Every 1 in 3 adults has hypertension, but only half know it

New WHO report called for prioritising  prevention, early detection and effective management of high blood pressure

By Nandita Banerji
Published: Tuesday 19 September 2023
Only estimated 54 per cent of hypertension patients have been diagnosed globally and 42 per cent are receiving treatment for it. Photo: iStock__

About 76 million deaths could be averted by 2050 if coverage against high blood pressure, also known as hypertension, is scaled up globally, World Health Organization (WHO) said in its first-ever report on the devastating impact of the health condition.

The number of people living with hypertension has doubled between 1990 and 2019, from 650 million to 1.3 billion. It is estimated to affect 33 per cent of adults aged 30-79 worldwide, or roughly one in every three adults, said the Global report on hypertension: The race against a silent killer, released September 19, 2023.

Approximately four out of every five people with hypertension are not adequately treated and more than three-quarters of adults with hypertension live in low- and middle-income countries, the report further found.

Read more: How changing blood pressure targets in South Africa could save costs and lives

In India, an estimated 188.3 million adults aged 30–79 years have hypertension.

About 67 million more people with hypertension would need to be effectively treated in the country to achieve a 50 per cent control rate, the report said. If the progress scenario were achieved, 4.6 million deaths due to high blood pressure would be averted by 2040.

The prevalence of high blood pressure in India is slightly lower than the global average — 31 per cent. An estimated 37 per cent of these have been diagnosed and 30 per cent are receiving treatment for it.

The WHO classified hypertension as having systolic blood pressure greater than or equal to 140 millimetres of mercury (mmHg) or diastolic blood pressure greater than or equal to 90 mmHg. High blood pressure can lead to many issues like stroke, heart attack, heart failure and kidney damage.  

The global health body pointed out gaps in diagnosis — nearly half of people with hypertension globally are currently unaware of their condition. Only estimated 54 per cent of hypertension patients have been diagnosed globally and 42 per cent are receiving treatment for it. Only 21 per cent have had their hypertension controlled. 

The treatment coverage for hypertension tends to be highly skewed in favour of high-income countries and rate of effective treatment coverage, or hypertension control, also followed the same patterns, the report found.

The coverage was highest in the WHO region of Americas (60 per cent) and lowest in the African region (27 per cent). The rates of effective treatment coverage were 36 per cent and 12 per cent, respectively. 

Read more: Mobile health system can help regulate hypertension, diabetes: study

Nearly 30 per cent of those with uncontrolled hypertension who had not previously been diagnosed have systolic blood pressure measurements greater than or equal to 160 mmHg or diastolic blood pressure measurements greater than 100 mmHg. This is significantly higher than the hypertension threshold, indicating an urgent need for treatment.

Globally, the percentage of adults aged 30–70 years with hypertension taking medication to control it has almost doubled in three decades to 42 per cent in 2019 from 22 per cent in 1990. 

Effective treatment coverage is estimated to have quadrupled to 21 per cent from 5 per cent in the same period.

The WHO called for prioritising the prevention, early detection and effective management of hypertension by countries as part of their national  health benefit package offered at a primary care level. These are among the most cost effective interventions in health care whose economic benefits outweigh the costs by about 18 to 1, it highlighted. 

Older age and genetics play a major role in increasing the risk for a high blood pressure, said the global health body. However, modifiable risk factors such as eating a high-salt diet, not being physically active and drinking too much alcohol can also increase the risk of hypertension.

WHO Director-General Tedros Adhanom Ghebreyesus in a WHO statement only about one in five people with hypertension have controlled their hypertension even though it could be done so effectively with simple, low-cost medication regimens.

Read more: More Indians were diagnosed with hypertension than diabetes in 2017

“Hypertension control programmes remain neglected,  under-prioritised and vastly underfunded. Strengthening hypertension control must be part of  every country’s journey towards universal health coverage, based on well-functioning,  equitable and resilient health systems, built on a foundation of primary health care,” he said.

An increase in the number of patients effectively treated for hypertension to levels observed in high-performing countries could prevent 76 million deaths, 120 million strokes, 79 million heart  attacks, and 17 million cases of heart failure between now and 2050.

The report was released during the United Nations General Assembly’s 78th session. It addressed progress towards the United Nations-mandated Sustainable Development Goals, including health goals such as pandemic preparedness and response, tuberculosis eradication and attaining Universal Health Coverage. Better hypertension prevention and control will be critical for progress in all of these areas. 

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