Prevention of HT

Primary prevention
■ (Acting before disease occurrence) …
■ Preventing the initial development of a disease...
■ Can be defined as the action taken prior to the onset of
disease, which removes the possibility that the disease will
ever occur.
■ It signifies intervention in person who is well not yet have the
disease or health problem ex ..vaccination.
■ Primary prevention may be accomplished by measures of
“Health promotion” and “specific protection”
Secondary prevention

■ (Acting after disease occurrence)

“Preclinical stage ”
■ It is defined as “ action which halts the progress
of a disease at its incipient stage , the persons
not yet have signs and symptoms. Preclinical
stage ”
■ The specific interventions are: early diagnosis
(e.g. screening tests, and case finding
programs….) and adequate treatment.
■ EX: breast cancer screening ..
Approaches for Prevention

• The WHO has recommended the following approaches for the

prevention of chronic diseases where the risk factors are established:

•a. Population (mass) strategy

•b. High -risk strategy
 Prevention of HT
• Community Approach:
Primary prevention of HT in the whole population
• High risk Approach :
- (Individual with high risk for development of HT)
-( Individual case management)
Identification of individuals with high BP who are at
increased risk of complications ( mainly secondary
prevention)
The two approaches are complementary:
Community Approach & High risk Approach.
Community Approach
Aim: Prevention of HT through:
1.Elimination of modifiable RFs

2.Promotion of protective factors maintaining reasonable BP

3.Reduction of risks of complications by altering the norms

and behavior of population
What is your COMMENT ?…
Components:
1. Public Education:
• Nature, causes, complications, prevalence and treatable nature of HT.
• Life –style measures for prevention, management, and contributory
role of other CV RFs.
2. Professional Education:
• Training in detection, management, and prevention of HT.
• Adoption of advocacy role in the community to adopt healthy life-
style.
Components:
3. Patient Education:
Components:
• The need for effective management
• Benefits of life-style changes
• The need to adhere to health care advice
• Regular monitoring and periodic visits
 Population approach
is highly effective in decreasing HT and its complications in the
community,
but it offers little direct individual effect, making it of less
motivation to people and physicians.
Life style modification at population level requires:
1.Inter-sectoral collaboration ‫ ﺗﻌﺎون ﻟﺠﮭﺎت ﻋﺪة ﺣﻜﻮﻣﯿﺔ وﻣﺠﺘﻤﻌﯿﺔ‬،‫اﺷﺘﺮاك‬
2.Multidisciplinary approach
3.Community involvement and participation particularly through
NGOs
Individual Approach
Aim: Prevention of complications among HT patients
Components:

• Identification of HT patients at risk of complications

• Effective management of HT through life-style
modification with or without pharmacologic
intervention.
This approach is associated with high motivation for
patients and physicians, but it is costly.
The two approaches are complementary to each other
Lifestyle measures for prevention of HT
In the whole population (primary prevention)
they help in:
• Decrease risk of development of HT
• Decrease risk of development of other life-style
related disorders (DM, CHDs,)
Lifestyle measures for prevention of HT

In individual patient, they help in:

• Decrease BP
• Avoid or decrease need for anti-HT treatment
• Control associated RFs
Needs of HT control Strategy
1.Early Detection: in the health setting and increased self referral
through increased public awareness
2.Health Care Services: responding to the needs of HT patients, and
providing adequate diagnostic and treatment facilities.
3.Coordination of the government and NGOs concerned in primary
prevention of HT and integrate it NCDs Prevention Program,
concentrating on life style measures
4.Community Participation: health education
5.Medical Audit: to monitor the process and quality of care to patients
with HT
FOUR life-style measures proved
effective in clinical trials:
1.Weight Reduction
• Decreases BP in HT patients with >10%
overweight
• Decreases insulin resistance / Decrease DM
• Improves lipid profile
Obese patients with mild or borderline HT should
try weight reduction for 3-6 months before
starting anti-HT treatment
Comments !!
2.Fight smoking & alcohol intake:

• When combined with 10 Kg weight loss in obese patient, BP

will decrease by 10.2/7.5 mmHg

• Fight Smoking !!!

3.Increased physical activity
• Effective for prevention and treatment of HT
• Dynamic , isotonic exercises ( walking) is more effective than
static , isometric exercises ( weight lifting)
• Brisk walking for 30-60 minutes /day for 5 times / week is
better than strenuous exercises.
4.Reduction of Sodium intake

• Recommended intake is < 6 gm /day

•Elderly people and blacks demonstrate
more sensitivity to sodium restriction