The greatest cause of death in Australia continues to be high blood pressure, or hypertension, according to new study from The George Institute for Global Health and UNSW Sydney. This reinforces the need for a coordinated national effort to change the national blood pressure control strategy.

The new study, which was published today in the international journal PLOS ONE, established that, during the 30 years from 1990 to 2019, elevated systolic blood pressure (SBP)* continued to be the primary risk factor for fatalities with a known cause, with dietary hazards and tobacco use coming in second and third.1.

In addition to the well-established associations with dangerous cardiovascular diseases, high blood pressure has been linked to kidney disease, pregnancy difficulties, cognitive decline, and worse outcomes from COVID; yet, it is easily managed with medication, dietary adjustments, and lifestyle modifications.

According to estimates, a 25% decrease in high blood pressure might save almost 37,000 lives per year in Australia, where 34% of adults have high blood pressure2.3. Compared to 68% of Canadians, just 32% of Australians with hypertension have lowered their blood pressure to within the healthy range.4 Most Australians who have high blood pressure do not know they have it, about half of them.5.

Lead author Alta Schutte, a professor of cardiovascular medicine at The George Institute and UNSW, stated, “This study shows it is past time for us to act. Australia lags well behind other high-income countries in blood pressure control.” “Our greatest defenses against heart disease and stroke are prevention, early detection, and efficient treatment. These are our weapons, and we ought to be utilizing them.

The data shows that elevated SBP was associated with 24% of fatalities in Australia from all causes in 1990 (29,056 persons), 14% (21,845) in 2010, and 14% (25,498) in 2019. Raised SBP was linked to 54%, 44%, and 44% of cardiovascular-related deaths in 1990, 2010, and 2019, respectively, following a similar pattern.1. Given that the results over the last 10 years indicate an initial improvement but no continuing decline, more focus and funding are required.

Prof. Schutte went on, “We know from the body of evidence that the arrival of new medications was likely responsible for the initial effect.” Although the precise reason for our decline is unknown, we do know that improving primary care’s ability to identify and treat patients effectively will help.

“We also know that more advanced therapy modalities are available today. Combining two or three low-dose blood pressure lowering drugs into one pill is not only more cost-efficient and easier for patients to take regularly, but it is also more successful at lowering blood pressure.

The study also found disparities in age and gender. Men between the ages of 25 and 49 had a higher than average contribution from high blood pressure to stroke-related deaths between 1990 and 2019, rising sharply over time to surpass 60%. This suggests that men in this age group may be overlooked.1.

“It would be especially recommended for men under 50 to get their blood pressure checked at their next doctor’s appointment,” he stated.

The authors of the study are Professors Schutte and Jennings, and the chair of Hypertension Australia is Professor Markus Schlaich. The National Hypertension Taskforce was founded in 2022 and formally introduced by the Australian Government in December of the same year.

The purpose of the taskforce, which is a collaboration between Hypertension Australia and the Australian Cardiovascular Alliance, is to raise Australia’s blood pressure management rates from 32% to 70% by 2030. It will unveil its first roadmap to achieve this goal on March 18, 2024, at Parliament House in Canberra.

* Diastolic blood pressure is the pressure that occurs when the heart is at rest; systolic blood pressure is the force that the heart produces in the arteries when it beats and pumps blood out into the body. Higher systolic blood pressure, which is represented by the upper number in a blood pressure reading, is linked to a higher risk of heart disease and stroke than higher diastolic blood pressure.