Advocacy brief: a summary of nutrition and dietary considerations for individuals living with hypertension
Authors: Al-Jawaldeh Ayoub , Taktouk Mandy , Derouiche Abdelfettah , Hammerich Asmus , Berri Hicham El , Peña-Rosas Juan Pablo , Tayyem Reema , Khairy Sahar , Almamary Salima 
Published: December 2024

Hypertension, or elevated blood pressure (BP), remains a leading cause of global death and disabilityfrom cardiovascular diseases (CVDs) and strokes. It is commonly referred to as the “silent killer”,often presenting without symptoms, and potentially leading to heart attacks, heart failure, strokesand end-stage kidney disease. The major risk factors of hypertension are age; genetics; family historyand co-morbidities; overweight and obesity; unhealthy diets characterized by high intakes of salt/sodium, saturated fats, trans fats, cholesterol and added sugars, and low intakes of potassium, fruits and vegetables; alcohol consumption; smoking; sedentary lifestyle; medications and supplements; stress; and environmental factors. Hypertension is critical during pregnancy since severe and uncontrolled high BP during this period can impact the health of the mother and the foetus. Children and adolescents are also a vulnerable population whereby hypertension may track into adulthood and increase the risk of CVDs.Globally, it was estimated that 1.28 billion adults aged 30 to 79 years were living with hypertension,and the majority (two thirds) resided in low- and middle-income countries. In 2019, it was estimatedthat 38% of adults aged 30-79 years in the Eastern Mediterranean Region (EMR) had hypertension(i.e. more than 104 million people), with more than half of them (51%) not being aware of their condition. This advocacy brief presents the most recent data on hypertension and its risk factors, asreported by the national World Health Organization (WHO) STEPS database and the WHO globalnon-communicable diseases (NCD) Data Portal. It also summarizes the recent scientific literature inthis condition and some of the implementation considerations for adaptation specific to the EasternMediterranean Member States.Proper management of nutrition and dietary-sensitive hypertension involves adequate nutritionalassessment, nutritional diagnosis, nutritional intervention (nutritional and behavioural management;clinical medical management) and consequently health monitoring and evaluation (including nutrition and diet), which are discussed in depth throughout this document. A summary of some of the existing recommendations from different national agencies and the WHO for the management of hypertension are included. Moreover, this brief emphasizes the need for a multifaceted approach, by highlighting the implementation considerations of general recommendations and guidelines that are pertinent to the EMR, to better tackle hypertension.This document, which is based on the most recent and relevant scientific evidence, is intended toserve as a resource for the general population, parents, family members, caregivers, physicians, primary healthcare practitioners and policy makers. This is not a WHO guideline but an updated review of various organizations guidelines in various countries, and those of the WHO, as a desk review of the topic. A preliminary version of this advocacy brief was prepared at the WHO Regional Office and circulated to the various experts from different countries for their feedback and consensus on the contents presented herein.