Many high blood pressure patients worldwide are not achieving target control.

A new global study, published by JAMA, the Journal of the American Medical Association, says that not only are many people with hypertension unaware of their condition, but those that do are not receiving enough treatment. This applies to countries regardless of whether they have high, middle or low incomes.

The study is part of the PURE (Prospective Urban Rural Epidemiology) study, which was initiated by the Population Health Research Institute (PHRI) of McMaster University and Hamilton Health Sciences. It included 154,000 adults, aged 35 to 70, with and without a history of heart disease or stroke, from 17 high, middle and low-income countries. Each participant had their blood pressure measured and medication use recorded. Data were also collected about their age, gender, education, and key risk factors, including whether they knew they had hypertension or not.

The researchers found 46.5 percent of those with high blood pressure were not aware they had it. Only about a third (32.5 percent) who were aware and being treated with medication, were achieving target blood pressure control. The study shows that very few patients are “taking enough treatment to control their blood pressure,” says Dr. Clara Chow, lead author, associate professor of medicine of Sydney University and the George Institute for Global Health in Australia, and a member of the PHRI.

Dr. Salim Yusuf, senior study author and professor of medicine of McMaster University’s Michael G. DeGroote School of Medicine, explained that drug treatments that work to control hypertension are well known, are generally inexpensive and are commonly available. However, he said the study showed that “only a third of patients commenced on treatment are on enough treatment to control their blood pressure. This is worst in low income countries, but significant in high and middle income countries too.”

The team of researchers have a few suggestions to address poor detection and inadequate treatment such as “systematic efforts to better detect those with high blood pressure” and “early use of combination therapies, that is, two or more types of blood pressure-lowering treatments taken together.”

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