Hypertension Goes Widely Unrecognized Worldwide

More than half of all patients that have hypertension are unaware they even suffer from the condition, according to a new study.

Researchers at Hamilton General Hospital (ON, Canada), Dubai Heart Center (United Arab Emirates), and dozens of other institutions worldwide conducted a cross-sectional study of 153,996 (age 35–70 years) from 628 communities in 3 high-income countries, 10 upper-middle-income and low-middle-income countries, and 4 low-income countries. The main outcome measure was hypertension, either self-reported or an average of two blood pressure measurements of at least 140/90 mmHg. Awareness was based on self-reports, treatment was based on the regular use of medication, and control was defined as individuals with blood pressure lower than 140/90 mmHg.

The results showed that among a population of patients from 17 countries with hypertension, only 46.5% were aware of their diagnosis. Of the total study population, 40.8% had hypertension and the mean blood pressure was 131/82 mmHg. The majority of those who did know they had high blood pressure received drug treatment for hypertension (87.5%), but only 32.5% of those receiving drug treatment had their hypertension under control. Participants who were 50 and older consistently had a higher prevalence of hypertension and a greater awareness of their hypertension compared with younger participants, and had higher rates of treatment and control.

Awareness, treatment, and control of hypertension were higher in urban communities compared with rural ones in low–middle-income and low-income countries, but similar for other countries. Low education was associated with lower rates of awareness, treatment, and control in low-income countries, but not in other countries.

Among those receiving medication for hypertension, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers were the most common drugs taken (13.6%), followed by beta blockers (8.2%), calcium antagonists (8.2%), and diuretics (7%). Roughly one-third (30.8%) had two or more medications on their antihypertensive drug lists. The study was published in the September 4, 2013, issue of the Journal of the American Medical Association (JAMA).

“Although overall rates of hypertension awareness and control were concerning, rates of medication usages were lowest in the low-income countries,” said lead author Salim Yusuf, MD, PhD, of Hamilton General Hospital, and colleagues. “Models of care that shift the detection and initial treatment of hypertension to non-physician health workers should be considered to meet this shortfall in treatment.”

Related Links:
Hamilton General Hospital
Dubai Heart Center