Hypertension: high blood pressure in Italy and neglected controls
According to the first results of the Iss's Cuore project, around half of men and two out of five women between the ages of 35 and 74 have values above the limits
Key points
About half of men and about two out of five women between the ages of 35 and 74 have high blood pressure values or are being treated for hypertension. This was revealed by the new preliminary data from the Superior Institute of Health's Heart Project, released on the occasion of World Hypertension Day on 17 May, which show an average maximum blood pressure of 134 mmHg in men and 126 mmHg in women, and a minimum of 79 mmHg in men and 75 mmHg in women. "A large proportion of the adult population - observes Chiara Donfrancesco, researcher at the Department of cardiovascular, endocrine-metabolic and ageing diseases of the Iss and responsible for the survey - lives with high blood pressure values, often without being aware of it. For this reason, it is essential to promote periodic blood pressure monitoring and to make the population aware of the need to follow the doctor's lifestyle suggestions and pharmacological prescriptions'.
Many uncontrolled cases
The proportion of adults with elevated blood pressure (equal to or above 140/90 mmHg) remains significant: 37% of men and 23% of women. A further critical element emerges from the data: a significant proportion of hypertensive people are untreated or, if treated, still have high blood pressure. "Among those who have high blood pressure or are undergoing treatment," the Italian National Institute of Health stresses, "a significant proportion are not aware that they may have problems controlling their blood pressure (41% of men and 31% of women), some are aware but are not undergoing pharmacological treatment (12% of men and 15% of women), others are undergoing treatment but still have high blood pressure levels (23% of men and 35% of women), and only a minority of hypertensives have blood pressure levels that are not high (24% of men and 19% of women).
Public health challenge from paediatric age
Hypertension is a major public health problem globally and is responsible for approximately 12.8% of all deaths. Although it is typical of adulthood, in recent years it is also on the rise among children and adolescents, especially in connection with the spread of obesity.
In the paediatric population, stresses the Bambino Gesù paediatric hospital, it affects 3-7% of apparently healthy subjects, but can reach up to 20-25% in overweight or obese children. In many cases it is linked to renal, endocrine or cardiovascular diseases, but in a significant proportion - up to 30% - the cause cannot be identified and is referred to as 'essential' hypertension. This condition is particularly relevant because it tends to persist over time and can cause damage to target organs, especially the heart, as early as childhood, with increased left ventricular mass and alterations in cardiac structure.
The role of the kidneys and the consequences for the heart
The study conducted by the Operative Unit of Sports Medicine and Hypertension and the Operative Unit of Multimodal Imaging at the Bambino Gesù focuses on a hitherto little considered possible cause: anatomical abnormalities of the renal arteries. Analysing 107 children and adolescents with primary hypertension, the researchers observed that around 65% had variants of the renal vasculature, such as accessory or reduced calibre arteries. The presence of these abnormalities could alter blood flow to the kidney and activate hormonal mechanisms that increase blood pressure. Thus, even in apparently 'causeless' cases, the kidney could play a direct role in causing the rise in blood pressure.
