A Global Look at Hypertension -- Where Is
It Lowest?
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April 13, 2014

By Genevieve Linton, Contributing Columnist

According to the Center for Disease Control (CDC), one out of
every three Americans has high blood pressure, also known as
hypertension. That equates to over 70 million Americans. In
the UK the figures are similar, as 30% of the population
suffers from hypertension.

These numbers are alarming, considering high blood pressure
can have serious health consequences, including strokes,
heart attacks and death. The American Heart Association
points out that high blood pressure directly caused the death
of over 60,000 Americans in 2010, and was either the primary
or contributing cause of death for over 300,000 Americans
that same year.

While those figures may seem shocking, high blood pressure
has been identified as a serious health problem not only in the
USA and UK, but also around the globe.

This health problem, which can be brought on by a number of
factors, affects millions of people throughout the world and
shapes global health care policy and strategy.

The World Health Organization (WHO), in a 40-page report
from 2013, looks intimately at the global effect of
hypertension, and labels it as a “major public health issue”.
According to this report, cardiovascular disease, a
complication of hypertension, is responsible for 17 million
deaths a year, or one third of all deaths globally.

Complications from hypertension are directly linked to at least
45 percent of deaths due to heart disease and 51 percent of
deaths due to stroke.

So hypertension proves to be a global health issue, but where
in the world do the lowest rates of high blood pressure occur?
Looking at some of the places on Earth where there is less
prevalence of hypertension may lead to insightful observations
about how to prevent high blood pressure.

According to a study out of Tulane University from 2005,
countries labeled as part of “other Asia and islands”
demonstrated the lowest overall prevalence of hypertension.

Countries under that label included Taiwan, Korea and
Thailand. Those countries also were identified as having a low
prevalence of high blood pressure in a study from 2004 titled
“Worldwide prevalence of hypertension: a systematic review”.

In 2014, the
WHO published a ranking of countries by
hypertension rates, broken down into low-income, middle-
income and high-income groups.

But this list hides an important truth.  The segregation by
income groups obscures a fact that cuts across income groups
-- countries with low salt consumption have low rates of high
blood pressure. For example, in the 1960's, a researcher
named L.K. Dahl conducted a study which started with a
startling observation. Japanese at the time consumed 30grams
of salt on average and had a 40% rate of hypertension.
Alaskan Inuits, on the other hand, consumed 5 grams of salt a
day and had an astonishing hypertension rate of zero (0%)

That triggered a nationwide drive to reduce the amount of salt
in the average Japanese diet, a drive which has resulted in a
reduction of hypertension from 40% in 1960 to only 12.9%

Along with the reduction in salt consumption, rates of death
from stroke plummeted to some of the lowest in the
industrialized world, and Japan regularly now tops the
rankings of the longest living people on Earth.

According to these and other studies, we have compiled a list
of the seventeen countries and their respective rates of

1. Thailand -11.3% to 11.8%
2. Bangladesh -11.8%
3. Egypt -12.1%
4. Japan -12.9%
5. Jordan -12.9%
6. Mexico -14.8%
7. Iran -16.2%

8.England -14.9% to 22%, depending on
9.France -16.8%
10.. USA -17.2%
11.South Korea -22.9%
12. Canada -23%
13.Taiwan -24.2%
14. Germany -25.6%
15.China -26.6%
16. Russia -27.8%
17. Australia -32%

Note that this  list of countries is not broken down between
men and women or by age groups. In general, men have
higher rates of hypertension than women of teh same age. For
example, in the UK (which includes England), men have an
overall rate of hypertension of 23.3% and women have a rate
of 20.7%.  

The list includes countries that have been identified by multiple
different sources as having comparatively lower hypertension
rates. While the prevalence within the United States is quite
high, when compared on a global basis, it actually ranks much
lower than other countries.

According to the WHO, high -income countries have a lower
overall prevalence of hypertension, which reaffirms the rates
seen in the USA, as well as in Canada and Australia. In
addition, according to the WHO, Japan and other Asian
countries have a relatively low number of deaths per year due
to cardiovascular disease.

We can see from this list that the countries are either
considered to be high-income, or they are Asian countries,
where the population tends to have a very particular diet
composed of fish and vegetables.

Understanding that hypertension is a major global health
problem that affects millions of people every day can be a
discouraging realization. But recognizing that we are all at risk
for hypertension, no matter where we are in the world, is the
first step in taking the necessary steps to insure that we care
for own personal health in the most effective way possible.

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