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.

中文翻译：

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在12个高收入国家中高血压意识，治疗和控制的长期和近期趋势：对123个全国代表性调查的分析

背景

抗高血压药可有效减少不良心血管事件。我们的目的是比较高收入国家对高血压的认识，治疗和控制以及其随着时间的变化。

方法

我们使用了1976年至2017年在12个高收入国家/地区参加40到79岁的人的数据，这些人参加了123个国家健康检查：澳大利亚，加拿大，芬兰，德国，爱尔兰，意大利，日本，新西兰，韩国，西班牙，英国和美国。我们计算了高血压参与者的比例，高血压的定义为收缩压为140 mm Hg或更高，舒张压为90 mm Hg或更高，或者正在接受高血压药理治疗的患者，他们知道自己的病情，接受治疗并控制了高血压（即低于140/90 mm Hg）。

发现

在这些分析中使用了来自526336名参与者的数据。在最近的调查中，加拿大，韩国，澳大利亚和英国的高血压患病率最低，芬兰最高。在1980年代和1990年代初，在大多数国家，年龄和性别群体中，治疗率至多为40％，控制率不到25％。在评估的这段时间内，所有12个国家的高血压意识和治疗均得到提高，控制率得到改善，韩国和德国的改善最大。观察到的大多数增长发生在1990年代和2000年代初，此后大多数国家都处于停滞状态。在最近的调查中，加拿大，德国，韩国和美国的意识，治疗和控制率最高，而芬兰，爱尔兰，日本和西班牙的最低。

解释

自1980年代和1990年代以来，高收入国家对高血压的认识，治疗和控制有了实质性的改善。但是，在过去的十年中，控制率一直处于稳定状态，低于高质量高血压计划的控制率。各国对高血压的认识，治疗和控制的比率存在很大差异。

资金

惠康基金会和世界卫生组织。