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<p>Hypertension is the leading modifiable risk factor for Cardiovascular (CV) disease and stroke, causing over 10&#xa0;million deaths annually worldwide. Despite therapeutic advances, prevalence and poor control remain disproportionately high in low- and middle-income countries (LMICs). This review synthesizes evidence from PubMed- and Scopus-indexed studies (2010–2025) to evaluate lifestyle and policy interventions for hypertension prevention. Global analyses demonstrate declining prevalence and high control rates (&gt; 50%) in countries with structured programs such as Canada, South Korea, and Iceland, contrasted with rising rates and poor control (&lt; 20%) in LMICs including India, China, and Nigeria. Lifestyle interventions consistently reduce systolic blood pressure (SBP): DASH diet (− 5 to − 7 mmHg), sodium restriction (− 3 mmHg), and isometric training (− 9 to − 11 mmHg). Alcohol reduction and stress management provide modest additional benefits. At the policy level, England’s salt reformulation program and South Africa’s sodium regulations significantly lowered population blood pressure, while the SSaSS trial in China showed potassium-enriched salt substitution reduced stroke (RR 0.86), major CVD (RR 0.87), and all-cause mortality (RR 0.88). Modeling studies suggest combined strategies can achieve 30–40% relative risk reductions in major CV disease and prevent over 200 events per 100,000 high-risk adults annually. However, implementation gaps and inequities persist, with LMICs lagging behind due to limited infrastructure and policy enforcement. Both individual-level and population-wide strategies are effective and complementary. Scalable adoption of lifestyle interventions alongside structural policies is essential to reduce global hypertension burden and close disparities in CV outcomes. These findings highlight that integrating evidence-based lifestyle measures with population-wide policy interventions is essential to reduce global hypertension burden and improve CV outcomes.</p>

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Global strategies for hypertension prevention: evidence from lifestyle and policy interventions (2010–2025)

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月18日

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  • Nada Soliman,
  • Ashraf T. Soliman

摘要

Hypertension is the leading modifiable risk factor for Cardiovascular (CV) disease and stroke, causing over 10 million deaths annually worldwide. Despite therapeutic advances, prevalence and poor control remain disproportionately high in low- and middle-income countries (LMICs). This review synthesizes evidence from PubMed- and Scopus-indexed studies (2010–2025) to evaluate lifestyle and policy interventions for hypertension prevention. Global analyses demonstrate declining prevalence and high control rates (> 50%) in countries with structured programs such as Canada, South Korea, and Iceland, contrasted with rising rates and poor control (< 20%) in LMICs including India, China, and Nigeria. Lifestyle interventions consistently reduce systolic blood pressure (SBP): DASH diet (− 5 to − 7 mmHg), sodium restriction (− 3 mmHg), and isometric training (− 9 to − 11 mmHg). Alcohol reduction and stress management provide modest additional benefits. At the policy level, England’s salt reformulation program and South Africa’s sodium regulations significantly lowered population blood pressure, while the SSaSS trial in China showed potassium-enriched salt substitution reduced stroke (RR 0.86), major CVD (RR 0.87), and all-cause mortality (RR 0.88). Modeling studies suggest combined strategies can achieve 30–40% relative risk reductions in major CV disease and prevent over 200 events per 100,000 high-risk adults annually. However, implementation gaps and inequities persist, with LMICs lagging behind due to limited infrastructure and policy enforcement. Both individual-level and population-wide strategies are effective and complementary. Scalable adoption of lifestyle interventions alongside structural policies is essential to reduce global hypertension burden and close disparities in CV outcomes. These findings highlight that integrating evidence-based lifestyle measures with population-wide policy interventions is essential to reduce global hypertension burden and improve CV outcomes.