The Concluding Remarks from the Chairmen of the Resistant Hypertension Course Asia Pacific 2013

Arterial hypertension is the single largest contributor to death worldwide. One in three adults (around 1 billion people) worldwide are affected and the number is expected to increase to 1.6 billion by 2025. Data from the World Health Organization (WHO) Southeast Asian regions indicate that the prevalence of hypertension (blood pressure ≥ 140/90mmHg) ranging from 5% to 47% in men and 7% to 38% in women causing up to 66% of cardiovascular diseases, including fatal ischemic heart disease and stroke. This finding underlines the vast impact that blood pressure-lowering strategies could have in this populous region.

To address this issue during the two-day Resistant Hypertension Course Asia Pacific, three main factors that differ from western geographies have been highlighted:

1) The ethnic differences in the AP region are greater than in the European patient population

2) The stroke mortality rates in AP are higher than in Europe

3) The role of dietary salt intake as a contributor to elevated blood pressure appears to be particularly evident in AP.  

Overall deaths from hypertension-attributable haemorrhagic strokes were higher among men at 21% to 66% vs. 15% to 49% in women. By country, the highest fraction of deaths caused by haemorrhagic stroke as a result of hypertension, > 60%, was found in men in Mongolia and Indonesia, and followed by > 50% in men in the Philippines, China, Hong Kong, South Korea, Malaysia, and Japan. In women, haemorrhagic strokes attributable to hypertension exceeded 40% in Indonesia, China, Malaysia, and Mongolia. The fractions of deaths from ischemic strokes caused by hypertension were 8% to 44% and 12% to 45%, in men and women, respectively, and highest (> 40%) in men and women in Mongolia and in women in Malaysia, Australia, and New Zealand.

Salt is cited as the leading cause of hypertension in the area, particularly in China, which has one of the highest consumptions of salt in the world.  Additionally, ageing population, rapid urbanisation and transition from agrarian life to a wage-earning, modern city life are reported as major contributors to increased blood pressure in urban areas.

The first Resistant Hypertension Course Asia Pacific officially closed last week, with 170 participants, from over fifteen countries across the region.  This first edition was a success in establishing a qualitative foundation for future courses.

In light of the above stated major health concern, we believe that it is befitting to have an RHC AP Course dedicated to the specificities of the Asian Pacific resistant hypertensive patient.   We have enjoyed learning and exchanging on this important subject with experts from the Asia Pacific Region and are grateful for their warm hospitality.  Thank you to all participants for joining us in Singapore.

Dates for the 2014 edition will be forthcoming.


Felix Mahfoud

Markus Schlaich

RHC Course Chairman RHC Course Chairman