Addressing global disparities in blood pressure control: perspectives of the International Society of Hypertension.

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.

Informations de copyright

© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.

Déclaration de conflit d'intérêts

Conflict of interest: A.E.S. received speaker honoraria from different pharmaceutical companies and device manufacturers for work unrelated to this paper; P.M.N. has received speaker honoraria from different pharmaceutical companies. K.K. reports research grants from A&D, Omron Healthcare, Fukuda Denshi, Otsuka Pharmaceutical, Otsuka Holdings, CureApp, Sanwa Kagaku Kenkyusho, Daiichi Sankyo, Taisho Pharmaceutical, Sumitomo Dainippon Pharma, Takeda Pharmaceutical, Mitsubishi Tanabe Pharma, Teijin Pharma, Boehringer-Ingelheim Japan, Pfizer Japan, Fukuda Lifetec, Bristol-Myers Squibb, Mochida Pharmaceutical, Roche Diagnostics; and Consulting fees from A&D, JIMRO, Omron Healthcare, CureApp, Kyowa Kirin, Sanwa Kagaku Kenkyusho, Terumo, Fukuda Denshi, Mochida Pharmaceutical; and Honoraria from Idorsia, Omron Healthcare, Daiichi Sankyo, Novartis Pharma, Mylan EPD; and Participation in Advisory Board of Daiichi Sankyo, Novartis Pharma, Fukuda Denshi outside the submitted work. J.-G.W. reports having received lecture and consulting fees from Novartis, Omron, Servier, and Viatris. M.P.S. has received consulting fees, and/or travel and research support from Medtronic, Abbott, Metavention, ReCor, Novartis, Servier, Pfizer, and Boehringer-Ingelheim. E.S.W.J. has received honoraria from pharmaceutical companies for work unrelated to this publication. N.R.P. has received financial support from several pharmaceutical companies which manufacture BP-lowering agents, for consultancy fees (Servier), research projects, and staff (Servier, Pfizer) and for arranging and speaking at educational meetings (AstraZeneca, Lri Therapharma, Napi, Servier, Sanofi, Eva Pharma, Pfizer, Glenmark Pharma, Alkem Lab, and Emcure India). He holds no stocks and shares in any such companies. This manuscript was handled by Guest Editor Thomas F. Lüscher