Abstract Body: Background: Hypertension is the leading preventable risk factor for premature death and disability worldwide.
Aims: We estimated global disparities in hypertension prevalence, awareness, treatment, and control in 2020 and compared secular changes from 2000 to 2020 worldwide.
Methods: We searched MEDLINE from 1995 to June 2023 and supplemented with a manual review of retrieved article references. We applied sex- and age- specific prevalences from each country to population data to calculate the number of hypertensive adults in each region and worldwide. Proportions of awareness, treatment, and control from each country were applied to hypertensive populations to obtain regional and global estimates.
Results: A total of 237 population-based surveys with 4,779,321 adults from 118 countries were included in analyses. We defined hypertension as SBP/DBP ≥140/90 mm Hg, or antihypertensive medication use and control of hypertension as SBP/DBP <140/90 mm Hg. An estimated 30.6% (95% CI, 30.0-31.2%) of the world’s adult population had hypertension in 2020. The prevalence was higher in low- and middle-income countries compared to high-income (Table). In 2020 an estimated 1.59 (1.57-1.61) billion people had hypertension; 378 (376-381) million in high-income and 1.21 (1.19-1.23) billion in low- and middle-income countries. From 2000 to 2010 the age-standardized prevalence of hypertension increased by 3.5% among men and 3.3% among women; from 2010 to 2020, the age-standardized prevalence increased by 2.1% among men and decreased by 1.0% among women. From 2000 to 2010 to 2020, worldwide proportions of hypertension awareness (38.7% vs 45.8% vs 48.0%), treatment (29.2% vs 36.9% vs 40.6%), and control among hypertensives (11.3% vs 14.0% vs 19.1%) increased. During the same period, proportions of awareness in high-income countries (57.3% vs 68.9% vs 68.6%) remained higher than in low-and middle-income countries (30.2% vs 37.6% vs 41.6%). Similar trends were identified for treatment in high-income countries (41.9% vs 56.2% vs 62.2%) compared to low- and middle- income countries (23.4% vs 28.8% vs 33.8%). Finally, control among hypertensives remained higher in high-income countries (15.1% vs 28.3% vs. 33.4%) compared to low- and middle-income countries (9.6% vs 9.0% vs 14.6%) in the same timeframe.
Conclusions: Collaborative efforts are needed to address the high burden of hypertension worldwide, particularly in low- and middle-income countries.