 4.06 billion adults were affected by high systolic blood pressure¹
• 1.3 billion adults (30-79 years) affected by hypertension¹
• 10.8 million deaths associated with raised blood pressure¹
• Approximately 60% of adults develop hypertension by 60 years of age¹
• Up to 90% of adults living to 80 years of age are likely to develop hypertension¹
• Hypertension causes over 50% of heart disease, stroke, and heart failure cases¹

South Africa faces an exceptionally high burden, with the South African Demographic and Health Survey (SADHS) reporting a hypertension prevalence of 46.0% in females and 44.0% in males above 18 years of age. Even more concerning, over 80% of people living with hypertension have uncontrolled blood pressure. This prevalence significantly exceeds the global average of 31.1%.¹

The treatment gap

A “treatment cascade”⁶ exists for patients with hypertension. According to a report by the World Heart Federation (WHF) – Roadmap for Hypertension⁶, it starts with those who have high blood pressure, although many don’t even know their status. Of those diagnosed, only a portion receive treatment, and fewer still achieve blood pressure control. Finally, patient adherence remains the greatest challenge.

Effective prevention and detection of hypertension require a multi-faceted approach. This includes robust screening policies that include initial blood pressure screenings from the age of 18, with regular follow-ups and opportunistic screenings in various settings such as workplaces, schools, and community spaces. Population-wide interventions play a crucial role in prevention by promoting weight control through healthier diets, (like the DASH diet) and improved access to nutritious foods and implementing salt-reduction strategies.

“Additionally, lifestyle interventions, such as adopting a balanced diet and increasing physical activity, are also essential in managing and reducing the risk of hypertension,” explains Professor Jones.

A WHF member survey⁴ conducted across 46 countries showed 65% of the polled healthcare respondents reporting that their patients do not adhere to their treatment plans, showing that even once the obstacles of detection and diagnosis are overcome, patients still struggle with maintaining their prescribed regimens.

Obstacles to prevention

Despite knowing how to prevent and treat high blood pressure, many barriers stand in the way of success. These challenges affect both patients and healthcare systems alike. For those diagnosed with hypertension, treatment brings its own challenges – medication costs can be expensive, many people struggle to stay motivated for a condition with no obvious symptoms, there are cultural attitudes that sometimes discourage medical intervention, and daily pill routines can be complicated and difficult to maintain.

The healthcare systems face their own set of obstacles, including limited resources for widespread blood pressure screening; equipment shortages, and inaccurate measurements; healthcare workers may have poor awareness of – or a misunderstanding of guidelines; and follow-up systems to monitor patient progress are often inadequate.

With proper awareness of these challenges, both patients and healthcare providers can work together to find practical solutions that make hypertension prevention and treatment more accessible for everyone.

“For more than 50 years, Servier has been committed to fighting high blood pressure – the ‘silent killer’ that affects millions without warning. According to the World Health Organisation this chronic illness claims over 11 million lives annually³ – making it humanity’s largest epidemic ever. As non-communicable diseases like hypertension continue to rise, it solidifies the importance of collaborative public information campaigns like ‘Because I say so’ and May Measurement Month. We compel South Africans to take action and check their blood pressure. It has never been more crucial for public health,” says Virosha Deonarain, Medical Manager at Servier.

South Africans are being reminded to go to their local pharmacy, clinic or doctor to get tested for free in May. Find a participating pharmacy in your area and get the test today:  https://bit.ly/FreeBPCheck

References:

1. World Heart Federation Roadmap for Hypertension – Update
2. Factors influencing treatment adherence in hypertension and HIV management in South Africa: A comparative literature review
3. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants The Lancet VOLUME 398, ISSUE 10304, P957-980, SEPTEMBER 11, 2021
4. World Heart Federation Roadmap for Hypertension – Update
   1. In England (2011) >56% from age 60. Lancet 2014; 383:1912-1919

5. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants The Lancet VOLUME 398, ISSUE 10304, P957-980, SEPTEMBER 11, 2021

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