Hypertension

Introduction

Hypertension forms part of the metabolic syndrome, which includes obesity, dyslipidaemia, and type 2 diabetes mellitus. When any one of these conditions is diagnosed, clinicians should actively screen for the others. Managing these conditions holistically and treating each to target offers the best opportunity to prevent cardiovascular and renal complications.

Recent advances in treatment have led to the concept of the cardio-renal-metabolic syndrome, recognising the close relationship between these conditions and the importance of addressing them together rather than in isolation. This article is the first in a series discussing these conditions, beginning with hypertension.

Cardiovascular disease (CVD) has become the leading cause of death in South Africa, surpassing HIV since 2019. Hypertension and hyperlipidaemia are often referred to as the “Terrible Twins” because of their major contribution to cardiovascular risk. Hypertension is the single most important modifiable risk factor for CVD, while hyperlipidaemia ranks among the most significant contributors. Approximately 50% of individuals with hyperlipidaemia are also hypertensive.

Together, these conditions represent some of the most preventable causes of disability and premature death. In fact, more people die from cardiovascular disease than from all cancers combined. Effective identification and treatment of hypertension therefore remain critical components of preventive healthcare.