Introduction: With a growing number of people with hypertension, the limited number of
physicians could not provide treatment to all patients. We quantified the gap between medical
appointments available and needed for hypertension care, overall and in relation to hypertension
treatment cascade metrics.
Methods: Ecological descriptive analysis. We combined country-year-specific data on
hypertension prevalence, awareness, treatment and control (from NCD-RisC) and number of
physicians (from WHO). We estimated from 1 to 12 medical appointments per year for
hypertensive patients. We assumed that physicians could see 25 patients per day, work 200 days
per year, and dedicate 10% of their time to hypertension care.
Results: We studied 191 countries. Forty-one countries would not have enough physicians to
provide at least 1 medical appointment per year to all the population with hypertension; these
countries were low/lower-middle income and in Sub-Saharan Africa or East Asia and Pacific.
Regardless of the world region, ≥50% of countries would not have enough physicians to provide
≥8 medical appointments to their population with hypertension. Countries where the demand
exceeded the offer of medical appointments for hypertension care had worse hypertension
diagnosis, treatment and control rates than countries where the demand did not exceed the offer.
There were positive correlations between the physician density and hypertension diagnosis
(r=0.70, p<0.001), treatment (r=0.70, p<0.001) and control (r=0.59, p<0.001).
Conclusions: Where physicians are the only healthcare professionals allowed to prescribe
antihypertensive medications, particularly in low- and middle-income countries, the healthcare
system may struggle to deliver antihypertensive treatment to hypertensive patients.