News & Commentary

Poorer Countries Fight Hypertension


Frank Diamond

It’s a good thing that fewer people on this planet are starving, but better life doesn’t mean better health in all respects. For the first time in history, the number of people in low- and middle-income countries with hypertension outnumber those in high-income countries with the condition, according to a study in Circulation.

The study states that 31.1% (1.39 billion) of the adult population worldwide had high blood pressure in 2010. Of those, 28.5% (349 million) of the adults lived in high-income countries and 31.5% (1.04 billion) lived in low- and middle-income countries.

“Aging and urbanization with accompanying unhealthy lifestyle may play a role in the epidemic of hypertension in low- and middle-income countries,” the study states.

The rate of hypertension in low- and middle-income countries increased by nearly eight percentage points from 2000 to 2010. The rate in higher income countries decreased by nearly three percentage points in the same time period.

The study’s main author, Jiang He, of Tulane University School of Public Health, told the Washington Post that “people who live in the countryside engage in the farmer lifestyle and have manual labor. When they move to the city, they get office jobs and stress.”

This department is called News & Commentary, and Managed Care would like to make this comment: Most people faced with a choice between a life of backbreaking farm labor that barely maintains subsistence, and one in which there’s a chance to make real money and maybe even earn some leisure time, would move off the farm pronto—stress, bad eating habits, and all.

Still, the study makes the point that the awareness of hypertension and the means of fighting it haven’t made as much of an inroad into poorer countries as an increase in the standard of living.

The poorer countries often lack a health care infrastructure that hinders access to care. Even cheap hypertensive medications may be too expensive for people to buy. Overburdened health care providers and low patient health literacy are also barriers to efforts that might target hypertension.

Jiang He told Science Daily that because hypertension doesn’t present symptoms and because many people in low- and middle-income countries do not have access to regular preventive health care, the condition is often underdiagnosed.