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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Abstract
BACKGROUND: 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. METHODS: 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. FINDINGS: 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. INTERPRETATION: 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. FUNDING: WHO.
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The record
- Venue
- The Lancet
- Topic
- Blood Pressure and Hypertension Studies
- Field
- Medicine
- Canadian institutions
- —
- Funders
- Norwegian Institute of Public HealthYonsei University College of MedicineResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesLeibniz-GemeinschaftMedical Research CouncilFood and Nutrition Research InstituteUniversity of Massachusetts AmherstConsiglio per la ricerca in agricoltura e l’analisi dell’economia agrariaMunster Technological UniversityCollege of Medicine, Seoul National UniversityInstituto Politécnico de LisboaNational Institutes of Biomedical Innovation, Health and NutritionUrmia University of Medical SciencesAl-Farabi Kazakh National UniversityLietuvos Sveikatos Mokslų UniversitetasCentre hospitalier régional universitaire de LilleUniwersytet Śląski w KatowicachShahid Sadoughi University of Medical SciencesKing Abdullah International Medical Research CenterNorges IdrettshøgskoleKwame Nkrumah University of Science and TechnologyPontificia Universidad Católica de ChileAfrican Population and Health Research CenterAddis Ababa UniversityXinjiang Medical UniversityUniversidade Federal de Minas GeraisUrmia UniversityUppsala UniversitetNational Taiwan UniversityAristotle University of ThessalonikiFogarty International CenterUniversidade Federal de PelotasNational University of SingaporeUniversität ZürichUniversitas IndonesiaDeutsches KrebsforschungszentrumZahedan University of Medical SciencesSyddansk UniversitetUniversität WienOulun YliopistoUniversidade Federal de Juiz de ForaTulane UniversityUniversidad de la República UruguayHellenic Health FoundationŚląski Uniwersytet Medyczny w KatowicachGöteborgs UniversitetVrije Universiteit AmsterdamUniversität BielefeldSveučilište u ZagrebuUniversità degli Studi dell'InsubriaUniversidade Federal do Rio de JaneiroLundbeckfondenUniversitetet i OsloUniversità degli Studi di PalermoInstituto Mexicano del Seguro SocialMadras Diabetes Research FoundationCentre National de la Recherche ScientifiqueUniversiti Sains MalaysiaPan American Health OrganizationUniversidad Autónoma de MadridTampereen YliopistoQatar UniversityNational and Kapodistrian University of AthensMahidol UniversityUniversité de LilleKarolinska InstitutetUniversité de BordeauxKaradeniz Teknik ÜniversitesiPublic Health Agency of CanadaUniversité de ToulouseUniwersytet RzeszowskiJordan University of Science and TechnologyUniversidade de São PauloÖrebro UniversitetImperial College LondonGentofte HospitalUniversità degli Studi di TorinoSouth African Medical Research CouncilMedizinische Universität InnsbruckErasmus Medisch CentrumUniversidade do PortoNational Heart, Lung, and Blood InstituteCentre Hospitalier Universitaire VaudoisKU LeuvenSeoul National UniversitySchool of MedicineDasman Diabetes InstituteSingapore Eye Research InstituteUniversity of New South WalesUniversité de LorraineUniverzita Karlova v PrazePublic Health AgencyJunta de Castilla y LeónIndia Diabetes Research FoundationRobert Koch InstitutUniversité de LausanneUniwersytet Jagielloński Collegium MedicumUniversity College LondonIndian Council of Medical ResearchUniversidad de ZaragozaDalhousie UniversityUniversidade Federal de Santa CatarinaUniversidade de PernambucoKoch Institute for Integrative Cancer Research, Massachusetts Institute of TechnologyUniversitetet i TromsøBirzeit UniversityYonsei UniversityUniversiteit GentUniwersytet ŁódzkiKing Abdulaziz UniversityHøgskulen på VestlandetUniversiteit van AmsterdamWorld Health OrganizationUniversité de StrasbourgNeyshabur University of Medical SciencesFlinders UniversityUniversiteit UtrechtKøbenhavns ProfessionshøjskoleDuke-NUS Medical SchoolUniversity of SouthamptonUniversidad de La LagunaInstitut de Recherche pour le DéveloppementMedizinische Universität WienMinistry of Health and WelfareCapital Medical UniversityMinistry of Health, New ZealandUniversität InnsbruckWellcome TrustHáskóli ÍslandsBritish Heart FoundationUniversity of GhanaUniversité Mohammed V de RabatMuséum National d'Histoire NaturelleItä-Suomen Yliopisto
- Keywords
- MedicinePooled analysisEnvironmental healthDemographyPopulationGerontologyMeta-analysisInternal medicineSociology
- Has abstract in OpenAlex
- yes