Hypertension: uncontrolled and conquering the world

When did you last have your blood pressure measured? In their Seminar on essential hypertension, Franz Messerli and colleagues point out that the risk of becoming hypertensive during lifetime exceeds a staggering 90% for a person in a developed country. The increasingly common combination and interaction of obesity, diabetes, hyperlipidaemia, and high blood pressure, if left untreated for too long, leads to cardiovascular disease, stroke, renal failure, dementia, and ultimately death.

Worldwide, the estimated number of adults with hypertension was 972 million in 2000; 639 million live in developing countries. By 2025, the total number is expected to increase to 1·56 billion. Lifestyle factors, such as physical inactivity, a salt-rich diet with processed and fatty foods, and alcohol and tobacco use, are at the heart of this increased disease burden, which is spreading at an alarming rate from developed countries to emerging economies, such as India and China. And even countries in Africa are noticing a sharp increase in patients with hypertension, at least in urban settings. For example, in 2006, hypertension was the second most reported medical condition in greater Accra, Ghana, up from fifth in 2005.