Research Information System
Blood pressure, vol.35, no.1, pp.2650019, 2026 (SCI-Expanded, Scopus)
PURPOSE: Hypertension remains the leading modifiable risk factor for cardiovascular morbidity and premature mortality worldwide. While its prevalence has declined across much of Europe in recent decades, this trend has not been observed in the Balkan region, where rates remain persistently high. This narrative review aims to synthesise current evidence on the epidemiology of hypertension in the Balkans and to explore potential determinants underlying this sustained burden. MATERIALS AND METHODS: We conducted a narrative review of available literature, including population-based surveys, reports from the World Health Organization, and national epidemiological data from Balkan countries. Relevant studies were identified to evaluate prevalence patterns and associated determinants of hypertension across the region. RESULTS: Data consistently indicate that hypertension prevalence in most Balkan countries approaches or exceeds 50% of the adult population. However, notable intra-regional variation exists, with Türkiye and Greece demonstrating prevalence levels closer to global averages. The excess burden of hypertension in the Balkans appears to be multifactorial, associated with persistently high dietary salt intake, socioeconomic disparities, structural limitations in healthcare systems, and region-specific environmental influences. These factors act synergistically rather than independently. CONCLUSION: The Balkan region represents a distinct epidemiological hotspot for hypertension within Europe. The sustained high prevalence is likely driven by the convergence of multiple interacting determinants, in contrast to Western Europe where long-term investments in primary care-based prevention have led to declining rates. Effective management of hypertension in the Balkans will require integrated, context-specific strategies that extend beyond individual-level interventions. Why is this topic important? High blood pressure (hypertension) is the leading preventable cause of heart disease and early death worldwide. In most European countries, hypertension rates have decreased over the past decades. However, this improvement has not occurred in the Balkan region, where high blood pressure remains very common.What did we do? We reviewed available studies, national surveys, and international reports to understand how common hypertension is in Balkan countries and why this region continues to have higher rates than the rest of Europe.What did we find? In many Balkan countries, about one in two adults has hypertension. Only Türkiye and Greece show rates closer to the global average. High salt consumption, limited public awareness, socioeconomic challenges, and health systems that focus more on hospital care than prevention all appear to contribute to this problem. In some areas, a kidney disease unique to the Balkans may also worsen blood pressure control.Why does this matter? Poorly controlled blood pressure leads to heart attacks, strokes, kidney disease, and early death. The findings suggest that the high burden of hypertension in the Balkans is not caused by a single factor but by several problems acting together.What can be done? Improving primary healthcare, reducing salt in foods, increasing public education about blood pressure, and strengthening national prevention programs could significantly reduce the health burden in this region.