Uncontrolled hypertension common, but untreated, worldwide

A GLOBAL study has found that many patients don’t know they have hypertension and, even if they do, too few are receiving adequate drug therapy for their hypertension.

In a study that included more than 140,000 participants from 17 countries of varying income levels, researchers found a large gap between both detection and control of hypertension across all countries studied, with just over half of participants with hypertension aware of their diagnosis, and about one-third of those being treated for hypertension successfully controlling their blood pressure. The report, which was published in the September 4 issue of JAMA, the journal of the American Medical Association, is part of the PURE (Prospective Urban Rural Epidemiological) study.

“High blood pressure is the leading cause of cardiovascular disease (CVD) and deaths globally. It is associated with at least 7.6 million deaths per year worldwide (13.5% of all deaths), making it the leading risk factor for CVD. The majority of CVD occurs in low-, low-middle-, and upper-middle-income countries. The importance of blood pressure as a modifiable risk factor for CVD is well-recognized and many effective and inexpensive blood pressure-lowering treatments are available. Therefore, hypertension control and prevention of subsequent morbidity and mortality clearly should be achievable,” according to background information in the article. “Information on hypertension prevalence, awareness, treatment, and control in multiple countries and different types of communities is necessary to provide a baseline for monitoring and also to inform the development of new strategies for improving hypertension control.”

This is true in high income countries, like Canada, as well as middle and low income countries, say an international team of researchers led by the Population Health Research Institute (PHRI) of McMaster University (Hamilton, Ontario) and Hamilton Health Sciences.

“Our study indicates over half of people with hypertension are unaware of their condition and, amongst those identified, very few are taking enough treatment to control their blood pressure,” said Dr. Clara Chow, lead author, a member of PHRI and an associate professor of medicine of Sydney University and the George Institute for Global Health in Australia.

Dr. Salim Yusuf, senior author and professor of medicine of McMaster University’s Michael G. DeGroote School of Medicine, added that drug treatments that work to control hypertension are well known, however this study found only about a third of patients who are aware of their condition were achieving target blood pressure control.

“Blood pressure-lowering drugs are generally inexpensive and commonly available treatments,” said Yusuf. “However only a third of patients commenced on treatment are on enough treatment to control their blood pressure. This is worst in low income countries, but significant in high and middle income countries too.”

This is important because hypertension or high blood pressure is the leading cause of cardiovascular disease, which is associated with at least 7.6 million deaths per year worldwide.

The study included 153,996 adults (complete data for this analysis on 142,042) 35 to 70 years of age, recruited between January 2003 andWomens Nike Cortez