“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”, says Professor Majid Ezzati, Imperial College London, UK, the senior author of the study.
The Non-Communicable Disease Risk Factor Collaboration (NCD-RisC) analyzed data from 1,201 population-representative studies, involving 104 million people from 184 countries (covering 99% of the world’s population).
Hypertension is defined as having systolic blood pressure of 140 mm Hg or greater, diastolic blood pressure of 90 mm Hg or greater.
Modelling was used to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis, who were taking medication for hypertension, and whose hypertension was controlled to below 140/90 mm Hg, by country, year, and age.
Results showed that prevalence of hypertension in adults has remained largely unchanged over the past 30 years and even rates have dropped sharply in high-income countries. Whereas, more than half of the population had hypertension in low- and middle-income countries (LMICs).
Treatment and control have improved in most countries since 1990, particularly in high-income countries where treatment levels were greater than 70%; and control rates were higher than 50% in 2019, and in several upper-middle and middle-income countries, more than 65% of adults with hypertension were treated and nearly half had their condition controlled in 2019.
However, there has been little change in LMICs, where less than a quarter of women and less than a fifth of men with hypertension were being treated in 2019, and fewer than 10% had well controlled blood pressure.
The standstill in global prevalence and the global control rates of approximately 20% should serve as an important global wakeup call that cardiovascular disease is going to be a main burden of illness for many years to come, especially if we carry on like this.