GSC May Hypertension Awareness Campaign

The Ghanaian Society of Cardiology is a society of medical professionals in Ghana made up of Cardiologists and other doctors who have interest in the care of patients with heart disease. The society has a mandate of working to ensure that Ghanaians have healthy hearts through health education, training of health professionals, training of Cardiologists (heart specialists) and research.

The May measurement Month is an annual global hypertension advocacy and screening event spearheaded by the International Society of Hypertension. The World Hypertension day is celebrated on May 17th annually and is championed by the World Hypertension League. The aims of both programs are similar.

It is important because hypertension is the commonest risk factor for the development of heart and heart related diseases such as stroke, heart attacks, heart failure and kidney failure. It is our firm believe that once the general public is made aware of hypertension, the silent killer, and its deadly effects, and subsequently encouraged to be screened for it, a lot of precious Ghanaian lives will be saved.

The blood pressure reading is measured in millimeters of mercury and is written as systolic blood pressure (the top number) over diastolic blood pressure(the bottom number). Systolic blood pressure is the force of blood against the artery walls as your heart beats. Diastolic blood pressure is the blood pressure in between heartbeats. Normal blood pressure is figures below 140 systolic pressure and less than 90 diastolic presuure but preferrably systolic pressure less than 120 and diastolic pressure less than 80.

Hypertension means high blood pressure. This means that blood is moving throught blood vessels in the body at a higher than normal pressure. This can cause damage to various organs of the body. Hypertension is diagnosed when the systolic blood pressure is above or equal to 140 and/or the diastolic blood pressure is above or equal to 90.

Hypertension can occur as primary or secondary hypertension. Primary hypertension also known as essential hypertension is the commoner of the two. The direct cause of “essential hypertension” is not known but several factors can contribute to the development of hypertension in a person. These are known as risk factors.

Secondary hypertension occurs as a result of another disease a person has such as kidney disease, thyroid problems, amongst others.

Risk factors increase a person’s chance of having hypertension. There are two types of risk factors: modifiable and non-modifiable.

Modifiable risk factors include those that you have the power to do something about. Examples are a sedentary lifestyle, being overweight or obese, drinking alcohol excessively, smoking and eating unhealthy diets. Non-modifiable risk factors cannot be changed. These include increasing age, a positive family history, genetic factors, advancing age and black race.

Stroke, Eye disease, heart diseases like heart failure and heart attack, kidney disease, erectile dysfunction

Usually not symptomatic meaning it normally does not come with any symptoms., that is why it is dangerous for people to wait to feel sometihing in their body before they think about checking their blood pressure. People need to periodically/ randomly check the blood pressure when they have the opportunity to do so, eg when they visit pharmacies or at health center when they escort people to the hospital. This understanding is also important for those who are being treated for hypertension, because you hear some people say I was not feeling anything in my body hence I stopped my medication.

However, if patient has end- organ dysfunction, they can develop symptoms from that organ failure. E.g. inability to talk or walk from stroke due to hypertension, chest pain/ difficulty in breathing from heart attack due to hypertension.

The diagnosis of hypertension is made by blood pressure measurement. This should be done accurately by a trained health professional. People can also be taught the correct way to check their blood pressure by a healthcare professional.

Non- Pharmacological: lifestyle changes recommended. Quit smoking, maintain a normal weight for your height (BMI), healthy diet, decrease salt content of food, regular aerobic exercise, limit alcohol intake, stress management.

Pharmacological: antihypertensive medications help to keep your blood pressure within the healthier range. They usually need to be taken for life. You may be on one or more antihypertensives depending on your blood pressure levels.

Usually not common but depends on the type of medication you have been prescribed. Your doctor or pharmacist can educate you on the specific side effects so that you can watch out for them. Also, each medication comes with an information leaflet which gives a list of side effects to look out for. The development of side effects of one medication does not mean you cannot take any high blood pressure medication again. There are different types of medications used for the treatment so you just need to inform your healthcare worker what you are feeling whiles n the medications and it will be changed to other types for you. Some people listen to friends and relatives and they give them medically inappropriate advice to stop the medications which is dangerous for the individual because the hypertension is not treated and causes devastating complications like stroke.

1. If you are diagnosed with high blood pressure, it is important to see your doctor on a regular basis as scheduled by your doctor.

2. If your blood pressure remains high in spite of taking antihypertensive medications. Remember not to conclude that the medication is not working, sometimes the dose of the medication has to be increased or additional medication must be added to control the blood pressure. Consult your doctor

3. If you are having side effects from the blood pressure medications.

4. Any other questions you may have with regards to your treatment.

Hypertension social media campaign. Hypertension screening and public education activities across Ghana. Lectures on hypertension for Health Professionals on World Hypertension Day (17th May, 2023)

Hypertension was the third most common newly diagnosed outpatient disease among adults (2012).Hypertension prevalence is estimated to be at 34% for men and women aged 30-79. Prevalence is higher in Ashanti and Volta regions (DHS 2014). Hypertension awareness is estimated to be 49% among men and women aged 30-79, many people are not aware that they have hypertension. An example is the MMM held in Ashanti region in 2018 revealed that 2/3rd of those found to have hypertension during that screening event were unaware of their condition( high blood pressure). 36% of those aware of their hypertension status are currently taking treatment (the Lancet, 2021). Data from Bosu et al. study and DHS 2014 reported 22% and 11.5% respectively. Of those taking treatment, only 18.6% have their BP under control (the Lancet, 2021). Bosu et al. found the percentage to be 6%.

Tobacco use, salt intake, obesity

9.5% of men and 0.3% of women, aged 15+ smoked tobacco in 2015. Tobacco smoke was more prevalent in Upper East and Northern regions. Estimated to be 8.3 g/day for people aged 50+. 43% of Ghanaians are either overweight or obese. The percentage is higher for women. Obesity is more prevalent in Greater Accra.

Illiteracy of the population about the hypertension is a major road block to the managment of hypertension and in this regard we need all stakeholders to help especially the media houses. Media houses need to be in the thick of events airing educational programs in english and our local dialects because the media has a wider reach and will make more impact in educating the populace. Insufficient funding for the health system and NCDs. At the national level, there needs to be coordination of CVD policies or strategies inorder to deliver a structured programs aimed at reaching the populace with health education and managment protocols at every level of the healthcare system in Ghana . There is a shortage of health professionals, particularly physicians, cardiologists and neurologists. Access to health-care services remains difficult, particularly in rural areas. Medicine availability and price continue to be issues.
It is unknown whether a fixed dose combination is available or inexpensive. There are no task-sharing guidelines available.

WE CALL UPON KEY STAKEHOLDERS LIKE PATIENTS THEMSELVES, CLINICIANS, POLICY MAKERS TO COME TOGETHER TO PROVIDE URGENT SOLUTIONS TO THESE ROADBLOCKS.