Addressing global disparities in blood pressure control: perspectives of the International Society of Hypertension.
Aletta Elisabeth SchutteTazeen Hasan JafarNeil R PoulterAlbertino A DamascenoNadia A KhanPeter M NilsssonJafar AlsaidDinesh NeupaneKazuomi KarioBeheiry M HindSofie BrouwersDylan BurgerFadi J CharcharMyeong-Chan ChoTomasz J GuzikGhazi F Haji Al-SaediMuhammad IshaqHiroshi ItohErika S W JonesTaskeen KhanYoshihiro KokuboPraew KotruchinElizabeth Silaid MuxfeldtAugustine Nonso OdiliMansi PatilUdaya RalapanawaCesar A RomeroMarkus P SchlaichAbdulla ShehabChing Siew MooiUlrike Muscha SteckelingsGeorge S StergiouRhian M TouyzThomas UngerRichard D WainfordJi-Gwang WangBryan WilliamsBrandi M WynneMaciej TomaszewskiPublished in: Cardiovascular research (2022)
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.
Keyphrases
- blood pressure
- healthcare
- hypertensive patients
- affordable care act
- cardiovascular disease
- palliative care
- quality improvement
- heart rate
- type diabetes
- pain management
- risk factors
- metabolic syndrome
- mental health
- blood glucose
- weight gain
- particulate matter
- adipose tissue
- alcohol consumption
- skeletal muscle
- chronic pain
- air pollution
- electronic health record