More than 1.2 billion adults around the world are currently living with hypertension, according to new data published in The Lancet. That represents a two-fold increase over the last 30 years, and a majority of the new cases occurred in low- and middle-income countries.
Researchers analyzed 1,201 studies that involved a total of 104 million people from 184 countries. Hypertension was defined as having a systolic blood pressure of 140 mm Hg or higher and a diastolic blood pressure of 90 mm Hg or greater. All data came from the Non-Communicable Disease Risk Factor Collaboration.
Overall, the number of adults aged 30-79 years living with hypertension has doubled, climbing from almost 331 million women and 317 million men in 1990 to 626 million women and 652 million men in 2019.
“Despite medical and pharmacological advances over decades, global progress in hypertension management has been slow, and the vast majority of people with hypertension remain untreated, with large disadvantages in low- and middle-income countries”, lead author Majid Ezzati, PhD, a specialist from Imperial College London in the U.K., said in a prepared statement. “Our analysis has revealed good practice in diagnosing and treating hypertension not just in high-income countries but also in middle-income countries. These successes show that preventing high blood pressure and improving its detection, treatment, and control are feasible across low- and middle-income settings if international donors and national governments commit to addressing this major cause of disease and death.”
The authors found that, although hypertension is easy to diagnose and treat with inexpensive medications, in 2019, almost half of all patients with hypertension did not know they had it and were not being treated.
In addition, blood pressure was being controlled by medication in less than one-fourth of all women and less than one-fifth of all men diagnosed with hypertension.
Ezzati et al. noted that high blood pressure is associated with more than 8.5 million fatalities worldwide annually and is among the leading risk factors for stroke, ischemic heart disease, other vascular diseases and renal disease.
According to the authors, countries with high incomes such as Canada, Switzerland, the U.K. and Spain reported record low levels of hypertension. Low- and middle-income countries such as Paraguay, Hungary, Poland, and Croatia have seen hypertension rates rise.
“Large improvements in treatment and control rates seen in some middle-income countries ... over the past three decades show that the expansion of universal health coverage and strengthening primary care have been instrumental in improving high blood pressure care and reducing the burden of this condition," the authors wrote.
Clara Chow, MD, with the University of Sydney, Australia, was not involved in this analysis, but she did comment on its findings in the press release.
"There is an urgent need for a transformation and innovative approaches to reduce the burden of hypertension globally," Chow said. "We need better strategies to increase diagnosis and management, leveraging primary care or existing systems or identifying new methods to engage consumers in blood pressure management.”
Read the full study here.