Blood pressure shift needs calm response
Millions more may be at risk under a new definition by the American Heart Association, but Chinese enjoy different lifestyles and city must not rush in blindly
Blood pressure, or hypertension, has rarely been far from the top of the global health agenda since the World Health Organisation declared it the theme of its annual World Health Day four years ago. An alarming study circulated in Hong Kong at that time resonates as much today as it did then in the light of a redefinition of high blood pressure this week by the American Heart Association that effectively diagnoses millions more Americans with the disease. The city study in question, by the School of Public Health at the University of Hong Kong in 2012, revealed that about one in three adults suffered from hypertension and half did not know. The Centre for Health Protection said this translated to about one in six people having hypertension without knowing. The centre said the study confirmed “the rule of halves” in hypertension, which holds that roughly half of all cases are diagnosed, half of those diagnosed are treated, and half of those treated are well controlled.
The American Heart Association said the disease should now be treated sooner, when blood pressure reaches 130 over 80, not the previous limit of 140 over 90, with doctors recognising that complications can occur at the lower level. But despite the prevalence of the disease known as “the silent killer”, local health authorities are not rushing to follow the US update. Dr Chui Tak-yi, undersecretary for food and health, said the city’s current guideline of 140/90 would be reviewed to see if following the US action would improve public well-being.
The authorities are right not to rush in blindly. As a local cardiologist says, Hong Kong is a Chinese society with a different lifestyle from Americans, and doctors have always prescribed drugs according to their clinical judgment rather than guidelines.
At the same time, it should be remembered that hypertension is a scourge of old age associated with an elevated risk of heart attacks or strokes. As a rapidly ageing society, Hong Kong should be treating any revision of guidelines for detection and treatment with a sense of urgency. And the review should prompt redoubled efforts to educate younger people in healthy lifestyles that reduce the incidence of obesity and other risk factors for high blood pressure.