What is the clinical evidence from this study?

Study design: Observational. Population: Hypertension. Intervention: Machine learning forecast (Year 2040) vs. Year 2015. Primary outcome: Global prevalence of hypertension (95% CI 20.2 - 20.4).

October 3, 2023BMC Public Health58 citationsOpen Access

A glimpse into the future: modelling global prevalence of hypertension

EBEmmanuel B. Boateng AAAma Gyamfua Ampofo

Key Result

Globally, the prevalence of hypertension is projected to decrease from 22.1% in 2015 to 20.3% in 2040, with higher expected rates in males than in females.

Study Design

Type

Observational

Structured PICO

Population

Global population of adults aged 18 years and older from 187 countries, using WHO data from 1975 to 2015 to forecast hypertension prevalence to 2040.

Outcome

Projected prevalence of hypertension in 2040 in males, females, and both sexes

Global hypertension prevalence is projected to decrease slightly to 20.3% by 2040, though specific regions like Africa, South-East Asia, and low-income countries will face disproportionately high burdens.

Main Result

Absolute Event Rate: 20.3% vs 22.1%

Limitations

Assumptions for cap and floor arguments in developing each Prophet model may slightly limit results
Paucity of data for some countries limits the ranking of highest hypertension prevalent countries
Subjectiveness in the choice of a representative cluster for each year
Common method of standardization across all features in all years' datasets may not be optimal for specific years
Projections do not account for rapid changes in lifestyle, introduction of cheap therapeutic interventions, and social determinants
Does not take into account the gradual effect of migration on hypertension
Variations in data collection and collation methods used in producing the WHO source data

Abstract

BACKGROUND: Hypertension is a major risk factor for cardiovascular diseases. Insights and foresights on trends of hypertension prevalence are crucial to informing health policymaking. We examined and projected the patterns of hypertension prevalence among sexes. METHODS: Using annual hypertension prevalence (18 + years) data sourced from WHO Global Health Observatory data repository from 1975 to 2015, Prophet models were developed to forecast the 2040 prevalence of hypertension in males, females, and both sexes. We used k-means clustering and self-organising maps to determine the clusters of hypertension prevalence concerning both sexes among 176 countries. RESULTS: Worldwide, Croatia is estimated to have the highest prevalence of hypertension in males by 2040, while that of females is in Niger. Among the world's most populated countries, Pakistan and India are likely to increase by 7.7% and 4.0% respectively in both sexes. South-East Asia is projected to experience the largest hypertension prevalence in males, whereas Africa is estimated to have the highest prevalence of hypertension in females. Low-income countries are projected to have the highest prevalence of hypertension in both sexes. By 2040, the prevalence of hypertension worldwide is expected to be higher in the male population than in female. Globally, the prevalence of hypertension is projected to decrease from 22.1% in 2015 to 20.3% (20.2 - 20.4%) in 2040. We also identified three patterns of hypertension prevalence in 2040, cluster one countries are estimated to have the highest prevalence of hypertension in males (29.6%, 22.2 - 41.1%) and females (29.6%, 19.4 - 38.7%). CONCLUSION: These findings emphasise the need for new and effective approaches toward the prevention and control of hypertension in Africa, South-East Asia, and Low-income countries.

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