Dear friends and colleagues,

Looking at stroke, arterial hypertension is the killer number one. In high-income countries, 90% of strokes occur in hypertensives. In middle and low-income countries 60% of strokes are caused by hypertension. Hypertension is the most prevalent risk factor for stroke and the Global Burden of Disease study shows that almost 8 million deaths are attributable to hypertension. One in three adults world-wide has high blood pressure.

Prevention programmes therefore aim at improving awareness and enabling treatment. Unfortunately, only a minority of the hypertensive patients are aware of their high blood pressure and also undergo regular and sufficient treatment. Recent data from the US Heart Disease and Stroke Statistics show that if the population mean blood pressure were lowered by 5 mm Hg, the percentage of US adults whose blood pressure would be ideal would raise from half the population to two thirds. The World Health Organization has recently held its World Health Day focussing on the high prevalence of high blood pressure. The WHO states that prevalence is highest in some low-income countries in Africa, with over 40% of adults in many African countries thought to be affected.

Among the measures of prevention the most important factors accordingly to WHO are:

  • reducing salt intake
  • eating a balanced diet
  • avoiding harmful use of alcohol
  • taking regular physical activity
  • maintaining a healthy body weight
  • avoing tobacco use

The World Stroke Organisation has participated at this year's World Health Day and has contributed several statements.

In this module of the World Stroke Academy two specialists with an outstanding academic career in hypertension research and prevention have contributed. Prof. David Spence from Ontario, Canada, has summarized his years of experience in treating hypertensive individuals in an outpatient setting and has published the results of his research into the many different causes for hypertension in stroke and stroke prone individuals. Prof. Jaakko Tuomilehto from Helsinki, Finland, is among the most eminent epidemiologists that have spearheaded the first national prevention programmes in Finland. The results were already astounding in the 80s and early 90s showing that by nutritional interventions arterial hypertension could be effectively reduced in an entire population. More recent results in Finland have also shown that significant reduction of sodium intake (mostly in processed food) has significant results in reduction of hypertension on an adult population level.

In sum, we are proud to offer this module to medical doctors and health workers within the frame work of the World Stroke Academy. Thus, we hope to disseminate more facts and expertise in the prevention and treatment of the most fatal stroke risk factor.

  • Michael Brainin, MD

  • WSA, Editor-in-Chief