Summary: Researchers are seeing a worrying trend despite the decline in cardiovascular mortality globally in the last couple of decades. It appears that the number of people living with hypertension has doubled between 1990-2019, from 648 million to about 1.3 billion. It means that we may also witness reversal in the trend of decline in cardiovascular mortality in the near future if urgent steps are not taken. It is especially worrisome considering that hypertension is successfully prevented with the help of lifestyle interventions like low salt intake, exercise, weight loss, and so on.
Hypertension is often called “the silent killer.” Since it would not kill anyone instantly moreover, it does not appear to cause many signs and symptoms in a large number of individuals. Thus, the majority of individuals living with hypertension fail to control it adequately, a concern that chronic pain specialists may address as part of comprehensive care.
However, over the years, uncontrolled hypertension may cause severe damage to blood vessels, cardiac muscles. Thus, it is the major underlying cause of heart attack, stroke, kidney disease, and much more. Therefore, indirectly, hypertension is associated with many deaths, disabilities, and increased healthcare costs, globally1.
In the last few years, there has been a downward trend in the incidence and of cardiovascular diseases. Studies show that lifestyle interventions like exercise, a balanced diet, stress management did help reduce mortality caused by cardiovascular diseases. In fact, mortality due to heart attack and stroke has continually fallen in most nations since mid-1990s2.
However, the data also shows that this decline in cardiovascular-events-related mortality is also slowing down. There could be many factors for this slowdown, like the increased prevalence of obesity, diabetes, hypertension, high cholesterol, and other metabolic disorders. Researchers worry that if further steps are not taken, cardiovascular mortality may start increasing again.
The new study published in the journal The Lancet shows some worrying global tendencies. It appears that people living with hypertension (people aged 30-79 years) have doubled since 1990 from 648 million to about 1.3 billion in 2019. A person is hypertensive if living with blood pressure above 140/90 mmHg or taking hypertensive drugs3.
Of course, this increase is partially due to the rise in the global population and increased lifespan. But the rise is much more than expected. Thus, it could not be solely explained based on the increased global population or aging of the population.
What is further worrying is that preventing and managing hypertension is not regarded as a highly complex task. Hypertension can be prevented with lifestyle interventions like exercise and low salt intake in many cases. Controlling cholesterol levels through lifestyle interventions or dietary changes may help, too. Thus, controlling hypertension is possible even in low-income nations.
Moreover, what is worrying is that hypertension is increasing at a greater pace in low- and middle-income nations. On the contrary, it is declining in high-income countries like the Canada, UK, Switzerland. Low- and middle-income nations are also witnessing an increase in cardiovascular ailments and related deaths.
Further, it appears that the covid-19 pandemic has only made things worse. In the last couple of years, cardiovascular health did not receive much attention.
Experts say that people need to realize that hypertension is a highly preventable condition through lifestyle modification. For example, it could be controlled through exercise, low salt and fat intake, low alcohol consumption. Further, there is also a need to control cholesterol levels better.
It is vital to understand that decline in cardiovascular mortality should not be misinterpreted. The rise in hypertension, diabetes and other metabolic disorders only confirms that this trend is about to change. These new findings suggest that an increase in hypertension may become a significant contributor to cardiovascular mortality in the near future.
References
- FastStats. Published October 20, 2021. Accessed November 23, 2021. https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
- Amini M, Zayeri F, Salehi M. Trend analysis of cardiovascular disease mortality, incidence, and mortality-to-incidence ratio: results from global burden of disease study 2017. BMC Public Health. 2021;21(1):401. doi:10.1186/s12889-021-10429-0
- Zhou B, Carrillo-Larco RM, Danaei G, et al. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. The Lancet. 2021;398(10304):957-980. doi:10.1016/S0140-6736(21)01330-1
