Dear Editor,
I am writing to highlight the alarming increase in the prevalence of hypertension in Iran over the past decade. Hypertension, a major risk factor for cardiovascular disease, stroke, and kidney failure, has emerged as a serious public health problem in the country. The number of complications due to hypertension is increasingly rising, with evident increases in mortality and morbidity rates. Current studies indicate that the prevalence of hypertension in Iran has continually risen over the years due to lifestyle, diet, urbanization, and population aging [1]. Data from national surveys for 2015–2025 reveal that hypertension affects over 30% of Iranian adults, with a marked regional variation between rural and urban settings [2]. This trend has been driven by increased consumption of processed foods, lack of physical activity, and elevated stress levels, all of which are contributors to the increasing incidence of non-communicable diseases.
Urbanization, particularly, has played a major role in this surge. A large percentage of Iran’s population now resides in urban areas, where vulnerability to poor nutrition, air pollution, and sedentary lifestyles are rampant. Prevalence of urban hypertension is more than 35%, with rates slightly lower in rural areas at approximately 28% [3]. While lower rates are reported among the rural population, access to healthcare is a major issue, and diagnosis and treatment of hypertension are consequently delayed. One of the most alarming aspects of hypertension in Iran is the large proportion of undiagnosed and uncontrolled cases. National surveys reveal that more than 40% of hypertensive patients remain unaware of their condition [4]. Among those diagnosed, only 25% are able to achieve adequate blood pressure control. Added to this are inadequate public awareness, lack of adequate healthcare infrastructure in certain regions, and poor medication adherence. Cultural attitudes, such as the perception of hypertension as a normal aspect of aging, also lead to inefficient management and prevention.
A multi-faceted solution is necessary to address this crisis. Starting with the implementation of nationwide screening programs to identify hypertension at the earlier levels, public health campaigns promoting healthier food habits, such as reducing sodium intake, are the need of the hour. Policymakers must ponder the restriction of sodium in processed foods so that the risk of hypertension at a greater level is minimized [5]. Moreover, lifestyle modification programs promoting increased physical activity and weight management can also play a vital role in controlling blood pressure levels and reducing overall cardiovascular risk. It is essential to expand coverage of primary healthcare services. In rural areas, where healthcare is limited, there is an urgent need to widen access to preventive services and immediate treatment. Select interventions, such as community awareness campaigns, can play a significant role in reaching the underserved. Further, applying digital health technologies for blood pressure monitoring can offer an easier and more accessible channel for patients to manage their condition, especially in remote locations. Given the significant healthcare and economic burden of hypertension, action is essential. Without intervention, Iran will only face mounting numbers of hypertension complications, overloading its healthcare system even more. Policymakers need to make rapid, fact-based decisions to fight this growing epidemic. Table 1 displays hypertension prevalence rates, key risk factors, access to care, and awareness and blood pressure control rates by region and population in Iran. It demonstrates extreme regional disparities between urban and rural populations, as well as hypertension awareness and control levels by age group.
In conclusion, hypertension is a serious public health issue in Iran, and the trend should be reversed through prompt action. Public health campaigns, national screening programs, and better access to healthcare in rural areas are vital components of a comprehensive strategy to address this crisis. I hope this letter will inform the discussion of hypertension prevention and encourage further research into effective intervention strategies.
Table 1. Hypertension Prevalence and Contributing Factors in Iran (2015–2025)
Region/ Population | Hypertension Prevalence, % | Risk Factors | Healthcare Access | Awareness Rate, % | Blood Pressure Control Rate, % | Additional Notes |
Urban Areas | 35% | High sodium diet, sedentary lifestyle, air pollution, high-stress environments | Better access to healthcare facilities, but low treatment adherence | 60% | 25% | Urbanization and unhealthy dietary habits are key contributors. |
Rural Areas | 28% | Limited physical activity, poor diet, lack of healthcare access | Limited healthcare access, delayed diagnosis | 55% | 20% | Limited resources and healthcare facilities affect management. |
Young Adults (25-35 years old) | 15% | Increased processed food consumption, reduced physical activity, high-stress jobs | Moderate access in cities, limited in rural areas | 50% | 20% | Rising prevalence due to lifestyle changes and urban pressures. |
Older Adults (60+ years old) | 55% | Age-related factors, poor diet, physical inactivity | Improved access in cities, poorer in rural areas | 40% | 30% | Aging population has a higher rate of hypertension. |
National Average | 30% | Unhealthy diet, high sodium intake, lack of exercise | Urban versus rural disparities in access | 58% | 25% | Significant national burden with regional differences |
References
- Khosravi A, Riazi N, Khosravi-Boroujeni H et al. Trends in hypertension prevalence, awareness, treatment, and control in the Iranian population: a systematic review and meta-analysis. Iran J Public Health. 2019;48(4):533-541.
- Rezaei S, Jafari M, Khakpour H et al. Prevalence of hypertension in the Iranian adult population: a national survey. Hypertension. 2020;75(6):1509-1517.
- Hashemi M, Yunesian M, Fattahi A et al. Regional disparities in hypertension prevalence in Iran: evidence from the national survey. Iran J Public Health. 2021;50(3):522-531.
- Karim H, Alizadeh M, Moini F et al. Hypertension awareness, treatment, and control in Iran: a systematic review of the literature. J Hypertens. 2018;36(10):2020-2027.
- Tabatabaei H, Fadaei R, Nezami K et al. National health policies for hypertension prevention and management in Iran: a systematic review. J Iran Med Counc. 2021;24(6):512-520.