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Lancet. 2015 Aug 22;386(9995):801-12. doi: 10.1016/S0140-6736(14)61468-9. Epub 2015 Mar 29.


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International Centre for Circulatory Health, Imperial College London, London, UK. Electronic address:
Centre for Chronic Disease Control and Public Health Foundation of India, New Delhi, India.
William Harvey Research Institute and NIHR Biomedical Research Unit in Cardiovascular Disease at Barts, Queen Mary University of London, London, UK.


Raised blood pressure is the biggest single contributor to the global burden of disease and to global mortality. The numbers of people affected and the prevalence of high blood pressure worldwide are expected to increase over the next decade. Preventive strategies are therefore urgently needed, especially in less developed countries, and management of hypertension must be optimised. Genetic advances in some rare causes of hypertension have been made lately, but the aggregate effect on blood pressure of all the genetic loci identified to date is small. Hence, intervention on key environmental determinants and effective implementation of trial-based therapies are needed. Three-drug combinations can control hypertension in about 90% of patients but only if resources allow identification of patients and drug delivery is affordable. Furthermore, assessment of optimal drug therapy for each ethnic group is needed.

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