{
  "release_id": "73130c34862e2d06",
  "id": "cardio:bottleneck-uncontrolled-hypertension",
  "owner": "cardio",
  "kind": "bottleneck",
  "slug": "bottleneck-uncontrolled-hypertension",
  "name": "Many people with hypertension are not diagnosed, treated or controlled",
  "aliases": [],
  "atlases": [
    "cardio"
  ],
  "summary_plain": "Many adults with high blood pressure do not know they have it, are not treated, or do not have it under control. WHO's 2023 global report estimates that in 2019, among adults aged 30 to 79 with hypertension, 54% had been diagnosed, 42% were being treated and 21% had their hypertension controlled. A WHO fact sheet from September 2025, whose key facts date its prevalence figure to 2024, says 44% are unaware, 44% are diagnosed and treated, and 23% have it controlled. These are separate estimates for different years, not a measured change. The blood pressure control gap is what Million Hearts' blood pressure priority in the United States and WHO's HEARTS package are aimed at.",
  "summary_technical": "Burden claim rests on two WHO publications with different estimate years and categories, shown side by side and not merged. They are modelled population estimates, not registry counts. WHO's fact sheet calls hypertension a major cause of premature death worldwide. HEARTS and Million Hearts are the efforts recorded here; neither record shows that closing the gap is achieved. The overlay on the WHO organization record adds WHO as an actor on this bottleneck.",
  "editorial_state": "draft",
  "last_substantive_edit": "2026-10-15",
  "last_evidence_check": "2026-10-15",
  "next_review_due": null,
  "identifiers": [],
  "navigation": {
    "cardio": {
      "system": [
        "blood-vessels"
      ],
      "condition-area": [
        "hypertension"
      ]
    }
  },
  "payload": {
    "stage": "Across the care cascade: finding hypertension, starting treatment and keeping blood pressure controlled",
    "scope": "Adults aged 30 to 79 years with hypertension worldwide, as WHO estimates; the report also gives variation by sex, region and country income level.",
    "severity_rationale": "WHO's fact sheet says hypertension is a major cause of premature death worldwide.",
    "burden_claims": [
      "cardio:claim-who-hypertension-care-cascade"
    ],
    "current_efforts": [
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      "cardio:million-hearts"
    ]
  },
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      "release_id": "73130c34862e2d06",
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      "category": "burden",
      "statement": "The WHO Global report on hypertension (2023) estimates that in 2019, among adults aged 30 to 79 years with hypertension, 54% had been diagnosed, 42% were being treated for their hypertension and 21% had their hypertension controlled. A WHO hypertension fact sheet dated 25 September 2025, whose key facts give the number of adults with hypertension for 2024, says that an estimated 600 million adults with hypertension (44%) are unaware that they have the condition, approximately 630 million adults with hypertension (44%) are diagnosed and treated, and approximately 320 million adults with hypertension (23%) have it under control. The fact sheet prints no year beside those three figures. The two sets are separate estimates for different years, not a measured change between 2019 and 2024 or 2025.",
      "context": {
        "id": "cardio:ctx-who-adults-30-79-hypertension",
        "label": "Adults aged 30 to 79 years with hypertension, worldwide (WHO estimates)",
        "recipient": "adult",
        "population": "Adults aged 30 to 79 years with hypertension. The report defines hypertension as blood pressure of 140 mmHg systolic or higher, or 90 mmHg diastolic or higher, or being on medication. The fact sheet gives 140/90 mmHg or higher.",
        "care_setting": "Population-level estimates from the NCD Risk Factor Collaboration with additional calculations (report figure source), not a care setting.",
        "geography": "Worldwide; the report also gives regional and country-income-level variation.",
        "life_stage_note": "Adults aged 30 to 79 years",
        "life_stage_terms": null,
        "gestational_age_min_days": null,
        "gestational_age_max_days": null,
        "gestational_age_basis": null,
        "postnatal_age_min_days": null,
        "postnatal_age_max_days": null,
        "gestational_age_status": null,
        "postnatal_age_status": null,
        "followup_description": "Not stated in the source: these are population estimates, not a follow-up of individuals. The report's diagnosis, treatment and control figures are for 2019; the fact sheet's key facts give 2024 for the number of adults with hypertension.",
        "eligibility": {
          "inclusion": [],
          "exclusion": []
        }
      },
      "evidence_stage": "synthesis",
      "certainty": "not_assessed",
      "certainty_method": null,
      "limitations": "The report and the fact sheet are two WHO publications. The report's figures are for 2019; the fact sheet gives a year only for its prevalence key fact (2024), and its categories differ from the report's (unaware, and diagnosed and treated, against diagnosed, treated and controlled). They are not reconciled here. The report defines hypertension as blood pressure of 140 mmHg systolic or higher, or 90 mmHg diastolic or higher, or being on medication; the fact sheet gives 140/90 mmHg or higher. The figures are modelled population estimates for ages 30 to 79 (the report cites the NCD Risk Factor Collaboration and additional calculations), not counts from a registry, and they are global averages: the report also describes variation by sex, region and country income level.",
      "editorial_state": "draft",
      "checked_at": "2026-10-15",
      "next_review_due": null,
      "valid_from": null,
      "valid_to": null,
      "citations": [
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          "evidence_role": "supports",
          "locator": "PDF page 24, section 2.3 Status of hypertension care, paragraph 1",
          "applicability_note": "Diagnosed, treated and controlled shares.",
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          "source": {
            "id": "cardio:who-global-hypertension-report-2023",
            "source_type": "publication",
            "title": "Global report on hypertension: the race against a silent killer",
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            "reuse_basis": "The PDF states the work is available under CC BY-NC-SA 3.0 IGO (copyright page, PDF page 4). Short quotations with attribution only, until the atlas settles its public data licence. The WHO terms of use (fetched 2026-10-15 as cl-who-terms-of-use.html, sha256 8edac88c0773639d74a023402b231adafb407e8a680e6620c099eb5a17fb61ab, hash only) say extracts of the web site may be reproduced for research or private study but not for sale or for commercial use, with acknowledgment of WHO as the source. Hashes only; neither the page nor the PDF is committed.",
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          "locator": "Key facts, bullets 3 to 5",
          "applicability_note": "Unaware, diagnosed and treated, and controlled shares from the fact sheet.",
          "snapshot": {
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            "retrieved_at": "2026-10-15T13:49:17Z",
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            "source_effective_date": "2025-09-25",
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          "source": {
            "id": "cardio:who-hypertension-fact-sheet",
            "source_type": "webpage",
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            "canonical_url": "https://www.who.int/news-room/fact-sheets/detail/hypertension",
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            "publisher": "World Health Organization",
            "edition": "WHO fact sheet fetched 2026-10-15; the page is dated 25 September 2025.",
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            "public_text": "quote",
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        },
        {
          "evidence_role": "context",
          "locator": "PDF page 22, global burden of hypertension",
          "applicability_note": "Number of adults with hypertension.",
          "snapshot": {
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}