The incidence of hypertension in Bulgaria is above the European average, reported doctors from the Bulgarian Hypertension League in connection with the 17th of May, when the world observed World Day of the Sick. According to experts, the country’s hypertension rate is around 55% while the average for Europe is 30-45%. Physicians’ data indicates that only 37% of the patients with this disease are treated adequately.
Arterial hypertension (AH) is identified as the leading global risk for mortality, responsible for 9.4 million deaths worldwide. Every third person in the world suffers from high blood pressure, and only one of the three is treated effectively.
Hypertension significantly increases the risk of micro and macrovascular complications, doubling the total mortality and the incidence of stroke, tripling the likelihood of coronary heart disease (CHD) and accelerating the progression of diabetic nephropathy, retinopathy and neuropathy.
The adequate treatment of AH prolongs life. The decrease in systolic blood pressure by 12 mm/Hg for 10 years saves from death 1 in 11 treated patients and decreases the frequency of stroke by 35-40%, of myocardial infarction – by 20-25%, and of heart failure – by 50%.
Arterial hypertension is often part of a combination of anthropometric and metabolic disorders, including abdominal obesity, dyslipidemia (abnormal lipid profile), high blood sugar, etc., defined as “metabolic syndrome” (MetS). Obesity is the risk factor №1 for hypertension. Therefore, the Bulgarian Hypertension League has selected the metabolic syndrome components to be the focus in the national information campaign dedicated to the World Hypertension Day 2015, which passed under the motto “Healthy weight – healthy blood pressure.”
Already in 2002, the World Health Organization alerted that the global epidemic cardiovascular disease increase is associated with an increase in the number of overweight and obese people. Over 1 billion people worldwide are overweight, 400 million of them – are obese. Obesity is a growing problem among adolescents. It is reported that 1 in 6 children in the world is overweight, and in the US – 1 of 3.
According to the Bulgarian Society of Endocrinology, 34.93% of the population in Bulgaria is obese, and 38.95% – overweight. This means that every second Bulgarian man (45%) and every third Bulgarian woman (32.4%) between 30-60 years is overweight. More alarming is the fact that 40% of Bulgarian children (21.9% of the boys and 17.7% of the girls of 5-17 years) are also overweight or obese. This identifies not only an aesthetic problem, but a problem of poor health, of risk for a number of serious diseases that threaten life quality and life expectancy. The close link between some cardiovascular diseases and obesity defines the group of “obesity-related cardiovascular diseases.” These are arterial hypertension, atherosclerosis, heart failure, atrial fibrillation, stroke, sleep apnea, and peripheral venous disease.
Being overweight is one of the strongest predictors of hypertension. Hypertension is about 6 times more frequent in obese people than in those with normal weight. The incidence of hypertension increases with the unidirectional growth of the body mass index (BMI = weight/kg divided by the height in m²).
When the BMI is below 25 kg/m² (the norm) the incidence of hypertension is about 15%. When the BMI is over 25 kg/m², the incidence of hypertension is 38% – in men and 42% – in women. When the BMI is over 30 kg/m² the risk of stroke increases by 32%. There is a close connection between abdominal obesity and arterial hypertension. The centimeters of the waist circumference, which carry an increased cardiovascular risk, are over 102 cm for men, and 88 cm – for women.
Weight reduction through a low calorie diet and increased physical activity can affect obesity and this is what is recommended as the first and most significant step in the body weight reduction therapeutic approach, and hence as the first measure to reduce cardiovascular risk, to prevent and/or treat diabetes mellitus type 2. Body weight reduction leads to blood pressure reduction. Weight reduction by 10 kg results in a decrease in systolic blood pressure by 5 to 20 mm/Hg, and also improves the medication response.