High Blood Pressure: Silent killer affecting 1.3 billion people globally

The World Health Organization (WHO) is taking on the world’s worst killer, hypertension—a level of high blood pressure that affects one in every three adults globally. This figure has doubled since 1990, and it now affects 1.3 billion people.

The WHO released a report today during the United Nations General Assembly, stating that three-fourths of people living with hypertension reside in low- and middle-income nations. High blood pressure, which causes heart attacks, kidney disease, and stroke, affects nearly half of them without their knowledge. Four-fifths of those affected, including both diagnosed individuals and those unaware of their condition, are not receiving adequate treatment to control it.

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 650 million to 1.3 billion. Nearly half of people with hypertension globally are currently unaware of their condition. More than three-quarters of adults with hypertension live in low- and middle-income countries.

Hypertension care: cost-effective for countries

Older age and genetics can increase the risk of having high blood pressure, but modifiable risk factors such as eating high-salt diet, not being physically active and drinking too much alcohol can also increase the risk of hypertension.

Lifestyle changes like eating a healthier diet, quitting tobacco and being more active can help lower blood pressure. Some people may need medicines that can control hypertension effectively and prevent related complications. 

Countries should prioritize the prevention, early detection, and effective management of hypertension as part of their national health benefit package offered at a primary care level, as these interventions are among the most cost-effective in health care. Improved hypertension treatment programmes outweigh the costs by about 18 to 1, resulting in significant economic benefits.

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, said, "Simple, low-cost medication regimens can effectively control hypertension, but only about one in five people with hypertension have controlled it." He added that hypertension control programmes are neglected, under-prioritized, and vastly underfunded. He emphasized that every country's journey towards universal health coverage should include strengthening hypertension control, based on well-functioning, equitable, and resilient health systems built on a foundation of primary health care.

UNGA Session to launch hypertension report

During the 78th Session of the United Nations General Assembly, which addresses progress for the Sustainable Development Goals including health goals on pandemic preparedness and response, ending tuberculosis, and attaining Universal Health Coverage, they will launch the report. Progress in all of these goals will require better prevention and control of hypertension.

An increase in the number of patients effectively treated for hypertension to levels observed in high-performing countries could prevent 76 million deaths, 120 million strokes, 79 million heart attacks, and 17 million cases of heart failure between now and 2050.

“Most heart attacks and strokes in the world today can be prevented with affordable, safe, accessible medicines and other interventions, such as sodium reduction,” said Michael R. Bloomberg, WHO Global Ambassador for Noncommunicable Diseases and Injuries. “Treating hypertension through primary health care will save lives, while also saving billions of dollars a year.”

Prioritize hypertension for health and economy

The WHO plan emphasizes that nations should prioritize combating hypertension not only out of compassion but also for economic reasons. More than one-third of hypertension-related deaths occur in people under 70, resulting in lost income for their families and a country's GDP. According to one estimate the agency cites, spending $1 on hypertension control yields an $18 return in the long run.

As the world emerges from Covid, recommending a focus on another pressing health issue may seem challenging. However, it could also be the opportune moment to do so. While Covid claimed nearly 7 million lives globally, non-infectious diseases account for 41 million annual deaths. Unlike Covid, hypertension is well-understood, and affordable medications are available to treat it.

Yet, as the new plan proposes, it hasn't received adequate attention. Gene Bukhman, a cardiologist who heads the Program on Global Noncommunicable Disease and Social Change at Harvard Medical School, says, "In general, the majority of the world has neglected noninfectious diseases. They've treated them as emerging problems, when in reality they have been endemic problems for decades." In other words, controlling hypertension doesn't require a discovery program—it simply demands willpower.

“Every hour, more than 1 000 people die from strokes and heart attacks. Most of these deaths are caused by high blood pressure, and most could have been prevented,” said Dr Tom Frieden, President & CEO, Resolve to Save Lives. “Good hypertension care is affordable, within reach, and strengthens primary health care. The challenge now is to go from “within reach” to “reached.” This will require commitment of governments around the world.”

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