Worldwide Trends in Hypertension: 40-Year Analysis

More than 1 billion people worldwide now have hypertension, with the highest levels now seen in low-income countries in south Asia and sub-Saharan Africa, according to a report in The Lancet.

The NCD Risk Factor Collaboration analyzed pooled data from 1479 studies that had measured blood pressure in 19.1 million adults. The researchers analyzed trends in mean systolic and diastolic blood pressure from 1975 to 2015, as well as the prevalence of raised blood pressure (140/90 mm Hg or higher) in 200 countries.

In 2015, global age-standardized mean blood pressure increased systolic blood pressure was 127.0/78.7 mm Hg in men and 122.3/76.7 mm Hg in women. The age-standardized prevalence of raised blood pressure was 24.1% and 20.1%, respectively.

High-income western and Asia Pacific countries went from having some of the highest measured blood pressure values in the world in 1975 to the lowest in 2015. By 2015, the regions with the highest measured blood pressure levels were central and eastern Europe, sub-Saharan Africa, and south Asia.

The overall number of adults with raised blood pressure increased from 594 million in 1975 to 1.13 billion in 2015, with most of the increase occurring in low- and middle-income countries. The global increase was attributable to population growth and ageing, partly offset by decreases in age-specific prevalence.

Over the past 40 years, the highest measured blood pressure values have shifted from high- to low-income countries, especially in sub-Saharan Africa. The total number of adults with raised blood pressure has increased by 90%. The authors call for multifaceted approaches to address the “large and inequitable burden of cardiovascular diseases and kidney disease associated with high blood pressure” [NCD Risk Factor Collaboration: Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participants. Lancet 2017; 389:37–55].


February 2017 (Vol 9, Number 2)