Hypertension Is A Growing Public Health Issue

Over the last 4 decades, the number of people living with this condition has doubled, and the prevalence seems to be accelerating with the issue shifting from wealthy western countries to the developing world. It is projected that by 2025 there could be well over 1.5 billion people with hypertension, that’s approximately 30-50% growth from the numbers in 2000. 

In the 2017 Global Burden of Disease study high systolic blood pressure was the leading risk factor for death, accounting for 10.4 million deaths in that year alone; the study suggests that hypertension is a higher risk factor than smoking, high BMI, and high fasting glucose for mortality. 

High blood pressure is thought to be a primary risk factor in all global diseases, if hypertension was reduced it would reduce the impact of many different diseases that claim the lives of tens of millions of people each and every year. To put a little perspective into this, high blood pressure is the leading cause of heart disease and stroke which take the lives of over 7.5 million people around the globe annually, that is at least 45% of deaths due to heart disease and 51% of deaths due to stroke. 

Hypertension should be taken seriously as it is a very significant risk factor for stroke, heart failure, coronary artery disease, kidney disease, and diabetes, as well as having an impact on brain health and cognitive function. The relationship between vascular brain pathology and syndromes of cognitive decline and dementia has been long recognized, and research has shown that lowering blood pressure can have a positive impact on brain health as well. 

According to the CDC in American alone, the total costs associated with high blood pressure in 2011 were over $46 billion, and it has kept increasing since then. The annual average of indirect and direct costs of high blood pressure from 2013-2014 was estimated to be over $53.2 billion, according to the American Heart Association. Globally a 2009 study estimated that blood pressure cost over $370 billion in 2001 representing 10% of the total global healthcare spending. Look at that over a ten year period it could cost one trillion dollars in global health spending with indirect costs reaching $3.6 trillion annually. However, the same study also pointed out there is room for improvement and estimated that there could be health care savings to curb these costs by implementing effective management of blood pressure to save roughly $100 billion annually. 

Although not new, this issue is largely going uncontrolled, hypertension has been called the silent killer because it has no physical symptoms and most people may not even know if they have high blood pressure or not. The CDC suggests that hypertension affects one-third of Americans, and in one-half of adults with hypertension, it is uncontrolled, representing nearly 35 million people. Among these 35 million 33% are not aware they have hypertension, 20% are aware but they are not treating it, and 47% are aware and are treating it but it is not adequately controlling their condition. 

This issue only gets worse when you look at it globally, for example, look at the PURE study which included data from over 142,000 people around the globe and found that 41% had hypertension, and only 46.4% of those with hypertension were aware of it. If you combine this data with W.H.O data showing over 1 billion people with hypertension, that suggests that over 500 million people are living with this silent killer around the globe. 

You do not have to sit back and accept having high blood pressure, in fact, according to the Mayo Clinic there are at least 10 lifestyle changes that one can make to help lower blood pressure and keep it down: lose extra weight and watch your waistline, exercise regularly, eat a healthy diet, reduce the amount of sodium in your diet, limit the amount of alcohol you drink, quit smoking, cut back on caffeine, reduce/manage stress, monitor your BP, and get support as needed. 

Nearly the end of 2020 a study was conducted on those with hypertension to understand the personal impact of managing hypertension and the potential for digital health solutions to help improve the management of the condition. According to Valencell, in their study, those with hypertension are not measuring their blood pressure enough with 62% measuring a few times a month or less, and 76% saying that they would measure more passively if they could in their device of choice. 

The Mayo Clinic recommends that those with hypertension should measure their blood pressure twice daily. 52% of the respondents were primarily interested in trending not the specific systolic and diastolic readings. 33% were most interested in whether their blood pressure was too low, too high, or normal, and another 19% wanted to know if their trending BP was too high/low. 

Respondents indicated a preference for finger clips(41%) and watches(40%) for device types to passively measure their blood pressure, with phones(32%), fitness bands(20%), and earbuds(10%) being in the top 5 preferred device types. Respondents indicated that they would like to measure their BP in situations they currently are not able to such as during or after a stressful event and before/after taking medications. 

According to this survey, there is a huge opportunity in digital health to help manage the growing hypertension issue. High blood pressure could be a global health epidemic in the making if it continues on the trajectory that it is on, unchallenged. What’s more, is that obesity, which is an epidemic in America, with around 70% of people being overweight, and a major cause of death that is attributable to heart disease, cancer, and diabetes, makes one more likely to develop high blood pressure. High cholesterol, obesity, and type-2 diabetes are documented comorbidities with high blood pressure. When is the last time that you had your blood pressure checked?