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Hypertension prevalence: is there any geographical impact?

Comment by Maria Simonenko, EAPC Secondary Prevention and Rehabilitation Section

Cardiovascular Rehabilitation

L. Neufcourt et al. suggested that analysis of international and intra-national variations in hypertension prevalence highlights areas of progress to prevent hypertension and its related cardiovascular consequences [1]. According to the World Health Organization (WHO), complications of hypertension are thought to cause 9.4 million deaths each year and it was predicted that without further action this number will increase [1]. It has been also predicted that by 2030 nearly a quarter of all deaths worldwide will be due to cardiovascular diseases (CVD) [2]. The prevalence of hypertension is lower in Canada (19%) and higher in the USA (29%) and England (30%). In addition, hypertension awareness is close to 80% in the USA (81%) and Canada (83%) and lower in England (65%). England also has lower levels of hypertension treatment (England 51%; the USA 74%; Canada 80%) and control (England 27%; the USA 53%; Canada 66%) [3].

Talking about other populations, hypertension in renal transplant recipients is common and ranges from 50% to 80% in adult recipients and from 47% to 82% in pediatric recipients [4] and in heart-transplanted patients – 50-90 % [5]. Back in 2017, the large study was performed in Italy: a total of 10,076 people were screened (49.2% - females) and 30.8 % had hypertension [6].

According to L. Neufcourt et al. [1], older age, family history of hypertension, higher BMI, lower education level, blue-collar occupation and more deprived area of residence increased the hypertension risk in both sexes. In addition, H. Neuhauser et al. believed that the key role of BP for morbidity and mortality stands in contrast to scarce population data.

Further population research is needed with a special focus on gender-specific and age-specific aspects [7]. L. Neufcourt et al. found marked differences between sexes such as the age-standardised hypertension prevalence was higher in men than women [1]. At the same time, G. Tocci et al. Authors stated that hypertension was higher in male aged <70 years than age-matched female [8].

We need to have more studies to show the prevalence of hypertension in different parts of the world, between genders and in specific populations.

Note: The content of this article reflects the personal opinion of the author and is not necessarily the official position of the European Society of Cardiology. 



1. Lola Neufcourt, Severine Deguen, Sahar Bayat, Francois Paillard, Marie Zins, Olivier Grimaud - Geographical variations in the prevalence of hypertension in France: cross-sectional analysis of the CONSTANCES cohort, EJPC, 2019; 26(12): 1242-1251 DOI: 10.1177/2047487319842229

2. World Health Organisation. A global brief on hypertension: silent killer, global public health crisis. 2013. bitstream/10665/79059/1/WHO_DCO_WHD_2013.2_eng.pdf?ua= 1. Accessed 19 June 2014

3. M. Joffres, E. Falaschetti, C. Gillespie, C. Robitaille, F. Loustalot, N. Poulter, F.A. McAlister, H. Johansen, O. Baclic, N. Campbell – Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischemic heart disease mortality: a cross-sectional study, BMJ Open, 2013;3:e003423. DOI: 10.1136/bmjopen-2013-003423

4. M.R. Weir, E.D. Burgess, J.E. Cooper, A.Z. Fenves, D. Goldsmith, D. McKay, A. Mehrotra, M.M. Mitsnefes, D.A. Sica, S.J. Taler – Assessment and Management of Hypertension in Transplant Patients, J Am Soc Nephrol, 2015; 26: 1248-1260 DOI: 10.1681/ASN.2014080834

5. Joao David de Souza-Neto, Italo Martins de Oliveira, Hermano Alexandre Lima-Rocha, Jose Wellington Oliveira-Lima, Fernando Bacal – Hypertension and arterial stiffness in heart transplantation patients, Clinics, 2016; 71(9):494-499. DOI: 10.6061/clinics/2016(09)02

6. Camilla Torlasco, Andrea Faini, Elhassan Makil, Grzegorz Bilo, Martino Pengo, Thomas Beaney, Xin Xia, Claudio Borghi, Neil R. Poulter, Giuliano Tocci, Ferruccio Galletti, Giovambattista Desideri, Franco Veglio, Claudio Ferri, and Gianfranco Parati – Nation-wide hypertension screening in Italy: data from May Measurements Month 2017 – Europe, European Heart Journal Supplements, 2019; 21 (Supplement D), D66-D70. DOI: 10.1093/eurheartj/suz058

7. Hannelore Neuhauser, Claudia Diederichs, Heiner Boeing, Stephan B. Felix, Claus Jünger, Roberto Lorbeer, Christine Meisinger, Annette Peters, Henry Völzke, Cornelia Weikert, Philipp Wild, Marcus Dörr – Hypertension in Germany, Deutsches Arzteblatt International, 2016; 113:809-15

8. G. Tocci, G. Nati, C. Cricelli, D. Paretti, F. Lapi, A. Ferrucci, C. Borghi, M. Volpe – Prevalence and control of hypertension in the general practice in Italy: updated analysis of a large