The first ever report from the WHO on the devastating global impact of high blood pressure – and ways to beat this silent killer – shows that four out of five people with hypertension are not adequately treated, but that 76m deaths could be averted before 2050.
That, says the report, would be possibly only if countries were to adequately scale up their coverage of the deadly condition, notes MedicalBrief.
Hypertension affects one in every three adults worldwide, it leads to stroke, heart attack, heart failure, kidney damage and various other health problems.
Boosting the number of patients effectively treated for hypertension to levels observed in high-performing countries could prevent 120m strokes, 79m heart attacks, and 17m cases of heart failure between now and 2050.
According to the report, the number of people living with hypertension (blood pressure of 140/90 mmHg or higher or taking medication for hypertension) doubled between 1990 and 2019, from 650m to 1.3bn. Nearly half of the people with hypertension globally are unaware of their condition, more than three-quarters of those affected by it living in low- and middle-income countries.
While older age and genetics can increase the risk of the condition, modifiable risk factors – eating high-salt diet, not being physically active and too much alcohol – can also increase the risks.
The WHO said prevention, early detection and effective management of hypertension are among the most cost-effective interventions and should be prioritised by countries as part of their national health benefit package offered at a primary care level.
The economic benefits of improved hypertension treatment programmes outweigh the costs by about 18 to one.
“Hypertension can be controlled effectively with simple, low-cost medication regimens, yet only about one in five people with hypertension have controlled it,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
He said 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.”
The report was launched during the 78th Session of the United Nations General Assembly earlier this month, focusing on progress for the Sustainable Development Goals including health goals on pandemic preparedness and response, ending tuberculosis and attaining Universal Health Coverage.
“Most heart attacks and strokes can be prevented with affordable, safe, accessible medicines and other interventions, such as sodium reduction,” said Michael Bloomberg, WHO Global Ambassador for Non-Communicable Diseases and Injuries.
Recommended sodium intake varies from country to country, but WHO recommends less than 2 000mg a day. The estimated global average salt intake is more than twice that: 10.8g per day, the organisation said.
“Treating hypertension through primary healthcare will save lives, while also saving billions of dollars a year,” added Bloomberg.
Hypertension, said the report, can easily be treated with safe, widely available, low-cost generic medications using programmes like the WHO's HEARTS technical package for cardiovascular disease management in primary health care and the Guideline for the pharmacological treatment of hypertension in adults, which provide practical steps to deliver effective hypertension care.
More than 40 low- and middle-income countries, including Bangladesh, Cuba, India and Sri Lanka, have strengthened their hypertension care with the HEARTS package, enrolling more than 17m people into treatment programmes.
These preventative measures include eating a healthy diet, maintaining a healthy weight, avoiding alcohol and tobacco, and exercising regularly, the report says. These strategies should be implemented in specific settings like schools and in the workplace to further promote healthier lifestyle choices, it says.
Another tactic is lowering daily sodium intake.
CNN reports that WHO highlighted practical dose- and drug-specific treatment protocols for managing uncontrolled blood pressure; regular, uninterrupted access to affordable medication, and the reduction of barriers to care through easy-to-take medication regimens, free medications and close-to-home follow-up visits, as well as readily available blood pressure monitoring.
Additionally, user-centred, simple information systems would facilitate rapid recording of essential patient-level data, reduce healthcare worker data entry burden, and support rapid scale-up while maintaining or improving the quality of care, it said.
WHO Global report on hypertension
Guidelines for hypertension
See more from MedicalBrief archives:
New hypertension guidelines released by ESH
New NICE hypertension guidelines a ‘pragmatic compromise’ — The Lancet
Napping cuts hypertension as much as does salt and alcohol reduction
Can SA reach targets to reduce hypertension?