Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries.
Level 1 - systematic review of randomized trials
Systematic review and pooled analysis of 135 population-based studies
PubMed 27502908 · doi:10.1161/CIRCULATIONAHA.115.018912
What was done
The authors systematically searched MEDLINE (1995–2014) and reference lists for population-based studies evaluating hypertension prevalence, awareness, treatment, and control. They included 135 studies comprising 968,419 adults across 90 countries. Age- and sex-specific estimates were applied to global and regional population data to calculate numbers for 2010 and evaluate secular trends from 2000 to 2010 comparing high-income countries (HICs) with low- and middle-income countries (LMICs).
What was found
In 2010, 31.1% (95% CI, 30.0%–32.2%) of adults globally had hypertension, representing approximately 1.39 billion people (349 million in HICs and 1.04 billion in LMICs). Prevalence was 28.5% (95% CI, 27.3%–29.7%) in HICs versus 31.5% (95% CI, 30.2%–32.9%) in LMICs. From 2000 to 2010, age-standardized prevalence decreased by 2.6% in HICs but increased by 7.7% in LMICs. During this decade, HICs saw substantial increases in awareness (58.2% to 67.0%), treatment (44.5% to 55.6%), and control (17.9% to 28.4%). Conversely, LMICs saw modest gains in awareness (32.3% to 37.9%) and treatment (24.9% to 29.0%), while control rates slightly declined (8.4% to 7.7%).
Why it matters
This study demonstrates that the global burden of hypertension has disproportionately shifted to LMICs, where prevalence is rising and fewer than 8% of affected individuals achieve blood pressure control.
Limits
Data were available from only 90 countries, requiring modeling and extrapolation for underrepresented regions. The analysis relies on pooled cross-sectional surveys with potential heterogeneity in blood pressure measurement protocols and survey years.
Cited by
- supports Hypertension currently affects nearly one third of the global population.