Abstract
The past 2 decades have seen a considerable global increase in cardiovascular disease,
with hypertension remaining by far the most common. More than one-third of adults
in Africa are hypertensive; as in the urban populations of most developing countries.
Being a condition that occurs with relatively few symptoms, hypertension remains underdetected
in many countries; especially in developing countries where routine screening at any
point of health care is grossly underutilized. Because hypertension is directly related
to cardiovascular disease, this has led to hypertension being the leading cause of
adverse cardiovascular outcomes, as a result of patients living, often unknowingly,
with uncontrolled hypertension for prolonged periods of time. In Africa, hypertension
is the leading cause of heart failure; whereas at global levels, hypertension is responsible
for more than half of deaths from stroke, just less than half of deaths from coronary
artery disease, and for more than one-tenth of all global deaths. In this review,
we discuss the escalating occurrence of hypertension in developing countries, before
exploring the strengths and weaknesses of different measures to control hypertension,
and the challenges of adopting these measures in developing countries. On a broad
level, these include steps to curb the ripple effect of urbanization on the health
and disease profile of developing societies, and suggestions to improve loopholes
in various aspects of health care delivery that affect surveillance and management
of hypertension. Furthermore, we consider how the industrial sectors' contributions
toward the burden of hypertension can also be the source of the solution.
Résumé
Les 2 dernières décennies ont été marquées par une importante augmentation des maladies
cardiovasculaires dans le monde, dont l’hypertension artérielle demeure de loin la
plus fréquente. Plus d’un tiers des adultes de l’Afrique sont hypertendus, comme dans
les populations urbaines de la plupart des pays en voie de développement. Étant une
affection qui présente relativement peu de symptômes, l’hypertension est sous-dépistée
dans plusieurs pays, particulièrement dans les pays en voie de développement où le
dépistage systématique à tout point de service est très largement sous-utilisé. Puisque
l’hypertension est directement liée aux maladies cardiovasculaires, elle est la cause
principale des résultats cardiovasculaires négatifs du fait que les patients vivent
souvent sans s’en apercevoir avec une hypertension non contrôlée durant de longues
périodes de temps. En Afrique, l’hypertension est la cause principale de l’insuffisance
cardiaque, alors qu’à l’échelle mondiale, l’hypertension est responsable de plus de
la moitié des décès dus aux accidents vasculaires cérébraux, d’un peu moins de la
moitié des décès dus à la coronaropathie et de plus d’un dixième de tous les décès
dans le monde. Dans cette revue, nous discutons de la survenue de plus en plus fréquente
de l’hypertension dans les pays en voie de développement avant d’examiner les forces
et les faiblesses des différentes mesures pour maîtriser l’hypertension, et des difficultés
liées à l’adoption de ces mesures dans les pays en voie de développement. Sur une
vaste échelle, ces dernières incluent des étapes pour limiter l’effet d’entraînement
de l’urbanisation sur la santé et le profil des maladies des sociétés en voie de développement,
et des suggestions pour combler les lacunes des divers aspects de la prestation des
soins de santé qui nuisent à la surveillance et à la prise en charge de l’hypertension.
De plus, nous examinons comment le secteur industriel qui contribue au fardeau de
l’hypertension peut également être la source de la solution.
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Article info
Publication history
Published online: March 06, 2014
Accepted:
February 28,
2014
Received:
February 10,
2014
Footnotes
See page 532 for disclosure information.
Identification
Copyright
© 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
