Elsevier

The Lancet

Volume 365, Issue 9455, 15 January 2005, Pages 217-223
The Lancet

Articles
Global burden of hypertension: analysis of worldwide data

https://doi.org/10.1016/S0140-6736(05)17741-1Get rights and content

Summary

Background

Reliable information about the prevalence of hypertension in different world regions is essential to the development of national and international health policies for prevention and control of this condition. We aimed to pool data from different regions of the world to estimate the overall prevalence and absolute burden of hypertension in 2000, and to estimate the global burden in 2025.

Methods

We searched the published literature from Jan 1, 1980, to Dec 31, 2002, using MEDLINE, supplemented by a manual search of bibliographies of retrieved articles. We included studies that reported sex-specific and age-specific prevalence of hypertension in representative population samples. All data were obtained independently by two investigators with a standardised protocol and data-collection form.

Results

Overall, 26·4% (95% CI 26·0–26·8%) of the adult population in 2000 had hypertension (26·6% of men [26·0–27·2%] and 26·1% of women [25·5–26·6%]), and 29·2% (28·8–29·7%) were projected to have this condition by 2025 (29·0% of men [28·6–29·4%] and 29·5% of women [29·1–29·9%]). The estimated total number of adults with hypertension in 2000 was 972 million (957–987 million); 333 million (329–336 million) in economically developed countries and 639 million (625–654 million) in economically developing countries. The number of adults with hypertension in 2025 was predicted to increase by about 60% to a total of 1·56 billion (1·54–1·58 billion).

Interpretation

Hypertension is an important public-health challenge worldwide. Prevention, detection, treatment, and control of this condition should receive high priority.

Introduction

Hypertension is an important worldwide public-health challenge because of its high frequency and concomitant risks of cardiovascular and kidney disease.1, 2 It has been identified as the leading risk factor for mortality, and is ranked third as a cause of disability-adjusted life-years.3 The prevalence of hypertension in various regions of the world has been widely reported;4, 5, 6, 7, 8, 9 however, no information has been compiled for its prevalence and absolute burden around the world. Accurate estimates of the worldwide prevalence of this condition are essential as a source of primary information and for rational planning of health services. Measurement of the global burden of hypertension would allow international public-health policy-makers to assign sufficient priority and resources to its management and prevention.

National representative studies of the prevalence of this condition have been done in some countries, whereas in others, published data are from regional or local population-based samples. We aimed to pool data from population-based studies in different regions to estimate the overall prevalence and absolute burden of hypertension in the whole world and in various regions in 2000, and to estimate the global burden in 2025.

Section snippets

Methods

We searched MEDLINE using the medical subject headings “prevalence”, “hypertension”, “blood pressure”, and “cross-sectional studies”. The search was restricted to studies in human beings published from Jan 1, 1980, to Dec 31, 2002. We searched for additional studies manually using references cited in reviews and original study articles. Additionally, we searched the WHO Global Cardiovascular InfoBase.10 Publications in another language were translated into English. Eligibility criteria for

Results

The number of participants per study ranged from 665 to 484 185 (table 1). The standard mercury sphygmomanometer was the most common device used to measure blood pressure. Apart from three studies, blood pressure was measured at least twice per visit. Three studies measured blood pressure at two visits, and the remaining studies measured it on a single occasion.

Table 2 shows crude and age-adjusted prevalence of hypertension for each study; figure 1 shows the estimated prevalence of hypertension

Discussion

Our analysis indicates that more than a quarter of the world's adult population—totalling nearly one billion—had hypertension in 2000, and that this proportion will increase to 29%—1·56 billion—by 2025. It also suggests that men and women have similar overall prevalence of hypertension, and that such prevalences increase with age consistently in all world regions. A particularly high prevalence of hypertension was reported in Latin America and the Caribbean, and other Asia and Islands had the

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