challenges of persistent hypertention

3. Dr Samir Sally, MD
Consultant Medicine & Nephrology,
Mansoura Urology and Nephrology
Centre

6. Attributable mortality in millions (total: 55,861,000)
Developing region
Developed region
0 87654321
Adapted from Ezzati et al. Lancet 2002;360:1347–60

7. 7
European Heart J 2011

9. Mortality
(floatingabsoluteriskand95%CI)
Usual SBP (mmHg)
50–59 years
60–69 years
70–79 years
80–89 years
Stroke
Age at risk:
256
128
64
32
16
8
4
2
1
0
120 140 160 180
IHD
Usual SBP (mmHg)
50–59 year
60–69 year
70–79 year
80–89 year
Age at r
40–49 year
256
128
64
32
16
8
4
2
1
0
120 140 160 180
Prospective Studies Collaboration. Lancet 2002;360:190313

10. High prevalence of hypertension in KSA compared to other countries
in Africa and Middle East
1. Arnaout MS, Almahmeed W, Ibrahim M, et al. Current Medical Research &
Opinion 2011; 27 (6): 1223–1236.

11. Cardiovascular
disease was
responsible for
47%
of all deaths
in Saudi Arabia1
Control rate
of
hypertension
was low
25%1
50% of
Saudi
diabetic patients
failed to achieve
their target BP of
130/85 mmHg1
1. Arnaout MS, Almahmeed W, Ibrahim M, et al. Current Medical Research
Opinion 2011; 27 (6): 1223–1236.

12. Prevalence, Awareness, Treatment, and
Control of Hypertension among Saudi Adult
Population: A National Survey
Abdalla A. Saeed, * Nasser A. Al-Hamdan, Ahmed A. Bahnassy,
Abdelshakour M. Abdalla, Mostafa A. F. Abbas, and Lamiaa Z.
Abuzaid
Int J Hypertens. Published online 2011
September 6.

13. Cross-sectional study.
Multistage stratified sampling was used to
select 4758 adult participants.
The overall prevalence of hypertension was
25.5%.
Only 44.7% of hypertensives were aware,
71.8% of them received pharmacotherapy, and
only 37.0% were controlled.

15. Prevalence is high, but
awareness, treatment, and control levels are
low indicating a need to develop a national
program for prevention, early detection, and
control of hypertension

16. Few patients under control?

17. 0
20
40
60
80
100
UK France Italy
Poor patient compliance
Products not effective
Side effects
Ménard and Chatellier. J Hum Hypertens 1995;9:S19–S23;
Andrade et al. Arq Bras Cardiol 2002;79:375–84
Doctorscitingreason(%)
*
* In patient surveys, side effects are a major reason for poor compliance

18. *P<0.007 vs. ACEIs
Bloom BS et al. Clin Ther. 1998;20:671-681.
38%
43%
50%
58%
64%*
Complianceat1Year(%)
65
60
55
50
45
40
35
Diuretics Beta Blockers CCBs ACEIs ARBs