1Swiss Tropical and Public Health Institute, Basel, Switzerland.
High blood pressure (BP) is the leading cause of mortality (and DALYs) in most countries and accountsfor 33% of all deaths in Albania (GBD). BP, as other cardiovascular risk factors, has a graded relation with cardiovascular disease (CVD), implying that a large proportion of all CVD events arise from individuals with only moderately elevated BP (“prevention paradox”). This underlies 2 main strategies to reduce the BP-related burden in the population. The “population strategy” aims to reduce BP in the whole population, largely through interventions in different sectors, e.g. reduction of salt in foods through regulations, high tax on alcohol, etc., as emphasized in the WHO Global Action Plan for the Prevention and Control of NCDs. The “high-risk strategy” aims at identifying (diagnosing) and managing (providing BP medications) among individuals at risk (e.g. those with high BP and/or at high CVD risk). Because the prevalence of HBPis very high (e.g. >20-30% of middle-aged adults) and treatment is highly cost-effective, safe and simple, HBP diagnosis and management should be handledlargely at the primary health care level. Several critical issues need tobe considered when managing HBP in individuals at risk,which will be briefly mentioned. Although several interventions to reduce BP in the population need tobe developedin sectors outside of the health sector, health professionals have an important role in spearheading such interventions.
Keywords:burden of disease, cardiovascular diseases, high blood pressure, non-communicable diseases.