Suboptimal blood pressure is the cause of more death than any other single risk factor and is the leading contributor to the global burden of disease. This contribution is expected to grow. Furthermore, hypertension (that level of raised blood pressure for which guidelines usually recommend drug treatment) affects more than 1 billion people globally, is the biggest contributor to cardiovascular disease, and yet it remains undiagnosed in most of those affected.
The direct consequences of raised blood pressure include stroke, coronary heart disease, heart failure, dementia, and renal failure. However, blood pressure can be measured quickly, cheaply, and painlessly and can be treated cost-effectively by well tolerated pharmacological and non-pharmacological evidence-based interventions. Nevertheless, perhaps partly because hypertension usually has no related symptoms and is so common, it receives insufficient attention from the general public, the medical profession, and health policy makers.
Global data highlight some of the key problems relating to hypertension. First, it is common with about 24% of men and 20% of women affected. Second, only about half of those with hypertension are aware of it. Third, fewer than a third of those treated reach currently recommended, and probably conservative, blood pressure targets. Finally, each of these problems is worse in low-income than in high-income countries, and it is in the former category—most of the world's population—that mean blood pressures are increasing. Consequently, major challenges exist for the improved prevention, detection, and management of hypertension, particularly in the developing world.
The World Heart Federation identified raised blood pressure as one of three primary targets for intervention most likely to bring about a 25% reduction in non-communicable disease mortality by 2025, as outlined in the UN declaration of 2014. Similarly, the 2016 Lancet Commission on hypertension showed that raised blood pressure is a key area of concern for global health. The World Heart Federation and the Lancet Commission identified the range of problems that drive the burden of disease caused by raised blood pressure, from unopposed environmental causes to inadequate education of the population and the medical profession through to poor detection and management of hypertension. However, both reports brought focus on improved awareness of blood pressure as an important action needed to address the current situation.
Source: The Lancet