SAMUELS... we can do better in preventing this

JAMAICA spends approximately $42 billion annually on the treatment of diabetes and hypertension, according to a Pan American Health Organisation (PAHO) official, who says that the country must concentrate on addressing the risk factors fuelling these and other chronic diseases.

High blood pressure tops the list of risk factors for death in the Caribbean, followed by obesity, alcohol, tobacco, low fruit and vegetable intake, physical inactivity and unsafe sex, said Dr Alafia Samuels, PAHO Washington representative. In Jamaica, high blood pressure causes about 22 per cent of deaths.

"There is an economic cost to all of this," Dr Samuels told the National Policy Dialogue on Non-Communicable Diseases (NCD) workshop at the Hilton Kingston Hotel last week.
"Diabetes is taking about two per cent of the GDP, high blood pressure is about three per cent, and when you combine the two, five per cent of our GDP is being lost because of high blood pressure and diabetes. That is a lot of money, and we can do better in preventing this."

Added Dr Samuels, who is an advisor on chronic diseases at PAHO: "These are the major risk factors for death and disabilities in the region, and this is where our target needs to be if we seriously want to prevent disease, because treatment is not going to do it for us, we need also to prevent it as well as control it."

Dr Samuels said the problem with high blood pressure is that it is being properly controlled by only one of five people with the disease.

"That means four out of five people with blood pressure are not controlled. Half of those don't even know they have high blood pressure," she said. "Those who know they have high blood pressure are not bothering to take the medicine, not checking themselves, can't bother, or sometimes, to be very honest, physicians are not aggressive enough in setting the targets for blood pressure control."

Dr Samuels also warned that high blood pressure heightens the risk of heart attack, heart failure, stroke and kidney disease.

"Significant reduction in salt can lead to half the number of people needing treatment, 22 per cent reduction in stroke and 16 per cent reduction in coronary heart disease," she said.

Dr Samuels advised that one way to tackle the non-communicable and chronic disease is to tailor interventions to individuals who are high risk.

"Small improvement in the entire population can in fact lead to a large reduction in chronic diseases," she said. "Other countries have done this. In Poland, since 1991, they have each year cut their cardiovascular disease mortality by 10 per cent. How did they do this? They removed subsidies on butter, cheaper vegetable oil, increased their fruits and decreased tobacco."

Health Minister Ruddy Spencer, in his presentation, pointed out that 66 per cent of Jamaican women and 32 per cent of the men are classified as overweight and obese, one of the risk factors for the development of a number of chronic diseases, including diabetes. This risk factor is also increasing among adolescents. In addition, he said 40 per cent of the population, ages 15 to 24, do no exercise or are totally inactive, which contributes to chronic illnesses such as heart disease.

"We are being overtaken by chronic diseases and we must unite to stop this, hence the importance of this conference," he said, adding that the workshop was a part of the strategy to tackle NCDs.

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