Almost half of Pakistan’s adult population is living with hypertension but only a very small fraction have their condition under control This discrepancy is now recognized as a public health emergency and demands urgent action

Health experts estimate that around forty to forty two percent of adults in the country have high blood pressure Yet only about twelve percent of those suffering from the condition manage to keep their readings within healthy limits despite being on treatment This means millions remain exposed to high risk of heart attacks, strokes, kidney disease and other serious complications

One major issue is that a large proportion of people do not even know they are hypertensive Routine health checks are rare especially in remote and rural areas where clinics are sparse and public health outreach is weak The condition often remains silent until it causes damage

For those diagnosed, treatment adherence is another challenge Many patients do not stay on their prescribed medications or do not follow up regularly Reasons include cost, lack of access to quality medicines, side effect fears, and lack of education about the importance of consistent treatment

Lifestyle factors make the problem worse High salt diet, excessive consumption of processed foods, frequent sugary drinks, lack of physical activity, obesity and stress are pervasive Contributors like tobacco use poor sleep, and excessive weight circulate widely without effective public awareness campaigns

Healthcare systems also struggle to support this burden Adequate screening programs, community health workers, primary care centres trained in hypertension management, and easy access to affordable medication are still insufficient In urban areas private costs and clinic fees put treatment out of reach for many

Young people are no longer exempt The rising hypertension rates in younger age groups are disturbing A sedentary lifestyle, frequent fast food, stress and obesity are pushing many in their twenties and thirties to have elevated blood pressure

To change this situation several steps are essential First expand screening and detection through community camps schools markets mosques or mobile clinics so hypertension is caught early Second strengthen treatment infrastructure: ensure access to affordable medications, track patient compliance, train primary healthcare providers Third launch massive awareness campaigns to educate people about risks symptoms and prevention through diet, exercise and regular monitoring

Policies must also support salt reduction, regulate processed food quality, promote active lifestyles through public spaces parks walking tracks and sport facilities Fair pricing for antihypertensive drugs, subsidies for low income patients and insurance support could be impactful

If these reforms succeed they could avert tens of thousands of deaths every year reduce burden on hospitals and improve life expectancy Importantly they can strengthen national well being and economic productivity by reducing lost working days and caring costs

Pakistan stands at a crossroads If the twelve percent control rate is not dramatically improved the health consequences will grow harder to reverse But with coordinated effort from government, health sector, civil society and individual behaviour change the silent killer can be confronted head on.