Nearly half the number of people with hypertension globally are unaware of their condition, says the World Health Organization’s first report on the “devastating global impact” of high blood pressure, also called a ‘silent killer’.

“The number of people living with hypertension (blood pressure of 140/90 mmHg or higher or taking medication for hypertension) doubled between 1990 and 2019, from 650 million to 1.3 billion, the UN health agency said. In fact, more than three-quarters of adults with hypertension live in low- and middle-income countries, it added.

The WHO report is being launched during the 78th Session of the United Nations General Assembly (New York), which addresses the Sustainable Development Goals including health goals on pandemic preparedness and response, ending tuberculosis, and attaining universal health coverage.

Further, the report points out, about four in five people with hypertension are not adequately treated. But if countries scale up coverage, about 76 million deaths could be averted between 2023 and 2050, it added.

Hypertension affects one in three adults worldwide and this common, yet deadly condition leads to stroke, heart attack, heart failure, and kidney damage. 

“Every hour, more than 1,000 people die from strokes and heart attacks. Most of these deaths are caused by high blood pressure, and most could have been prevented,” said Dr Tom Frieden, President and Chief Executive, Resolve to Save Lives, a not-for-profit organisation. “Good hypertension care is affordable, within reach, and strengthens primary healthcare,” he said, calling for commitment from governments around the world.

High risk

While old age and genetics increase the risk of having high blood pressure, the risk increased further with a high-salt diet, not being physically active, and drinking too much alcohol, the WHO report added. Lifestyle changes including a healthier diet, quitting tobacco, and being more active can help lower blood pressure, and some may need medicines to control hypertension and prevent complications. 

Prevention, early detection, and effective management of hypertension are cost-effective health interventions and countries should prioritise them as a part of the national health benefit packages offered at primary care level, it said. “The economic benefits of improved hypertension treatment programmes outweigh the costs by about 18 to 1,” it added. 

Disease management

Hypertension can be easily treated with safe, widely available, low-cost generic medications through programmes such as HEARTS — the WHO’s technical package for cardiovascular disease management in primary healthcare, the report said.

More than 40 low- and middle-income countries, including Bangladesh, Cuba, India and Sri Lanka, have strengthened their hypertension care with the HEARTS package, enrolling more than 17 million people into treatment programmes, the WHO said.

“An increase in the number of patients effectively treated for hypertension to levels observed in high-performing countries could prevent 76 million deaths, 120 million strokes, 79 million heart attacks, and 17 million cases of heart failure between now and 2050,” it said.

The report underscores the implementation of WHO-recommended hypertension care to save lives, including practical dose- and drug-specific treatment protocols with specific actions for managing uncontrolled blood pressure. Regular and uninterrupted access to affordable medication is necessary for effective hypertension treatment, it said, adding that currently the prices of essential anti-hypertensive medicines vary by more than ten-fold between countries.