Research press release


Nature Medicine

Health: Global blood pressure targets may reduce deaths from cardiovascular diseases



S Pickersgillたちは、各国が国の高血圧対策として「80-80-80目標」を導入することを提案している。80-80-80目標とは、高血圧と思われる人の80%が検査を受けて診断結果を知り、自身が高血圧だと知った人の80%が治療薬を処方され、こうして治療中の人の80%がガイドラインで推奨された血圧レベルを達成するというものである。著者たちは、182か国について、高血圧管理のこの目標に沿った3通りのシナリオ、つまり「現状維持」(診断や治療の規模拡大を図るような追加の取り組みはしない)、「進展」(歴史的に管理をうまく行ってきた国にあたる)、「強く推進」(歴史的に管理をうまく行ってきた国を上回る速さで対策が進展する)を想定して、これらが与える影響をモデル化した。「進展」と「強く推進」のシナリオの場合、あらゆる死因による死亡数が2050年までにそれぞれ4%(7600万人)あるいは7%(1億3000万人)減らせる可能性があると著者たちは推定している。この目標から最も大きな利益を実際に受けるのは、現時点で高血圧対策の普及率の低い最貧国と考えられる。「強く推進」のシナリオでは、ほとんどの国が2040年までに80-80-80目標を達成できる可能性がある。


Between 76 million and 130 million deaths from cardiovascular diseases could be averted globally between 2022 and 2050 if global hypertension targets of 80% screened, 80% receiving treatment and 80% achieving guideline-based blood pressure levels are attained, according to a modeling study in Nature Medicine.

High blood pressure (hypertension) is the leading modifiable risk factor for cardiovascular diseases (CVDs) and associated mortality. Cost-effective interventions for prevention and management exist; however, scaling these up to national and global levels has not been a political priority in many countries.

Sarah Pickersgill and colleagues propose that countries adopt an 80-80-80 target for national hypertension policies: 80% of people with hypertension are screened and aware of their diagnosis; 80% of those who are aware are prescribed treatment; and 80% of those on treatment have achieved recommended guideline-specified blood pressure levels. The authors modeled the impacts of three scenarios of hypertension control in 182 countries in the context of these targets: business as usual (with no additional attempts to scale up diagnosis and treatment); progress (progress matches historically well-performing countries); and aspirational (progress is faster than historically well-performing countries). The team estimated that 4–7% (76–130 million) of all-cause deaths could be averted in the progress and aspirational scenarios respectively by 2050. The largest gains would be realised in the poorest countries, where hypertension intervention coverage is currently low. Most countries would be able to achieve an 80-80-80 target by 2040 in the aspirational scenario.

The authors conclude that achieving 80-80-80 targets for hypertension worldwide could represent one of the single most important global public health accomplishments of the coming decades. Implementation of such a strategy, they state, could substantially reduce global inequalities in CVD outcomes.

doi: 10.1038/s41591-022-01890-4


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