HYPERTENSION

The definition of hypertension is controversial. However, the best accepted is that level of blood pressure above which investigation and treatment do more good than harm. The World Health Organisation/International Society of Hypertension joint committee defines hypertension as blood pressure(BP) consistently above 140/90mmHg.
It is the most common problem for which patients visit physicians, the most common cardiovascular disease in the world, affecting about 1 billion people with approximately 7.1 million deaths per year.
The consequences of hypertension aresevere and adversely affect many end organs like the heart, kidneys etc. Early diagnosis and institution of appropriate management plays an important role in the limitation of the morbidity and mortality associated with the disease.
Though, it is easy to detect and make a diagnosis of hypertension, population surveys have documented low level of awareness in various countries. This undoubtedly leads to late presentation for treatment with attendant development of target organ damage and associated clinical conditions which in turn is associated with increased morbidity and mortality.
It is known that even small reductions in BP are associated with large reductions in cardiovascular risk. However, surveys in several countries have shown poor control with only 6.27% of hypertensive patients having a bood pressure of less than 140/90mmHg. Epidemiological studies in the USA and Europe also show that patients with well controlled BP represent a small fraction of the hypertensive population. Such findings are believed to be due to poor adherence to antihypertensive therapy.
Good blood pressure control involves lifestyle modification and the use of drugs. However, failure to adhere to therapy is most often present in chronic asymptomatic conditions that require long-term treatment. In particular, non-adherence with antihypertensive drug therapy is a significant problem. It is also documented that despite the proven benefits of lifestyle modification, these measures are not usually prescribed by physicians and are not being practised by all patients with hypertension. The patients need motivation for effective therapy. Such motivation includes social support from family members. Thus, effective management requires the concerted effort of the family.