A modeling analysis presented at the American Heart Association Hypertension Scientific Sessions 2026 estimated that expanding evidence‑based preventive services across 20 upper‑ and lower‑middle‑income countries could prevent substantial numbers of deaths. The largest projected benefit was from improved blood pressure control, estimated to prevent more than 518,476 cardiovascular deaths annually. Wider use of statins when indicated and improved glucose control in people with Type 1 or Type 2 diabetes were the next most effective strategies, projected to prevent 340,682 and 309,520 annual cardiovascular deaths, respectively. Increasing colon cancer screening to 80% was estimated to prevent 206,767 annual colon cancer deaths. The greatest opportunities for mortality reduction were seen in upper‑middle and lower‑middle‑income countries.
Noncommunicable diseases account for roughly three of five deaths worldwide, and about 73% of these deaths occur in low‑ or middle‑income countries. Cardiovascular disease (CVD) is a leading cause of NCD deaths. Untreated or undertreated high blood pressure leads to vascular damage and a range of cardiac conditions, including coronary artery disease, heart failure, left ventricular hypertrophy and stroke. Given that hypertension is the most prevalent and modifiable CVD risk factor, the investigators evaluated how expanding preventive care services could reduce deaths.
The researchers performed a modeling analysis of eligible populations across 20 countries selected for high numbers of NCD deaths. They estimated lives saved if six guideline‑based preventive services were increased from current country levels to a target of approximately 80% of eligible patients, a level comparable to high‑performing U.S. systems. Preventive services modeled were:
Eligibility and treatment or screening thresholds were taken from major clinical guidelines: blood pressure below 140/90 mm Hg as a modeled target (the release notes that the American Heart Association’s 2025 guideline recommends treated targets below 130/80 mm Hg), statin eligibility per the 2026 dyslipidemia guideline, hemoglobin A1c below 7.0% per American Diabetes Association guidance, and U.S. Preventive Services Task Force‑recommended screening intervals for cancers. Age‑ and sex‑specific estimates of eligibility and current use came from the Global Burden of Disease network, the NCD Risk Factor Collaboration, WHO STEPwise surveys and WHO cancer screening databases. Outcomes were reported overall and stratified by World Bank income categories; no low‑income countries were included among the 20.
When modeled uptake of preventive services was increased to about 80% across the 20 countries, estimated annual deaths averted were:
The analysis found that improved blood pressure control prevented the greatest number of deaths compared with any single preventive service, with particularly large effects in upper‑middle‑income (223,282 deaths averted) and lower‑middle‑income (223,655 deaths averted) country groups.
The modeling used observed baseline rates of preventive care. At the time of analysis, only about one in five adults with hypertension in the 20 countries had blood pressure controlled to below 140/90 mm Hg. Other baseline rates included 16% of individuals with high cholesterol using statins, 39% of people with Type 1 or Type 2 diabetes achieving optimal glycemic control, and between 14% and 26% undergoing routinely indicated cancer screenings. These low baseline attainment levels underlie the large modeled mortality gains from improved uptake.
The investigators noted several limitations:
The modeling suggests that prioritizing expansion of hypertension diagnosis and management could yield the largest immediate reduction in cardiovascular mortality among the services evaluated. Broader use of statins and improved glycemic control in people with diabetes also have substantial potential to lower CVD deaths. The investigators highlight especially large opportunities in lower‑middle‑income countries, where current control rates for hypertension and high cholesterol are low and cancer screening use is minimal. The study underscores the potential population health impact of scaling up evidence‑based preventive services, but it does not prescribe the operational or policy steps needed to achieve those targets.
These results were presented orally at the AHA Hypertension Scientific Sessions 2026 (oral presentation #89). The abstract was embargoed until the presentation and is preliminary; abstracts at the Association’s scientific meetings are not peer‑reviewed and are considered preliminary until published as a full manuscript in a peer‑reviewed journal. The Hypertension Scientific Sessions 2026 Supplement will publish the meeting abstracts on Nov. 17, 2026. Co‑authors, disclosures and funding sources are listed in the abstract.