Attributable Risk of Hypertension for Cardiovascular Disease

Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, and hypertension is a modifiable risk factor with the strongest association for developing heart disease. This review evaluates the attributable risk of hypertension for CVD at the population level and examines how this risk varies by demographic, geographic, and socioeconomic factors. Understanding the extent to which hypertension contributes to CVD can help inform targeted prevention and intervention treatment strategies. Recent studies have examined the attributable risk of hypertension for CVD across different populations. Hypertension had the highest population attributable risk (PAR) and population attributable fraction (PAF) values for overall CVD, stroke, heart failure, and coronary heart disease, especially among Black adults, younger individuals, and residents of low- and middle-income countries. Although hypertension prevalence has increased over time, some high-income countries have observed a decline in its attributable risk for CVD. This decline is likely due to improved blood pressure management and public health interventions. In the US, recent data shows blood pressure control among adults remains low. Population-level interventions such as sodium restrictions in the food supply, standardized treatment protocols to improve blood pressure control, and improved healthcare access have been shown to mitigate the burden of hypertension. Despite advancements in awareness and treatment, hypertension continues to be a major driver of the global CVD burden. The meaningful attributable risk for CVD highlights the need for improved public health protocols. Interventions that combine clinical management with population-level prevention strategies offer the greatest potential for reducing disparities and improving cardiovascular outcomes.