Hypertension increase among younger age groups

If you thought high blood pressure is mainly a health issue of the aged, it’s not.

Globally, there has been a rise in the prevalence of hypertension in younger age groups, including in South Africa.

Professor Erika Jones, a board member with the Southern African Hypertension Society, said: “While we still see the highest prevalence in those over 65 years (±84-85%), hypertension is seen in between 30% and 53% of people between the ages of 25 and 44 years. The prevalence of hypertension has risen, even in people below 25 years of age.

“In a 2016 survey, ±20% of youths between 15 and 25 years had hypertension. This was a rise from 8-9% in 1998. Limited national data are available after 2016, but there are reports that there is a consistent rise in all age groups. We have also noted a rise in childhood hypertension for which no cause can be found,” she said.

World Hypertension Day was observed on 17 May, a day dedicated to highlighting the importance of monitoring blood pressure.

The initiative is led by The World Hypertension League, an umbrella body for national hypertension societies and leagues across the globe.

Hypertension (high blood pressure) is when the pressure in your blood vessels is too high. It is common but can be serious if not treated.

According to the World Health Organization (WHO), an estimated 1.28 billion adults aged 30 to 79 years worldwide have hypertension.

Most (two-thirds) are living in low- and middle-income countries, with 46% of adults with hypertension unaware that they have the condition.

The organisation said hypertension is a major cause of premature death worldwide.

“Psychosocial stressors, like the economy and job losses, do contribute to hypertension, but the major reason for the rise in the prevalence of hypertension is the lifestyle that people are living. There has been a fast rise in obesity, eating fast foods, eating an excess of sugary foods and salty foods, a sedentary lifestyle and a drop in eating healthy foods. This disordered lifestyle is the major contributing factor to the development of hypertension,” said Jones.

In South Africa, more than 1 in 3 adults live with high blood pressure, and it is responsible for one in every two strokes and two in every five heart attacks, according to the Heart and Stroke Foundation of South Africa.

Sister Juandre Watson, the Heart and Stroke Foundation's Health Promotion Officer, said high blood pressure is known as a ‘silent killer’ because there are rarely any symptoms or visible signs to warn that blood pressure is high.

“That is why more than 50% of people with high blood pressure are unaware of their condition. In some cases, typically with very high blood pressure, symptoms such as headaches, visual disturbances, nose bleeds, nausea, vomiting, facial flushing and sleepiness may be experienced.

“Do not wait for symptoms to appear. High blood pressure becomes more likely with older age, but anyone, no matter their age, can develop high blood pressure. Blood pressure should be measured at least once every year,” said Watson.

She said as people get older, they are more likely to have elevated blood pressure.

“But there are various modifiable physical and behavioural factors that can make individuals in younger age groups also likely to develop high blood pressure, such as an unhealthy diet high in salt and low in fruits and vegetables, being overweight or obese, physical inactivity, stress, excessive alcohol intake, smoking (including the use of E-cigarettes) and tobacco use. According to the National Institutes of Health (NIH) obesity is considered one of the major contributing factors to hypertension in young people.”

She said genetic predisposition is also an important unmodifiable risk factor.

“Having a close member of your family who has high blood pressure can make you more likely to develop high blood pressure.”

Watson said stress alone in younger age groups seldom causes heart disease but that it is a well-known risk factor that contributes to the development of heart disease.

“Being stressed often leads to other unhealthy behaviours, which are often major risk factors for heart disease and stroke (CVD). These unhealthy behaviours include physical inactivity, snacking on unhealthy foods, overeating, smoking or drinking alcohol excessively.”

Jones said there were a number of factors that posed challenges to managing hypertension. These included that hypertension is undetected unless the blood pressure is checked. “This often means people only know about their blood pressure once there is damage to the organs. We need everyone to check their blood pressure every year. The rising problem of a poor lifestyle is driving up the prevalence of hypertension. And the (South African) healthcare system is overwhelmed.”

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