1.4 billion people lived with hypertension in 2024

• The World Health Organisation’s (WHO) second ‘Global Report on Hypertension 2025’ shows that 1.4 billion people lived with hypertension in 2024.

• However, just over one in five have it under control either through medication or addressing modifiable health risks.

• Uncontrolled high blood pressure claims more than 10 million lives every year, despite being both preventable and treatable. 

• Only 28 per cent of low-income countries report that all WHO-recommended hypertension medicines are generally available in pharmacies or primary care facilities.

• Every hour, over 1,000 lives are lost to strokes and heart attacks from high blood pressure, and most of these deaths are preventable.

• The report highlights major gaps in hypertension prevention, diagnosis, treatment, and long-term care. 

The need for urgent action

• Hypertension is a chronic condition that significantly increases the risk of cardiovascular and kidney diseases. 

• It is defined as a sustained elevation of blood pressure in the arteries, which carry blood from the heart to all tissues and organs. 

• Most individuals with elevated blood pressure have no symptoms and are unaware of their condition until serious health issues arise, earning it the designation “silent killer”.

• Hypertension is a major global public health threat. 

• In 2024, it affects approximately 1.4 billion people aged 30-79 years worldwide, yet only 320 million people had their blood pressure controlled. 

• Uncontrolled hypertension leads to heart attacks, heart failure, strokes, chronic kidney disease, dementia, and other serious complications, resulting in substantial socioeconomic costs. 

• The high prevalence demonstrates the need for stronger prevention efforts, while the high number of people with uncontrolled hypertension highlights systemic weaknesses in detection, diagnosis, and long-term management.

• As hypertension also often occurs with other comorbid physical and mental health conditions, with shared risk factors, integrated care, especially in primary care, is crucial. 

• Hypertension imposes a significant financial burden on individuals, families, health systems, and economies. 

• The challenge is even more severe in low and middle-income countries, where cardiovascular diseases, including hypertension, led to economic losses estimated at $3.7 trillion from 2011 to 2025 — around 2 per cent of GDP in these countries. 

• Despite the potential for billions of dollars of savings in global healthcare, public health commitment and investment in hypertension prevention and control remains insufficient.

• Action will become even more important in the coming decades, with the global burden of hypertension set to rise due to people living longer and the population structure shifting towards older age groups. 

Persistent barriers

• Countries that integrate hypertension care into universal health coverage and primary care are making real progress, but too many low and middle-income countries are still left behind.

• Bangladesh, Philippines, and South Korea have made significant progress by integrating hypertension care into Universal Health Coverage (UHC), investing in primary care, and engaging communities.

• Analysis of data from 195 countries and territories shows that 99 of them have national hypertension control rates below 20 per cent. 

• The majority of the affected people live in low and middle-income countries, where health systems face resource constraints.

Countries frequently lack:

i) Effective prevention policies, such as the promotion of potassium enriched, low-sodium salt.

ii) Access to validated blood pressure devices.

iii) Standardised treatment protocols, and adequately trained primary care teams.

iv) Reliable budgetary allocation, procurement and supply chains for essential medicines.

v) Financial protection for patients, particularly in low and middle-income countries.

vi) Robust information systems to monitor quality of care and equity – i.e. how well services are being provided to every person.

Key enabling factors for hypertension control

i) Health promotion and prevention: Increasing health literacy and awareness on hypertension, and implementing the WHO HEARTS technical package, are essential to address important risk factors, such as excess salt intake, physical inactivity, alcohol use, tobacco use, and consumption of industrially-produced trans fats. The HEARTS technical package provides a strategic approach to improving cardiovascular health in countries.

ii) Accurate and timely diagnosis: Universal measurement of blood pressure among adult patients attending all health care facilities, can be facilitated by adopting national policies and guidelines to include routine blood pressure measurement into primary care.

iii) Treatment: Key enablers for better treatment outcomes include reliable access to affordable medications; simplified treatment protocols (including single-pill combinations); team-based care models; task-sharing among health care workers; and policies to include anti-hypertensive medicines in national essential medicines lists, subsidised programmes, and health benefit packages.

iv) Continuity of care and adherence: Engaging patients in self-management; implementing team-based care; simplifying treatment regimens; improving patient tracking and recall systems; and leveraging mobile health, digital tools, and telemedicine, can strengthen follow-up and long-term blood pressure control.

• WHO calls on all countries to embed hypertension control in UHC reforms. 

India Hypertension Control Initiative (IHCI)

• There are an estimated 20 crore adults with hypertension in India, of whom approximately only 2 crore have it under control.

• The control of hypertension at primary care system level will contribute to reducing deaths due to heart attacks, stroke and kidney failures.

• India Hypertension Control Initiative (IHCI) has been able to leverage and strengthen the existing healthcare delivery system, hypertension control interventions under National Health Mission and improve the linkages between populations-based screening initiative with health care.  

• The initiative was launched in 2017 and expanded in a phased manner to cover more than 20,000 government hospitals and health centers across 150 districts in 26 states.

• In September 2022, IHCI won the ‘2022 UN Interagency Task Force, and WHO Special Programme on Primary Health Care Award’ at the UN General Assembly side event.