March 1, 2010
Industrialization Linked To Rising Rates Of Hypertension
One quarter of the world's adult population has hypertension and now scientists are pointing a finger at urbanization and modern conveniences as a key factor in causing this major health problem. In a special report published in the March issue of American Journal of Kidney Diseases, the official journal of the National Kidney Foundation, researchers project a likely increase in global hypertension rates to 29% by 2025. This report is part of a global forum in recognition of World Kidney Day on March 11.
"Hypertension is a leading cause of death and disability around the world. Major complications include kidney failure, cardiovascular disease and stroke"“ all largely preventable conditions," said Dr. Kerry Willis, Senior Vice President of Scientific Activities of the National Kidney Foundation.
The report reviewed data from fourteen separate studies of a total of 160,000 people that examined the prevalence of hypertension in diverse countries and populations around the world. These include China, India, Pakistan, Egypt, Ghana, Mexico, Paraguay, Latin America and the U.S. In these studies, hypertension was defined as 140/90.
A number of the studies analyzed in this report attributed the increasing rates of hypertension in developing regions to lifestyle changes related to industrialization and urbanization. It was noted that increased income, while enhancing overall quality of life, often leads to the adoption of an unhealthy lifestyle that includes transition from traditional rural diets (high in fiber) to a diet rich in salt, saturated fat and poor-quality carbohydrates such as those found in fast food. Urbanization is also often accompanied by reduced physical activity due to sedentary, desk-job, occupations that contribute to increased hypertension risk.
Other factors that play a role in rising hypertension rates include low birth weight, lack of awareness and lack of access to medical care.
Racial and Ethnic Differences
The report found that hypertension in the black population in the United States and West Indies is higher than in the white population and also is much higher than that observed in sub-Saharan Africa. Authors hypothesize that this difference is related to the urbanization effect over the last 300 years on blacks that emigrated to the U.S.
Additionally, one study analyzed in this report found that most whites are resistant to the effects of salt on blood pressure, whereas blacks are salt-sensitive, which leads to increased hypertension rates in African Americans.
Addressing Global Hypertension
"Screening for hypertension is straightforward," said Dr. Willis. "With appropriate measures in place, the disease potentially is preventable, even in countries with limited resources."
Strategies to address the rising rates of hypertension and prevent its complications include the following:
Assessing estimated glomerular filtration rate and urine protein in those with hypertension to promote early detection of kidney disease
Targeted training of general practitioners in optimal management of hypertension
Reducing salt intake through voluntary agreements with industry (i.e. makers of pickled foods, soy sauce, cereals, baked goods) and legislation to mandate salt reduction
Promoting awareness of healthy lifestyle changes such as increasing exercise and decreasing consumption of calorie and fat rich foods
Increasing awareness of the harmful effects of smoking
In the U.S., the National Kidney Foundation is addressing hypertension as a major risk factor for kidney disease by offering free kidney screenings through its Kidney Early Evaluation Program (KEEP) for those with hypertension and diabetes. KEEP screenings are offered throughout the year but will be provided in at least 50 cities across the country on or around World Kidney Day, March 11.
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