Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital

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

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Targeting IL-6 in patients at high cardiovascular risk

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Oral rimegepant for migraine prevention

    Research output: Contribution to journalComment/debateResearchpeer-review

  3. Migraine: epidemiology and systems of care

    Research output: Contribution to journalReviewResearchpeer-review

  4. Migraine: integrated approaches to clinical management and emerging treatments

    Research output: Contribution to journalReviewResearchpeer-review

  1. Common variants in Alzheimer's disease and risk stratification by polygenic risk scores

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Hypophosphataemia is common in patients with aneurysmal subarachnoid haemorrhage

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Elevated apolipoprotein A1 and HDL cholesterol associated with age-related macular degeneration: 2 population cohorts

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Determinants of penetrance and variable expressivity in monogenic metabolic conditions across 77,184 exomes

    Research output: Contribution to journalJournal articleResearchpeer-review

  • NCD Risk Factor Collaboration (NCD-RisC)
  • Torben Jørgensen (Member of study group)
  • Allan Linneberg (Member of study group)
  • Freja Bach Kampmann (Member of study group)
  • Line Tang Møllehave (Member of study group)
  • Line Lund Kårhus (Member of study group)
  • Betina Heinsbæk Thuesen (Member of study group)
  • Ruth Frikke-Schmidt (Member of study group)
  • Børge G. Nordestgaard (Member of study group)
  • Shoaib Afzal (Member of study group)
  • Stig Egil Bojesen (Member of study group)
  • Anette Varbo (Member of study group)
  • Thomas Meinertz Dantoft (Member of study group)
  • Marie Holm Eliasen (Member of study group)
  • Peter Schnohr (Member of study group)
  • Ulla Nørgaard Toft (Member of study group)
View graph of relations

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.


Original languageEnglish
JournalThe Lancet
Issue number10304
Pages (from-to)957-980
Number of pages24
Publication statusPublished - 11 Sep 2021

ID: 67567125