World Health Day

Preventing hypertension in an increasingly urbanized, globalized world

Aishath Abdul Gafoor gets up every morning and exercises before she starts her hectic day in the city of Male, Maldives. She is 61 years old.

“I have been exercising every day since I was 30 years old. Back then I had to manage four small kids and a job. But I always took the time to go for a walk around Male” Says Aishath. A family history of diseases such as hypertension and diabetes inspired her to exercise regularly for the last three decades.

One in three adults in WHO’s South-East Asia Region has hypertension and Maldives show similar trends. As the population of South-East Asia ages, more and more people are likely to develop hypertension.

The island nation of Maldives has a population of 300 000 people living in 196 of its 1300 islands. Economic progress over the past decades has brought a drastic change in lifestyles. Unhealthy lifestyles such as increased consumption of processed foods containing excessive salt, low levels of physical activity, and use of tobacco have increased. Increasing levels of mental stress have also resulted in the adoption of unhealthy behaviours putting people at a higher risk of hypertension.

It has not been easy for Aishath to accommodate an active physical routine into her busy urban lifestyle. Male, a small island with 110 000 inhabitants is densely populated with shrinking open spaces. One of the most popular community outdoor spaces is the artificial beach in Male where young men can be seen playing volleyball, football and on the trampoline.

“Women often tell us they find it inconvenient to go for a swim or walk in Male. They do not feel safe” says Dr. Ali Abdul Latheef, physician at the Indira Gandhi Memorial Hospital (IGMH). This limits the choices for women to engage in physical exercise.

But Aishath did not let this come in the way of her regular exercise routine. She now goes to the local gym to exercise. Moderate physical exercise of at least 150 minutes every week is recommended to prevent diseases like hypertension.

Over the past 14 years Dr. Latif has noticed an increasing trend of hypertension at the IGMH. “what is alarming is that we now see a lot of young hypertensive patients. Many patients are in their early thirties and sometimes as young as early twenties.” Says Dr. Latif.

Hypertension is a “silent killer” with no signs or symptoms. Many people do not realize that they have hypertension. This is why regular B.P. checkups are recommended. Hypertension is the single most important risk factor for death, accounting for 1 in every 10 deaths in WHO’s South-East Asia Region. High blood pressure increases the risk of heart attacks, strokes, loss of vision and kidney disease. Each year, hypertension kills nearly 1.5 million people in the Region.

Traditional diets have also changed in the Maldives. With economic prosperity, more processed food is available in the markets and is making its way into children’s diets.

High salt content in processed foods is one of the key risk factors for hypertension. WHO recommends less than 5 grams of salt per day per person. A diet containing more whole grains, vegetables and fruits is recommended for prevention of hypertension. “The national nutrition programs in the Maldives have traditionally targeted children aged five and under. But with rising obesity among children, we are now planning to promote healthy diet through the school curriculum for all children” said Mr. Ubeydulla Thoufeeq, Public Health Program Coordinator for the Ministry of health , Maldives.

Once hypertension is detected, it is important to take medicines as prescribed to prevent complications such as stroke, heart attacks, kidney and eye damage.