Publication:
Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Issued Date

2021-09-11

Resource Type

Article

ISSN

1474547X
01406736

DOI

10.1016/S0140-6736(21)01330-1

Other identifier(s)

2-s2.0-85114679906

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

The Lancet. Vol.398, No.10304 (2021), 957-980

Suggested Citation

Bin Zhou, Rodrigo M. Carrillo-Larco, Goodarz Danaei, Leanne M. Riley, Christopher J. Paciorek, Gretchen A. Stevens, Edward W. Gregg, James E. Bennett, Bethlehem Solomon, Rosie K. Singleton, Marisa K. Sophiea, Maria L.C. Iurilli, Victor P.F. Lhoste, Melanie J. Cowan, Stefan Savin, Mark Woodward, Yulia Balanova, Renata Cifkova, Albertino Damasceno, Paul Elliott, Farshad Farzadfar, Jiang He, Nayu Ikeda, Andre P. Kengne, Young Ho Khang, Hyeon Chang Kim, Avula Laxmaiah, Hsien Ho Lin, Paula Margozzini Maira, J. Jaime Miranda, Hannelore Neuhauser, Johan Sundström, Cherian Varghese, Indah S. Widyahening, Tomasz Zdrojewski, Majid Ezzati, Leandra Abarca-Gómez, Ziad A. Abdeen, Hanan F. Abdul Rahim, Niveen M. Abu-Rmeileh, Benjamin Acosta-Cazares, Robert J. Adams, Wichai Aekplakorn, Kaosar Afsana, Shoaib Afzal, Imelda A. Agdeppa, Javad Aghazadeh-Attari, Carlos A. Aguilar-Salinas, Charles Agyemang, Noor Ani Ahmad, Ali Ahmadi, Naser Ahmadi, Nastaran Ahmadi, Fariba Ahmadizar, Soheir H. Ahmed, Wolfgang Ahrens, Kamel Ajlouni, Rajaa Al-Raddadi, Monira Alarouj, Fadia AlBuhairan, Shahla AlDhukair, Mohamed M. Ali, Abdullah Alkandari, Ala’a Alkerwi, Kristine Allin, Eman Aly, Deepak N. Amarapurkar, Norbert Amougou, Philippe Amouyel, Lars Bo Andersen, Sigmund A. Anderssen, Ranjit Mohan Anjana, Alireza Ansari-Moghaddam, Daniel Ansong, Hajer Aounallah-Skhiri, Joana Araújo, Inger Ariansen, Tahir Aris, Raphael E. Arku, Nimmathota Arlappa, Krishna K. Aryal, Thor Aspelund, Felix K. Assah, Maria Cecília F. Assunção, Juha Auvinen, Mária Avdićová, Ana Azevedo, Mohsen Azimi-Nezhad, Fereidoun Azizi, Mehrdad Azmin, Bontha V. Babu, Suhad Bahijri, Nagalla Balakrishna, Mohamed Bamoshmoosh, Maciej Banach, Maja Banadinović, Piotr Bandosz, José R. Banegas, Joanna Baran, Carlo M. Barbagallo Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. The Lancet. Vol.398, No.10304 (2021), 957-980. doi:10.1016/S0140-6736(21)01330-1 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77859

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Thesis

Title

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Author(s)

Bin Zhou
 Rodrigo M. Carrillo-Larco
 Goodarz Danaei
 Leanne M. Riley
 Christopher J. Paciorek
 Gretchen A. Stevens
 Edward W. Gregg
 James E. Bennett
 Bethlehem Solomon
 Rosie K. Singleton
 Marisa K. Sophiea
 Maria L.C. Iurilli
 Victor P.F. Lhoste
 Melanie J. Cowan
 Stefan Savin
 Mark Woodward
 Yulia Balanova
 Renata Cifkova
 Albertino Damasceno
 Paul Elliott
 Farshad Farzadfar
 Jiang He
 Nayu Ikeda
 Andre P. Kengne
 Young Ho Khang
 Hyeon Chang Kim
 Avula Laxmaiah
 Hsien Ho Lin
 Paula Margozzini Maira
 J. Jaime Miranda
 Hannelore Neuhauser
 Johan Sundström
 Cherian Varghese
 Indah S. Widyahening
 Tomasz Zdrojewski
 Majid Ezzati
 Leandra Abarca-Gómez
 Ziad A. Abdeen
 Hanan F. Abdul Rahim
 Niveen M. Abu-Rmeileh
 Benjamin Acosta-Cazares
 Robert J. Adams
 Wichai Aekplakorn
 Kaosar Afsana
 Shoaib Afzal
 Imelda A. Agdeppa
 Javad Aghazadeh-Attari
 Carlos A. Aguilar-Salinas
 Charles Agyemang
 Noor Ani Ahmad
 Ali Ahmadi
 Naser Ahmadi
 Nastaran Ahmadi
 Fariba Ahmadizar
 Soheir H. Ahmed
 Wolfgang Ahrens
 Kamel Ajlouni
 Rajaa Al-Raddadi
 Monira Alarouj
 Fadia AlBuhairan
 Shahla AlDhukair
 Mohamed M. Ali
 Abdullah Alkandari
 Ala’a Alkerwi
 Kristine Allin
 Eman Aly
 Deepak N. Amarapurkar
 Norbert Amougou
 Philippe Amouyel
 Lars Bo Andersen
 Sigmund A. Anderssen
 Ranjit Mohan Anjana
 Alireza Ansari-Moghaddam
 Daniel Ansong
 Hajer Aounallah-Skhiri
 Joana Araújo
 Inger Ariansen
 Tahir Aris
 Raphael E. Arku
 Nimmathota Arlappa
 Krishna K. Aryal
 Thor Aspelund
 Felix K. Assah
 Maria Cecília F. Assunção
 Juha Auvinen
 Mária Avdićová
 Ana Azevedo
 Mohsen Azimi-Nezhad
 Fereidoun Azizi
 Mehrdad Azmin
 Bontha V. Babu
 Suhad Bahijri
 Nagalla Balakrishna
 Mohamed Bamoshmoosh
 Maciej Banach
 Maja Banadinović
 Piotr Bandosz
 José R. Banegas
 Joanna Baran
 Carlo M. Barbagallo

Other Contributor(s)

Éco-anthropologie
 Dasman Diabetes Institute
 Leibniz Institute for Prevention Research and Epidemiology
 Western Norway University of Applied Sciences
 Neyshabur University of Medical Sciences
 Université de Lille
 Caja Costarricense de Seguro Social
 King Saud bin Abdulaziz University for Health Sciences
 Qatar University
 Birzeit University
 Universidade Eduardo Mondlane
 Luxembourg Institute of Health
 Kwame Nkrumah University of Science and Technology
 Food and Nutrition Research Institute Manila
 Universidad Peruana Cayetano Heredia
 Haskoli Islands
 Université de Yaoundé I
 Universitas Indonesia
 Harvard T.H. Chan School of Public Health
 Erasmus MC
 Al-Quds University
 Københavns Universitet
 Zahedan University of Medical Sciences
 Pontificia Universidad Católica de Chile
 South African Medical Research Council
 UNSW Sydney
 Organisation Mondiale de la Santé
 Universidad Autónoma de Madrid
 Indian Council of Medical Research
 University of California, Berkeley
 Urmia University of Medical Sciences
 Flinders University
 University of Ghana
 CHU Lille
 Università degli Studi di Palermo
 Tulane University
 Faculdade de Medicina da Universidade do Porto (FMUP)
 Yonsei University
 Oulu University Hospital
 Charles University
 Robert Koch Institut
 Copenhagen University Hospital
 Imperial College London
 Universidade Federal de Pelotas
 University of Massachusetts Amherst
 University of Oulu
 Kementerian Kesihatan Malaysia
 Mahidol University
 Gdanski Uniwersytet Medyczny
 Norwegian Institute of Public Health
 Bombay Hospital and Medical Research Centre
 Universitetet i Oslo
 Instituto Nacional de la Nutrición Salvador Zubiran
 BRAC University
 Instituto Mexicano del Seguro Social
 Shahid Sadoughi University of Medical Sciences
 University of Rzeszów
 Universidade do Porto
 Frederiksberg Hospital
 Medical University of Lodz
 University of Zagreb School of Medicine
 National Institute of Biomedical Innovation
 National Taiwan University
 King Abdulaziz University
 Norges idrettshøgskole
 Uppsala Universitet
 Universiteit van Amsterdam
 Seoul National University College of Medicine
 Madras Diabetes Research Foundation
 ICMR-National Institute of Nutrition
 Non-Communicable Diseases Research Center
 University of Science and Technology
 Modeling in the Health Research Center
 Research Institute for Endocrine Sciences
 Abt Associates
 Natl. Preventive Medicine Res. Ctr.
 Aldara Hospital and Medical Center
 Regional Authority of Public Health in Banska Bystrica
 National Center for Diabetes
 National Institute of Public Health
 Thomayer Hospital
 WHO Regional Office for the Eastern Mediterranean

Abstract

Background: Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods: We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings: The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation: Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. Funding: WHO.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/77859

Collections

Scopus 2021