UNIVERSIDAD JUÁREZ AUTÓNOMA DE TABASCO

DIVISIÓN ACADÉMICA MULTIDISCIPLINARIA DE

COMALCALCO
“Study in doubt, Action in faith"

Bachelor's Degree in Nursing

Presents:
Leonor Aras Jiménez
Sara Isabel Broca Fuentes
Jovita Gámez de la Rosa

Subject:
Global Health

Grade y group:
6to D

Work:
Analysis

Due date:
22/03/2022
 Historical antecedents
Hypertension is the most common preventable cause of cardiovascular disease (CVD)
worldwide. It is commonly referred as a “silent killer” because it gradually damages the heart,
blood vessels, and other organs without any apparent symptoms. Elevated blood pressure
(BP) is a major risk factor for myocardial infarction, heart failure (HF), stroke, chronic kidney
disease, peripheral artery disease, and atrial fibrillation. Although hypertension can be readily
diagnosed, and in most instances successfully treated with improvements in lifestyle and with
well-tolerated inexpensive medications, hypertension continues to be a major cause of global
morbidity and mortality. The purpose of this paper is to analyze the importance of providing
quality care to people at risk and with Arterial Hypertension, raising awareness of how
dangerous this disease is and the consequences it can generate.
Hypertension is a global public health problem. It contributes to the burden of heart disease,
stroke and kidney failure, and to premature mortality and disability premature mortality and
disability. It disproportionately affects populations in low- and middle-income countries low
and middle-income countries, where health systems are weak.
Hypertension rarely produces symptoms in the early stages and in many cases goes
undiagnosed. Those cases that are diagnosed, sometimes do not have access to treatment and
may not be able to successfully control their disease in the long term.
Early detection, appropriate treatment and control of hypertension yield significant health
and economic benefits health and economic benefits. Treatment of the complications of
hypertension includes expensive costly interventions such as myocardial revascularization
surgery, carotid endarterectomy, or carotid endarterectomy or dialysis, which drain
government and individual budgets.
Primary (essential) hypertension
In most adults, there is no identifiable cause of high blood pressure. This type of high blood
pressure, called primary (essential) hypertension, usually develops gradually over many
years.
Secondary hypertension
Some people have high blood pressure caused by an underlying disease. This type of high
blood pressure, called secondary hypertension, tends to appear suddenly and causes higher
blood pressure than primary hypertension. A number of disorders and medications can
cause secondary high blood pressure, including:
❖ Obstructive sleep apnea
❖ Kidney disease
❖ Tumors of the adrenal gland
❖ Thyroid problems
❖ Certain birth (congenital) blood vessel defects
 ❖ Certain medications, such as birth control pills, cold medicines, decongestants, over-
the-counter pain medications, and some prescription drugs
❖ Illicit drugs, such as cocaine and amphetamines
Overall strategies for prevention and control of hypertension
Prevention and control of hypertension can be achieved by application of targeted and/or
population-based strategies. The targeted approach is the traditional strategy used in health
care practice and seeks to achieve a clinically important reduction in BP for individuals at
the upper end of the BP distribution. The targeted approach is used in the management of
patients with hypertension, but the same approach is well-proven as an effective strategy for
prevention of hypertension in those at high risk of developing hypertension. The population-
based strategy is derived from public health mass environmental control experience. It aims
to achieve a smaller reduction in BP that is applied to the entire population, resulting in a
small downward shift in the entire BP distribution.
An appeal of the population-based approach is that modeling studies have consistently
suggested that it provides greater potential to prevent CVD compared with the targeted
strategy. This finding is based on the principle that a large number of people exposed to a
small increased CVD risk may generate many more cases than a small number of people
exposed to a large increased risk. For example, a general population DBP-lowering of as little
as 2 mm Hg would be expected to result in a 17% reduction in the incidence of hypertension,
a 14% reduction in stroke risk, and a 6% reduction in the risk of coronary heart disease.
Because they use the same interventions, the targeted and population-based strategies are
complementary and mutually reinforcing.
The risk factors for hypertension
Modifiable risk factors include unhealthy diets (excessive salt consumption, a diet high in
saturated fat and trans fats, low intake of fruits and vegetables), physical inactivity,
consumption of tobacco and alcohol, and being overweight or obese.
Non-modifiable risk factors include a family history of hypertension, age over 65 years and
co-existing diseases such as diabetes or kidney disease.
Global care for arterial hypertension
High blood pressure is a leading modifiable cause of premature death and one of WHO's
global targets for the prevention of non-communicable diseases.
Hypertension prevalence, treatment and control rates vary significantly according to
ethnicity. Such differences are mainly attributed to genetic differences, but lifestyle and
socioeconomic status possibly filters through into health behaviors such as diet – which
appear to be major contributors.
Monitoring high blood pressure globally while understanding what is happening at a country
level is important to identify tangible and customized solutions for local, national, and global
polices to address high blood pressure. As reported in The Lancet by the NCD Risk Factor
Collaboration (NCD-RisC), 1 the number of people with hypertension globally in 2019 was
over 1 billion and this number has doubled since 1990. In 2019, the prevalence of
hypertension in adults aged 30–79 years was 32% in women and 34% in men and very similar
to 1990 levels of 32% (95% credible interval [CrI] 30–34) in women and 32% (32–37) in
men and consistent with other reports. However, what the authors more clearly explain is that
this stable prevalence is the net sum of distinct differences across the world. The analysis
highlights the stark differences in hypertension prevalence, treatment, and control, with some
regions seeing substantial increases over time and others substantial decreases in prevalence.
For example, declines in hypertension prevalence by greater than 12 percentage points in
women in Germany, Spain, and Japan and men in Germany, Switzerland, the UK, Finland,
and Canada; unchanged rates in many low-income and middle-income countries; and steep
increases in hypertension prevalence among women in Kiribati, Tonga, Tuvalu, and
Indonesia and men in Uzbekistan, Argentina, and Paraguay.
 Annexes

Articles
1. A typical example of the course of untreated hypertension in the 1940s was that of Franklin
Delano Roosevelt whose blood pressure became elevated in 1937 and progressively rose over
the next 7 to 8 years. He developed left ventricular hypertrophy, congestive heart failure,
multiple lacunar infarcts, renal failure, and died at the relatively young age of 63 of a cerebral
hemorrhage.
The late 1940s and 1950s heralded a dramatic change in the approach to the treatment of
hypertension. While there were still some physicians who continued to have doubts regarding
the significance of hypertension, most had accepted the fact that increased pressure increased
risk for cardiovascular disease. In addition, there were now some data that, at least in severe,
accelerated, or malignant hypertension, the lowering of blood pressure reversed some of the
complications of the disease.
This was the first time we had seen reversal of the signs of malignant hypertension.
2. Prevention of HT is the most important, universal and least costly measure. Improving
blood pressure prevention and control is an important challenge for all countries and should
be a priority for health institutions, the population, and governments. Adequate perception of
the risk of suffering from hypertension obliges us to implement a population strategy with
educational and promotional measures aimed at lowering the average blood pressure of the
population, with an impact on other risk factors associated with hypertension, mainly lack of
physical exercise, inadequate levels of blood lipids, high salt intake, smoking and alcoholism.
On the other hand, an individual strategy is needed to detect and control, with specific
measures by the health care services, those individuals who are exposed to high levels of one
or more risk factors and have a high probability of suffering from it or are suffering from it.
Thus, it is essential to achieve the most appropriate therapy to maintain adequate control of
blood pressure. In both cases, positive lifestyle modification is a pillar for obtaining these
benefits.
3. Hypertension or high blood pressure is a disorder in which the blood vessels have
persistently high pressure. Blood is distributed from the heart to the entire body through blood
vessels. With each beat, the heart pumps blood into the vessels. Blood pressure is generated
by the force of blood pushing against the walls of blood vessels (arteries) as the heart pumps.
The higher the tension, the more difficult it is for the heart to pump.
Hypertension is a serious medical disorder that can increase the risk of cardiovascular, brain,
kidney and other diseases. This leading cause of premature death worldwide affects more
than one in four men and one in five women, or more than 1 billion people. The burden of
disease from hypertension is disproportionately high in low- and middle-income countries,
accounting for two-thirds of cases, largely due to increases in risk factors among these
populations in recent decades. (OMS, 2016)
 Bibliographic
• Guidelines on the management of arterial hypertension and related comorbidities in
Latin America. Task Force of the Latin American Society of Hypertension. J
Hypertens 2017, 35:1529–1545.
• NCD Risk Factor Collaboration (NCD-RisC) 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.
Lancet. 2021; (published online Aug 24.) https://doi.org/10.1016/S0140-
6736(21)01330-1
• Zhou B, Danaei G, Stevens GA et al. Long-term and recent trends in hypertension
awareness, treatment, and control in 12 high-income countries: an analysis of
123 nationally representative surveys. Lancet. 2019; 394: 639-651
• (1999). Programa Nacional de Prevención, Diagnóstico, Evaluación y Control de la
Hipertensión Arterial. Revista Cubana de Medicina General Integral, 15(1), 46-87.
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• World Health Organization. (2016, January 5). A report about health. Retrieveed
from https://www.who.int/news-room/fact-sheets/detail/hypertension