Raised blood pressure remains the leading risk factor for all-cause and cardiovascular deaths in Australia

PLOSFeb 21 2024

Raised blood pressure has been the leading risk factor for death in Australia for the past three decades, according to a study published February 21, 2024, in the open-access journal PLOS ONE led by Alta Schutte and Xiaoyue Xu from The George Institute for Global Health and UNSW, Sydney, with colleagues across Australia. It is also the main contributor to deaths from cardiovascular disease (CVD) specifically. 

Raised blood pressure has long been recognized as a contributing factor to CVD and death, but is not always prioritized in national health plans. In this study, researchers focused on Australia, which lags behind other high-income countries in hypertension control. Data on how raised blood pressure compares to other risk factors for CVD burden-;and how this changes over time-;can help to guide public health agendas and inform the effectiveness of public health policies. 

Researchers analyzed epidemiologic data from the Global Burden of Disease (GBD) study between 1990 and 2019 to determine the leading risk factors associated with both all-cause and CVD deaths, over time and between gender and age groups. The GBD study provides data on nearly 400 diseases and 87 risk factors across 204 countries. 

They found that while the contribution of raised blood pressure to these outcomes declined early in the study period (from around 54% to around 44%), it persisted as the leading risk factor for all-cause and CVD deaths. Dietary factors and tobacco use rounded out the top three risk factors. These findings strongly align with the recently established National Hypertension Taskforce of Australia, which aims to improve Australia's blood pressure control rates from 32% to 70% by 2030 (Hypertension - Australian Cardiovascular Alliance (ozheart.org)). The research findings further advocate for the prioritization of blood pressure control on the public health agenda. 

Differences by gender and age were also seen. For example, the contribution of raised blood pressure to stroke-related deaths in males aged 25-49 years were higher than other age groups, exceeding 60% and increasing steeply over time. 

The study reinforces the importance of blood pressure control and awareness. The researchers hope that the data will urge policymakers to prioritize blood pressure control efforts in Australia and will provide insight into age groups and populations that would benefit from more targeted action. 

The authors add: "There is no doubt that raised blood pressure has remained the leading risk factor for all-cause and cardiovascular deaths in Australia across the past three decades. Our findings support actions to strengthen primary care and to improve the prevention, detection, treatment and control of raised blood pressure, with the goal of significantly reducing all-cause and cardiovascular deaths in Australia over the next decade."