Hypertension, commonly known as high blood pressure, is a widespread medical condition where the pressure in a person’s blood vessels remains elevated. This persistent high pressure forces the heart to work harder to pump blood throughout the body. The World Health Organization (WHO) is a leading global authority addressing this condition, recognizing its significant impact on public health worldwide.
WHO’s Definition of Hypertension
The World Health Organization defines hypertension as a condition where blood pressure is consistently at or above 140/90 mmHg. The first number, systolic blood pressure, represents the pressure in blood vessels when the heart contracts. The second number, diastolic blood pressure, indicates the pressure in the vessels when the heart rests between beats.
A diagnosis of hypertension is made if, after being measured on two separate days, the systolic blood pressure readings on both days are 140 mmHg or higher, and/or the diastolic blood pressure readings on both days are 90 mmHg or higher. While the WHO uses these general thresholds for adults, specific guidelines may be adjusted for individuals with certain pre-existing conditions.
Global Burden and Contributing Factors
Hypertension presents a substantial global health challenge, affecting an estimated 1.28 billion adults aged 30–79 years worldwide. A significant proportion of these individuals, approximately two-thirds, reside in low- and middle-income countries. Nearly half (46%) of adults with hypertension are unaware they have the condition, and less than half (42%) are diagnosed and treated. This widespread lack of awareness and control contributes to hypertension being a major cause of premature death globally.
Several factors contribute to the prevalence of hypertension, categorized as either modifiable or non-modifiable. Modifiable risk factors include unhealthy diets with excessive salt consumption, low intake of fruits and vegetables, physical inactivity, tobacco use, harmful alcohol consumption, and being overweight or obese. Non-modifiable factors include older age, genetics, and a family history of hypertension. Certain co-existing conditions like diabetes or kidney disease also increase the risk.
Preventing Hypertension According to WHO
The WHO emphasizes primary prevention strategies to reduce the occurrence of hypertension, focusing on both population-level interventions and individual lifestyle changes. Promoting healthy diets is a core recommendation, which includes reducing salt intake and increasing the consumption of fruits and vegetables.
Regular physical activity is also advocated, with recommendations for at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, along with strength-building exercises two or more days a week. Maintaining a healthy weight, reducing harmful alcohol consumption, and ceasing tobacco use are additional lifestyle modifications that can help prevent hypertension. These comprehensive strategies aim to lower blood pressure and mitigate the associated risks of heart, brain, and kidney diseases.
WHO’s Approach to Management and Control
Once hypertension is diagnosed, the WHO outlines a comprehensive approach to its management and control, emphasizing long-term care. Regular blood pressure monitoring is an element, which can be done at home or with a health professional. Adherence to prescribed medication is also a part of management, as many individuals will require medicine in addition to lifestyle changes.
The WHO recommends initial treatment with drugs from specific classes, including thiazide and thiazide-like agents, angiotensin-converting enzyme inhibitors (ACEis) or angiotensin-receptor blockers (ARBs), and long-acting dihydropyridine calcium channel blockers (CCBs). Combination therapy is also suggested. For most patients without other health conditions, the target blood pressure goal is less than 140/90 mmHg, with lower targets for individuals with existing cardiovascular disease or high cardiovascular risk. The importance of access to affordable and essential medicines and care, particularly in low-resource settings, is a focus of WHO initiatives like the Global Hearts Initiative.