The largest problem for controlling high blood pressure (hypertension) is compliance with treatment, according to an Editorial in this week's issue of The Lancet, Cardiology Special Edition .

The editorial states "Despite very effective and cost-effective treatments, target blood pressure levels are very rarely reached, even in countries where cost of medication is not an issue. Many patients still believe that hypertension is a disease that can be cured, and stop or reduce medication when blood pressure levels fall."

The Editorial mentions that a person's risk of becoming hypertensive in the developed world is over 90%. As more and more people suffer from hypertension, obesity, diabetes and hyperlipidaemia, their risk of developing cardiovascular disease, stroke, renal failure, and ultimately death grows significantly.

In the years to come the burden of hypertension is expected to rise enormously. There were approximately 972 million people living with high blood pressure in the world in the year 2000, compared to an estimated 1.56 billion in 2025.

"Lifestyle factors, such as physical inactivity, a salt-rich diet with high processed and fatty foods, and alcohol and tobacco use, are at the heart of this increased disease burden, which is spreading at an alarming rate from developed countries to emerging economies, such as India and China," writes the Editorial.

"Physicians need to convey the message that hypertension is the first, and easily measurable, irreversible sign that many organs in the body are under attack. Perhaps this message will make people think more carefully about the consequences of an unhealthy lifestyle and give preventative measures a real chance," the Editorial concludes.

lancet