Hypertension among older adults in lowand middle-income countries: Prevalence, awareness and control

Peter Lloyd-Sherlock*, John Beard, Nadia Minicuci, Shah Ebrahim, Somnath Chatterji

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

350 Citations (Scopus)
10 Downloads (Pure)


Background: This study uses data from the World Health Organization's Study on Global Ageing and Adult Health (SAGE) to examine patterns of hypertension prevalence, awareness, treatment and control for people aged 50 years and over in China, Ghana, India, Mexico, the Russian Federation and South Africa. 

Methods: The SAGE sample comprises of 35 125 people aged 50 years and older, selected randomly. Hypertension was defined as ≥140mmHg (systolic blood pressure) or ≥90mmHg (diastolic blood pressure) or by currently taking antihypertensives. Control of hypertension was defined as blood pressure below 140/90mmHg on treatment. A person was defined as aware if he/she was hypertensive and self-reported the condition. 

Results: Prevalence rates in all countries are broadly comparable to those of developed countries (52.9%; range 32.3% in India to 77.9% in SouthAfrica). Hypertension was associated with overweight/obesity and as more common in women, those in the lowest wealth quintile and in heavy alcohol consumers. Awareness was found to be lowfor all countries, albeit with substantial national variations (48.3%; range 23.3% in Ghana to 72.1% in the Russian Federation). This was also the case for control (10.2%; range 4.1% in Ghana to 14.1% India) and treatment efficacy (26.3%; range 17.4% in the Russian Federation to 55.2% in India). Awareness was associated with increasing age, being female and being overweight or obese. Effective control of hypertension was more likely in older people, women and in the richest quintile. Obesity was associated with poorer control. 

Conclusions: The high rates of hypertension in low- and middle-income countries are striking. Levels of treatment and control are inadequate despite half those sampled being aware of their condition. Since cardiovascular disease is by far the largest cause of years of life lost in these settings, these findings emphasize the need for new approaches towards control of this major risk factor.

Original languageEnglish
Article numberdyt215
Pages (from-to)116-128
Number of pages13
JournalInternational Journal of Epidemiology
Issue number1
Publication statusPublished - 6 Feb 2014
Externally publishedYes

Cite this