The World Health Organization released the first-ever "Global Hypertension Report". What did it say?

Recently, the World Health Organization (WHO) released the first-ever Global Report on Hypertension (the Report), which details the devastating impact of hypertension around the world and provides recommendations on how to defeat this silent killer.

The report shows that hypertension affects one-third of adults worldwide. The number of people with hypertension (systolic blood pressure ≥ 140 mmHg, or diastolic blood pressure ≥ 90 mmHg, or taking antihypertensive drugs) has doubled in the past 30 years, from 650 million in 1990 to 1.3 billion in 2019. However, nearly half of these hypertensive patients are unaware of their condition, and about four-fifths of them fail to receive adequate treatment . Measuring blood pressure is the only way to diagnose hypertension. All adults should measure their blood pressure regularly; if you feel at risk, see a doctor as soon as possible. Hypertension can cause stroke, heart attack, heart failure, kidney damage and many other health problems. Excessive systolic blood pressure can cause more than 10 million deaths worldwide each year, exceeding deaths caused by other health risks. But if countries can work together to increase the hypertension control rate to 50%, 76 million deaths can be avoided between 2023 and 2050.

But many of these deaths could be prevented through policy measures to reduce the risk of high blood pressure.

Advanced age and genetic factors increase the risk of developing high blood pressure; so do some modifiable risk factors, such as a high-salt diet, physical inactivity, and excessive alcohol consumption.

Changing lifestyles, including eating a healthier diet, quitting smoking, and increasing physical activity, can help lower blood pressure. The report uses the "Provincial-Ministry Joint Salt Reduction and Hypertension Prevention Project (SMASH)" carried out in Shandong from 2011 to 2016 as a case study to show that comprehensive measures can help increase public awareness of recommended salt intake and attention to processed food labels, and take salt reduction actions, thereby reducing blood pressure levels at the population level.

(Case from the Global Hypertension Report)

Furthermore, improving hypertension treatment could save millions of lives. Prevention, early detection and effective management of hypertension are among the most cost-effective interventions in health care and should be prioritized as part of national health service packages at the primary health care level.

As WHO Director-General Dr Tedros Adhanom Ghebreyesus said, “Hypertension control programmes remain neglected, low priority and severely underfunded. Strengthening hypertension control must be part of every country’s journey towards universal health coverage, underpinned by well-functioning, equitable and resilient health systems based on primary health care.”

The WHO HEARTS toolkit and Guidelines on pharmacotherapy of hypertension in adults provide validated and proven steps that can be used to provide effective hypertension care in primary health care settings.

The report also emphasizes that effective hypertension care, as recommended by WHO, is critical to saving lives. These include the following five components:

● Protocols: Practical dosage- and medication-specific treatment protocols, with concrete action steps to manage uncontrolled blood pressure, can simplify care and improve patient compliance.

● Drug and equipment supply: Regular, uninterrupted access to affordable medicines is essential for the effective treatment of hypertension. Currently, the price of essential antihypertensive medicines can vary by more than tenfold between countries.

● Team-based care: Through teamwork, adjusting and intensifying blood pressure medication regimens according to physician orders and protocols can improve patient outcomes.

● Patient-centered services : Reduce barriers to care by providing easy-to-take medication regimens, free medications and follow-up visits at home, and 24/7 blood pressure monitoring.

● Information systems: Simple, user-centered information systems can help quickly record important patient data, reduce the burden of data entry on healthcare workers, and support rapid scale-up while maintaining or improving quality of care. Improving the prevention and treatment of hypertension is feasible, low-cost, and safe, and is key to achieving a range of global and national goals.