Highest risk of death from high blood pressure in women
If you suffer from chronic high blood pressure, you risk cardiovascular health. The "quiet death" is not noticed by most of those affected - and that is what makes it so dangerous. The complications are heart attack and heart failure. Hypertension often leads to death. Millions of people worldwide suffer from hypertension.
More and more people around the world have high blood pressure. Too high an upper blood pressure value is the most important health risk for women today. In men, tobacco smoking is responsible for more years of life lost. This emerges from the latest results of the Global Burden of Disease study, which has now been published in The Lancet. The German High Pressure League e. V. DHL® - German Society for Hypertension and Prevention attributes the increase in high-pressure illnesses in addition to the increasing age to overweight and lack of exercise; both endanger the health of the population in Germany. Political action is also required here.
The Global Burden of Disease (GBD) study is the largest epidemiological study on the state of health of the world population. The Institute for Health Metrics and Evaluation in Seattle regularly compiles figures for the GBD on the frequency of diseases and their effects on quality of life, which are measured as DALY (disease-adjusted life years). A DALY is a measure of the sum of the years of life lost due to premature death and the years of life lived with illness and / or disability.
Hypertension is the most important risk factor
The latest inventory has identified the impact of 84 risk factors on health. The researchers came to the conclusion that high blood pressure in 2016 was responsible for 124.1 million DALY in men and 89.9 million DALY in women worldwide. "Too high blood pressure was the most important health risk for women, for men it is only exceeded by tobacco smoking," explains DHL® CEO Professor Dr. med. Bernhard Krämer, director of the V. Medical Clinic of the UMM University Medicine Mannheim.
High blood pressure does not cause discomfort in most people. "There is a loss of quality of life because hypertension can unnoticed damage organs such as the heart or kidney," explains Professor Dr. Peter Trenkwalder, Deputy DHL CEO and Chief Physician of the Medical Clinic at the Starnberg Clinic. According to the GBD's results, ischemic heart diseases, i.e. heart attacks, and strokes were responsible for the high DALY numbers. Professor Krämer emphasizes: "With timely blood pressure settings, around half of all strokes and heart attacks can be avoided."
Compared to an earlier GBD study initiated by the World Health Organization in 1990, the impact of hypertension has increased. The examination is primarily responsible for the increase in high-pressure illnesses, being overweight. "An increase in body weight in combination with a lack of exercise is the most important civilizing cause of high blood pressure," explains Professor Trenkwalder.
Exercise and lose weight help
Increased blood pressure can often be managed without medication through lifestyle changes - regular exercise, the right diet, a normal weight and the absence of alcohol and nicotine. Should accompanying drug therapy still be necessary, there is a wide selection of largely side effects-free drugs today. These lead to satisfactory blood pressure values in most patients. For Professor Krämer, the figures document the unchanged high need for action also for Germany. The GBD study should also sensitize the German population not to underestimate the risk.
In Germany, around 25 million Germans continue to experience high blood pressure. "However, blood pressure is now well adjusted in half of those affected in Germany," says Professor Krämer. “However, the other half still has high blood pressure. There are also many people in Germany who do not know that their blood pressure is too high, who cannot be treated or who are not adequately treated. Due to the demographic development, the absolute proportion of hypertensives will increase strongly in the next few years, despite the declining population. Professor Krämer emphasizes: "Huge challenges await our healthcare system."
Prevention must become more attractive for health insurance companies. “The high-pressure league is therefore calling for the risk structure compensation to be changed so that prevention is again worthwhile for the health insurance companies. Because then they will try to intensively promote the early detection and prevention of high blood pressure - as the most important cause of cardiovascular diseases. ”
In addition, the German Hypertension League also demands to improve the individual treatment of difficult to adjust hypertension patients. The treatment processes should focus more on the patient, not on outdated structures. "The patient must be the focus again," says Professor Trenkwalder. Here it is important to prevent revolving door effects or over- and incorrect treatment. "This can only be achieved through concerted collaboration across sectors, specialists and health insurance companies."
GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioral, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390: 1345-422
Neuhauser, Hannelore et al. Hypertension in Germany. Data from seven population-based epidemiological studies (1994–2012). Deutsches Ärzteblatt International 2016; 113 (48): 809-15