SSA 02-2 CHANGING CONCEPTS IN THE MANAGEMENT OF HYPERTENSION: MIDDLE EAST.

The Middle East Region is undergoing a transition from communicable to non-communicable disease. Although the population is to a large extent young, there is also an increasing number of elderly people due to improved health care facilities and socioeconomic status. Similar to developing countries, there is a high burden of cardiovascular risk factors.Hypertension, a major cause of increased morbidity and mortality from cardiovascular events, is quite prevalent, varying from 25-40%, associated with an increased prevalence of obesity, diabetes mellitus and high salt intake.With improvement of socioeconomic conditions and increased rate of education, there is a changing concept in the evaluation and management of hypertension, due largely to an increased number of local hypertension societies which follow guidelines recommended by international hypertension societies. Blood pressure measurement is still determined by mercury sphygmomanometers although automatic oscillometric manometers are increasingly used. Further, ambulatory blood pressure measurement is also recommended by a large number of healthcare professionals.Lifestyle measures are increasingly recommended including weight reduction, salt restriction, nicotine/smoking cessation and increased physical activity.Blood pressure goals for control of hypertension depend upon the countries. Combination pharmacotherapy is often initiated with combination therapy. Diuretics remain however the major antihypertensive agent used in most countries.