Importantly, there has been a shift in prevalence from richer countries to poorer. The percentage of the population with high blood pressure has not changed much since 1990 but the total number has risen due to a growing and aging population.
Less than a quarter of women and a fifth of men with high blood pressure have it brought under control with medicines. About 580 million people with high blood pressure don’t know it because it has not been diagnosed. 720 million people are not receiving the treatment they need – that’s more than half of those with high blood pressure (53% of women and 62% of men). 28 billion adults aged 30-79 have high blood pressure, doubling from 650 million 30 years ago. Data shared by researchers around the world, collected from 1990 to 2019, showed: The WHO published their guidelines on the same day that they released the latest figures for those living with high blood pressure in collaboration with Imperial College London. High blood pressure is a major cause of heart attacks, strokes and other disease, at huge cost to individuals and health care services around the world, but once diagnosed the treatments are simple and inexpensive.ħ20 million are not receiving treatment for high blood pressure The guidelines also provide a basis for how health professionals can help improve the detection of high blood pressure – as it is commonly undiagnosed. Which health professionals can prescribe medicines, including nurses, with proper training and management. How often to have follow-up checks: monthly after starting or changing medicines, then every 3-6 months. The target blood pressure level: <140/90mmHg for people without other disease, and <130mmHg for those with. Deciding whether to use one or two medicines or a combination pill: the guidelines recommend a combination pill to improve adherence and persistence (using medicines as prescribed in the long term). Which drugs to use first, including thiazide and thiazide-like agents, ACE inhibitors, ARBs, and calcium channel blockers (CCBs). 
Risk assessment for diseases of the heart and blood vessels.Laboratory testing for other diseases (where it doesn’t cause a delay).The threshold is lower for people with existing disease of the heart and blood vessels at 130–139 mmHg. The threshold of blood pressure for starting medication: systolic blood pressure (the top number) of ≥140 mmHg or diastolic blood pressure (the bottom number) of ≥90 mmHg.
The guidelines include the most current and relevant evidence-based guidelines for starting treatment. This August, the World Health Organisation (WHO) published their Guideline for the pharmacological treatment of hypertension in adults, providing new recommendations to help countries improve the management of hypertension (high blood pressure).
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