High blood pressure is a major risk factor for heart disease, stroke, dementia, and kidney and heart failure

The number of adults aged 30-79 years with hypertension or high blood pressure has increased from 650 million to 1.28 billion in the last thirty years, according to the first comprehensive global analysis of trends in hypertension prevalence, detection, treatment and control, led by Imperial College London and the World Health Organization (WHO), and published in The Lancet. Nearly half these people did not know they had high blood pressure.

The UK was one of the top ten countries with the lowest prevalence of high blood pressure among women in 2019 at 23 per cent while in Ireland this figure was 26.6 per cent.

The study found that the country with the highest prevalence of high blood pressure in men was  Paraguay at 62 per cent compared to 22 per cent in Eritrea which had the lowest prevalence among men.

In Ireland the prevalence of high blood pressure among men in 2019 was 38.2 per cent.

High blood pressure or hypertension significantly increases the risk of heart, brain and kidney diseases, and is one of the top causes of death and disease throughout the world. It can be easily detected through measuring blood pressure, at home or in a health centre, and can often be treated effectively with medications that are low cost.

The study, conducted by a global network of physicians and researchers, covered the period 1990-2019. It used blood pressure measurement and treatment data from over 100 million people aged 30-79 years in 184 countries, together covering 99% of the global population, which makes it the most comprehensive review of global trends in hypertension to date.

By analysing this massive amount of data, the researchers found that there was little change in the overall rate of hypertension in the world from 1990 to 2019, but the burden has shifted from wealthy nations to low- and middle-income countries. The rate of hypertension has decreased in wealthy countries – which now typically have some of the lowest rates – but has increased in many low- or middle-income countries.

As a result, Canada, Peru and Switzerland had among the lowest prevalence of hypertension in the world in 2019, while some of the highest rates were seen in the Dominican Republic, Jamaica and Paraguay for women and Hungary, Paraguay and Poland for men.

Although the percent of people who have hypertension has changed little since 1990, the number of people with hypertension doubled to 1.28 billion. This was primarily due to population growth and ageing. In 2019, over one billion people with hypertension (82% of all people with hypertension in the world) lived in low- and middle-income countries.

Although it is straightforward to diagnose hypertension 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% of women and 51% of men) were unaware of their condition because they were never diagnosed.

The study also indicated that more than half of people (53% of women and 62% of men) with hypertension, or a total 720 million people, were not receiving the treatment that they need. Blood pressure was controlled, which means medicines were effective in bringing blood pressure to normal ranges, in fewer than 1 in 4 women and 1 in 5 men with hypertension.

Professor Majid Ezzati, senior author of the study and Professor of Global Environmental Health at the School of Public Health at Imperial College London, 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.”

Commenting Dr Angie Brown, Medical Director of the Irish Heart Foundation said, “This large study confirms the rising burden of high blood pressure around the world. Although there has been a relative improvement in Ireland, we still have an increasing prevalence of hypertension, and a lack of awareness of the importance of diagnosing and treating high blood pressure.

“The need to better manage hypertension is crucial in preventing adverse outcomes such as stroke, heart failure, kidney failure and dementia . By increasing and improving access to blood pressure measurement, identifying and adequately treating high blood pressure as well as managing  comorbidities such as diabetes and pre-existing heart disease, promoting healthier diets and regular physical activity, and more strictly controlling tobacco products, we can save lives and improve people’s lives.”