News briefs

High blood pressure rates have doubled to more than 1.2 billion

Over the past 30 years, the number of adults (aged 30–79 years) living with hypertension worldwide has doubled — rising from an estimated 331 million women and 317 million men in 1990, to 626 million women and 652 million men in 2019, with most of this increase occurring in low and middle income countries. The international study, published in The Lancet, analysed blood pressure measurements from more than 100 million people taken over three decades in 184 countries. Nearly half of people (41% of women and 51% of men) with hypertension worldwide in 2019 were unaware of their condition; and more than half of women (53%) and men (62%) with the condition were not treated. Worldwide, blood pressure was controlled (ie, medicines were effective in bringing blood pressure to normal ranges) in fewer than 1 in 4 women and 1 in 5 men with hypertension. The Non‐Communicable Disease Risk Factor Collaboration analysed data from 1201 population‐representative studies, involving 104 million people from 184 countries (covering 99% of the world’s population). The authors only used data from studies that had measured blood pressure, to avoid biases in self‐reported data. Hypertension was defined as having systolic blood pressure of ≥ 140 mmHg, diastolic blood pressure of ≥ 90 mmHg, or taking medication for high blood pressure. Modelling was used to estimate prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis, who were taking medication for hypertension, and whose hypertension was controlled to below 140/90 mmHg, by country, year and age. The authors noted that while the study provides the first comparable estimates of blood pressure prevalence, diagnosis, treatment and control in adults for all countries of the world, it may be affected by a lack of data in some countries, especially in Oceania and sub‐Saharan Africa.

https://www.thelancet.com/journals/lancet/article/piiS0140-6736(21)01330-1/fulltext

COVID‐19 infection linked to higher blood clot risk after surgery

Research published in Anaesthesia shows that venous thromboembolisms (VTEs), a known complication of surgery, are 50% more likely to occur in patients with current COVID‐19 and almost twice as likely in those with recent COVID‐19. The study also found having a VTE was associated with a five‐time increased risk of death within 30 days following surgery compared with patients with no VTE. Patients were categorised as having VTE (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. COVID‐19 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (7 weeks or more before surgery); or no diagnosis past or present. The postoperative VTE rate was 0.5% (666/123 591) in patients without COVID‐19; 2.2% (50/2317) in patients with peri‐operative COVID‐19; 1.6% (15/953) in patients with recent COVID‐19; and 1.0% (11/1148) in patients with previous COVID‐19. After adjustment for confounding factors, patients with peri‐operative COVID‐19 had a 50% higher risk of VTE and those with recent COVID‐19 had a 90% increased risk. Patients with previous COVID‐19 had a 70% increased risk of VTE, but this result was of borderline statistical significance. Overall, VTE was independently associated with 30‐day mortality, increasing the risk of death during this period by 5.4 times. In patients with COVID‐19, mortality without VTE was 7.4% (319/4342), and with VTE, was again more than five times higher at 40.8% (31/76). The authors concluded: “Routine postoperative care of surgical patients should include interventions to reduce VTE risk in general, and further research is needed to define the best protocols for VTE prevention and treatment in this setting.”

https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15563