The Silent Killer – New Heart & Stroke survey reveals more needs to be done to tackle “silent killer”

BY SIMONE J. SMITH

As you read this today, I want you to take a moment to reflect on some questions; how much has your life changed since the start of the pandemic? How have your views on health changed? Is catching COVID-19 one of your top health concerns? Have you taken the time to make an appointment with your doctor? Have you noticed any other health declines?

What the pandemic has done is push to the backseat many of the serious health concerns that currently plague Canadians, and more specifically African-Caribbeans. The danger of this is that a serious health concern continues to be ignored, and it is the cause of mass hospitalization, and even more detrimental, death.

In an article titled, “Disparities in hypertension among black Caribbean populations: a scoping review by the U.S. Caribbean Alliance for Health Disparities Research Group (USCAHDR),”, a total of 455 hypertension related records, published between 1972 and 2012, were identified and screened. Overall, studies reported a higher prevalence of hypertension among Caribbean Blacks compared to West African Blacks and Caucasians. Hypertension and its related complications were highest in persons with low socioeconomic status.

Last week I received a media advisory from the Heart & Stroke Foundation reporting an increase in rates of high blood pressure (hypertension) and associated risks. These risks are a significant concern according to a new national Heart & Stroke survey of almost 1,000 health experts across the country. The health community identified lack of awareness, prevention, detection and treatment –made worse by the pandemic – as essential areas for improvement to address hypertension.

Almost eight million adults in Canada are affected by high blood pressure (about one in four). This number rises as the population ages, but at the same time, more people are being diagnosed at an earlier age. It also comes with a hefty price tag, as the annual cost associated with high blood pressure is $13.9 billion.

According to the survey, 8 in 10 health professionals are worried about high blood pressure in Canada as it is the number one risk factor for stroke and a major risk factor for heart disease. More than 7 in 10 health professionals worry that people do not understand what the condition is, or the risks associated with it. Additionally, more than 7 in 10 health professionals expressed concern that people do not realize when they develop high blood pressure because there are usually no warning signs – in fact it is often referred to as the “silent killer.”

“Hypertension is like an on-ramp to stroke and heart disease, so we have a tremendous opportunity here to catch people before they are too far down that road by raising awareness, supporting prevention, and improving access to screening and management,” says Dr. Patrice Lindsay (Director Health Systems, Heart & Stroke). “If we can prevent high blood pressure or manage it through changes to lifestyle and medication, we can dramatically reduce stroke and heart disease.”

Canada used to be a leader in hypertension awareness, treatment and control, but unfortunately there has been a decline in these statistics over the last 10 years, especially for women.

The respondents to their survey acknowledged this trend: 7 in 10 identified a lack of high blood pressure screening practices and 6 in 10 noted inadequate treatment and control as areas of concern. Further, 7  in 10 health professionals are worried that the people at highest risk for high blood pressure are often those who face inequities, including barriers to treatment and support.

More than 7  in 10 health professionals are worried that people do not realize when they develop high blood pressure because there are usually no warning signs, and that they do not understand what it is or the risks associated with it. Disturbingly, this awareness is lowest among younger adults.

The survey revealed that disruptions to people’s lives, including their ability to access health care during the pandemic, impacted their blood pressure, and put them at an even higher risk.

More than 8  in 10 health professionals believe lifestyle risk factors (eg, lack of physical activity, unhealthy diet, not managing stress) that negatively affect blood pressure increased due to the pandemic, and more than 6  in 10 believe equity-deserving (marginalized) groups are facing an even greater increase.

Eight in 10 health professionals are afraid there has been an increase in undiagnosed new cases and that more people with existing high blood pressure have not been adequately managing and controlling their condition due to the pandemic; this is not surprising due to the documented decrease in doctor visits.

Over half of health professionals are concerned that more people have developed high blood pressure than would have normally been the case during the pandemic due to: increased lifestyle risk factors, lack of regular in-person check-ups, increase in stress and inability to prioritize existing health conditions due to other challenges and concerns.

What needs to be understood here is that high blood pressure can be better prevented, detected and controlled in Canada, yet not enough is being done. The improvements that can be made include: better awareness and education, ensuring access to regular care and follow up with health professionals, more routine blood pressure screening in the community, better prevention, and addressing the social determinants of health.

I learned that there are not enough services and supports in place to detect, monitor and manage blood pressure in Canada. Seven in 10 health professionals are worried about the lack of high blood pressure screening practices, and 6 in 10 health professionals are worried that high blood pressure is not being adequately treated and controlled.

The Heart & Stroke Foundation is working actively: funding research, raising awareness, providing information and resources to support people to know and control their blood pressure, advocating for and supporting change across health systems, and working in partnerships across the country with key stakeholders such as Hypertension Canada.

The health professionals surveyed identified several key areas to best support people who have, or are at risk of developing high blood pressure:

• Ensure access to regular care and follow-up with health professionals
• Ensure access to routine blood pressure screening in the community and/or by primary care including pharmacists and community para-medicine
• Address the social determinants of health (e.g., education, literacy, income, shelter, social supports, access to nutritious foods and physical activity)
• Increase public awareness of the importance of monitoring blood pressure
• Ensure access to culturally safe and appropriate lifestyle modification programs and supports
• Ensure universal access to medication, including high blood pressure medications

I want to note here before we close that the responsibility does not only lie on our health professionals; YOU have to start to actively take care of your health. Here are actions everyone can take to prevent and manage high blood pressure:

• Know your numbers – check or get your blood pressure checked regularly
• If you are diagnosed with high blood pressure and prescribed medication, take them as prescribed
• Be active for at least 150 minutes per week
• Eat as healthy as possible including lots of vegetables and fruit, whole grains and protein foods
• Limit highly processed foods and avoid sugary drinks
• Be smoke-free.
• If you drink alcohol, limit yourself to small amounts
• Manage your stress (This last one is of the most importance)

We are not out of the woods yet community; yes, COVID-19 might be under control, but a silent killer lurks, and we need to stay aware, stay active, and stay alive!