Do Hypertension And Obesity Affect Only Developed Countries?

Obesity has historically been viewed as a sign of wealth and prosperity. It, together with hypertension (high blood pressure), has been problem of the wealthy or developed nations.

However, it seems that these health risks might have also spread to developing countries. According to a paper published online March 12, 2013 in ‘Circulation’, the average BMI (body mass index) of population is now as high or higher in middle-income countries and there is a tendency for women’s blood pressure to be higher in poorer countries.

Researchers at Imperial College London, Harvard School of Public Health, and worldwide collaborators analyzed data from a total of 199 countries on the prevalence of risk factors related to heart and circulatory disease between 1980 and 2008.

Their analysis showed that a country's income was correlated with the population's average blood pressure, cholesterol as well as BMI in 1980. There was no association between national income and blood pressure in men in 2008, but blood pressure was higher in poorer countries for women.

While BMI was still lowest in the poorest countries, it was higher in middle-income countries than the wealthiest countries. Cholesterol remained higher in higher-income Western countries. Fasting blood sugar, which is linked to diabetes, was only weakly related with income and affluence, but correlated with obesity. 

Meanwhile, the study also found that BMI has consistently been related to the proportion of the population living in cities. This might imply that urban lifestyle might be playing a critical role in the obesity epidemics both now and in the past. 

What worrying the researchers is that developing countries will be facing a rising numbers of obesity, diabetes and hypertension should the current trend continues, and developed nations will continue to be confronted with an epidemic of diabetes and high cholesterol.

To change the relationship between national income and blood pressure, it is necessary to improve the diagnosis and treatment of hypertension in wealthier countries, coupled with changes in diet and lifestyle.

Reason why high cholesterol is still associated with national wealth is probably the cost of meat and other animal products are relatively high. As such, lower income nations should encourage their people to choose unsaturated fats over saturated fats to avoid the problems that richer countries already have.

Developing countries should strive to replicate the success that developed countries have had in lowering blood pressure by improving primary health care services, lowering salt intake and making fresh fruit and vegetables more available.

Cost imposed by circulatory and heart diseases could be huge on healthcare systems in high- and middle-income countries, hence redirecting some of these resources to prevention might save a lot in the long run.

Why You Should Take Less Salt?

It has been known and probably shown by dozens of studies that consuming too much salt (sodium) can cause hypertension (high blood pressure), which in turn will increase the risk of heart disease and stroke.

CDC (Centers for Disease Control and Prevention) estimated that more than 800,000 Americans die from heart disease, stroke and other vascular diseases every year. According to AHA (American Heart Association), nearly half of all deaths caused by cardiovascular disease in the United States are related to hypertension. 

Statistics shows that Americans consumes an average of 3,600 mg of salt a day (about a teaspoon and a half), which is obviously much higher than that stipulated in recommended guidelines.

Current dietary guidelines recommend that people should take less than 2,300 mg of salt a day (about a teaspoon). For people who are 51 or older, are African-American or have hypertension, diabetes or chronic kidney disease, their daily intake should not be more than 1,500 mg.

A paper published February 11, 2013 in the journal ‘Hypertension’ suggested that hundreds of thousands of lives could be saved in the next decade, if Americans could cut the amount of salt they consume.

Scientists from the University of California San Francisco, Harvard Medical School and Simon Fraser University in Canada each used completely different computer simulation models to estimate how lowering sodium would save lives, largely by reducing the number of heart attacks and strokes.

One model examined the effects of gradually reducing sodium intake by 40 percent over 10 years to 2,200 milligrams a day (about a teaspoon), the second model calculated the impact of instantly reducing sodium intake by 40 percent, and the third model assessed the benefits of instantly cutting sodium intake to 1,500 mg a day, about a half teaspoon. 

All the 3 models found consistent and substantial benefits of lowering sodium consumption from the current level of intake. While gradually reducing sodium intake by 40 percent over 10 years could save an estimated 280,000 to 500,000 lives, immediately lowering sodium intake would save 500,000 to 850,000 more lives, about 60 percent more.

The researchers admitted that people might not be able to instantly reduce their salt intake, taking into account of the prevailing high salt intake. It might be more realistic for people to gradually reduce their salt intake over time.

According to AHA, an estimated 80 percent of salt intake comes from commercially prepared and processed foods. Hence, it is important that the public health approach should target lower levels of added sodium in these products through a combined effort of regulation, consumer education and food labeling and voluntary partnership with food manufacturers.

Why Less Sugary Drinks Should Be Consumed?

There are plenty of evidence showing sugar-sweetened beverages are loaded with calories that carry little nutritional value. These beverages are considered as a public health hazard as they are linked to obesity. A large number of deaths are actually caused by obesity-related diseases including cancer, heart disease, high blood pressure, stroke, and Type-2 diabetes.

A paper presented at EPI/NPAM by researchers from the Harvard School of Public Health in Boston linked sugar-sweetened beverage consumption to 180,000 deaths a year worldwide, including 25,000 deaths a year in the United States, mainly due to Type-2 diabetes. EPI/NPAM, stands for Epidemiology & Prevention and Nutrition, Physical Activity & Metabolism, was a conference hosted by American Heart Association (AHA) and held between March 19 and 22, 2013 in New Orleans.

Information from 114 countries was included in the new study that looked at dietary surveys to assess sugar-sweetened beverage consumption, and the number of deaths from certain diseases. Information from earlier studies was also used to estimate the effect of sugary drink consumption on weight gain, and the effect of weight gain on the risk of death from cardiovascular disease, diabetes and cancer.

As indicated by their analysis, sugar-sweetened beverage consumption was linked to 133,000 deaths from diabetes, 44,000 deaths from cardiovascular diseases and 6,000 deaths from cancer.

In 2010, Latin America/Caribbean had the most diabetes deaths at 38,000, and East/Central Eurasia had the most cardiovascular deaths at 11,000. Among the 15 most populated countries, Mexico had the highest rate of death linked to the beverages at 318 yearly deaths per million adults, and Japan had the lowest at 10 yearly deaths per million adults.

It is hoped that the new findings could push policy makers worldwide to implement effective policies like taxation and mass media campaigns to lower consumption of sugary beverages.

Nevertheless, other health professionals in the fields cautioned the study found only association and did not prove that sugar-sweetened beverage consumption actually caused those deaths.

Sugar-sweetened beverages are often just part of a bad diet that contribute to bad health. That is why people should still focus on overall diet. If people could improve the quality of diets by cutting down the sugar intake, salt intake and everything else, they should have better health. Reducing sugar-sweetened beverages but eating more of other junk foods could actually worsen the health.

The AHA recommends adults consume no more than 450 calories per week from sugar-sweetened beverages, based on a 2,000 calorie per day diet.

Beware Of Harms By Hypertension!

High blood pressure, also known as hypertension, is the most common cardiovascular disease. If it is left untreated, it could lead to not only vision problems and kidney failure but also life threatening events such as stroke and heart attack. In the United States, 1 in 3 adults have high blood pressure.

According to the announcement made by The World Health Organizations (WHO) on the eve of World Health Day on April 7, 2013, nearly 1.5 million people died of high blood pressure each year in South-East Asia making it the single-most important risk factor for non-communicable diseases like heart attack and stroke.

What makes high blood pressure dangerous is that it rarely causes any symptoms! Hence it is also called “the silent killer”. In fact, nearly one-third of people who have high blood pressure do not realize it. Certain symptoms still, however, persist if one’s blood pressure is extremely high. These include severe headache, chest pain, vision problems, fatigue, confusion and irregular heartbeat.

Regular checkup is probably the only way that one can tell whether his or her blood pressure is high. Most of the mortality caused by high blood pressure can simply be prevented through healthy lifestyles, early detection and treatment by medications.

Every individual does have the obligation to prevent hypertension by adopting a healthy lifestyle: eat a balanced diet, reduce salt, has regular exercise, avoid excessive consumption of alcohol, quit smoking and check the blood pressure regularly.

Meanwhile, health-promoting environments created by governments are essential as it can help people adopt healthy lifestyle and impose regulations for lowering the amount of salt in packaged food and making healthier foods affordable and accessible.

Remember this, it is cheaper to prevent, detect and treat hypertension than interventions like cardiac bypass surgery or kidney dialysis that may be required if hypertension is not diagnosed and treated in time.

Almost 95 percent of hypertensive patients have so-called essential hypertension in which the underlying causes cannot be determined. While essential hypertension is somehow mysterious, it has been linked to certain risk factors including family history, age, consumption of salt, obesity, diabetes, stress, lack of physical activity, insufficient intake of potassium, calcium and magnesium and chronic alcohol consumption.

The remaining 5 percent of hypertensive cases belong to so-called secondary hypertension in which the cause can be identified. Such causes include kidney disease, tumors, birth control pills and pregnancy.

Hypertension is a serious global issue. That is why in September 2011, the United Nations General Assembly adopted the Political Declaration of the High-Level Meeting on the Prevention and Control of Non-communicable Diseases, and committed governments to a series of actions.  Member States have agreed to 9 global targets for prevention and control of non-communicable diseases including lowering the prevalence of hypertension by 25 percent by 2025.

Can Eating Fish Prolong Life?

American Heart Association (AHA) recommends that people who have no coronary heart disease (CHD) should eat a variety of fish, preferably oily fish such as salmon and tuna, at least twice a week.  

Eating fish is good for the health because of omega-3 fatty acids, particularly EPA (Eicosapentaenoic acid) and DHA (Docosahexaenoic acid), These fatty acids have been shown to benefit the heart of healthy people and those at high risk for or who already have cardiovascular disease.

In a study released on April 2, 2013 in the journal ‘Annals of Internal Medicine’, researchers from the Brigham and Women's Hospital, Harvard Medical School, Harvard School of Public Health, University of New Mexico, Fred Hutchinson Cancer Research Center and University of Washington reported that people, who were 65 and older and ate fish, may live an average of 2 years longer than people who did not consume the omega-3 fatty acids.

While other studies have found link between omega-3 fatty acids and lower risk of heart disease, this study aimed to determine the link between fish eating and mortality risk.

Researchers analyzed records of older people by scanning 16 years of data on about 2,692 American adults aged 74 years (plus or minus 5 years) without prevalent CHD, stroke, or heart failure. These participants were not taking fish oil supplements.

Their findings indicated that those with the highest blood levels of omega-3 fatty acids had the lowest risk of dying from any cause, and lived an average of 2.2 years longer than those with low levels. Omega-3 fatty acids were found mainly in fish like salmon, tuna, halibut, sardines, herring and mackerel.

DHA was found to be the most strongly linked to lower risk of CHD death. EPA, on the other hand, was strongly related to lower risk of nonfatal heart attack and DPA (docosapentaenoic acid) was most strongly associated with lower risk of dying from a stroke. Even after adjusting for demographic, lifestyle and diet factors, the results persisted.

Importance of adequate blood omega-3 levels for cardiovascular health was indeed supported by the findings, which also suggested that in life these benefits could extend the years of remaining life.

According to AHA, people who had CHD are advised to consume about 1 gram of EPA and DHA per day, preferably from oily fish, though EPA & DHA supplements could be taken as well but should be in consultation with their doctors. People who have elevated triglycerides require 2 to 4 grams of EPA and DHA provided as capsules on a daily basis under doctor’s care.