THE PAN AMERICAN HYPERTENSION INITIATIVE (PAHI) MISSION

The mission of PAHI is to advance knowledge and to facilitate action towards the prevention and quality management of high blood pressure in the Americas
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A SILENT EPIDEMIC AFFECTING EVERYONE
Hypertension is the most prevalent treatable cardiovascular disease in the Americas, affecting approximately one in four adults or 140 million. It affects men and women in all socioeconomic groups equally. If untreated, hypertension is a major cause of stroke, coronary heart disease, and renal failure, as well as other conditions. Easily diagnosed, and in most instances readily controlled, hypertension is often unsuspected or inadequately treated. Though potentially serious, it seldom produces symptoms discernible to the person who has it. It is estimated that between 55 and 70 million of the 140 million adults suffering from hypertension do not know they have it and of those who know, fewer than half may be adequately treated.

WHAT CAN BE DONE:


Prevention
Hypertension is not an inevitable consequence of aging. It can be prevented. There is enough scientific knowledge to indicate that a diet rich in fruit and vegetables, and low in fat and salt, combined with regular moderate physical activity and weight control significantly lowers blood pressure and therefore prevents the appearance of hypertension. Abstaining from smoking is also essential to maximize the prevention potential. Primary prevention is most effective when it addresses several risk factors as above, through multiple channels (schools, medical services, community organizations, and others), at all relevant levels (international, national and local), using a number of strategies (environmental, behavioral and biomedical) as part of a concerted multisectoral effort of community, policy-makers, and professionals, within and without the health sector.

Control
If hypertension develops, it may be treated by means of lifestyle changes, and effective and reasonably priced drugs when necessary. Treating all persons who are presently unaware of their hypertension will require fully funded programs, including provision for anti-hypertensive drugs. However the cost of such programs will be largely offset by the savings from avoided productivity loss and death and disability from the consequences of hypertension.

THE GOAL

In view of the magnitude of the problem PAHO, NHLBI and the other cosigners of this document wish to further stimulate the international response to address the issue of hypertension control in the Americas. The goal of this international action is to reduce morbidity, disability and premature mortality due to cardiovascular diseases in the Americas with special attention to the prevention and control of hypertension by sharing knowledge, experience and technology in hypertension prevention among interested parties based on the following principles:

Use of an integrated approach targeted at the population at large as well as individuals at high-risk or already ill, through a public health strategy combining appropriate and effective clinical care with community action that, when possible, will address hypertension jointly with other major related and preventable risk factors.

Creation of a synergy between the existing resources of the health system and those that can be marshaled from a variety of community resources.

THE PLAN:
The Pan American Hypertension Initiative

NHLBI, PAHO and the other cosigners of this document call on health and scientific organizations, professional associations and societies, and industry, to work together to

1. Build public health policies that will enable the countries of the Americas to

  • Prioritize hypertension on the national agenda by stressing that it is a serious, prevalent and costly public health problem whose true epidemiological and economic burden should be determined in every country.
  • Design national strategies to confront hypertension as part of an integrated approach to non-communicable diseases prevention and control.
  • Develop and implement national policies and programs to include primary and secondary prevention as well as delivery of quality care.
  • Allocate adequate and appropriate resources to implement sustainable strategies, policies and programs.

2. Encourage health care systems to

  • Provide cost-effective services for the prevention and control of hypertension combining care and education in an integrated health care model involving people affected by hypertension and health care professionals.
  • Ensure the availability of affordable essential drugs for the treatment of hypertension.

3. Empower people affected by hypertension to gain or improve their ability to

  • Acquire or improve knowledge and skills to prevent and/or take care of their problem.
  • Communicate effectively with the health care team.
  • Develop national organizations to promote public awareness and provide avenues for participation in building public policy and reorienting services.

4. Promote partnerships among the major stakeholders involved in preventing hypertension and achieving better health for people living with high blood pressure.

5. Create supportive environments to allow individuals and their communities to make healthy choices to prevent hypertension.

6. Develop and implement a common information system to

  • Observe trends and patterns of risk factors for hypertension and cardiovascular diseases.
  • Monitor the prevalence of unawareness and inadequate treatment among hypertensives.
  • Evaluate the impact of the initiative and of national implementation processes.

Signatories: Inter-American Heart Foundation (IAHF) Inter-American Society of Cardiology (IASC) Inter-American Society of Hypertension (IASH) National Heart, Lung and Blood Institute (NHLBI) Pan American Health Organization (PAHO) Pan American Network of CARMEN Programs Sociedad Latinoamericana de Nefrolog'a e Hipertension World Heart Federation (WHF) (pending endorsement) World Hypertension League (WHL)

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