Australia’s Hypertension Challenge: A Deep Dive into Diagnosis, Control, and the Path Forward
Key Findings on the State of Hypertension in Australia
- In 2022, approximately 39% of Australian adults had hypertension, with rates reaching 85% among those aged 75 and over.
- Only about 40% of people with hypertension had their blood pressure under control, according to the Australian Institute of Health and Welfare (AIHW).
- This is well below the 70% target set by the National Hypertension Taskforce, which was established in 2022 with a goal of reaching that level by 2030.
The Taskforce estimates that around 2.2 million Australians have diagnosed and controlled hypertension (<140/90 mmHg), 1.2 million are aware but uncontrolled, and a further 3.4 million may be unaware of their condition.
Updated Clinical Guideline on the Horizon
An updated national clinical guideline on hypertension diagnosis and management is due for publication later in 2026. The previous guideline was published in 2016, meaning the new version will reflect over a decade of research and international best practices.
Expert Perspectives on the Roadmap to 70% Control
Professor Mark Nelson, Chair of General Practice at the University of Tasmania and a member of the Taskforce steering committee, stated that the 70% target is ambitious but worth pursuing. He noted that Canada implemented a similar program earlier and achieved higher control rates—an estimated 70%.
"Canada has shown it's possible," Professor Nelson said, expressing optimism that Australia can improve through population-level interventions and general practice.
Professor Charlotte Hespe, Head of General Practice and Primary Care Research at the University of Notre Dame and co-chair of a Taskforce working group, stated that the current guideline is out of line internationally.
She advocates for a target blood pressure of <130/80 mmHg, emphasizing that risks from high blood pressure outweigh those from low blood pressure. She supports home blood pressure monitoring and addressing patient and clinician fears of overtreatment.
Addressing the Undertreatment of Older Patients
Professor Nelson noted that older patients are often undertreated due to fear of causing harm. However, clinical trials show lower serious adverse events with blood-pressure-lowering medication in this demographic.
He welcomed PBS changes that allow dual single-pill combinations as initial treatment, but stressed that population-level changes—such as reduced salt and alcohol intake—also contribute significantly to improving control rates.
Background: The Taskforce and the New Guideline
- The National Hypertension Taskforce was established in 2022 with a 2030 target of 70% control.
- The updated guideline will adopt a risk-based approach, similar to the 2023 cardiovascular disease guideline, tailoring treatment intensity to individual patient risk profiles.