Managing hypertension and cardiovascular risk in resource-limited settings

Hypertension management is a gateway for cardiovascular risk reduction. The status of hypertension treatment and control is low in resource-limited lower income countries and similar settings in middle-income and high-income countries. Implementation of strategies for prevention and management of hypertension can lead to a substantial increase in its control and decline in associated cardiovascular mortality and disease burden.

Population-wide and clinical interventions that can be deployed in resource-limited settings globally to improve hypertension control have been summarized in the WHO's Global Report on Hypertension (2025). Focusing on social determinants (poverty, hunger, literacy, clean energy, economic growth, inequalities, sustainable cities, and climate action) can lead to primordial prevention, and risk factor control (such as salt reduction, physical activity, pollution, obesity, and a healthy diet) for primary prevention. Guidelines emphasize simplified medical treatment with algorithm-based single-pill combinations. Specific strategies that focus on nonphysician health worker-led interventions to promote identification and adherence to treatment in low-resource settings ae important. Technology-based interventions for the identification of hypertension and promotion of adherence need more studies.

Primordial and primary prevention of hypertension, combined with interventions that support clinical management and promote adherence to therapies, are important for resource-limited settings to reduce cardiovascular risk.