The challenges: awareness, education and health services
The question
How is hypertension generally addressed in clinical, social and health terms?
Answer: Arterial hypertension represents the most important modifiable risk factor, in Italia and worldwide. Nevertheless, the social and health scenario that appears to us is characterised by a lack of awareness of the problem among citizens and an underestimation of the possible complications, which is followed, among hypertensive patients who are assigned drug therapy, by insufficient adherence to therapy, hence an underuse of drugs, which inevitably results in insufficient control of blood pressure values among patients. To improve this, it is therefore essential to tackle the problem on several fronts.
In clinical terms, it is essential in degree courses to teach this discipline in all its aspects to future doctors, nurses and healthcare professionals. An in-depth knowledge of the problem is the essential basis for a treatment of arterial hypertension that is not limited to the mere reduction of blood pressure values, but is part of a broader and more articulated patient-centred clinical pathway, broadening the horizons to include related medical disciplines. All this in the knowledge that high blood pressure encompasses numerous areas of internal medicine, with a particular focus on general medicine. Only a doctor who knows the problem is able to explain it to the patient and motivate him or her adequately.
It is also essential to address the issue in social terms: numerous surveys carried out in the general population - including the campaigns conducted annually by the Italian Society of Hypertension - have shown that a worrying percentage of the general population, from the youngest to the oldest, is not sufficiently aware of the importance of blood pressure measurement, does not know what it means to have high blood pressure and its complications. In other words, among adults, only a few do effective prevention by measuring their blood pressure periodically (at least once a year). This creates the paradoxical situation that many hypertensive patients do not know they are hypertensive. It is therefore important to amplify awareness campaigns through all the means that technology offers us, the press, television, social media. All this in order to make the population more aware of the risk associated with even a modest increase in blood pressure, to improve the accuracy of blood pressure measurements and, furthermore, to make people understand the importance of taking the prescribed therapy consistently.
World Hypertension Day, promoted worldwide by the World Hypertension League, scheduled on 17 May each year and promoted in Italia by the Italian Hypertension Society (Siia), is certainly an important initiative, which should be accompanied by further awareness campaigns throughout the year.
Finally, how to deal with the problem in terms of healthcare: high blood pressure is a condition that in many cases is dealt with on an outpatient basis, but in some circumstances requires a hospital facility to carry out certain diagnostic-therapeutic investigations. It is important that all over Italy there are adequate healthcare facilities capable of guaranteeing outpatient or inpatient care for patients with hypertension who need it.