A national commitment to improved blood pressure control would lead to significant health and economic gains
Globally, the leading risk factor for death is widely acknowledged as being raised blood pressure (BP).1 The Global Burden of Disease study found that a systolic BP of 110 mmHg and above accounted for 10.8 million deaths in 2019.1 This constitutes one in every five deaths,1 mainly due to coronary heart disease and cerebrovascular disease. A report on deaths in Australia2 confirmed that also here the leading cause of death is coronary heart disease, followed by dementia and cerebrovascular disease — with coronary disease, vascular dementia and cerebrovascular disease sharing a common risk factor: raised BP. Australian data have shown raised BP to be responsible for 43% of coronary heart disease, 41% of stroke, 65% of the burden of hypertensive heart disease, 38% of chronic kidney disease, 32% of atrial fibrillation and flutter, and 3.6% of dementia.3,4
- 1. GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990‐2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396: 1223–1249.
- 2. Australian Institute of Health and Welfare. Deaths in Australia (Cat. No. PHE 229). Canberra: AIHW, 2021. https://www.aihw.gov.au/reports/phe/229/deaths/deaths‐in‐australia/contents/leading‐causes‐of‐death (viewed Nov 2021).
- 3. Australian Institute of Health and Welfare. Australian Burden of Disease study: impact and causes of illness and death in Australia 2015 (Cat. No. BOD 22). Canberra: AIHW. 2021. https://www.aihw.gov.au/reports/burden‐of‐disease/burden‐disease‐study‐illness‐death‐2015/summary (viewed Nov 2021).
- 4. Australian Institute of Health and Welfare. High blood pressure (Cat. No. PHE 250). Canberra: AIHW, 2019. https://www.aihw.gov.au/reports/risk‐factors/high‐blood‐pressure/contents/high‐blood‐pressure (viewed Nov 2021).
- 5. Unger T, Borghi C, Charchar F, et al. 2020 International Society of Hypertension global hypertension practice guidelines. Hypertension 2020; 75: 1334–1357.
- 6. US Department of Health and Human Services. The Surgeon General’s call to action to control hypertension. Washington, DC: US Department of Health and Human Services, Office of the Surgeon General, 2020. https://www.ncbi.nlm.nih.gov/books/NBK567645/pdf/Bookshelf_NBK567645.pdf (viewed Nov 2021).
- 7. Carnagarin R, Fonseca R, Brockman D, et al. May Measurement Month 2018: an analysis of blood pressure screening results from Australia. Eur Heart J Suppl 2020; 22 (Suppl H): H17–H19.
- 8. Adler A, Agodoa L, Algra A, et al. Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant‐level data meta‐analysis. Lancet 2021; 397: 1625–1636.
- 9. Banks E, Crouch SR, Korda RJ, et al. Absolute risk of cardiovascular disease events, and blood pressure‐ and lipid‐lowering therapy in Australia. Med J Aust 2016; 204: 320. https://www.mja.com.au/journal/2016/204/8/absolute‐risk‐cardiovascular‐disease‐events‐and‐blood‐pressure‐and‐lipid
- 10. Roseleur J, Gonzalez‐Chica DA, Bernardo CO, et al. Blood pressure control in Australian general practice: analysis using general practice records of 1.2 million patients from the MedicineInsight database. J Hypertens 2021; 39: 1134–1142.
- 11. Australian Institute of Health and Welfare. Australia’s health 2020: data insights (Australia’s Health Series No.17; Cat. No. AUS 231). Canberra: AIHW, 2020. https://www.aihw.gov.au/getmedia/be95235d‐fd4d‐4824‐9ade‐34b7491dd66f/aihw‐aus‐231.pdf.aspx?inline=true (viewed Nov 2021).
- 12. NCD Risk Factor Collaboration. Long‐term and recent trends in hypertension awareness, treatment, and control in 12 high‐income countries: an analysis of 123 nationally representative surveys. Lancet 2019; 394: 639–651.
- 13. NCD Risk Factor Collaboration. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population‐representative studies with 104 million participants. Lancet 2021; 398: 957–980.
- 14. Olsen MH, Angell SY, Asma S, et al. A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations: the Lancet Commission on hypertension. Lancet 2016; 388: 2665–2712.
- 15. Schiffrin EL, Campbell NR, Feldman RD, et al. Hypertension in Canada: past, present, and future. Ann Glob Health 2016; 82: 288–299.
- 16. Hird TR, Zomer E, Owen AJ, et al. Productivity burden of hypertension in Australia. Hypertension 2019; 73: 777–784.
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