Researchers analyzing the global health difference in the prevalence of hypertension have found that, for the first time the disease is now more common in lowand middle-income countries. Around the world, hypertension, or high blood pressure, is one of the leading preventable risk factors responsible for disease burden. In 2013, there were around 9 to 12 million deaths as a result of complications arising from raised blood pressure, including cardiovascular disease, heart disease, stroke, and chronic kidney disease.
Previous reports had indicated that the prevalence of hypertension in low- and middle-income countries is on the rise, while it was steady or decreasing in high-income countries. But the latest study shows that of the more than 30 percent of the adult population worldwide known to have high blood pressure, 75 percent live in low- to middle-income countries.
Data analysis involved 135 population-based studies, including 968,419 adults from 90 countries. Researchers used sex- and agespecific high blood pressure prevalence from past reports to calculate the regional and global estimates of hypertensive adults. The researchers found that in 2010, there were1.39 billion people worldwide living with high blood pressure. A total of 1.04 billion of those people — almost three times the amount of high-income countries — were living in low- to middle-income countries. In high-income countries, the greatest burden was in adults over 60 years, whereas in low- and middle-income countries, the most significant burden was in adults between 40-59 years.
In the ten years between 2000 and2010, high blood pressure prevalence decreased by 2.6 percent in high-income countries, while increasing by 7.7 percent in low- and middle-income countries. In 2010, less than half of adults with hypertension were aware of their condition. Compared with low- and middle-income countries, high-income countries had almost double the proportions of awareness (67 percent versus 37.9 percent) and treatment (55.6 percent versus 29 percent), and four times the amount of control among patients with hypertension (28.4 percent versus 7.7 percent).
Experts believe a number of factors could be contributing to this disparity among regions: Healthcare systems in many low- and middle-income countries are overburdened and do not have the resources to effectively treat and control hypertension. In addition, because hypertension is symptomless and many people in low- and middle-income countries do not have access to screenings or regular preventative medical care, it is often underdiagnosed. Also, aging populations and urbanization, which is often accompanied by unhealthy lifestyle factors, such as high sodium, fat and calorie diets and lack of physical activity, may play an important role in the epidemic of hypertension in lowand middle-income countries.
The new research points to the need for global strategies to prevent and control hypertension through greater collaboration from national and international stakeholders to develop cost-effective programs to prevent and control this condition.