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
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2021 |
| Outros Autores: | , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
| Texto Completo: | http://hdl.handle.net/10400.18/8223 |
Resumo: | NCD Risk Factor Collaboration (NCD-RisC): National Institute of Health Doutor Ricardo Jorge, Portugal (Baltazar Nunes and Marta Barreto) |
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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 participantsHypertensionEpidemiologyAdultAntihypertensive AgentsDrug TherapyPrevention and ControlEstados de Saúde e de DoençaNCD Risk Factor Collaboration (NCD-RisC): National Institute of Health Doutor Ricardo Jorge, Portugal (Baltazar Nunes and Marta Barreto)Erratum in: Department of Error. Lancet. 2022 Feb 5;399(10324):520. doi: 10.1016/S0140-6736(22)00061-7. NCD Risk Factor Collaboration (NCD-RisC). "In this Article, Marialaura Bonaccio, Maria Benedetta Donati, and Francesco Gianfagna have been added to the NCD Risk Factor Collaboration list, and Steinar Krokstad's name has been corrected. These corrections have been made to the online version as of Feb 3, 2022"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. 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.Evidence before this study: We searched MEDLINE (via PubMed) for articles published from inception to Jan 15, 2021, using the search terms ((hypertension[Title] AND (((medication OR treatment) AND control) OR aware*) AND “blood pressure”) OR (cardiovascular[Title] AND risk factor*[Title] AND “blood pressure” AND (((medication OR treatment) AND control) OR aware*))) AND (trend* OR global OR worldwide) NOT patient*[Title]. No language restrictions were applied. We found a few multi-country studies that reported hypertension prevalence, treatment, and control. These studies used up to 135 data sources that had sampled from national or sub-national populations or data from small communities. Few multi-country studies reported trends over time. The largest of these analyses covered snapshots in 2000 and 2010 and grouped countries into high income versus low income and middle income. We also found several studies that analysed trends in individual countries. To our knowledge, there is no study on long-term trends in, nor the contemporary levels of, hypertension prevalence, detection, treatment, and control that covers the entire world. Added value of this study: To our knowledge, this study is the first comprehensive global analysis of trends in hypertension prevalence, detection, treatment, and control that covers all countries worldwide. The data used in the study were from 184 countries, together covering 99% of the global population, and were subject to rigorous inclusion and exclusion criteria. Data were analysed using a standardised protocol and were pooled using a statistical model designed to incorporate how hypertension and its care and control vary in relation to age, geography, and time. Implications of all the available evidence: Hypertension care—including detection, treatment, and control—varies substantially worldwide and even within the same region of the world. Sub-Saharan Africa, Oceania, and south Asia have the lowest rates of detection, treatment, and control and many countries in these regions have seen little improvement in these outcomes over the past 30 years. The large improvements observed in some upper-middle-income and recently high-income countries show that the expansion of universal health coverage and primary care can be leveraged to enhance hypertension care and reduce the health burden of this condition.World Health OrganizationElsevierRepositório Científico do Instituto Nacional de SaúdeNCD Risk Factor Collaboration (NCD-RisC)Barreto, MartaNunes, Baltazar2022-07-11T15:17:41Z2021-08-242021-08-24T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfhttp://hdl.handle.net/10400.18/8223engLancet. 2021 Sep 11;398(10304):957-980. doi: 10.1016/S0140-6736(21)01330-1. Epub 2021 Aug 240140-673610.1016/S0140-6736(21)01330-1info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-20T15:42:24Zoai:repositorio.insa.pt:10400.18/8223Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T18:42:47.532160Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
| dc.title.none.fl_str_mv |
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 |
| title |
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 |
| spellingShingle |
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 NCD Risk Factor Collaboration (NCD-RisC) Hypertension Epidemiology Adult Antihypertensive Agents Drug Therapy Prevention and Control Estados de Saúde e de Doença |
| title_short |
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 |
| title_full |
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 |
| title_fullStr |
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 |
| title_full_unstemmed |
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 |
| title_sort |
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 |
| author |
NCD Risk Factor Collaboration (NCD-RisC) |
| author_facet |
NCD Risk Factor Collaboration (NCD-RisC) Barreto, Marta Nunes, Baltazar |
| author_role |
author |
| author2 |
Barreto, Marta Nunes, Baltazar |
| author2_role |
author author |
| dc.contributor.none.fl_str_mv |
Repositório Científico do Instituto Nacional de Saúde |
| dc.contributor.author.fl_str_mv |
NCD Risk Factor Collaboration (NCD-RisC) Barreto, Marta Nunes, Baltazar |
| dc.subject.por.fl_str_mv |
Hypertension Epidemiology Adult Antihypertensive Agents Drug Therapy Prevention and Control Estados de Saúde e de Doença |
| topic |
Hypertension Epidemiology Adult Antihypertensive Agents Drug Therapy Prevention and Control Estados de Saúde e de Doença |
| description |
NCD Risk Factor Collaboration (NCD-RisC): National Institute of Health Doutor Ricardo Jorge, Portugal (Baltazar Nunes and Marta Barreto) |
| publishDate |
2021 |
| dc.date.none.fl_str_mv |
2021-08-24 2021-08-24T00:00:00Z 2022-07-11T15:17:41Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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http://hdl.handle.net/10400.18/8223 |
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http://hdl.handle.net/10400.18/8223 |
| dc.language.iso.fl_str_mv |
eng |
| language |
eng |
| dc.relation.none.fl_str_mv |
Lancet. 2021 Sep 11;398(10304):957-980. doi: 10.1016/S0140-6736(21)01330-1. Epub 2021 Aug 24 0140-6736 10.1016/S0140-6736(21)01330-1 |
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Elsevier |
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Elsevier |
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