Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants.
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Title
Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants.
Journal
Lancet
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NCD Risk Factor Collaboration (NCD-RisC)
Contributor(s)
Carrillo-Larco R.M., Danaei G., Riley L.M., Paciorek C.J., Stevens G.A., Gregg E.W., Bennett J.E., Solomon B., Singleton R.K., Sophiea M.K., Iurilli M.L., Lhoste V.P., Cowan M.J., Savin S., Woodward M., Balanova Y., Cifkova R., Damasceno A., Elliott P., Farzadfar F., He J., Ikeda N., Kengne A.P., Khang Y.H., Kim H.C., Laxmaiah A., Lin H.H., Margozzini Maira P., Miranda J.J., Neuhauser H., Sundström J., Varghese C., Widyahening I.S., Zdrojewski T., Abarca-Gómez L., Abdeen Z.A., Abdul Rahim H.F., Abu-Rmeileh N.M., Acosta-Cazares B., Adams R.J., Aekplakorn W., Afsana K., Afzal S., Agdeppa I.A., Aghazadeh-Attari J., Aguilar-Salinas C.A., Agyemang C., Ahmad N.A., Ahmadi A., Ahmadi N., Ahmadi N., Ahmadizar F., Ahmed S.H., Ahrens W., Ajlouni K., Al-Raddadi R., Alarouj M., AlBuhairan F., AlDhukair S., Ali M.M., Alkandari A., Alkerwi A., Allin K., Aly E., Amarapurkar D.N., Amougou N., Amouyel P., Andersen L.B., Anderssen S.A., Anjana R.M., Ansari-Moghaddam A., Ansong D., Aounallah-Skhiri H., Araújo J., Ariansen I., Aris T., Arku R.E., Arlappa N., Aryal K.K., Aspelund T., Assah F.K., Assunção MCF, Auvinen J., Avdićová M., Azevedo A., Azimi-Nezhad M., Azizi F., Azmin M., Babu B.V., Bahijri S., Balakrishna N., Bamoshmoosh M., Banach M., Banadinović M., Bandosz P., Banegas J.R., Baran J., Barbagallo C.M., Barceló A., Barkat A., Barreto M., Barros A.J., Barros MVG, Bartosiewicz A., Basit A., Bastos JLD, Bata I., Batieha A.M., Batyrbek A., Baur L.A., Beaglehole R., Belavendra A., Ben Romdhane H., Benet M., Benson L.S., Berkinbayev S., Bernabe-Ortiz A., Bernotiene G., Bettiol H., Bezerra J., Bhagyalaxmi A., Bhargava S.K., Bia D., Biasch K., Bika Lele E.C., Bikbov M.M., Bista B., Bjerregaard P., Bjertness E., Bjertness M.B., Björkelund C., Bloch K.V., Blokstra A., Bo S., Bobak M., Boeing H., Boggia J.G., Boissonnet C.P., Bojesen S.E., Bongard V., Bonilla-Vargas A., Bopp M., Borghs H., Bovet P., Boyer C.B., Braeckman L., Brajkovich I., Branca F., Breckenkamp J., Brenner H., Brewster L.M., Briceño Y., Brito M., Bruno G., Bueno-de-Mesquita H.B., Bueno G., Bugge A., Burns C., Bursztyn M., Cabrera de León A., Cacciottolo J., Cameron C., Can G., Cândido APC, Capanzana M.V., Čapková N., Capuano E., Capuano V., Cardoso V.C., Carlsson A.C., Carvalho J., Casanueva F.F., Censi L., Cervantes-Loaiza M., Chadjigeorgiou C.A., Chamukuttan S., Chan A.W., Chan Q., Chaturvedi H.K., Chaturvedi N., Chee M.L., Chen C.J., Chen F., Chen H., Chen S., Chen Z., Cheng C.Y., Cheraghian B., Cherkaoui Dekkaki I., Chetrit A., Chien K.L., Chiolero A., Chiou S.T., Chirita-Emandi A., Chirlaque M.D., Cho B., Christensen K., Christofaro D.G., Chudek J., Cinteza E., Claessens F., Clarke J., Clays E., Cohen E., Concin H., Cooper C., Coppinger T.C., Costanzo S., Cottel D., Cowell C., Craig C.L., Crampin A.C., Crujeiras A.B., Cruz J.J., Csilla S., Cui L., Cureau F.V., Cuschieri S., D'Arrigo G., d'Orsi E., Dallongeville J., Dankner R., Dantoft T.M., Dauchet L., Davletov K., De Backer G., De Bacquer D., De Curtis A., de Gaetano G., De Henauw S., de Oliveira P.D., De Ridder D., De Smedt D., Deepa M., Deev A.D., DeGennaro V.J., Delisle H., Demarest S., Dennison E., Deschamps V., Dhimal M., Di Castelnuovo A.F., Dias-da-Costa J.S., Diaz A., Dickerson T.T., Dika Z., Djalalinia S., Do H.T., Dobson A.J., Donfrancesco C., Donoso S.P., Döring A., Dorobantu M., Dörr M., Doua K., Dragano N., Drygas W., Duante C.A., Duboz P., Duda R.B., Dulskiene V., Dushpanova A., Džakula A., Dzerve V., Dziankowska-Zaborszczyk E., Eddie R., Eftekhar E., Eggertsen R., Eghtesad S., Eiben G., Ekelund U., El-Khateeb M., El Ati J., Eldemire-Shearer D., Eliasen M., Elosua R., Erasmus R.T., Erbel R., Erem C., Eriksen L., Eriksson J.G., Escobedo-de la Peña J., Eslami S., Esmaeili A., Evans A., Faeh D., Fakhretdinova A.A., Fall C.H., Faramarzi E., Farjam M., Fattahi M.R., Fawwad A., Felix-Redondo F.J., Felix S.B., Ferguson T.S., Fernandes R.A., Fernández-Bergés D., Ferrante D., Ferrao T., Ferrari M., Ferrario M.M., Ferreccio C., Ferreira H.S., Ferrer E., Ferrieres J., Figueiró T.H., Fink G., Fischer K., Foo L.H., Forsner M., Fouad H.M., Francis D.K., Franco MDC, Frikke-Schmidt R., Frontera G., Fuchs F.D., Fuchs S.C., Fujita Y., Fumihiko M., Furdela V., Furer A., Furusawa T., Gaciong Z., Galbarczyk A., Galenkamp H., Galvano F., Gao J., Gao P., Garcia-de-la-Hera M., Garcia P., Gareta D., Garnett S.P., Gaspoz J.M., Gasull M., Gazzinelli A., Gehring U., Geleijnse J.M., George R., Ghanbari A., Ghasemi E., Gheorghe-Fronea O.F., Ghimire A., Gialluisi A., Giampaoli S., Gieger C., Gill T.K., Giovannelli J., Gironella G., Giwercman A., Gkiouras K., Goldberg M., Goldsmith R.A., Gomez L.F., Gomula A., Gonçalves H., Gonçalves M., Gonçalves Cordeiro da Silva B., Gonzalez-Chica D.A., Gonzalez-Gross M., González-Rivas J.P., González-Villalpando C., González-Villalpando M.E., Gonzalez A.R., Gorbea M.B., Gottrand F., Graff-Iversen S., Grafnetter D., Grajda A., Grammatikopoulou M.G., Gregor R.D., Grodzicki T., Grosso G., Gruden G., Gu D., Guan O.P., Gudmundsson E.F., Gudnason V., Guerrero R., Guessous I., Guimaraes A.L., Gulliford M.C., Gunnlaugsdottir J., Gunter M.J., Gupta P.C., Gupta R., Gureje O., Gurzkowska B., Gutierrez L., Gutzwiller F., Ha S., Hadaegh F., Haghshenas R., Hakimi H., Halkjær J., Hambleton I.R., Hamzeh B., Hange D., Hanif A.A., Hantunen S., Hao J., Hardman C.M., Hari Kumar R., Hashemi-Shahri S.M., Hata J., Haugsgjerd T., Hayes A.J., He Y., Heier M., Hendriks M.E., Henrique RDS, Henriques A., Hernandez Cadena L., Herrala S., Heshmat R., Hill A.G., Ho S.Y., Ho S.C., Hobbs M., Holdsworth M., Homayounfar R., Horasan Dinc G., Horimoto A.R., Hormiga C.M., Horta B.L., Houti L., Howitt C., Htay T.T., Htet A.S., Htike MMT, Hu Y., Huerta J.M., Huhtaniemi I.T., Huiart L., Huisman M., Husseini A.S., Huybrechts I., Hwalla N., Iacoviello L., Iannone A.G., Ibrahim M.M., Ibrahim Wong N., Ikram M.A., Iotova V., Irazola V.E., Ishida T., Isiguzo G.C., Islam M., Islam SMS, Iwasaki M., Jackson R.T., Jacobs J.M., Jaddou H.Y., Jafar T., James K., Jamrozik K., Janszky I., Janus E., Jarvelin M.R., Jasienska G., Jelaković A., Jelaković B., Jennings G., Jha A.K., Jiang C.Q., Jimenez R.O., Jöckel K.H., Joffres M., Johansson M., Jokelainen J.J., Jonas J.B., Jørgensen T., Joshi P., Joukar F., Jóżwiak J., Juolevi A., Jurak G., Jureša V., Kaaks R., Kafatos A., Kajantie E.O., Kalmatayeva Z., Kalpourtzi N., Kalter-Leibovici O., Kampmann F.B., Kannan S., Karaglani E., Kårhus L.L., Karki K.B., Katibeh M., Katz J., Kauhanen J., Kaur P., Kavousi M., Kazakbaeva G.M., Keil U., Keinan Boker L., Keinänen-Kiukaanniemi S., Kelishadi R., Kemper H.C., Keramati M., Kerimkulova A., Kersting M., Key T., Khader Y.S., Khalili D., Khaw K.T., Kheiri B., Kheradmand M., Khosravi A., Kiechl-Kohlendorfer U., Kiechl S., Killewo J., Kim D.W., Kim J., Klakk H., Klimek M., Klumbiene J., Knoflach M., Kolle E., Kolsteren P., Kontto J.P., Korpelainen R., Korrovits P., Kos J., Koskinen S., Kouda K., Kowlessur S., Koziel S., Kratenova J., Kriaucioniene V., Kristensen P.L., Krokstad S., Kromhout D., Kruger H.S., Kubinova R., Kuciene R., Kujala U.M., Kulaga Z., Kumar R.K., Kurjata P., Kusuma Y.S., Kutsenko V., Kuulasmaa K., Kyobutungi C., Laatikainen T., Lachat C., Laid Y., Lam T.H., Landrove O., Lanska V., Lappas G., Larijani B., Latt T.S., Le Coroller G., Le Nguyen Bao K., Le T.D., Lee J., Lee J., Lehmann N., Lehtimäki T., Lemogoum D., Levitt N.S., Li Y., Lilly C.L., Lim W.Y., Lima-Costa M.F., Lin X., Lin Y.T., Lind L., Lingam V., Linneberg A., Lissner L., Litwin M., Lo W.C., Loit H.M., Lopez-Garcia E., Lopez T., Lotufo P.A., Lozano J.E., Lukačević Lovrenčić I., Lukrafka J.L., Luksiene D., Lundqvist A., Lundqvist R., Lunet N., Lustigová M., Luszczki E., Ma G., Ma J., Machado-Coelho G.L., Machado-Rodrigues A.M., Macia E., Macieira L.M., Madar A.A., Maggi S., Magliano D.J., Magriplis E., Mahasampath G., Maire B., Majer M., Makdisse M., Malekzadeh F., Malekzadeh R., Malhotra R., Mallikharjuna Rao K., Malyutina S.K., Maniego L.V., Manios Y., Mann J.I., Mansour-Ghanaei F., Manzato E., Marcil A., Mårild S.B., Marinović Glavić M., Marques-Vidal P., Marques L.P., Marrugat J., Martorell R., Mascarenhas L.P., Matasin M., Mathiesen E.B., Mathur P., Matijasevich A., Matlosz P., Matsha T.E., Mavrogianni C., Mbanya JCN, Mc Donald Posso A.J., McFarlane S.R., McGarvey S.T., McLachlan S., McLean R.M., McLean S.B., McNulty B.A., Mediene Benchekor S., Medzioniene J., Mehdipour P., Mehlig K., Mehrparvar A.H., Meirhaeghe A., Meisinger C., Mendoza Montano C., Menezes AMB, Menon G.R., Mereke A., Meshram I.I., Metspalu A., Meyer H.E., Mi J., Michels N., Mikkel K., Milkowska K., Miller J.C., Minderico C.S., Mini G.K., Mirjalili M.R., Mirrakhimov E., Mišigoj-Duraković M., Modesti P.A., Moghaddam S.S., Mohajer B., Mohamed M.K., Mohamed S.F., Mohammad K., Mohammadi M.R., Mohammadi Z., Mohammadifard N., Mohammadpourhodki R., Mohan V., Mohanna S., Mohd Yusoff M.F., Mohebbi I., Mohebi F., Moitry M., Møllehave L.T., Molnár D., Momenan A., Mondo C.K., Monterrubio-Flores E., Monyeki KDK, Moon J.S., Moosazadeh M., Moreira L.B., Morejon A., Moreno L.A., Morgan K., Moschonis G., Mossakowska M., Mostafa A., Mostafavi S.A., Mota J., Motlagh M.E., Motta J., Moura-Dos-Santos M.A., Mridha M.K., Msyamboza K.P., Mu T.T., Muhihi A.J., Muiesan M.L., Müller-Nurasyid M., Murphy N., Mursu J., Musa K.I., Musić Milanović S., Musil V., Mustafa N., Nabipour I., Naderimagham S., Nagel G., Naidu B.M., Najafi F., Nakamura H., Námešná J., Nang EEK, Nangia V.B., Narake S., Ndiaye N.C., Neal W.A., Nejatizadeh A., Nenko I., Neovius M., Nguyen C.T., Nguyen N.D., Nguyen Q.V., Nguyen Q.N., Nieto-Martínez R.E., Niiranen T.J., Nikitin Y.P., Ninomiya T., Nishtar S., Njelekela M.A., Noale M., Noboa O.A., Noorbala A.A., Norat T., Nordendahl M., Nordestgaard B.G., Noto D., Nowak-Szczepanska N., Nsour M.A., Nunes B., O'Neill T.W., O'Reilly D., Ochimana C., Oda E., Odili A.N., Oh K., Ohara K., Ohtsuka R., Olié V., Olinto MTA, Oliveira I.O., Omar M.A., Onat A., Ong S.K., Ono L.M., Ordunez P., Ornelas R., Ortiz P.J., Osmond C., Ostojic S.M., Ostovar A., Otero J.A., Overvad K., Owusu-Dabo E., Paccaud F.M., Padez C., Pahomova E., Paiva K.M., Pająk A., Palli D., Palmieri L., Pan W.H., Panda-Jonas S., Panza F., Paoli M., Papandreou D., Park S.W., Park S., Parnell W.R., Parsaeian M., Pasquet P., Patel N.D., Pavlyshyn H., Pećin I., Pednekar M.S., Pedro J.M., Peer N., Peixoto S.V., Peltonen M., Pereira A.C., Peres K.G., Peres M.A., Peters A., Petkeviciene J., Peykari N., Pham S.T., Pichardo R.N., Pigeot I., Pikhart H., Pilav A., Pilotto L., Pitakaka F., Piwonska A., Pizarro A.N., Plans-Rubió P., Polašek O., Porta M., Poudyal A., Pourfarzi F., Pourshams A., Poustchi H., Pradeepa R., Price A.J., Price J.F., Providencia R., Puhakka S.E., Puiu M., Punab M., Qasrawi R.F., Qorbani M., Queiroz D., Quoc Bao T., Radić I., Radisauskas R., Rahimikazerooni S., Rahman M., Raitakari O., Raj M., Rakhimova E.M., Ramachandra Rao S., Ramachandran A., Ramos E., Rampal L., Rampal S., Rangel Reina D.A., Rarra V., Rech C.R., Redon J., Reganit PFM, Regecová V., Revilla L., Rezaianzadeh A., Ribeiro R., Riboli E., Richter A., Rigo F., Rinke de Wit T.F., Ritti-Dias R.M., Robitaille C., Rodríguez-Artalejo F., Rodriguez-Perez MDC, Rodríguez-Villamizar L.A., Roggenbuck U., Rojas-Martinez R., Romaguera D., Romeo E.L., Rosengren A., Roy J.G., Rubinstein A., Ruidavets J.B., Ruiz-Betancourt B.S., Ruiz-Castell M., Rusakova I.A., Russo P., Rutkowski M., Sabanayagam C., Sabbaghi H., Sachdev H.S., Sadjadi A., Safarpour A.R., Safi S., Safiri S., Saidi O., Sakarya S., Saki N., Salanave B., Salazar Martinez E., Salmerón D., Salomaa V., Salonen J.T., Salvetti M., Sánchez-Abanto J., Sans S., Santos D.A., Santos I.S., Santos L.C., Santos M.P., Santos R., Saramies J.L., Sardinha L.B., Sarganas G., Sarrafzadegan N., Sathish T., Saum K.U., Savva S., Sawada N., Sbaraini M., Scazufca M., Schaan B.D., Schargrodsky H., Schipf S., Schmidt C.O., Schnohr P., Schöttker B., Schramm S., Schultsz C., Schutte A.E., Sebert S., Sein A.A., Sen A., Senbanjo I.O., Sepanlou S.G., Servais J., Shalnova S.A., Shamah-Levy T., Shamshirgaran M., Shanthirani C.S., Sharafkhah M., Sharma S.K., Shaw J.E., Shayanrad A., Shayesteh A.A., Shi Z., Shibuya K., Shimizu-Furusawa H., Shin D.W., Shirani M., Shiri R., Shrestha N., Si-Ramlee K., Siani A., Siantar R., Sibai A.M., Silva CRM, Silva DAS, Simon M., Simons J., Simons L.A., Sjöström M., Slowikowska-Hilczer J., Slusarczyk P., Smeeth L., So H.K., Soares F.C., Sobngwi E., Söderberg S., Soemantri A., Sofat R., Solfrizzi V., Somi M.H., Sonestedt E., Song Y., Sørensen T.I., Sørgjerd E.P., Sorić M., Sossa Jérome C., Soumaré A., Sparboe-Nilsen B., Sparrenberger K., Staessen J.A., Starc G., Stavreski B., Steene-Johannessen J., Stehle P., Stein A.D., Stergiou G.S., Stessman J., Stieber J., Stöckl D., Stocks T., Stokwiszewski J., Stronks K., Strufaldi M.W., Suka M., Sun C.A., Sung Y.T., Suriyawongpaisal P., Sy R.G., Syddall H.E., Sylva R.C., Szklo M., Tai E.S., Tammesoo M.L., Tamosiunas A., Tan E.J., Tang X., Tanser F., Tao Y., Tarawneh M.R., Tarqui-Mamani C.B., Taylor A., Taylor J., Tebar W.R., Tell G.S., Tello T., Tham Y.C., Thankappan K.R., Theobald H., Theodoridis X., Thijs L., Thinggaard M., Thomas N., Thorand B., Thuesen B.H., Timmermans E.J., Tjandrarini D.H., Tjonneland A., Toft U., Tolonen H.K., Tolstrup J.S., Topbas M., Topór-Madry R., Tormo M.J., Tornaritis M.J., Torrent M., Torres-Collado L., Touloumi G., Traissac P., Triantafyllou A., Trichopoulos D., Trichopoulou A., Trinh O.T., Trivedi A., Tshepo L., Tsugane S., Tuliakova A.M., Tulloch-Reid M.K., Tullu F., Tuomainen T.P., Tuomilehto J., Turley M.L., Twig G., Tynelius P., Tzourio C., Ueda P., Ugel E., Ulmer H., Uusitalo H.M., Valdivia G., Valvi D., van Dam R.M., van den Born B.J., Van der Heyden J., van der Schouw Y.T., Van Herck K., Van Minh H., Van Schoor N.M., van Valkengoed I.G., van Zutphen E.M., Vanderschueren D., Vanuzzo D., Varbo A., Vasan S.K., Vega T., Veidebaum T., Velasquez-Melendez G., Veronesi G., Verschuren W.M., Verstraeten R., Victora C.G., Viet L., Villalpando S., Vineis P., Vioque J., Virtanen J.K., Visvikis-Siest S., Viswanathan B., Vlasoff T., Vollenweider P., Voutilainen A., Wade A.N., Walton J., Wambiya E.O., Wan Bebakar W.M., Wan Mohamud W.N., Wanderley Júnior R.S., Wang M.D., Wang N., Wang Q., Wang X., Wang Y.X., Wang Y.W., Wannamethee S.G., Wareham N., Wei W., Weres A., Werner B., Whincup P.H., Widhalm K., Wiecek A., Wilks R.J., Willeit J., Willeit P., Williams E.A., Wilsgaard T., Wojtyniak B., Wong-McClure R.A., Wong A., Wong T.Y., Woo J., Wu F.C., Wu S., Wyszynska J., Xu H., Xu L., Yaacob N.A., Yan W., Yang L., Yang X., Yang Y., Yasuharu T., Ye X., Yiallouros P.K., Yoosefi M., Yoshihara A., You S.L., Younger-Coleman N.O., Yusoff A.F., Zainuddin A.A., Zakavi S.R., Zamani F., Zambon S., Zampelas A., Zapata M.E., Zaw K.K., Zejglicova K., Zeljkovic Vrkic T., Zeng Y., Zhang L., Zhang Z.Y., Zhao D., Zhao M.H., Zhen S., Zheng Y., Zholdin B., Zhu D., Zins M., Zitt E., Zocalo Y., Zoghlami N., Zuñiga Cisneros J., Ezzati M.
ISSN
1474-547X (Electronic)
ISSN-L
0140-6736
Publication state
Published
Issued date
11/09/2021
Peer-reviewed
Oui
Volume
398
Number
10304
Pages
957-980
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories.
We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age.
The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran.
Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings.
WHO.
We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age.
The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran.
Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings.
WHO.
Keywords
Adult, Aged, Antihypertensive Agents/therapeutic use, Female, Global Health, Humans, Hypertension/diagnosis, Hypertension/drug therapy, Hypertension/epidemiology, Hypertension/prevention & control, Male, Middle Aged, Prevalence
Pubmed
Web of science
Open Access
Yes
Create date
08/10/2021 17:24
Last modification date
09/08/2024 14:53
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