An Important Health Condition Goes Under Recognized

High blood pressure (hypertension), defined as a measurement above 140/90 mm Hg, is the most important preventable cause of disease and death globally, yet more than half of all patients with hypertension are unaware they have the condition. Salim Yusuf, from Hamilton General Hospital (Canada), and colleagues completed a cross-sectional global analysis on the prevalence, awareness, treatment, and control of hypertension in a population of 142,042 participants from 17 countries. Data were grouped by country income through the Prospective Urban Rural Epidemiology (PURE) study. Subjects were followed for 10 years, were ages 35 to 70 years at the study’s start, and received measurements of cardiovascular disease risk factor history -- including smoking, history of hypertension, psychosocial factors, alcohol consumptions, and physical measures -- and sitting blood pressure. Primary outcomes were measures of participants' awareness of their hypertension status, use of treatment for hypertension, and whether or not hypertension was controlled. Control was defined as bringing hypertensive patients down to average blood pressure measurements below 140 mm Hg systolic and 90 mm Hg diastolic. In the total study population, 40.8% had hypertension and the mean blood pressure was 131/82 mm/Hg. All totaled, across the 17 countries with hypertension, only 46.5% were aware of their diagnosis. The majority of those who did know they had high blood pressure received drug treatment for hypertension (87.5%), but only about a third of those had their hypertension under control (32.5% of those receiving drug treatment), Compared with patients in middle- or higher-income nations, those in low-income countries had the lowest rates of awareness of their hypertension and of treatment. Observing that: “Among a multinational study population, 46.5% of participants with hypertension were aware of the diagnosis, with blood pressure control among 32.5% of those being treated,” the study authors submit that: “these findings suggest substantial room for improvement in hypertension diagnosis and treatment.”