Detection, treatment and control of hypertension vary widely from country to country

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25 August 2021

3 minutes to read

Disclosures: Ezzati reports receiving a charitable grant from the AstraZeneca Young Health program and personal expenses from Prudential outside of the submitted work. Zhou does not report any relevant financial disclosure. Please see the study for relevant financial information from all other authors.


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The detection, treatment and control of hypertension vary widely from country to country, with some middle-income countries outperforming high-income countries, researchers in The Lancet.

“Comparable data on the detection, treatment and control of hypertension are needed to learn from good practice and guide health system programs” Bin Zhou, PhD, researcher in health analysis and machine learning at the School of Public Health at Imperial College London and researcher for the NCD Risk Factor Collaboration, and colleagues wrote. “There is no comparable global data to assess which countries have high or low rates of detection, treatment and control and how these measures have changed over time.”

Infographic explaining how the detection, treatment and control of hypertension varies widely from country to country.
The detection, treatment and control of hypertension vary widely from country to country, with some middle-income countries outperforming high-income countries. Data was derived from Zhou B, et al. Lancet. 2021; doi: 10.1016 / A0140-6736 (21) 01330-1.

Researchers evaluated data from 1990 to 2019 on individuals (aged 30 to 79) from representative population studies with BP measurements and BP treatment data. Hypertension was defined as a person with systolic BP> 140 mm Hg, diastolic BP> 90 mm Hg, or taking medication for hypertension. Using this information, the researchers estimated the prevalence of hypertension and the number of people with hypertension with a previous diagnosis, those taking medication for hypertension, and those with controlled hypertension unless of 140/90 mm Hg.

From 1990 to 2019, the number of people aged 30 to 79 with hypertension doubled from 331 million women and 317 million men to 626 million women and 652 million men. The lowest age-standardized hypertension prevalence was observed in Canada and Peru for both sexes, Taiwan, South Korea, Japan, Switzerland, Spain and the United Kingdom for women and in low- and middle-income countries such as Eritrea, Bangladesh, Ethiopia and the Solomon Islands for men.

Prevalence, treatment, control

The researchers observed a prevalence of hypertension exceeding 50% in two countries for women and in nine countries for men. Reports of a previous diagnosis of hypertension in 2019 were seen in 59% of women and 49% of men worldwide, with 47% of women and 38% of men being treated for it. Additionally, hypertension control rates in people with hypertension in 2019 were 23% for women and 18% for men.

South Korea, Canada and Iceland had the highest antihypertensive therapy (> 70%) and control (> 50%), followed by the United States, Costa Rica, Germany, Portugal and Taiwan. However, in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania, treatment rates for hypertension were

Global progress is slow

“Despite medical and pharmacological advances over the decades, global progress in the management of hypertension has been slow, and the vast majority of people with hypertension go untreated, with great disadvantages in income countries. low and intermediate ” Majid Ezzati, Doctorate, FMedSci, chair in global environmental health at Imperial College London, said in a press release. “Our analysis revealed good practices in the diagnosis and treatment of hypertension not only 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 is achievable in low- and middle-income settings if international donors and national governments commit to addressing it. this major cause of illness and death.

According to the researchers, rates of treatment and control of hypertension have improved in many countries since 1990, but there has been little change in most countries in sub-Saharan Africa and Oceania. The most significant improvements in hypertension treatment and control rates occurred in high-income countries, central Europe, and some countries whose income level improved during the study, notably Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey and Iran.

“Universal Medicare has been instrumental in achieving high effective coverage, but should be complemented by strengthening primary care, evidence-based hypertension guidelines that are up to date and relevant in national contexts, training of health personnel and a strong system of drug procurement and distribution, ”the researchers wrote. “Programs should also be evaluated regularly, both at the population level, as our work has done, and in health facilities to ensure accountability and drive improvement. “

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