• Carlene M M Lawes, Stephen Vander Hoorn, Anthony Rodgers, and International Society of Hypertension.
• Clinical Trials Research Unit, University of Auckland, Auckland, New Zealand.
• Lancet. 2008 May 3; 371 (9623): 1513-8.

BackgroundFew studies have assessed the extent and distribution of the blood-pressure burden worldwide. The aim of this study was to quantify the global burden of disease related to high blood pressure.MethodsWorldwide burden of disease attributable to high blood pressure (> or =115 mm Hg systolic) was estimated for groups according to age (> or =30 years), sex, and World Bank region in the year 2001. Population impact fractions were calculated with data for mean systolic blood pressure, burden of deaths and disability-adjusted life years (DALYs), and relative risk corrected for regression dilution bias.FindingsWorldwide, 7.6 million premature deaths (about 13.5% of the global total) and 92 million DALYs (6.0% of the global total) were attributed to high blood pressure. About 54% of stroke and 47% of ischaemic heart disease worldwide were attributable to high blood pressure. About half this burden was in people with hypertension; the remainder was in those with lesser degrees of high blood pressure. Overall, about 80% of the attributable burden occurred in low-income and middle-income economies, and over half occurred in people aged 45-69 years.InterpretationMost of the disease burden caused by high blood pressure is borne by low-income and middle-income countries, by people in middle age, and by people with prehypertension. Prevention and treatment strategies restricted to individuals with hypertension will miss much blood-pressure-related disease.

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