Abstract / Summary
In 2025, the United Nations General Assembly adopted a target of 150 million additional people with hypertension under control by 2030, but did not specify the baseline year. We quantified how baseline choice affects estimated progress towards this target and forecast the number of adults with controlled hypertension globally through 2030. Age- and sex-specific hypertension prevalence and control estimates from the NCD Risk Factor Collaboration for 1990-2019 were combined with United Nations World Population Prospects 2024 for adults aged 30-79 years in 200 countries and territories. Bayesian state-space models generated separate prevalence and control forecasts, propagated through 100 000 posterior draws. We evaluated baselines of 2020, 2023, 2024 and 2025 and decomposed the 2024-2030 change using continuous-change decomposition. Holding the 2030 forecast constant, estimated target attainment ranged from 94.4% with a 2020 baseline to 51.4% with a 2025 baseline. Using the prespecified 2024 baseline, the number of adults with controlled hypertension was forecast to increase from 332.4 million in 2024 to 423.9 million in 2030, an increase of 91.5 million (95% uncertainty interval 75.2-110.0 million), corresponding to 61.0% (95% uncertainty interval 50.2-73.3%) of the target and a median shortfall of 58.5 million. The control-rate improvement component accounted for 66.3% of the increase and demographic change for 44.0%, while declining age-sex-specific hypertension prevalence offset 10.4%. Progress towards this absolute target cannot be interpreted unambiguously without an explicit baseline year. From a 2024 baseline, current forecast trajectories fall short of the 2030 target.