Large numbers of South Africans with high blood pressure remain undiagnosed

“Know your numbers” this World Hypertension Day

Friday, May 18 2018

An alarming number of South Africans are unaware that they have high blood pressure (BP), or hypertension, because this potentially serious chronic medical condition often shows no symptoms.

“It is estimated that 40% of South Africans suffer from hypertension but that only approximately half of them are aware of their condition,” says Dr Gugulethu Magubane, a physician who practises at Netcare Krugersdorp Hospital.

“When high blood pressure goes untreated it may damage arteries and organs throughout the body,” she warns. “This can lead to a greatly increased risk of coronary heart disease, renal failure, heart attack and stroke, which is why hypertension is often known as ‘the silent killer’.”

Pic: Dr Gugulethu Magubane, a physician who practises at Netcare Krugersdorp Hospital, speaking on World Hypertension Day (WHD), which is marked annually on 17 May.

According to Dr Magubane, the substantial and on-going Framingham Heart Study on residents of the town of Framingham, Massachusetts, which is lead by various health professionals from the hospitals and universities of the Greater Boston area, highlights just how life-threatening this condition can be, suggesting that hypertension doubles the risk for coronary heart disease, and heart failure and stroke four-fold.

“A very real problem we come across in the hospital setting is that most people have no idea what their blood pressure should be. Some 80% of patients admitted for a blood pressure related event do not know what their BP numbers are,” she explains.

Dr Magubane was speaking on World Hypertension Day (WHD), which is marked annually on 17 May. This year, the theme ‘Know Your Numbers’ aims to improve public awareness of hypertension. According to May Measurement Month (MMM), a worldwide awareness campaign led by the International Society of Hypertension (ISH), the number one contributing risk factor for death globally is high blood pressure. The MMM estimates 10 million lives are lost each year as a result of hypertension.

The importance of screening
“Unfortunately, most South Africans only discover they are suffering from high blood pressure purely by chance: a person will, for instance, get tested by a nurse as part of a prevention drive or programme. Only then are they made aware that they have a blood pressure problem,” points out Dr Magubane.

“Increasing access to blood pressure screening is potentially the most effective way to reduce the condition’s adverse toll on the health of South Africans. It is imperative for people to ensure that they have their blood pressure checked at least once a year, and more regularly if they are at risk. Furthermore, if you do have high blood pressure, you should adhere to your treatment as prescribed by your healthcare practitioner,” Dr Magubane stresses.

in blood pressure measurement is called systolic blood pressure, which measures the maximum pressure in the arteries at the moment when the heart beats. The second number, called diastolic blood pressure, measures the minimum arterial pressure when the heart rests between beats. A blood pressure reading of lower than 120/80 mmHg is considered normal.

Lifestyle factors
The Pan-African Society of Cardiology (PASCAR) has identified hypertension as the highest area of priority for action to reduce heart disease and stroke on the continent. According to the PASCAR there are four key factors that influence people on the African continent’s knowledge about hypertension: poor patient awareness and its consequences, poor adherence to drug therapy because of limited access to medication, difficulty in changing lifestyles, and a mistaken belief that hypertension is curable.

The World Health Organization (WHO) states: “Metabolic risk factors that can lead to cardiovascular disease, the leading cause of premature deaths worldwide, can be attributed to unhealthy diets and a lack of physical activity that causes raised blood pressure, increased blood glucose, elevated blood lipids and obesity.”

Dr Magubane concurs, noting: “High blood pressure is increasingly affecting younger patients, with many people in their forties now suffering from the condition. Although hypertension can be inherited, many more South Africans are developing the condition, in large part due to poor lifestyle and diet.”

She says a diet high in sodium is an important contributing factor to hypertension, with most people not realising just how much salt they consume daily. “We are increasingly eating processed foods and we do not check the labels and salt content thoroughly. The most dangerous aisles in the supermarket from this perspective are first and foremost the convenience soups and sauces, and then the chips and sweets aisles,” she explains.

“Improving the quality of food that you consume, forgoing the salt, relying on fresh foods and using herbs to flavour your food instead of salt, may go some way in decreasing your risk of developing hypertension. It is also recommended that South Africans adopt an active lifestyle, know their BP numbers and adhere to any treatment regimes prescribed by their doctors,” Dr Magubane concludes.


Know your numbers: what you need to know

Dr Gugulethu Magubane, a physician who practises at Netcare Krugersdorp Hospital, says that as a result of the increasingly large number of people suffering from hypertension, international guidelines for the treatment of this condition changed in 2018.

  • High blood pressure, previously defined as ≥140/90 mm Hg, is now defined as ≥130/80 mm Hg. This change reflects the latest research that shows health problems can potentially occur at those lower blood pressure levels. Risk for heart attack, stroke and other negative health consequences can begin anywhere above 120 mm Hg, and the risk doubles at 130 mm Hg.
  • Determination of eligibility for blood pressure-lowering medication treatment is no longer based solely on blood pressure level, but now also considers cardiovascular disease risk level.


References and further reading

Issued by:           Martina Nicholson Associates (MNA) on behalf of Netcare Krugersdorp Hospital
Contact:               Martina Nicholson, Graeme Swinney, Meggan Saville and Estene Lotriet-Vorster
Telephone:        (011) 469 3016
Email:                   [email protected], [email protected], [email protected] or [email protected]