A recent global analysis found that high blood pressure remains a significant public health concern, with low- and middle-income countries bearing the brunt of the epidemic, despite being readily treatable with existing medications and lifestyle interventions.
Hypertension, a disease that is both easy to test for and readily treatable with existing medications and lifestyle interventions, remains a stubborn and deadly silent epidemic whose burden on public health systems has only increased in the past 20 years. A new global analysis found that the prevalence of hypertension has decreased slightly in high-income countries from 2000 to 2020, but has substantially increased in low- to middle-income countries. Nearly 90% of the increase in adults with hypertension occurred in low- and middle-income countries, with the disease now affecting 33% of the world's adults, approximately 1.7 billion people, as of 2020.
The study, which pooled data from 287 population-based studies involving more than six million adults across 119 countries, examined changes in hypertension prevalence, awareness, treatment, and control. The findings revealed that Latin America, the Caribbean, and sub-Saharan Africa had the highest hypertension prevalence as of 2020, while the largest total number of adults with hypertension was in East Asia and the Pacific, followed by South Asia. Researchers also found that the disparity in hypertension prevalence has grown over time, with 83% of adults with uncontrolled hypertension living in low- and middle-income countries in 2020, up from 70% in 2000.
The disease claims an estimated 10 million lives annually and is a major contributor to heart attacks, strokes, kidney disease, and dementia. However, it often has no symptoms, leading to gaps in diagnoses. Even after diagnosis, controlling hypertension can be difficult, with less than 20% of adults with hypertension worldwide having their blood pressure controlled in 2020. Control rates were nearly three times greater in high-income countries than in low- and middle-income countries, with 40.2% in high-income countries compared to 13.6% in low- and middle-income countries.
The study's findings underscore the need to better implement proven strategies, including wider access to affordable blood pressure medications, team-based care, accurate blood pressure measurement, simpler treatment protocols, and health systems designed to support long-term management of chronic diseases. According to the lead author, there is urgent work to be done everywhere, and awareness, treatment, and control are not where they need to be, not only in low- and middle-income countries but also in high-income countries. The senior author while progress has been made in hypertension control, it is still extremely low globally, and control is still only about 40% in high-income countries, despite the fact that effective interventions to control hypertension exist.
The high prevalence of hypertension can impose huge financial burdens on any health care system, but low- and middle-income countries' health systems also must manage and prioritize a heavy burden of infectious diseases and maternal and child health needs, while facing limited resources for chronic disease care. The findings of the study highlight the need to address the barriers to hypertension control at the patient level, clinician level, and system level in order to meaningfully improve these numbers. By doing so, it may be possible to reduce the significant public health burden of hypertension and improve the health and well-being of millions of people worldwide.
