Latest From PURE: 40% of Adult Population Worldwide Has Hypertension
By Sue Hughes, from Medscape
September 5, 2012 (Munich, Germany) — Hypertension is truly a global epidemic, being highly prevalent in all communities worldwide, according to new data from the Prospective Urban Rural Epidemiology (PURE) study. Other findings show that awareness is very low and that once patients are aware, most are treated, but control is very poor.The hypertension cohort of the PURE study was presented at last week’s European Society of Cardiology (ESC) 2012 Congress by Dr Rafael Diaz (Instituto Cardiovascular de Rosario, Argentina). The study aimed to assess the prevalence, awareness, and control of hypertension worldwide by measuring blood pressure in 153 000 individuals from 528 urban and rural communities in 17 countries from five continents.
The mean age of the participants was 50.4, 60% were female, and 46% were from rural communities.
The prevalence of hypertension was lowest in lowest-income countries (around 30%) and highest in upper-middle-income economies (around 50%), with high-income and low-middle-income economies having an intermediate level (around 40%).
Only 13% controlled
Only 30% of the population had optimal blood pressure, with another 30% found to be in the prehypertension range. Of the 40% with hypertension, 46% of these individuals were aware of their condition, 40% were treated, but only 13% were controlled.
In low-income countries, there were higher rates of hypertension in urban areas than in rural areas, but this was reversed in upper-income countries, where hypertension was more prevalent in rural communities.
Men were more likely to be hypertensive than women in high- and middle-income countries, but women were more likely to be hypertensive than men in low-income countries.
Low levels of education were association with increased prevalence of hypertension in high- and middle-income economies, but the reverse was true in low-income countries, where hypertension was actually more common in better-educated people.
Awareness, treatment, and control was higher in urban than in rural communities across all incomes, and women had higher rates of awareness, treatment, and control than men again across the board.
The use of multiple antihypertensive drugs was very low, at just 14%, and “practically nonexistent” in low-income countries, Diaz reported.
He concluded that better screening methods are required and increased use of combination medications is needed.
More cooperation needed
Designated discussant Dr Georg Ertl (Wurzburg University, Germany) said the study had the strengths of being very large and truly international, covering a wide spectrum of social and cultural backgrounds.
“For me, the most interesting data are those that show that awareness, treatment, and control are very low all over the world and are virtually absent in rural communities in low-income countries,” Ertl commented. Noting that lessons learned in high-income countries may help low-income countries, he suggested that cooperation needs to be fostered between medical institutions in the two economies.
Dr. Pinna says:
There is absolutely no need for this. In my practice there are very few patients who need constant attention. These are generally Africans with explosive personalities. But even these patients are controllable with special meds for those episodes.
I have written an article on Hypertension that explains the various forces involved. It is being re-printed today. The article is long, but explains the many facets of hypertension.