The World Health Organisation (WHO) has issued its inaugural report on the worldwide impact of high blood pressure, shedding light on the devastating consequences of this silent but deadly health condition. Alongside this eye-opening report, WHO has outlined recommendations aimed at addressing the looming threat of hypertension and preventing its catastrophic toll. Shockingly, the report underscores that nearly 80% of individuals suffering from hypertension are not receiving adequate treatment. However, with increased coverage, it is estimated that scaling up treatment could avert a staggering 76 million deaths between 2023 and 2050.
Hypertension, commonly known as high blood pressure, afflicts one in three adults globally. This pervasive yet perilous condition can lead to severe health complications, including strokes, heart attacks, heart failure, and kidney damage. The numbers are alarming: from 1990 to 2019, the count of people grappling with it, defined as blood pressure of 140/90 mmHg or higher or receiving medication, surged from 650 million to a staggering 1.3 billion. Astonishingly, almost half of these individuals remain unaware of their hypertension status. Even more concerning is the fact that over three-quarters of hypertensive adults reside in low- and middle-income nations.
While factors like age and genetics can elevate the risk of hypertension, modifiable elements such as consuming a high-salt diet, physical inactivity, and excessive alcohol consumption also contribute significantly. Fortunately, lifestyle changes such as adopting a healthier diet, quitting tobacco use, and increasing physical activity can be effective in lowering blood pressure. In some cases, individuals may require medication to effectively control hypertension and prevent associated complications.
Prevention, early detection, and efficient management rank among the most cost-effective healthcare interventions and should be prioritised at the primary care level by nations. The economic gains from improving treatment programmes are staggering, outweighing costs by approximately 18 to 1.
Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, emphasised the importance of effective hypertension control, stating, “Hypertension can be controlled effectively with simple, low-cost medication regimens, and yet only about one in five people with hypertension have controlled it.” He highlighted the dire underfunding and neglect of hypertension control programmes, underscoring the need to strengthen these programmes as part of every nation’s journey towards universal health coverage.
This pivotal report coincides with the 78th Session of the United Nations General Assembly, which focuses on progress towards the Sustainable Development Goals, including health objectives related to pandemic preparedness, tuberculosis elimination, and Universal Health Coverage. Effective prevention and control will play a pivotal role in achieving these global goals.
It is projected that elevating the number of patients receiving effective hypertension treatment to levels seen in high-performing countries could prevent a staggering 76 million deaths, along with 120 million strokes, 79 million heart attacks, and 17 million cases of heart failure by 2050.
Michael R. Bloomberg, WHO Global Ambassador for Noncommunicable Diseases and Injuries, emphasized the preventable nature of heart attacks and strokes through affordable, accessible medications and interventions, such as sodium reduction. He noted that treating hypertension via primary healthcare can not only save lives but also yield significant financial savings.
Effective management of hypertension can be accomplished through low-cost generic medications available through programs like HEARTS (the HEARTS technical package for cardiovascular disease management in primary healthcare) and adherence to WHO guidelines for pharmacological treatment in adults. Encouragingly, successful community- and country-wide blood pressure management programs are attainable regardless of income level.
Several low- and middle-income countries, including Bangladesh, Cuba, India, and Sri Lanka, have bolstered their hypertension care through the HEARTS package, enrolling over 17 million individuals into treatment programmes. Meanwhile, countries like Canada and South Korea have implemented comprehensive national hypertension treatment initiatives, surpassing the 50% benchmark for blood pressure control among adults with hypertension. Sustained, systematic national hypertension control efforts can yield significant dividends, reducing strokes and heart attacks while promoting longer, healthier lives.
The WHO report emphasises the necessity of adopting WHO-recommended effective hypertension care to save lives. These recommendations encompass five key components, including practical dose- and drug-specific treatment protocols, consistent medication and equipment supply, team-based care, patient-centered services, and user-friendly information systems. With these measures in place, a global commitment is needed to bridge the gap from “within reach” to “reached,” as preventing hypertension-related deaths requires governments worldwide to prioritise and invest in effective hypertension control programmes.
