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Hypertension in Low- and Middle-Income Countries

Circulation research, 2021-04, Vol.128 (7), p.808-826 [Peer Reviewed Journal]

ISSN: 0009-7330 ;EISSN: 1524-4571 ;DOI: 10.1161/CIRCRESAHA.120.318729 ;PMID: 33793340

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Title:
Hypertension in Low- and Middle-Income Countries
Author: Schutte, Aletta E ; Srinivasapura Venkateshmurthy, Nikhil ; Mohan, Sailesh ; Prabhakaran, Dorairaj
Subjects: Alcohol Drinking - adverse effects ; Blood Pressure Monitors - standards ; Blood Pressure Monitors - supply & distribution ; Cardiovascular Physiological Phenomena ; COVID-19 - complications ; COVID-19 - epidemiology ; Developing Countries - statistics & numerical data ; Diet - adverse effects ; Environment ; Environmental Pollution - adverse effects ; Health Behavior ; Heart Diseases - mortality ; Humans ; Hypertension - drug therapy ; Hypertension - epidemiology ; Hypertension - etiology ; Life Course Perspective ; Life Style ; Nurses - supply & distribution ; Obesity - complications ; Physicians - supply & distribution ; Prevalence ; Risk Factors ; Sedentary Behavior ; Social Determinants of Health ; Stroke - mortality ; Tobacco Use - adverse effects ; Urbanization
Is Part Of: Circulation research, 2021-04, Vol.128 (7), p.808-826
Description: In recent decades low- and middle-income countries (LMICs) have been witnessing a significant shift toward raised blood pressure; yet in LMICs, only 1 in 3 are aware of their hypertension status, and ≈8% have their blood pressure controlled. This rising burden widens the inequality gap, contributes to massive economic hardships of patients and carers, and increases costs to the health system, facing challenges such as low physician-to-patient ratios and lack of access to medicines. Established risk factors include unhealthy diet (high salt and low fruit and vegetable intake), physical inactivity, tobacco and alcohol use, and obesity. Emerging risk factors include pollution (air, water, noise, and light), urbanization, and a loss of green space. Risk factors that require further in-depth research are low birth weight and social and commercial determinants of health. Global actions include the HEARTS technical package and the push for universal health care. Promising research efforts highlight that successful interventions are feasible in LMICs. These include creation of health-promoting environments by introducing salt-reduction policies and sugar and alcohol tax; implementing cost-effective screening and simplified treatment protocols to mitigate treatment inertia; pooled procurement of low-cost single-pill combination therapy to improve adherence; increasing access to telehealth and mHealth (mobile health); and training health care staff, including community health workers, to strengthen team-based care. As the blood pressure trajectory continues creeping upward in LMICs, contextual research on effective, safe, and cost-effective interventions is urgent. New emergent risk factors require novel solutions. Lowering blood pressure in LMICs requires urgent global political and scientific priority and action.
Publisher: United States
Language: English
Identifier: ISSN: 0009-7330
EISSN: 1524-4571
DOI: 10.1161/CIRCRESAHA.120.318729
PMID: 33793340
Source: Geneva Foundation Free Medical Journals at publisher websites
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Hypertension in Low- and Middle-Income Countries

ISSN: 0009-7330 ;EISSN: 1524-4571 ;DOI: 10.1161/CIRCRESAHA.120.318729 ;PMID: 33793340

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