WHO Global Report on High Blood Pressure

The World Health Organization (WHO) has published its first report on the devastating global effects of high blood pressure, including recommendations on how to beat this silent killer . According to the report, approximately four out of five people with high blood pressure do not receive adequate treatment ; However, if countries manage to expand coverage, 76 million deaths could be avoided between 2023 and 2050.

High blood pressure affects one in three adults worldwide. This common and fatal condition causes strokes, heart attacks, heart failure, kidney damage, and many other health problems.

Summary

High systolic blood pressure is the leading risk factor for mortality in the world.
Hypertension affects one in three adults and occurs without symptoms: the “silent killer.” Almost half of people with hypertension are unaware of their condition.
Over the past three decades, the number of adults ages 30 to 79 living with hypertension has doubled to approximately 1.3 billion.
More than three-quarters of adults with hypertension live in low- and middle-income countries.
Only about one in five people with hypertension has controlled their hypertension.
The world is not on track to meet the voluntary global target of a 25% reduction in the prevalence of high blood pressure (uncontrolled hypertension) by 2025.
Comprehensive data, including population-based surveys and death registration data, are essential for monitoring hypertension in countries.
Monitoring the performance of health governance and infrastructure.
It helps in the creation of a strong health care system, capable of addressing widespread health problems such as hypertension.
About a third of the world’s adults live with hypertension and are at risk of heart disease, stroke or death.
WHO supports reducing dietary sodium (and increasing potassium), reducing alcohol consumption, controlling tobacco use, promoting physical activity and reducing air pollution to prevent hypertension .
The most effective way to control these risk factors for hypertension is through large-scale, population-level public health programs.
When hypertension is diagnosed, simple, low-cost treatments are available to control blood pressure and prevent heart disease, stroke, or death.

The number of people with high blood pressure (a blood pressure of 140/90 mmHg or higher or taking medications for high blood pressure) doubled between 1990 and 2019, from 650 million to 1.3 billion . Almost half of people with high blood pressure worldwide are currently unaware that they suffer from this condition. More than three-quarters of adults with high blood pressure live in low- and middle-income countries.

Although older age and genetics can increase the risk of high blood pressure, modifiable risk factors, such as a high-salt diet, lack of physical activity, or excessive alcohol consumption, can also increase this risk.

Making lifestyle changes, such as adopting a healthier diet, quitting smoking, and engaging in more physical activity, can help reduce blood pressure. Some people may need medications to effectively control high blood pressure and prevent related complications.

Prevention, early detection and effective management of high blood pressure are some of the most cost-effective interventions in health care, and countries should prioritize them as part of the national package of health benefits they offer. at the primary care level. The economic benefits of improved high blood pressure treatment programs outweigh the costs by approximately 18 to 1.

Figure: Hypertension treatment cascade in 2019, for adults aged 30 to 79 years worldwide, by sex. Rates standardized by age.

WHO Global Report on High Blood Pressure

"Although hypertension can be effectively controlled with simple, low-cost medications, only one in five people with high blood pressure has it under control," said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. control of high blood pressure still do not receive the attention they deserve, they are barely prioritized and their funding is far below what is necessary. Strengthening the control of high blood pressure must be part of the actions that all countries must implement in favor of universal health coverage, based on health systems that function properly, are equitable and resilient and are based on care. primary health.

The report will be presented during the seventy-eighth session of the United Nations General Assembly, which will address progress made towards achieving the Sustainable Development Goals, including health goals related to preparedness and response. to pandemics, the end of tuberculosis and universal health coverage. Better prevention and control of high blood pressure will be key to advancing in all of them.

Starting at a blood pressure of 115/75 mmHg, the risk of death from heart attack or stroke between ages 35 and 69 doubles with every 20-point increase in systolic blood pressure.

The longer a person lives with undiagnosed and inadequately treated hypertension, the worse their health outcomes will be.

An increase in the number of patients effectively treated for high blood pressure to the levels observed in countries with a high level of results could prevent, between now and 2050, 76 million deaths, 120 million strokes, 79 million heart attacks of myocardium and 17 million cases of heart failure .

Figure : Percentage of global deaths attributable to high systolic blood pressure (1990 and 2019), by cause of death.

WHO Global Report on High Blood Pressure

38% of deaths attributed to systolic high blood pressure occur in adults under 70 years of age.

"The majority of heart attacks and strokes occurring today can be prevented through affordable, safe and accessible medicines and other interventions, such as sodium reduction," said Michael R. Bloomberg, WHO Global Ambassador. for Non-Communicable Diseases and Trauma.

If countries mobilize to achieve the goal of controlling hypertension in 50% of the population by 2050, 76 million cardiovascular deaths and 450 million DALYs would be avoided.
Although the costs of achieving 50% blood pressure control are substantial, the economic benefits generated are estimated to be 18 times greater than those of standard practice.

"Treating high blood pressure in primary health care will save lives, as well as save billions of dollars each year."

High blood pressure can be easily treated with safe, widely available, low-cost generic medications through programs like the HEARTS program . This WHO technical package for the management of cardiovascular diseases in primary health care and the Guideline for the pharmacological treatment of hypertension in adults provide a series of proven practical measures to provide effective care for high blood pressure in adults. primary health care settings.

Effectively controlling blood pressure at both community and national levels in income countries of all types is possible. More than 40 low- and middle-income countries, including Bangladesh, Cuba, India and Sri Lanka, have strengthened their high blood pressure care through the HEARTS package, enrolling more than 17 million people in treatment programs. Countries such as Canada and South Korea offered comprehensive national programs for the treatment of high blood pressure, and in both cases the 50% rate for blood pressure control in adults with high blood pressure was exceeded. Sustained and systematic national high blood pressure control programs can be successful, and a higher level of blood pressure control leads to fewer strokes and heart attacks, and a longer, healthier life.

The report highlights the importance of implementing the WHO-recommended measures for effective, life-saving care of high blood pressure, which include the following five components:

Practical treatment protocols that specify dosages and medications, accompanied by specific measures to manage uncontrolled blood pressure, can expedite care and improve compliance.
Supply of medicines and equipment: Regular and uninterrupted access to affordable medicines is necessary for effective treatment of hypertension; Currently, the variation from one country to another in the price of essential drugs against high blood pressure is more than tenfold.
Team Care: Patient outcomes improve when working as a team to adjust and intensify blood pressure medication regimens according to physician instructions and protocols.
Patient-centered services: Providing easy-to-adhere treatment regimens, free medications, scheduling follow-up visits close to home, and easy access to blood pressure monitoring systems reduce barriers to care.
Information systems: Simple, user-centered information systems facilitate rapid recording of essential patient data, reduce the burden on healthcare workers in data entry, and help rapidly scale up actions, maintaining or while improving the quality of care.

«Every hour, more than 1,000 people die from strokes and heart attacks. “Many of these deaths are due to high blood pressure, and most could have been prevented,” said Dr. Tom Frieden, President and CEO of Resolve to Save Lives. «Good high blood pressure care is affordable, within our reach and strengthens primary health care. The challenge we face today is that this care simply ceases to be within our reach to be able to say that we already offer it, which will require the commitment of governments around the world.

Here you will find more information about the global effects of high blood pressure and the HEARTS package of control measures.

You can read the full report here .

References:

First WHO report details devastating impact of hypertension and ways to stop it . 19 September 2023 News release, ISBN: 978-92-4-008106-2
Global Report on Hypertension: The Race against a Silent Killer ,

WHO Global Report on High Blood Pressure

The World Health Organization provides a comprehensive report detailing the global impact of high blood pressure and strategies to mitigate its devastating effects.