A1 Journal article (refereed)
Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries : an analysis of 123 nationally representative surveys (2019)


NCD Risk Factor Collaboration. (2019). Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries : an analysis of 123 nationally representative surveys. The Lancet, 394(10199), 639-651. https://doi.org/10.1016/S0140-6736(19)31145-6


JYU authors or editors


Publication details

All authors or editors: NCD Risk Factor Collaboration

Journal or series: The Lancet

ISSN: 0140-6736

eISSN: 1474-547X

Publication year: 2019

Volume: 394

Issue number: 10199

Pages range: 639-651

Publisher: Elsevier

Publication country: Netherlands

Publication language: English

DOI: https://doi.org/10.1016/S0140-6736(19)31145-6

Publication open access: Openly available

Publication channel open access: Partially open access channel

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/65445


Abstract

Background
Antihypertensive medicines are effective in reducing adverse cardiovascular events. Our aim was to compare hypertension awareness, treatment, and control, and how they have changed over time, in high-income countries.
Methods
We used data from people aged 40–79 years who participated in 123 national health examination surveys from 1976 to 2017 in 12 high-income countries: Australia, Canada, Finland, Germany, Ireland, Italy, Japan, New Zealand, South Korea, Spain, the UK, and the USA. We calculated the proportion of participants with hypertension, which was defined as systolic blood pressure of 140 mm Hg or more, or diastolic blood pressure of 90 mm Hg or more, or being on pharmacological treatment for hypertension, who were aware of their condition, who were treated, and whose hypertension was controlled (ie, lower than 140/90 mm Hg).
Findings
Data from 526 336 participants were used in these analyses. In their most recent surveys, Canada, South Korea, Australia, and the UK had the lowest prevalence of hypertension, and Finland the highest. In the 1980s and early 1990s, treatment rates were at most 40% and control rates were less than 25% in most countries and age and sex groups. Over the time period assessed, hypertension awareness and treatment increased and control rate improved in all 12 countries, with South Korea and Germany experiencing the largest improvements. Most of the observed increase occurred in the 1990s and early-mid 2000s, having plateaued since in most countries. In their most recent surveys, Canada, Germany, South Korea, and the USA had the highest rates of awareness, treatment, and control, whereas Finland, Ireland, Japan, and Spain had the lowest. Even in the best performing countries, treatment coverage was at most 80% and control rates were less than 70%.
Interpretation
Hypertension awareness, treatment, and control have improved substantially in high-income countries since the 1980s and 1990s. However, control rates have plateaued in the past decade, at levels lower than those in high-quality hypertension programmes. There is substantial variation across countries in the rates of hypertension awareness, treatment, and control.


Keywords: hypertension; care; clinical guidelines; pharmacotherapy; control; survey research; developed countries


Contributing organizations


Ministry reporting: Yes

Reporting Year: 2019

JUFO rating: 3


Last updated on 2021-20-09 at 16:38