Hypertension in Pakistan: time to take some serious action.

Hypertension is counted as the major cause and most important factor in the development of cardiovascular diseases worldwide. 1 However, even in the presence of efficacious antihypertensive agents and intensive research data, large numbers of patients in actual clinical practice still suffer with uncontrolled hypertension. Studies indicate that control rates vary according to various countries and geographic regions. 2,3 Even though, the rate of awareness towards hypertension is quite prominent from 62% in Australia to 72% in US, the control rates are quite discouraging as with to 24% and 35% respectively. In the South Asian region, the scenario is more threatening as China reported only 8% control rates and India with 6% in management of hypertension. 4 At present, it is estimated that about 1 billion people worldwide have hypertension (>140/90 mmHg), and this number is expected to increase to 1.56 billion by 2025. 5 A similar scenario is seen in Pakistan. The National Health Survey of Pakistan estimated that hypertension affects 18% of adults and 33% of adults above 45 years old. In another report, it was shown that 18% of people in Pakistan suffer from hypertension with every third person over the age of 40 becoming increasingly vulnerable to a wide range of diseases. It was also mentioned that only 50% of the people with hypertension were diagnosed and that only half of those diagnosed were ever treated. Thus, only 12.5% of hypertension cases were hypertension in the Pakistani population. The consequences are no doubt alarming and can lead to unnecessary casualties or the development of further cardiac diseases, thus placing an additional burden on the health system, patients, and, as a result, on society itself. One option is perhaps to initiate an awareness programme for physicians, pharmacists, and patients. Introduction of generic medicines, availability, and promotion are another prominent space available. Increasing financial budgets and facilities could improve the problem but may be impossible in the light of current political and social unrest. It is time that the patient should be extensively involved in developing the concept of 'this is your health so you must get involved'. This is achievable only if a 'pharmacist' status in hospital is accepted as 'drug counselor' by the healthcare system. Being the custodian of drugs, pharmacists play a vital role in educating the patients regarding hypertension, drug use, medication adherence, mentioning and reporting adverse drug reactions, and thus reducing the chances …