Hypertension affects 1.13 billion people globally; 199 million reside in India

One of the targets of World Health Organization global status report on Non-communicable Diseases was to reduce the prevalence of high blood pressure levels among adults by 25 per cent by the year 2025. But meeting these targets might be challenging, as a recent study by a team of scientists from Imperial College London shows that the cases of high blood pressure have increased from 594 million adults in 1975 to 1.13 billion adults in 2015. Men are more affected than women. Top 5 countries with high blood pressure amongst men and women has been given below.

Published in the journal The Lancet on November 16, 2016, the study analysed blood pressure trends among adults from 1975 to 2015 in 200 countries. It referred to national, sub-national or community population-based research that measured blood pressure in people above 18 years. Following this, the researchers calculated the changes in prevalence of high blood pressure while taking into account the population growth and ageing.

Majid Ezzati, senior author of the study at the School of Public Health at Imperial, said, "High blood pressure is no longer related to affluence—as it was in 1975. Now, it is a major health issue linked with poverty."

The study goes on to reveal that the burden of high blood pressure witnessed a dip in high and middle-income countries but low-income countries experienced a surge in such cases. India, in fact, has high prevalence of people with high blood pressure. In 2015, 23 per cent of 1.13 billion adults with high blood pressure lived in South Asia, of which 199 million reside in India.

Increased blood pressure also makes them vulnerable to cardiovascular diseases and chronic kidney disease. Another publication in Circulation in April 2016 revealed that in India, premature mortality in terms of years of life lost because of cardiovascular diseases has increased by 59 per cent by 2010. “Tackling the epidemic of high blood pressure in low and middle-income countries is one of the most pressing global health challenges,” added Ezzati.

Some of the factors, which the study claims having led to unfavourable trends, include ignored early child nutrition, low consumption of fruits, high consumption of salt, obesity along with insufficient exercise as well as environmental factors like lead exposure and air pollution. The high-income countries, which have seen reducing trends of high blood pressures, owe it partly to a change in risk factors, including smoking, physical activity, psychosocial stress and use of blood pressure lowering drugs.

The team of scientists also reinforced the need for targeting the population sooner as well as focussing on population-based interventions, altering individual lifestyle management and treatment through primary care systems.

Such population-based interventions focussing on cardiovascular diseases and their risk factors have been performed in India and research has shown that most of the interventions improved knowledge, but almost all of them failed to influence risk factors or disease outcomes. For example, in case of cardiovascular diseases, secondary interventions like aspirin and beta-blockers lower the risk of recurrent cardiovascular events, but these interventions have been plagued with major gaps.

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India Environment Portal Resources :

• Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants
• Assessment of schoolchildren for congenital heart disease using murmurs and blood pressure as markers
• Global disparities of hypertension prevalence and control
• Risks and population burden of cardiovascular diseases associated with diabetes in China: A prospective study of 0.5 million adults