Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension

Zeng, Bin; Perel, Pablo; Mensah, George A.; Ezzati, Majid

doi:10.1038/s41569-021-00559-8

Cited by 795 publications

(580 citation statements)

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“…We used data from 1990 to 2019, collated by the NCD Risk Factor Collaboration (NCD-RisC), as detailed previously 6 and summarised in the appendix (pp 2-3). The inclusion criteria were that (1) data were collected using a probabilistic sampling method with a defined sampling frame; (2) data were from population samples at the national, sub-national (covering one or more subnational regions), or community (one or a small number of communities) level; (3) systolic blood pressure and diastolic blood pressure were measured; and (4) data on hypertension treatment were available.…”

Section: Data Sourcesmentioning

confidence: 99%

“…Studies were excluded if they (1) included or excluded participants on the basis of health status; (2) were done only among minority ethnic groups or specific educational, occupational, or other socioeconomic groups; (3) recruited participants through health facilities, except studies whose sampling frame was health insurance schemes in countries where at least 80% of the population were insured, and studies based on primary care systems in high-income and central European countries with universal insurance; or (4) had not measured blood pressure. A list of data sources and their characteristics is provided in the appendix (pp .…”

Section: Data Sourcesmentioning

confidence: 99%

“…Hypertension, along with pre-hypertension and other hazardously high blood pressure, is responsible for 8•5 million deaths from stroke, ischaemic heart disease, other vascular diseases, and renal disease worldwide. 1,2 Hypertension can be detected in the community and primary care facilities, and several effective drugs are available at fairly low cost for treating patients with hypertension and reducing the risk of its sequelae. 1, [3][4][5] Improving the effective coverage of treatment for patients with hypertension is an objective of many global, regional, and national initiatives, and programmes.…”

Section: Introductionmentioning

confidence: 99%

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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

Zeng¹,

Carrillo‐Larco²,

Danaei³

et al. 2021

The Lancet

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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. MethodsWe 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

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Section: Data Sourcesmentioning

confidence: 99%

Section: Data Sourcesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Zeng¹,

Carrillo‐Larco²,

Danaei³

et al. 2021

The Lancet

Self Cite

1,870

862

View full text Add to dashboard Cite

show abstract

“…Hypertension is an important risk factor for cardiovascular diseases and a serious global problem. The prevalence of hypertension has doubled in the past three decades, accounting for 8.5 million deaths annually worldwide ( 26 , 27 ). More importantly, Hypertension was the most common comorbidity among patients with cancer in a large observational cohort study, with a reported prevalence of 38% ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk of Hypertension in Cancer Patients Treated With Atezolizumab and Bevacizumab: A Systematic Review and Meta-Analysis

Jiang

Tan

et al. 2021

Front. Oncol.

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PurposeThis study aims to inform previous clinical assessments to better understand the total risk of hypertension with atezolizumab and bevacizumab (hereafter referred to as “A-B”) in cancer patients, and reduce future incidence of hypertension-related cardiovascular complications.MethodsDatabases, including PubMed, Embase, Cochrane, and Web of Science were searched to identify relevant studies, which were retrieved from inception to March 6, 2021. Studies focused on cancer patients treated with A-B that provided data on hypertension were included. Statistical analyses were conducted to calculate hypertension incidence and relative risk (RR) with a random-effects or fixed-effects model, hinging on heterogeneity status.ResultsTen studies including 2106 patients with renal cell carcinoma (RCC), hepatocellular carcinoma (HCC), ovarian cancer, anal cancer, neuroendocrine tumors (NETs), and cervical cancer were selected for this meta-analysis. For patients treated with A-B, the all-grade and high-grade (grade 3) hypertension incidence were 31.1% (95% CI: 25.5-37.3) and 14.1% (95% CI: 10.9-18.1), respectively. No significant difference was observed in all-grade hypertension incidence between RCC and a non-RCC patients (32.9% [95% CI: 25.3-42.6] v.s. 29.2% [95% CI: 19.7-39.6)]). However, the number of high-grade hypertension incidence in RCC patients (9.4% [95% CI: 4.1-21.3]) was lower than that of non-RCC patients (15.6% [95% CI: 12.8-19.1]). RCC or HCC patients who received the A-B treatment were associated with significantly increased risk of all-grade hypertension with a RR of 7.22 (95% CI: 3.3-15.7; p = 0.6) compared with patients treated with atezolizumab.ConclusionsCancer Patients treated with atezolizumab and bevacizumab have a significantly increased risk of hypertension. Sufficient monitoring is highly recommended to prevent the consequences of treatment-induced hypertension and other cardiovascular complications.

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“…The prevalence of hypertension was 31.1% in 2010, 28.5% in high-income countries, and 31.5% in low-and middle-income countries (3). An estimated 8.5 million deaths in 2015 were due to systolic blood pressure (SBP) >115 mm Hg, 88% of these deaths were in low-and middle-income countries (4). Worse still, the prevalence of hypertension in low-and middle-income countries is still on the rise (5).…”

Section: Introductionmentioning

confidence: 99%

Lifestyle Score and Genetic Factors With Hypertension and Blood Pressure Among Adults in Rural China

Niu

Zhang

Wang

et al. 2021

Front. Public Health

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Background: Although high genetic risk and unhealthful lifestyles are associated with a high risk of hypertension, but the combined relationship between lifestyle score and genetic factors on blood pressure remains limited, especially in resource-constrained areas.Aim: To explore the separate and joint effects between genetic and lifestyle factors on blood pressure and hypertension in rural areas.Methods: In 4,592 adults from rural China with a 3-year of follow-up, a genetic risk score (GRS) was established using 13 single nucleotide polymorphisms (SNPs) and the lifestyle score was calculated including factors diet, body mass index (BMI), smoking status, drinking status, and physical activity. The associations of genetic and lifestyle factors with blood pressure and hypertension were determined with generalized linear and logistic regression models, respectively.Results: The high-risk GRS was found to be associated with evaluated blood pressure and hypertension and the healthful lifestyle with diastolic blood pressure (DBP) level. Individuals with unhealthful lifestyles in the high GRS risk group had an odds ratio (OR) (95% CI) of 1.904 (1.006, 3.603) for hypertension than those with a healthful lifestyle in the low GRS risk group. Besides, the relative risk (RR), attributable risk (AR), and population attributable risk (PAR) for unhealthful lifestyle are 1.39, 5.87, 0.04%, respectively, and the prevented fraction for the population (PFP) for healthful lifestyle is 9.47%.Conclusion: These results propose a joint effect between genetic and lifestyle factors on blood pressure and hypertension. The findings provide support for adherence to a healthful lifestyle in hypertension precision prevention.Clinical Trial Registration: The Henan Rural Cohort Study has been registered at the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). http://www.chictr.org.cn/showproj.aspx?proj=11375.

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Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension

Cited by 795 publications

References 254 publications

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

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

Incidence and Risk of Hypertension in Cancer Patients Treated With Atezolizumab and Bevacizumab: A Systematic Review and Meta-Analysis

Lifestyle Score and Genetic Factors With Hypertension and Blood Pressure Among Adults in Rural China

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