Management of Hypertension in Women. Pakistan Hypertension Clinical Practice Guidelines

Hypertension has been recognized as a global health concern. In developing countries, it is not addressed and described to the extent that the actual prevalence of the disease makes it necessary. In these countries, control of blood pressure (BP) remains suboptimal. Worldwide BP reduction is a serious issue, and the situation is more alarming situation in our country. Pakistan is one of them, more than 46% of the Pakistani population are hypertensive. In 2010, hypertension was the leading cause of death and disability worldwide, and a greater contributor to events in women. South Asia contributes 24% of world population and is undergoing a rapid epidemiological transition with significant rates of hypertension in different countries. The prevalence of hypertension in low socioeconomic population in Pakistan is 39% in women vs. 37% in men. There is no proper data regarding hypertension in women in Pakistan, except for a few populations based surveys conducted which showed the prevalence of hypertension. The pooled prevalence in Pakistani women is 24.76% vs. 24.9% for men for an age bracket of above 40 years. The occurrence is higher in urban compared to rural areas. General practitioners (GP) in Pakistan underdiagnose and undertreat high BP, especially in the elderly women. Only in 37% of patients, the treatment was initiated by a GP. 23% of this group received only sedatives alone or combination of sedatives and hypertension control medication. We lack published guidelines regarding hypertension. Hypertension still remains the major preventable cause of cardiovascular disease. Hypertension is a leading cause of mortality globally, and especially in our continent. The purpose of these guidelines is to highlight the neglected population (i.e., Women) of Pakistan, who are physically and hormonally different from men. They have more complications as a result of hypertension. Early diagnosis and proper treatment and adherence to the treatment is therefore important. The task of developing guideline on hypertension is by Go Red Chairperson and Scientific Council Pakistan in collaboration with Pakistan cardiac society. This is first clinical practice guidelines for management of hypertension which is a need of our time with the objective to control the epidemic of hypertension in women. This scientific document on hypertension in women with local recommendation which are made local studies and randomized trials and south Asian studies. These educational tool he