Hypertension affects around one third of the adult population in Australia and represents the leading modifiable risk factor for major adverse outcomes such as coronary heart disease and cerebrovascular disease globally.
To put this into an Australian context, elevated blood pressure (BP) alone is responsible for 43% of coronary heart disease, 41% of stroke, 65% of the burden of hypertensive heart disease, 38% of chronic kidney disease, 32% of atrial fibrillation and flutter and 3.6% of dementia.
While these numbers should not deter from the valid concept of overall cardiovascular risk assessment as the basis for clinical management, they do highlight the importance of frequent and accurate BP measurement and the relevance of adequate BP management in line with the latest evidence.
Lowering of blood pressure by any means is one of the most effective health interventions that can be achieved by lifestyle modification, guideline-based pharmacotherapy including early combination therapy, and interventional approaches where required, representing three major pillars of hypertension management.
Indeed, a recent meta-analysis based on individual participant-level data from 344,716 participants demonstrated that a systolic BP reduction of 5 mmHg is associated with a 10% reduction in major cardiovascular events. This was irrespective of the baseline BP level and evident in both patients with and without previous cardiovascular disease.
Based on these findings it would seem logical that controlling BP is a priority on the national health agenda.
However, we are far from it, with recent data demonstrating that only around 50% of Australians with hypertension are aware of the condition, and only 32% of patients with treated hypertension achieve adequate BP control.
Economic analyses suggest that adequate treatment and achieving control of BP in patients currently living with hypertension would save 83,000 lives over the working lifetime and save $91.6 billion in Gross Domestic Product. Hypertension remains a neglected priority.
The High Blood Pressure Research Council of Australia (HBPRCA) has been at the forefront of research into the causes, prevention and treatment of high blood pressure since its inception in 1979. Its members are among the national and international leaders in the field of cardiovascular research and have contributed substantially to the national and international literature.
While discovery and clinical research are critical to identify novel treatment options and provide robust trial evidence to inform guidelines and clinical recommendations, research alone is insufficient to curb the burden that hypertension poses on the Australian society.
The HBPRCA Executive Committee in 2020 set out to create a national entity that would focus on all aspects of hypertension with the mission of “advancing health through the prevention, detection and control of high blood pressure and its complications”. It aims to work with leading minds across all relevant medical and health disciplines and consumers to advance research and education and to engage policy makers to ensure all adult Australians will be screened for elevated BP and receive adequate support to avoid the potentially deadly complications of hypertension.
After surveying the membership of the HBPRCA, it was agreed to transition to the new entity named Hypertension Australia, which will be launched officially on December 8 at the HBPRCA Annual Scientific Meeting.
Hypertension Australia aims to deliver its vision of “Australians having the best-managed blood pressure in the world” by striving for excellence in several core areas including:
- Research: knowledge generation through discovery and innovation, and translation into practice
- Education: knowledge translation by turning policy and discovery into practice
- Implementation: Translation of research and education into practice
- Development of guidelines and position papers
- Advocacy: Creating supportive environments through public policy and healthy lifestyles.
This is only possible in close partnership with relevant stakeholders including the National Heart Foundation, Stroke Foundation, Kidney Health Australia, colleges, primary care physicians, nurses, pharmacists, consumer groups and all interested to contribute.
An important first step is the creation of a national taskforce as a close collaboration between Hypertension Australia and the Australian Cardiovascular Alliance (ACvA), which will also be launched in December.
Now is the time to make a difference.
Key messages
- Hypertension is the leading modifiable risk factor for major adverse health outcomes
- Blood pressure control rates in Australia remain unacceptably low
- A national concerted effort is required to curb the enormous burden of hypertension.
References available on request
Author competing interests – nil