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Review
. 2020 Apr;16(4):223-237.
doi: 10.1038/s41581-019-0244-2. Epub 2020 Feb 5.

The global epidemiology of hypertension

Affiliations
Review

The global epidemiology of hypertension

Katherine T Mills et al. Nat Rev Nephrol. 2020 Apr.

Abstract

Hypertension is the leading cause of cardiovascular disease and premature death worldwide. Owing to the widespread use of antihypertensive medications, global mean blood pressure (BP) has remained constant or has decreased slightly over the past four decades. By contrast, the prevalence of hypertension has increased, especially in low- and middle-income countries (LMICs). Estimates suggest that 31.1% of adults (1.39 billion) worldwide had hypertension in 2010. The prevalence of hypertension among adults was higher in LMICs (31.5%, 1.04 billion people) than in high-income countries (28.5%, 349 million people). Variations in the levels of risk factors for hypertension, such as high sodium intake, low potassium intake, obesity, alcohol consumption, physical inactivity and unhealthy diet, may explain some of the regional heterogeneity in hypertension prevalence. Despite the increasing prevalence, the proportions of hypertension awareness, treatment and BP control are low, particularly in LMICs, and few comprehensive assessments of the economic impact of hypertension exist. Future studies are warranted to test implementation strategies for hypertension prevention and control, especially in low-income populations, and to accurately assess the prevalence and financial burden of hypertension worldwide.

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Conflict of interest statement

Competing interest statement

The authors declare no competing interests.

Figures

Figure 1.
Figure 1.. Changes in mean estimated blood pressure by world region between 1975 and 2015.
A. Change in systolic blood pressure (BP) in men. B. Change in systolic BP in women. C. Change in diastolic BP in men. D. Change in diastolic BP in Women. Data obtained from reference.
Figure 2.
Figure 2.. Hypertension prevalence by world region in 2010.
Prevalence of hypertension defined as systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg or use of antihypertensive medication in A. Men and B. Women. Data obtained from reference.
Figure 3.
Figure 3.. Causes of deaths worldwide attributed to increased blood pressure in 2015.
A. Estimated numbers of deaths attributed to systolic blood pressure (SBP) ≥110–115 mmHg and B. SBP ≥140 mmHg by cause of death. Data obtained from reference.

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