In line with informing and promoting health teachings and taking into consideration the general policies of health communicated by the Supreme Leader concerning “realization of the approach of all-conclusive health and the healthy human in all laws, regulations and administrative policies, by observing the priority of prevention over treatment and reducing health risks based on reliable scientific evidence” and in order to improve health indicators, Neyshabour University of Medical Sciences implemented the National Mobilization to Control Blood Pressure. According to the policies of the Ministry of Health and Medical Education, the aim of this mobilization is to raise sensitivity of people and policymakers, enhancing the awareness and literacy of the society about high blood pressure, setting the grounds to direct attentions to control high blood pressure as a culture of behavior, identifying, taking care of and treating the patients afflicted to high blood pressure; and to measure blood pressure of all people above thirty, pregnant women, and patients with kidney failure. Implementing this national mobilization in Neyshabour was a preventive measure taken by all health participants and health and treatment staff of Neyshabour University of Medical Sciences. The first stage of running this campaign in Neyshabour (as the first city) included informing and sensitizing people prior to implementing the national mobilization of blood pressure control throughout the country that took from April 6 to 20, 2019 and was operationalized from April 21 to May 5, 2019. Putting up eighteen advertising billboards in various spots of the city, sending sensitizing SMSs before campaign launches to about 50,000 Neyshabour citizens, sending SMSs notifying 98,000 citizens of the beginning of the mobilization, holding press conferences with the presence of majority of reporters, cooperating with Khorasan Razavi IRIB to introduce and interview the university’s chancellor, broadcasting television subtitles to make people aware of this campaign, preparing motion graphics, uploading more than 400 posts on social media, preparing 10 clips showing interviews with high-ranking officials of the city and celebrities to invite people to measure their blood pressure, interviewing the patients with high blood pressure and uploading in social media are among media-related measures taken to implement this mobilization in Neyshabour.
The second round of implementing the national mobilization to control blood pressure was carried out in Neyshabour and Firuzeh as well as other parts of the country from June 7 to July 6, 2019. By implementing this plan, 2588 persons suspicious of having high blood pressure and 2688 new patients afflicted with high blood pressure were treated of which more than 68 percent are women.
Chancellor of Neyshabour University of Medical Sciences said: “under this plan, 146,116 persons in Neyshabour and 23,543 persons in Firuzeh were screened for high blood pressure of which 2588 persons were suspicious and were referred to the physician for further examination, and 7 persons below 30 were found to be afflicted with it.
Pointing to the fact that about 50 percent of the Neyshabour and Firuzeh population has a mean age of more than 30 years, Dr. Mohsen Aziminejad added: “this mobilization plan was implemented in 53 comprehensive health centers, 195 local health departments, 34 health bases and 67 stations in cooperation with a number of NGOs active in the field of health in Neyshabour and Firuzeh. The target population in this plan was people above 30 years old, pregnant women, and kidney failure patients.
According to Dr. Aziminejad, the most important reason for Iranian’s death is cardiovascular diseases, cancers, and accidents. 46 percent of deaths is caused by cardiovascular diseases which early diagnosis of high blood pressure plays a key role to control. Dr. Aziminejad added: “according to the latest study conducted in Khorasan Razavi Province, nearly 26 percent of its above-30-years-old population suffer from hypertension and this amount varies as the age increases so much that in over 70 years, more than 64 percent of the population suffer from this disease. He believes that the number of people being aware of their illness varies in different provinces of the country. This number varies between 21 to 65 percent of the population (in various provinces) of which less than half enjoy proper, continuous treatment for their disease.
This faculty member stated: “increase in blood pressure of vital organs of the body such as kidneys leads to damage to coronary arteries or cerebrovascular rupture. Therefore preventing from it is crucial in reducing treatment costs.
National mobilization to control blood pressure throughout the country was notified and implemented in two stages for the people above 30 from May 17 to July 6, 2019. Enabling people to take care of themselves and sensitizing the society for self-control are among the aims of this national plan.
What is Blood Pressure and How Much Do We Know about It?
Hypertension is the first cause of death and disability in Iran and the world. This risk factor is avoidable to a great extent and it is also controllable. Annually, 10.4 million people lost their lives due to hypertension. High blood pressure is a main cause of coronary diseases, ischemic heart disease and hemorrhagic stroke and is positively and continuously connected with them. Heart failure, peripheral vascular disease, and subconjunctival hemorrhage are among other complications of hypertension. Treating high blood pressure and reducing it to less than 140/90 mm/Hg is associated with a reduction in cardiovascular complications.
Blood in the vessels has a power that is called blood pressure which is produced in the heart. Blood pressure is usually expressed in terms of the systolic pressure (maximum during one heartbeat) over diastolic pressure (minimum in between two heartbeats).
Blood pressure is measured in two systolic and diastolic levels as a fraction and in millimeters of mercury (mmHg). The systolic pressure or the bigger number is written in the numerator and the diastolic pressure or the smaller number is given in the denominator.
Blood pressure depends on age, race, etc. according to the latest national instruction, in people above the age of 18, normal blood pressure should be less than 120/80 mmHg. In case blood pressure ranges between 120-139/80-89 mmHg, it is categorized as prehypertension. If blood pressure falls between 140-159/90-99 mmHg, it is considered stage 1 hypertension. Stage 2 hypertension is when blood pressure is 160/100 mmHg or higher.
People whose blood pressure is in the prehypertension stage are more prone to hypertension.
People with normal blood pressure and less than 120/80 mmHg, need to measure their blood pressure at most every 3 years.
Hypertension varies throughout the day due to various factors such as muscle activity, nervous stimulation, painful irritation, full bladder, environmental factors such as air temperature and sound volume, smoking, drinking alcohol, coffee and medication.
Hypertension is of two types: primary and secondary. In the primary type, which accounts for 95% of hypertensive patients, the cause of high blood pressure is unknown and risk factors such as age, male gender, race, blood lipid disorder, smoking, alcohol, high salt intake, obesity, diabetes and family history are involved in its incidence.
In the secondary type, the cause of almost all secondary blood pressure is variations in hormone secretion or kidney function. This type of hypertension can be returned to normal by timely treatment of underlying diseases.
Who is at Greater Risk?
* People with first-degree family members who have hypertension.
* People over 30 years old
* People who are obese
* People with no physical activity
* People who consume too much salt
* People with diabetes, gout, kidney disease
* Pregnant women
* People who drink alcohol or smoke
* Women taking birth control pills
Many people with hypertension are unaware of their illness because in most cases it has no symptoms and is referred to as "the silent killer". The only way to become aware of it is to have your doctor monitor your blood pressure regularly, but in some cases symptoms such as headaches, visual impairments, nausea and vomiting are mentioned.
Treatment of High Blood Pressure
- Pharmaceutical care: There are several drugs available in the market for treatment of hypertension, and the physician's ultimate endeavor is to choose a drug that is easy to take and has less side effects. Therefore, every person's medicine is his/her own and cannot be recommended to others. Some patients need to take the drug for the rest of their lives. Some patients will need to take several different medications to lower their blood pressure.
- Non-pharmacological treatments: Non-pharmacological treatments such as weight loss, maintaining a healthy diet and increasing physical activity, in addition to its positive effects on hypertension and cardiovascular disease, reduces insulin resistance and better controls diabetes. Therefore, pharmacological treatments should always be concurrent with non-pharmacological treatments.