Global High Blood Pressure, Obesity, and Poverty

Over the last three decades, high blood pressure has doubled around the world, driven in large part by obesity and poverty. These conclusions come from a new study published this week in Lancet. Obesity, a key risk factor for hypertension, is growing all over the world. But high income countries have been able to control hypertension, despite rising obesity rates. For lower and middle income countries, this has not been the case.

Professor Majid Ezzati was senior author of the study. He describes the findings as a spotlight on a major public health failure driven by poverty:

“Nearly half a century after we started treating hypertension, which is easy to diagnose and treat with low-cost medicines, it is a public health failure that so many of the people with high blood pressure in the world are still not getting the treatment they need.”

Hypertension:
Controlled and Uncontrolled

Largely because of the growing prevalence of obesity, high blood pressure is growing almost everywhere in the world. But this study reveals a sharp dividing line between high and low income countries. High-income countries – and even some middle-income countries – have managed to drive down the rates of uncontrolled hypertension. The authors of this study conclude that the roadmap for overcoming hypertension is clear enough:

“The large improvements observed in some upper-middle-income and recently high-income countries show that the expansion of universal health coverage and primary care can be leveraged to enhance hypertension care and reduce the health burden of this condition.”

Global Health Disparities

The open question before us is quite simple. For hypertension, we know how to reduce the burden of disease. Most wealthy and some middle-income countries have shown the way. But even within those countries, huge disparities exist, often driven by poverty. When will we muster the determination to drive those disparities down?

The COVID-19 pandemic has served to magnify global health disparities. Wealthy countries have taken up almost all of the initial supply of vaccines. But when the Delta variant emerged in India and then swept through the rest of the world, we learned an important lesson. In public health, no one is safe until everyone is safe.

Click here for the study in Lancet, then here, here, and here for further reporting.

The Wondrous Globe, photograph by Anne Brigman / WikiArt

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.

August 27, 2021