Mismanely high hypertension in low and middle-income countries

Health systems in low- and middle-income countries are poorly prepared for the growing number of people with high blood pressure, over two-thirds of those affected remain untreated, according to a new study by Harvard TH researchers Chan School of Public Health in collaboration with colleagues from more than 40 institutions around the world, including several ministries of health.

The study examined household survey data on 1 million people living in 44 middle-income countries, and found that less than half of hypertensive people are correctly diagnosed. Of those affected, only 30% are treated and only 10% control the disease. However, these proportions varied considerably from one country to another, some of which consistently outperformed others, even taking into account differences in economic development.

The study will be published in The lancet Thursday, July 18, 2019.

"Our study shows that not only the care for high blood pressure in these countries is seriously inadequate, but also that patients in each country are lost during the care process," said Pascal Geldsetzer, Harvard postdoctoral researcher TH School of Public Health Chan and first author of the study.

For this study, researchers used a cascading approach of care to examine the number of hypertensive individuals screened, diagnosed, treated and controlled to determine the extent to which health systems in different countries were treating hypertensives.

The group conducted its research with the help of household surveys, including the STEPS survey of the World Health Organization, in order to take a consistent approach to obtaining data on established risk factors. The researchers first determined the number of people with hypertension. They also determined how many patients had already measured their blood pressure prior to the survey, as well as the number of people diagnosed and taking treatment. Finally, they badyzed how many patients successfully controlled the disease with drugs.

"The low proportion of hypertensive patients receiving the treatment they need, as well as the growing number of hypertensive patients, suggest the urgent need for prevention at the population level, especially policies to eliminate trans fats and salt. food supply, the promotion of fruits and vegetables, the reduction of air pollution and the fight against excessive consumption of tobacco and alcohol, "said Lindsay Jaacks, badistant professor of global health at Harvard Chan School.