S7 Acta Cardiologia Indonesiana (Vol. 3 No. 1) 2017 [supplement]: S7 Symposium II. Prevention in Hypertension Is Hypertension Preventable Disease: Primary and Secondary Prevention Tjahjono CT* Division of Cardiovascular Prevention and Rehabilitation, Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Brawijaya - Saiful Anwar Hospital, Malang, Indonesia *corresponding author: cholidtt@gmail.com Abstract Hypertension remains one of the most important preventable contributors to disease and death. A direct positive relationship between blood pressure and cardiovascular risk has long been recognized. This relationship is strong, continuous, graded, consistent, independent, predictive and etiologically significant for those with and without coronary heart disease. It has been identified in both men and women, younger and older adults, different racial and ethnic groups, different countries and applies to those with high-normal blood pressure as well as those with hypertension. Raised blood pressure is estimated to cause about 7 million premature deaths throughout theworld, and 4.5% of the disease burden (64 million disability-adjusted life years (DALYs).It is a major risk factor for cerebrovascular disease, coronary heart disease, and cardiac and renalfailure. Treating raised blood pressure has been associated with a 35–40% reduction in the riskof stroke and at least a 16% reduction in the risk of myocardial infarction. Raised bloodpressure often coexists with other cardiovascular risk factors, such as tobacco use, overweight orobesity, dyslipidaemia and dysglycaemia, which increase the cardiovascular risk attributable to anylevel of blood pressure. Worldwide, these coexisting risk factors are often inadequately addressedin patients with raised blood pressure, with the result that, even if their blood pressure is lowered,these people still have high cardiovascular morbidity and mortality rates . Primary prevention of hypertension Primary prevention includes health promotion and protection involving education in personal health and development, proper nutrition, adequate exercise, and a safe living environment Primary prevention aims to prevent disease or injury before it ever occurs. This is done by preventing exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviours that can lead to disease or injury, and increasing resistance to disease or injury should exposure occur. Hypertension can be prevented by complementary application of strategies that target general population and individuals and group at higher risk for high blood pressure. Lifestyle interventions are more likely to be successful and the absolute risk reductions in risk of hypertension are likely to be greater when targeted in persons who are older and those who have a higher risk of developing hypertension compared with their counterparts who are younger and have a lower risk. However, prevention strategies applied early in life provide the greatest long-term potential for avoiding the precursors that lead to hypertension and elevated blood pressure levels and for reducing the overall burden of blood pressure-related complications in community. A population based approach aimed at achieving a downward shift in the distribution of high blood pressure in general population is an important component for any comprehensive plan to prevent hypertension. Public health approaches, such as lowering sodium content and caloric density in the food supply and providing attractive, safe and convenient opportunities for exercise are ideal population-based approaches for reduction of average blood pressure in the community. More intensive targeted approaches, aimed at achieving greater reduction in those who are most likely to develop hypertension complement the previously based strategies for prevention of hypertension. Groups at high risk of hypertension include those at high normal blood pressure, a family history of hypertension, African American black ancestry, overweight or obesity, a sedentary life style, excess intake of dietary sodium, insufficient intake of potassium, or excess consumption of alcohol. brought to you by CORE View metadata, citation and similar papers at core.ac.uk provided by ACI (Acta Cardiologia Indonesiana)