MILAN, Italy – This city of high fashion is also fast emerging as a mecca for quality research, particularly in hypertension. Several thousand cardiovascular specialists from all over the world gathered in the city this week to discuss important new findings for an old malady, the perfect solution for which seemingly evades even experts whose lives have been dedicated to its study.

Hypertension, despite the advances in treatment, remains a highly prevalent risk factor for cardiovascular disease (CVD) both in developed and developing countries. It now accounts for a third of all deaths worldwide, making it the No. 1 cause of death—sparing no color, creed or economic status. In cardiovascular terms, high blood pressure has reached pandemic proportions, and continuously kills people more than a worst-case scenario for the A (H1N1) or any infectious pandemic could.

Prevalence

In 2000, close to a billion people worldwide were estimated to have hypertension with around six million in the Philippines. By the year 2025, if the prevalence of hypertension continues to increase at the same rate, 60 percent of all adults are likely to have this problem. The paradox of it all is that it is well known how to prevent it; yet the resolve to do the necessary preventive measures is simply not there. Unhealthy diet, obesity, lack of exercise, unmanaged stress and smoking remain prevalent factors that contribute to an elevation of blood pressure.

Physicians treating hypertensive patients can only do so much in making sure that their patients are adequately treated; but it’s like futile fire-fighting. This will hardly create any dent on the national prevalence of hypertension. On a population perspective, the only way we can really prevent people from developing hypertension is by instituting measures that will involve entire communities and not only individual patients. The government has the responsibility to spearhead these measures and provide the necessary legislative foundation.

Salt reduction is one perfect example. Even if we stay away from the salt shaker on the table, if the processed foods we buy in the supermarkets are literally salt-loaded, then our salt intake will remain high, and so will our blood pressure.

In other countries like Japan, they have practically cut to less than half their incidence of stroke due to hypertension by legislating for a maximum amount of salt which manufacturers can use per gram of food product they process. So as not to drastically shock the salt-sensitive taste buds of Filipinos, it can be done gradually. But even if we immediately cut by 50 percent the amount of salt used in manufacturing food products like canned goods and instant noodles, they should still remain palatable.

Every community—big or small—should also provide enough space for parks which can serve as exercise areas. Buildings must be required to allocate space where the tenants can exercise during work breaks or after office hours. It is most unfortunate that the tendency in most communities and big buildings is to convert all available space into real-estate assets which can yield more revenues. Health and wellness always have to take a backseat.

The third important area where legislation can come in is by resolutely discouraging the manufacture and marketing of cigarettes and tobacco products. Although they may be a major source of revenue for the government in terms of taxes, the amount being spent by the government and the patients made ill by smoking, is much more than any monetary value cigarettes might yield.

Spend a few minutes in front a small store or grocery and you would certainly encounter a teenager or young adult buying some cigarettes. There should be a law banning minors to buy cigarettes or merchants selling cigarettes to these minors. Doing so must be considered a criminal offense.

Effecting necessary behavior

Time and again we have stressed in this space that gentle persuasion simply will not work anymore in effecting the necessary “behavior” to prevent hypertension and many prevalent medical problems in our country. We need legislation specifically in these areas: compulsory salt reduction in food preparations by manufacturers and food establishments, allocating exercise areas in communities and buildings, and measures to curb smoking.

Our pleas have so far seemingly fallen on deaf ears, in an unfortunate legislative culture that seems to find more expedience in legislating to rename streets and other landmarks. But if our lawmakers will only consider what happened to many of their constituents who had fallen victim to heart attacks and strokes due to hypertension, then they might find some rationale for including above health measures in their legislative agenda.