Hypertension; Low, Middle Income Countries On Top

Blood Pressure Levels Rose During Covid 19 pandemic

People in low and middle-income countries are more prone to high blood pressure or hypertension, which is a medical condition that significantly increases the risks of heart, brain, kidney and other diseases, according to a recent report of the World Health Organization (WHO).

The report, which is the first comprehensive global analysis of trends in hypertension prevalence, detection, treatment and control, said that the number of adults aged 30-79 years with hypertension increased from 650 million to 1.28 billion in the last thirty years. The Lancet published the study done by Imperial College London and WHO.


Another major finding is that nearly half of the people did not know they had high blood pressure. The report pointed out that Canada, Peru and Switzerland had among the lowest prevalence of hypertension in the world in 2019. When the Dominican Republic, Jamaica and Paraguay had the highest rates for women, Hungary, Paraguay and Poland had the highest rate for men.


The study covered the period 1990-2019. The researchers used blood pressure measurement and treatment data from over 100 million people aged 30-79 years in 184 countries, together covering 99 per cent of the global population. This makes the study the most comprehensive review of global trends in hypertension to date.


Though easy to diagnose and relatively easy to treat the condition with low-cost drugs, the study revealed significant gaps in diagnosis and treatment. About 580 million people with hypertension (41 per cent of women and 51 per cent men) were unaware of their condition, as they were never diagnosed. More than half of the population (53 per cent women and 62 per cent men) with hypertension, or a total of 720 million people, were not receiving the treatment that they needed. Senior author of the study Professor Majid Ezzati said “nearly half a century after we started treating hypertension, which is easy to diagnose and treat with low-cost medicines, it is a public health failure that so many of the people with high blood pressure in the world are still not getting the treatment they need.” Majid Ezzati is Professor of Global Environmental Health at the School of Public Health at Imperial College London, medication

The report noted that men and women in Canada, Iceland and the Republic of Korea were most likely to receive medication to effectively treat and control their hypertension. The study said that more than 70 per cent of people with hypertension in these countries received treatment in 2019. On the other hand, men and women in sub-Saharan Africa, central, south and south-east Asia Pacific Island nations are the least likely to be receiving medication.

Treatment rates were below 25 per cent for women and 20 per cent for men. Moreover, the report pointed out that some middle-income countries successfully scaled up treatment and are now achieving better treatment and control rates than most high-income nations. As an example, they noted that Costa Rica and Kazakhstan now have higher treatment rates than most higher-income countries.

Dr Bin Zhou, research fellow at the School of Public Health at Imperial College London, who led the analysis, said, “Although hypertension treatment and control rates have improved in most countries since 1990, there has been little change in much of sub-Saharan Africa and Pacific Island nations. International funders and national governments need to prioritize global treatment equity for this major global health risk.”


The WHO also released the new Guideline for the pharmacological treatment of hypertension in adults along with the report. Dr Taskeen Khan, of WHO’s Department of Noncommunicable Diseases, who led the guideline development, said: “The new global guideline on the treatment of hypertension, the first in 20 years, provides the most current and relevant evidence-based guidance on the initiation of medicines for hypertension in adults.” The recommendations cover the level of blood pressure to start medication, what type of medicine or combination of medicines to use, the target blood pressure level, and how often to have follow-up checks on blood pressure. In addition, the guideline provides the basis for how physicians and other health workers can contribute to improving hypertension detection and management.

Dr Bente Mikkelsen, Director of WHO’s Department of Non-communicable  Diseases added: “The need to better manage hypertension cannot be exaggerated. By following the recommendations in this new guideline, increasing and improving access to blood pressure medication, identifying and treating comorbidities such as diabetes and pre-existing heart disease, promoting healthier diets and regular physical activity, and more strictly controlling Tobacco products, countries will be able to save lives and reduce public health expenditures.”

  • A condition in which the blood vessels have persistently raised pressure
  • Blood pressure is created by the force of blood pushing against the walls of blood vessels (arteries) as it is pumped by the heart. The higher the pressure, the harder the heart has to pump.
  • Hypertension is a serious medical condition and can increase the risk of heart, brain, kidney and other diseases.
  • It is a major cause of premature death worldwide, with upwards of 1 in 4 men and 1 in 5 women – over a billion people having the condition
  • The burden of hypertension is felt disproportionately in low- and middle income countries, where two thirds of cases are found, largely due to increased risk factors in those populations in recent decades.



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