TY - JOUR
T1 - Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries
T2 - an analysis of 123 nationally representative surveys
AU - NCD Risk Factor Collaboration (NCD-RisC)
AU - Zhou, Bin
AU - Danaei, Goodarz
AU - Stevens, Gretchen A.
AU - Bixby, Honor
AU - Taddei, Cristina
AU - Carrillo-Larco, Rodrigo M.
AU - Solomon, Bethlehem
AU - Riley, Leanne M.
AU - Di Cesare, Mariachiara
AU - Iurilli, Maria Laura Caminia
AU - Rodriguez-Martinez, Andrea
AU - Zhu, Aubrianna
AU - Hajifathalian, Kaveh
AU - Amuzu, Antoinette
AU - Banegas, José R.
AU - Bennett, James E.
AU - Cameron, Christine
AU - Cho, Yumi
AU - Clarke, Janine
AU - Craig, Cora L.
AU - Cruz, Juan J.
AU - Gates, Louise
AU - Giampaoli, Simona
AU - Gregg, Edward W.
AU - Hardy, Rebecca
AU - Hayes, Alison J.
AU - Ikeda, Nayu
AU - Jackson, Rod T.
AU - Jennings, Garry
AU - Joffres, Michel
AU - Khang, Young Ho
AU - Koskinen, Seppo
AU - Kuh, Diana
AU - Kujala, Urho M.
AU - Laatikainen, Tiina
AU - Lehtimäki, Terho
AU - Lopez-Garcia, Esther
AU - Lundqvist, Annamari
AU - Maggi, Stefania
AU - Magliano, Dianna J.
AU - Mann, Jim I.
AU - McLean, Rachael M.
AU - McLean, Scott B.
AU - Miller, Jody C.
AU - Morgan, Karen
AU - Neuhauser, Hannelore K.
AU - Niiranen, Teemu J.
AU - Noale, Marianna
AU - Oh, Kyungwon
AU - Palmieri, Luigi
PY - 2019/8/24
Y1 - 2019/8/24
N2 - 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. Funding: Wellcome Trust and WHO.
AB - 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. Funding: Wellcome Trust and WHO.
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U2 - 10.1016/S0140-6736(19)31145-6
DO - 10.1016/S0140-6736(19)31145-6
M3 - Article
C2 - 31327564
AN - SCOPUS:85070928826
VL - 394
SP - 639
EP - 651
JO - The Lancet
JF - The Lancet
SN - 0140-6736
IS - 10199
ER -