Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries
Open accessAbstract
Background: Hypertension is the leading preventable cause of premature death worldwide. We examined global disparities of hypertension prevalence, awareness, treatment, and control in 2010 and compared secular changes from 2000 to 2010. Methods: We searched MEDLINE from 1995 through 2014 and supplemented with manual searches of retrieved article references. We included 135 population-based studies of 968 419 adults from 90 countries. Sex- and age-specific hypertension prevalences from each country were applied to population data to calculate regional and global numbers of hypertensive adults. Proportions of awareness, treatment, and control from each country were applied to hypertensive populations to obtain regional and global estimates. Results: In 2010, 31.1% (95% confidence interval, 30.0%–32.2%) of the world’s adults had hypertension; 28.5% (27.3%–29.7%) in high-income countries and 31.5% (30.2%–32.9%) in low- and middle-income countries. An estimated 1.39 (1.34–1.44) billion people had hypertension in 2010: 349 (337–361) million in high-income countries and 1.04 (0.99–1.09) billion in low- and middle-income countries. From 2000 to 2010, the age-standardized prevalence of hypertension decreased by 2.6% in high-income countries, but increased by 7.7% in low- and middle-income countries. During the same period, the proportions of awareness (58.2% versus 67.0%), treatment (44.5% versus 55.6%), and control (17.9% versus 28.4%) increased substantially in high-income countries, whereas awareness (32.3% versus 37.9%) and treatment (24.9% versus 29.0%) increased less, and control (8.4% versus 7.7%) even slightly decreased in low- and middle-income countries. Conclusions: Global hypertension disparities are large and increasing. Collaborative efforts are urgently needed to combat the emerging hypertension burden in low- and middle-income countries.
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The prevalence of raised blood pressure and its adverse impact on cardiovascular morbidity and mortality are increasing globally, irrespective of income.
“Despite several initiatives, the prevalence of raised BP and adverse impact on cardiovascular morbidity and mortality are increasing globally, irrespective of income. 4,5”
From 2020 International Society of Hypertension Global Hypertension Practice Guidelines (2020) · cites this paper as [4]
The Discussion states that hypertension prevalence decreased in high-income countries from 2000 to 2010 while increasing in low- and middle-income countries, contrary to the claim that it is increasing irrespective of income. The paper links hypertension to cardiovascular morbidity and mortality, but the cited passages do not establish that those outcomes increased across all income groups. (LLM, conf=0.87)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredAn estimated 1.39 billion people had hypertension in 2010.
“When reviewing global figures, an estimated 1.39 billion people had hypertension in 2010. 4”
From 2020 International Society of Hypertension Global Hypertension Practice Guidelines (2020) · cites this paper as [4]
Low levels of awareness, treatment and control rates in low- and middle-income countries are accompanied by large disparities in the regional burden of hypertension when compared to high-income countries.
“The large disparities in the regional burden of hypertension are accompanied by low levels of awareness, treatment and control rates in LMIC, when compared to HIC.”
From 2020 International Society of Hypertension Global Hypertension Practice Guidelines (2020) · cites this paper as [4]
An estimated 349 million people had hypertension in high-income countries and 1.04 billion in low- and middle-income countries.
“with an estimated 349 million with hypertension in HIC and 1.04 billion in LMICs. 4”
From 2020 International Society of Hypertension Global Hypertension Practice Guidelines (2020) · cites this paper as [4]
Global awareness of hypertension is estimated at 67% in high-income countries and 38% in low- and middle-income countries.
“In response to poor global awareness for hypertension (estimated 67% in HIC and 38% in LMIC), 4”
From 2020 International Society of Hypertension Global Hypertension Practice Guidelines (2020) · cites this paper as [4]
Good blood pressure control was only achieved in less than one-third and one-tenth of patients with hypertension in high-income and lower-income countries, respectively.
“good BP control was only achieved in less than one-third and one-tenth of patients with hypertension in highincome and lower-income countries, respectively. 4”
Approximately 1 in 4 adults have hypertension (≥140/90 mm Hg), including 40% of those over age 25 years.
“About 1/4th of adults have high blood pressure”
From São Paulo call to action for the prevention and control of high blood pressure: 2020 (2019) · cites this paper as [1]
Between 1.13 and 1.4 billion people had hypertension in 2010 (defined as >140/90 mm Hg).
“Between 1.13 and 1.4 billion people had hypertension in 2010 (defined as >140/90 mm Hg.”
From São Paulo call to action for the prevention and control of high blood pressure: 2020 (2019) · cites this paper as [1]
Worldwide, about half of adults with hypertension are unaware that their blood pressure is high, a situation more dire in low-income countries.
“Worldwide, about half of adults with hypertension are unaware that their blood pressure is high, a situation more dire in low-income countries.”
From São Paulo call to action for the prevention and control of high blood pressure: 2020 (2019) · cites this paper as [1]
Two-thirds of those living with hypertension are in low- and middle-income countries where most of the world's population lives.
“Two-thirds of those living with hypertension are in low- and middle-income countries where most of the world's population lives”
From São Paulo call to action for the prevention and control of high blood pressure: 2020 (2019) · cites this paper as [1]
In high-income countries, the average rates of awareness, treatment, and control are 67%, 55.6%, and 28.4%, respectively, while in low- to middle-income countries the rates are 37.9%, 29%, and 7.7%, respectively.
“In high-income countries, the average rates of awareness, treatment, and control are 67%, 55.6%, and 28.4%, respectively, while in low- to middle-income countries the rates are 37.9%, 29%, and 7.7%, respectively.”
From São Paulo call to action for the prevention and control of high blood pressure: 2020 (2019) · cites this paper as [1]
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- Authors
- Mills, K. T., Bundy, J. D., Kelly, T. N., Reed, J. E., Kearney, P. M., Reynolds, K., Chen, J., & He, J.
- Affiliations
- Tulane University (US)
- ORCID
- Venue
- Circulation
- Published
- 2016-08-09
- Volume
- 134
- Issue
- 6
- Pages
- 441-450
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC4979614
- OpenAlex
- W2504981678
- Cited by
- 3,531
- References
- 39
- Citations by year
- 2026: 248 · 2025: 362 · 2024: 410 · 2023: 432 · 2022: 468 · 2021: 549 · 2020: 401 · 2019: 331 · 2018: 203 · 2017: 113 · 2016: 10
- FWCI
- 180.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- World Health Organization
- National Heart, Lung, and Blood Institute (U01HL114197, T32HL007024)
- National Institute of General Medical Sciences (P20GM109036)
- Fogarty International Center (D43TW009107)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- hypertension, global health disparities, hypertension prevalence, hypertension awareness, antihypertensive therapy, blood pressure control, low- and middle-income countries, high-income countries, secular trends, global burden of disease
- MeSH terms
- Cross-Sectional Studies, Developing Countries, Humans, Hypertension, Population Surveillance, Global Health, Prevalence, Developed Countries, Healthcare Disparities
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