Frieden Thomas R, Garg Renu, Banigbe Bolanle, Choudhury Sohel, Ogbureke Nanlop, Duguma Dereje, Tangcharoensathien Viroj
Resolve to Save Lives, New York, NY, USA.
National Heart Foundation, Dhaka, Bangladesh.
EClinicalMedicine. 2025 Jan 30;81:103094. doi: 10.1016/j.eclinm.2025.103094. eCollection 2025 Mar.
Hypertension kills more people than any other condition; approximately 80% of deaths occur in low- and middle-income countries (LMICs). Only about 1 in 5 adults with hypertension worldwide and less than 1 in 10 in LMICs have their condition controlled. Adherence to antihypertensive medications increases control and decreases hospitalizations, strokes, heart attacks, and health care costs. Eliminating patient copayments for antihypertensive medications increases adherence and hypertension control. This powerful but underutilized strategy can advance universal health coverage and reduce economic hardship. Medication access with no out-of-pocket cost to patients is feasible and economically sound, but requires increased investment and careful implementation to avoid unintended consequences of reducing flexible funding needed for primary health care systems. Provision of medications that are free to patients at the point of care should be part of a multi-component, sustainable approach to addresses systemic barriers to treatment of hypertension, the world's leading cause of death.
高血压造成的死亡人数超过其他任何疾病；约80%的死亡发生在低收入和中等收入国家（LMICs）。全球每5名高血压成年人中只有约1人、在低收入和中等收入国家每10人中不到1人血压得到控制。坚持服用降压药可提高血压控制率，减少住院、中风、心脏病发作次数，并降低医疗费用。取消患者的降压药自付费用可提高服药依从性和血压控制率。这一强大但未得到充分利用的策略可推动全民健康覆盖并减轻经济困难。为患者提供无需自掏腰包的药物是可行且经济合理的，但需要增加投资并谨慎实施，以避免减少初级卫生保健系统所需灵活资金带来的意外后果。在护理点为患者提供免费药物应成为解决高血压这一全球主要死因治疗系统性障碍的多方面、可持续方法的一部分。
