International Society of Hypertension

The Lancet Commission on Hypertension is launched at the 2016 ISH Meeting, Seoul, Korea

A major review is calling for improvements in the way hypertension is treated on a global scale. The Lancet Commission on Hypertension cites ‘unsolved areas’ that if tackled could help reduce the burden of high blood pressure, the world’s number one cause of death.

New report calls for fresh approach to treating the world’s No. 1 killer

The Lancet Commission on Hypertension is launched at the 26th Scientific Meeting of the International Society of Hypertension


A major review is calling for improvements in the way hypertension is treated on a global scale. The Lancet Commission on Hypertension cites ‘unsolved areas’ that if tackled could help reduce the burden of high blood pressure, the world’s number one cause of death.

These include variations in the way blood pressure is measured and debate over what constitutes safe levels of salt in the diet.

Launched at the International Society of Hypertension’s scientific meeting in Seoul, South Korea, the Commission says hypertension too often goes unrecognised because there are no symptoms and inadequate screening. Despite there being extensive knowledge about how to prevent and treat high blood pressure, hypertension still affects 30% of adults worldwide.

Stuart Spencer, Senior Executive Editor at The Lancet, said: “Hypertension is the main cause of cardiovascular disease and often goes untreated. The report identifies a number of unresolved issues, for instance, how people in the developing world can access drug treatments and screening, and aims to prompt new ways of tackling hypertension, both from an individual and public health perspective.”

Professor Neil Poulter, incoming President of the International Society of Hypertension (ISH), said: “We are delighted the Commission has chosen to launch this very important report at our event. Hypertension is widespread and it is essential that we create awareness among health professionals and individuals on a global scale.

“The main risk factors are all those things that become more common as societies ‘develop’ - exercise less, drink more alcohol, consume more salt and calories and eat less fruit and vegetables. These factors sit alongside the ageing process itself that increases the risk of high blood pressure. We need to make sure that people know they have high blood pressure. The answer lies in improving knowledge and enabling more effective methods of screening.”

The Commission examines existing epidemiological and trial evidence and emphasises where support is strong and where more research is needed. It claims as a result of increases in population, ageing, urbanisation and obesity, the number of people with hypertension can be expected to increase in low-income and some middle-income countries if not counteracted by concerted action. It calls for more sophisticated methods of individualised treatment based on robust research findings but also new research to fill knowledge gaps. It sets out ten priority actions* it hopes will be adopted by governments worldwide to reduce the global burden of hypertension.



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The Lancet launched its Commission on Hypertension in 2015 with the aim of generating a campaign to implement priority actions to improve the management of raised blood pressure and hypertension globally. Chaired by Professor Michael Hecht Olsen from the Odense University Hospital in Denmark, the Commission also includes 19 other Commissioners from across the world with high levels of expertise in different fields of hypertension.

For the full report see:

*The Commission states previous action plans for improving management of elevated blood pressure and hypertension have not provided adequate results. Therefore, it identified ten essential and achievable goals and ten accompanying key actions that, if implemented effectively and broadly, will make substantial contributions to the management of blood pressure globally. These are listed below:


Prevention: lifestyle and environmental changes

Health promoting environment

Creating a healthy environment through strategies that accelerate socioeconomic improvements and implementation of accepted health-promoting policies

Healthy behaviours

Universal understanding of unhealthy and healthy lifestyles and blood pressure through endorsed, early, and sustained education using new technologies

Measurement access

Universal access to measurement of blood pressure through inexpensive blood pressure monitors (linked to establishment of global blood pressure surveillance)

Blood pressure diagnosis and evaluation

Measurement quality

Better quality of blood pressure measurements through endorsed protocols and certified and validated blood pressure monitors


Better identification of people at high risk to optimise treatment approaches through endorsed education of patients and health-care professionals (linked to stratified treatment approaches)

Secondary hypertension

Better identification of people with secondary hypertension through endorsed and simple flow charts (linked to stratified treatment approaches)

Pharmacological prevention and monitoring

Workforce expansion

Expand the workforce engaged in the management of blood pressure through task sharing and the use of endorsed education of community health workers (linked to health-care system accountability)

Medication access

Universal access to affordable, high-quality, and effective antihypertensive drugs through collaboration between all major stakeholders

Standardised treatment

Treatment approaches stratified according to age, cardiovascular risk, social, cultural, and ethnic differences through endorsed education of health-care professionals and initiation of new research

Blood pressure and health-care system

Health-system strengthening

Promote and ensure capacity and accountability of the health system to conduct surveillance and monitoring, and respond appropriately to blood pressure levels

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