Bin ZhouRodrigo M. Carrillo-LarcoGoodarz DanaeiLeanne M. RileyChristopher J. PaciorekGretchen A. StevensEdward W. GreggJames E. BennettBethlehem SolomonRosie K. SingletonMarisa K. SophieaMaria L.C. IurilliVictor P.F. LhosteMelanie J. CowanStefan SavinMark WoodwardYulia BalanovaRenata CifkovaAlbertino DamascenoPaul ElliottFarshad FarzadfarJiang HeNayu IkedaAndre P. KengneYoung Ho KhangHyeon Chang KimAvula LaxmaiahHsien Ho LinPaula Margozzini MairaJ. Jaime MirandaHannelore NeuhauserJohan SundströmCherian VargheseIndah S. WidyaheningTomasz ZdrojewskiMajid EzzatiLeandra Abarca-GómezZiad A. AbdeenHanan F. Abdul RahimNiveen M. Abu-RmeilehBenjamin Acosta-CazaresRobert J. AdamsWichai AekplakornKaosar AfsanaShoaib AfzalImelda A. AgdeppaJavad Aghazadeh-AttariCarlos A. Aguilar-SalinasCharles AgyemangNoor Ani AhmadAli AhmadiNaser AhmadiNastaran AhmadiFariba AhmadizarSoheir H. AhmedWolfgang AhrensKamel AjlouniRajaa Al-RaddadiMonira AlaroujFadia AlBuhairanShahla AlDhukairMohamed M. AliAbdullah AlkandariAla’a AlkerwiKristine AllinEman AlyDeepak N. AmarapurkarNorbert AmougouPhilippe AmouyelLars Bo AndersenSigmund A. AnderssenRanjit Mohan AnjanaAlireza Ansari-MoghaddamDaniel AnsongHajer Aounallah-SkhiriJoana AraújoInger AriansenTahir ArisRaphael E. ArkuNimmathota ArlappaKrishna K. AryalThor AspelundFelix K. AssahMaria Cecília F. AssunçãoJuha AuvinenMária AvdićováAna AzevedoMohsen Azimi-NezhadFereidoun AziziMehrdad AzminBontha V. BabuSuhad BahijriNagalla BalakrishnaMohamed BamoshmooshMaciej BanachMaja BanadinovićPiotr BandoszJosé R. BanegasJoanna BaranCarlo M. BarbagalloÉco-anthropologieDasman Diabetes InstituteLeibniz Institute for Prevention Research and EpidemiologyWestern Norway University of Applied SciencesNeyshabur University of Medical SciencesUniversité de LilleCaja Costarricense de Seguro SocialKing Saud bin Abdulaziz University for Health SciencesQatar UniversityBirzeit UniversityUniversidade Eduardo MondlaneLuxembourg Institute of HealthKwame Nkrumah University of Science and TechnologyFood and Nutrition Research Institute ManilaUniversidad Peruana Cayetano HerediaHaskoli IslandsUniversité de Yaoundé IUniversitas IndonesiaHarvard T.H. Chan School of Public HealthErasmus MCAl-Quds UniversityKøbenhavns UniversitetZahedan University of Medical SciencesPontificia Universidad Católica de ChileSouth African Medical Research CouncilUNSW SydneyOrganisation Mondiale de la SantéUniversidad Autónoma de MadridIndian Council of Medical ResearchUniversity of California, BerkeleyUrmia University of Medical SciencesFlinders UniversityUniversity of GhanaCHU LilleUniversità degli Studi di PalermoTulane UniversityFaculdade de Medicina da Universidade do Porto (FMUP)Yonsei UniversityOulu University HospitalCharles UniversityRobert Koch InstitutCopenhagen University HospitalImperial College LondonUniversidade Federal de PelotasUniversity of Massachusetts AmherstUniversity of OuluKementerian Kesihatan MalaysiaMahidol UniversityGdanski Uniwersytet MedycznyNorwegian Institute of Public HealthBombay Hospital and Medical Research CentreUniversitetet i OsloInstituto Nacional de la Nutrición Salvador ZubiranBRAC UniversityInstituto Mexicano del Seguro SocialShahid Sadoughi University of Medical SciencesUniversity of RzeszówUniversidade do PortoFrederiksberg HospitalMedical University of LodzUniversity of Zagreb School of MedicineNational Institute of Biomedical InnovationNational Taiwan UniversityKing Abdulaziz UniversityNorges idrettshøgskoleUppsala UniversitetUniversiteit van AmsterdamSeoul National University College of MedicineMadras Diabetes Research FoundationICMR-National Institute of NutritionNon-Communicable Diseases Research CenterUniversity of Science and TechnologyModeling in the Health Research CenterResearch Institute for Endocrine SciencesAbt AssociatesNatl. Preventive Medicine Res. Ctr.Aldara Hospital and Medical CenterRegional Authority of Public Health in Banska BystricaNational Center for DiabetesNational Institute of Public HealthThomayer HospitalWHO Regional Office for the Eastern Mediterranean2022-08-042022-08-042021-09-11The Lancet. Vol.398, No.10304 (2021), 957-9801474547X014067362-s2.0-85114679906https://repository.li.mahidol.ac.th/handle/20.500.14594/77859Background: 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.Mahidol UniversityMedicineArticleSCOPUS10.1016/S0140-6736(21)01330-1