Lower- and middle-income countries struggle to treat, control high blood pressure

For the first time in history, people living in low- and middle-income countries have a higher prevalence of hypertension, or high blood pressure, than people in high-income countries, according to a new study by Tulane researchers. The results have been published in the American Heart Association’s journal Circulation.

Analyzing data from 968,000 participants in 90 countries, researchers found more than 30 percent of the world’s adults (or 1.4 billion) had high blood pressure in 2010. Of those who had hypertension, more than 75 percent lived in low- and middle-income countries. While high blood pressure prevalence decreased in high-income countries, it increased in developing areas with low- and middle-income populations, according to the study. There are many reasons for these global disparities.

“Aging populations and urbanization, which is often accompanied by unhealthy lifestyle factors, such as high sodium, fat and calorie diets and lack of physical activity, may play an important role in the epidemic of hypertension in low- and middle-income countries,” said senoir study author Dr. Jiang He, Joseph S. Copes Chair and Professor in the Department of Epidemiology at Tulane University School of Public Health and Tropical Medicine.

“Hypertension needs to be a public health priority in low- and middle-income countries to prevent future cardiovascular and kidney disease, and associated costs to society,”

Katherine Mills, lead author and researcher at Tulane University

The study found that in high-income countries, 67 percent of hypertensive patients were aware of their condition, 56 percent received treatment, and 28 percent controlled their blood pressure. On other hand, awareness (38 percent), treatment (29 percent), and control (8 percent) was much lower in low- and middle-income countries.

“Hypertension needs to be a public health priority in low- and middle-income countries to prevent future cardiovascular and kidney disease, and associated costs to society,” said Katherine Mills, lead author and researcher at Tulane University. “Collaboration is needed from national and international stakeholders to develop innovative and cost-effective programs to prevent and control this condition.”

High blood pressure is a major risk factor for heart disease and stroke as well as the leading preventable cause of premature death and disability worldwide.