Guyana is the only English speaking country in South America. Its two largest ethnic groups are the Indo-Guyanese, descendants of Indian indentured labourers and the Afro-Guyanese, descendants of African slaves. Mixed raced individuals comprise 16.7% of the population, Amerindians 9.1%, and the remaining 0.5% encompasses Portuguese, Chinese and Caucasian. Approximately one-third of Guyana’s 735,000 population lives below the poverty line. The majority of Guyanese (37.42%) are between the ages of 25 and 54 years, followed by the 15-24 year age bracket (21.26%). Only 13.25% of the population are over the age of 54.
Non-communicable diseases are the leading cause of mortality in Guyana, South America; accounting for 822 deaths per 100,000 population. Cardiovascular disease is the non-communicable disease responsible for the greatest number of deaths in Guyana; accounting for 526 deaths per 100,000 population. Hypertension is a major modifiable risk factor of cardiovascular mortality. It is also a global health concern, affecting approximately 20% of the adult population in most countries. Hypertension is responsible for 20-50% of all cardiovascular mortality and morbidity, which contributes to increased healthcare costs. In Guyana, hypertension is the leading cause of mortality among those between 45 and 64 years.
Hypertension is inversely related to education, income and occupation; therefore higher levels of blood presure are prevalent in lower socioeconomic groups. Guyana has a two-tiered health care system. Thus, there is a publicly funded hospital where patients receive free medical care and prescription medication. The country of Guyana is divided into three counties; each county has a publicly funded hospital. It is difficult and expensive for the residents of Charlestown to access the nearest publically funded hospital. This is a deterrent for most, thus residents typically only visit the hospital when there is an acute, emergency, medical concern. It is noteworthy that more than 80% of Guyanese with tertiary level education have emigrated. Thus, brain drain and a concentration of medical resources in one hospital per county, hamper Guyana’s ability to meet the health needs of its population.
Interventions are necessary to increase awareness that elevated blood pressure is a serious condition, inspite of its asymptomatic nature. Prevention of hypertension is linked to the elimination of relevant modifiable risk factors, and the promotion of a healthy lifestyle. H.E.L.P (Hypertension Evaluation & Learning Program) was launched in 2009 in Charlestown, Guyana. This intervention screens patients for, and creates an awareness of, hypertension. Pharmacist volunteers provide one-on-one patient counseling, while clinic volunteers tested participants' blood pressure and make relevant recommendations. We continuously follow up with patients to track their drug therapy adherence and remind them about the importance of controlling their hypertension.
- Excerpts from the Canadian Pharmacists Journal