14
views
0
recommends
+1 Recommend
3 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Addressing global disparities in blood pressure control: perspectives of the International Society of Hypertension

      review-article
      , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
      Cardiovascular Research
      Oxford University Press
      Epidemiology, Hypertension, Global, International, Cardiovascular disease, Regions, Inequity, Prevention, Awareness, Treatment, Control

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Raised blood pressure (BP) is the leading cause of preventable death in the world. Yet, its global prevalence is increasing, and it remains poorly detected, treated, and controlled in both high- and low-resource settings. From the perspective of members of the International Society of Hypertension based in all regions, we reflect on the past, present, and future of hypertension care, highlighting key challenges and opportunities, which are often region-specific. We report that most countries failed to show sufficient improvements in BP control rates over the past three decades, with greater improvements mainly seen in some high-income countries, also reflected in substantial reductions in the burden of cardiovascular disease and deaths. Globally, there are significant inequities and disparities based on resources, sociodemographic environment, and race with subsequent disproportionate hypertension-related outcomes. Additional unique challenges in specific regions include conflict, wars, migration, unemployment, rapid urbanization, extremely limited funding, pollution, COVID-19-related restrictions and inequalities, obesity, and excessive salt and alcohol intake. Immediate action is needed to address suboptimal hypertension care and related disparities on a global scale. We propose a Global Hypertension Care Taskforce including multiple stakeholders and societies to identify and implement actions in reducing inequities, addressing social, commercial, and environmental determinants, and strengthening health systems implement a well-designed customized quality-of-care improvement framework.

          Related collections

          Most cited references211

          • Record: found
          • Abstract: found
          • Article: found

          2018 ESC/ESH Guidelines for the management of arterial hypertension

            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

            Summary Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk–outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk–outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk–outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95% uncertainty interval [UI] 9·51–12·1) deaths (19·2% [16·9–21·3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12–9·31) deaths (15·4% [14·6–16·2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253–350) DALYs (11·6% [10·3–13·1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0–9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10–24 years, alcohol use for those aged 25–49 years, and high systolic blood pressure for those aged 50–74 years and 75 years and older. Interpretation Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. Funding Bill & Melinda Gates Foundation.
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              2020 International Society of Hypertension Global Hypertension Practice Guidelines

                Bookmark

                Author and article information

                Contributors
                Journal
                Cardiovasc Res
                Cardiovasc Res
                cardiovascres
                Cardiovascular Research
                Oxford University Press (US )
                0008-6363
                1755-3245
                11 October 2022
                11 October 2022
                : cvac130
                Affiliations
                School of Population Health, University of New South Wales, Kensington Campus , High Street, Sydney 2052 NSW, Australia; The George Institute for Global Health, King Street, Newton, Sydney NSW 2052, Australia
                Hypertension in Africa Research Team, SAMRC Unit for Hypertension and Cardiovascular Disease; North-West University , Hoffman Street, Potchefstroom 2520, South Africa
                SAMRC Development Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand , 1 Jan Smuts Ave, Braamfontein, Johannesburg, 2000, South Africa
                Program in Health Services and Systems Research, Duke-NUS Medical School, Department of Renal Medicine , 8 College Rd., Singapore 169857, Singapore
                Duke Global Health Institute, Duke University , 310 Trent Dr, Durham, NC 27710, USA
                Imperial Clinical Trials Unit, School of Public Health, Imperial College London , London W12 7RH, UK
                Faculty of Medicine, Eduardo Mondlane University , 3453 Avenida Julius Nyerere, Maputo, Mozambique
                Department of Medicine, University of British Columbia , Vancouver, British Columbia, Canada
                Center for Health Evaluation and Outcomes Sciences , Vancouver, British Columbia, Canada
                Department of Clinical Sciences, Skane University Hospital, Lund University , Malmö, Sweden
                Ochsner Health System , New Orleans, Louisiana, USA
                Queensland University , Brisbane, Queensland, Australia
                Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University , Baltimore, MD, USA
                Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine , Tochigi, Japan
                International University of Africa , Khartoum, Sudan
                Department of Cardiology, Cardiovascular Center Aalst, OLV Clinic Aalst , Aalst, Belgium
                Department of Experimental Pharmacology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel , Brussels, Belgium
                Kidney Research Centre, Ottawa Hospital Research Institute, Department of Cellular and Molecular Medicine, University of Ottawa , Ottawa, Ontario, Canada
                Health Innovation and Transformation Centre, Federation University , Ballarat, Victoria, Australia
                Department of Physiology and Anatomy, University of Melbourne , Melbourne, Victoria, Australia
                Department of Internal Medicine, College of Medicine, Chungbuk National University , Cheongju, Korea
                Institute of Cardiovascular and Medical Sciences, University of Glasgow , Glasgow, UK
                Baghdad College of Medicine , Baghdad, Iraq
                Pakistan Hypertension League , Karachi, Pakistan
                Department of Endocrinology, Metabolism and Nephrology, School of Medicine, Keio University , 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8585, Japan
                Division of Nephrology and Hypertension, Groote Schuur Hospital and Kidney and Hypertension Research Unit, University of Cape Town , Cape Town, South Africa
                Department of Public Health Medicine, University of Pretoria , Pretoria, South Africa
                Department of Preventive Cardiology, National Cerebral and Cardiovascular Center , Osaka, Japan
                Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University , Khon Kaen, Thailand
                University Hospital Clementino Fraga Filho, Hypertension Program, Universidade Federal do Rio de Janeiro , Brazil
                Circulatory Health Research Laboratory, College of Health Sciences, University of Abuja , Abuja, Nigeria
                Department of Nutrition and Dietetics, Asha Kiran JHC Hospital , Chinchwad, India
                Faculty of Medicine, University of Peradeniya , Kandy, Central Province, Sri Lanka
                Renal Division, Department of Internal Medicine, Emory University School of Medicine , Atlanta, GA, USA
                Dobney Hypertension Centre, School of Medicine, Royal Perth Hospital Unit and RPH Research Foundation, The University of Western Australia , Perth, Australia
                Department of Cardiology, Royal Perth Hospital , Perth, Western Australia, Australia
                Department of Nephrology, Royal Perth Hospital , Perth, Western Australia, Perth, Western Australia, Australia
                College of Medicine and Health Sciences, United Arab Emirates University , Al Ain, United Arab Emirates
                Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia , Malaysia
                Department of Cardiovascular & Renal Research, Institute of Molecular Medicine. University of Southern Denmark , Odense, Denmark
                Hypertension Centre STRIDE-7, School of Medicine, Third Department of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens , Athens, Greece
                Research Institute of the McGill University Health Centre, McGill University , Montreal, QC, Canada
                CARIM - Cardiovascular Research Institute, Maastricht University , Maastricht, The Netherlands
                Department of Pharmacology & Experimental Therapeutics and the Whitaker, Cardiovascular Institute, Boston University School of Medicine , Boston, MA, USA
                Department of Hypertension, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China
                Institute of Cardiovascular Science, University College London (UCL), National Institute for Health Research (NIHR), UCL Hospitals Biomedical Research Centre , London, UK
                Department of Internal Medicine, Division of Nephrology & Hypertension, University of Utah , Salt Lake City, UT, USA
                Division of Cardiovascular Sciences, Faculty of Medicine, Biology and Health, University of Manchester , Manchester, UK
                Manchester Heart Centre, Manchester University NHS Foundation Trust , Manchester, UK
                Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust , Manchester, UK
                Author notes
                Corresponding author. Tel. +61 450 315 918, E-mail: a.schutte@ 123456unsw.edu.au (A.E.S.); Tel. +44 161 275 0232, E-mail: maciej.tomaszewski@ 123456manchester.ac.uk (M.T.)

                Tazeen H. Jafar, Neil R. Poulter, Albertino Damasceno, Nadia A. Khan, Peter M. Nilsson, Jafar Alsaid, Dinesh Neupane and Kazuomi Kario contributed equally to the study.

                Conflict of interest: A.E.S. received speaker honoraria from different pharmaceutical companies and device manufacturers for work unrelated to this paper; P.M.N. has received speaker honoraria from different pharmaceutical companies. K.K. reports research grants from A&D, Omron Healthcare, Fukuda Denshi, Otsuka Pharmaceutical, Otsuka Holdings, CureApp, Sanwa Kagaku Kenkyusho, Daiichi Sankyo, Taisho Pharmaceutical, Sumitomo Dainippon Pharma, Takeda Pharmaceutical, Mitsubishi Tanabe Pharma, Teijin Pharma, Boehringer-Ingelheim Japan, Pfizer Japan, Fukuda Lifetec, Bristol-Myers Squibb, Mochida Pharmaceutical, Roche Diagnostics; and Consulting fees from A&D, JIMRO, Omron Healthcare, CureApp, Kyowa Kirin, Sanwa Kagaku Kenkyusho, Terumo, Fukuda Denshi, Mochida Pharmaceutical; and Honoraria from Idorsia, Omron Healthcare, Daiichi Sankyo, Novartis Pharma, Mylan EPD; and Participation in Advisory Board of Daiichi Sankyo, Novartis Pharma, Fukuda Denshi outside the submitted work. J.-G.W. reports having received lecture and consulting fees from Novartis, Omron, Servier, and Viatris. M.P.S. has received consulting fees, and/or travel and research support from Medtronic, Abbott, Metavention, ReCor, Novartis, Servier, Pfizer, and Boehringer-Ingelheim. E.S.W.J. has received honoraria from pharmaceutical companies for work unrelated to this publication. N.R.P. has received financial support from several pharmaceutical companies which manufacture BP-lowering agents, for consultancy fees (Servier), research projects, and staff (Servier, Pfizer) and for arranging and speaking at educational meetings (AstraZeneca, Lri Therapharma, Napi, Servier, Sanofi, Eva Pharma, Pfizer, Glenmark Pharma, Alkem Lab, and Emcure India). He holds no stocks and shares in any such companies. This manuscript was handled by Guest Editor Thomas F. Lüscher

                Author information
                https://orcid.org/0000-0001-9217-4937
                https://orcid.org/0000-0001-7454-8376
                https://orcid.org/0000-0002-6292-997X
                https://orcid.org/0000-0002-5547-0224
                https://orcid.org/0000-0002-5652-8459
                https://orcid.org/0000-0002-0269-5630
                https://orcid.org/0000-0002-1501-2990
                https://orcid.org/0000-0002-8251-4480
                https://orcid.org/0000-0001-6905-1867
                https://orcid.org/0000-0002-7081-4881
                https://orcid.org/0000-0003-3951-2911
                https://orcid.org/0000-0002-6164-9941
                https://orcid.org/0000-0002-0047-0227
                https://orcid.org/0000-0002-5039-7849
                https://orcid.org/0000-0001-5261-3106
                https://orcid.org/0000-0001-9725-2164
                https://orcid.org/0000-0003-2514-4919
                https://orcid.org/0000-0002-3569-3498
                https://orcid.org/0000-0002-1676-4895
                https://orcid.org/0000-0002-0705-9449
                https://orcid.org/0000-0003-3519-3415
                https://orcid.org/0000-0003-3853-7842
                https://orcid.org/0000-0002-4564-1587
                https://orcid.org/0000-0002-2337-385X
                https://orcid.org/0000-0002-7416-7984
                https://orcid.org/0000-0002-8445-9665
                https://orcid.org/0000-0002-1765-0195
                https://orcid.org/0000-0001-8533-9174
                https://orcid.org/0000-0002-4425-7989
                https://orcid.org/0000-0002-5430-4275
                https://orcid.org/0000-0002-6132-0038
                https://orcid.org/0000-0003-0670-0887
                https://orcid.org/0000-0002-0233-8705
                https://orcid.org/0000-0003-2830-5618
                https://orcid.org/0000-0001-8511-1524
                https://orcid.org/0000-0002-8094-1841
                https://orcid.org/0000-0003-0861-4245
                https://orcid.org/0000-0001-8215-6567
                Article
                cvac130
                10.1093/cvr/cvac130
                9619669
                36219457
                07997ed6-54d4-4206-bace-3e08bae9a9fe
                © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 March 2022
                : 13 May 2022
                : 31 May 2022
                : 11 October 2022
                Page count
                Pages: 29
                Funding
                Funded by: National Medical Research Council, doi 10.13039/501100001349;
                Funded by: NMRC, doi 10.13039/501100001349;
                Funded by: National Institutes of Health, doi 10.13039/100000002;
                Funded by: National Health and Medical Research Council, doi 10.13039/501100000925;
                Funded by: NHMRC, doi 10.13039/501100000925;
                Categories
                Invited Review
                AcademicSubjects/MED00200
                Custom metadata
                corrected-proof
                PAP

                Cardiovascular Medicine
                epidemiology,hypertension,global,international,cardiovascular disease,regions,inequity,prevention,awareness,treatment,control

                Comments

                Comment on this article