Sarah Newey Global Health Security Correspondent, in Bangkok

South Korea has given the world K-pop, K-beauty and K-dramas but its most important export could prove to be far less glamorous: a blueprint for beating high blood pressure.

According to the World Health Organization (WHO), the East Asian country is one of just four nations across the globe to reach a hypertension control rate above 50 per cent – meaning at least half of those diagnosed with high blood pressure have brought it within a healthy range after treatment. Only Costa Rica, Canada and Iceland have achieved the same feat.

“It’s the single most important thing to get right in healthcare… but most countries don’t,” Dr Tom Frieden, president of Resolve to Save Lives, an initiative working on global health threats, told The Telegraph. “South Korea is one of the rare successes in the world, on both the treatment and prevention of high blood pressure.”

In 1990, the age adjusted cardiovascular death rate was 330 per 100,000 adults; now that figure stands at just 86, according to Korean data. Over the same period, the hypertension control rate has risen from just five per cent to 59 per cent – well ahead of the UK, which stands at just 35 per cent.

But with non-communicable diseases overtaking infectious pathogens as the world’s leading health threats, South Korea’s dramatic turnaround offers critical lessons for high and low income nations alike.

The WHO has warned that 1.4 billion people had high blood pressure in 2024, a number that’s doubled since 1990. There are roughly 11 million fatalities as a result, while hypertension cost the economies in low and middle income countries $3.7 trillion between 2011 and 2025 alone.

“This is the most under-addressed problem in global health,” said Dr Frieden. “[Tackling hypertension] also makes good economic sense… It’s a lot cheaper to give safe, generic, effective anti-hypertension medication that really costs pennies per pill, than to have to treat someone’s heart attack or stroke or kidney failure or dementia.”

So how has South Korea transformed its trajectory?

According to doctors and professors in the country, there’s no silver bullet – and some factors, like a health-focused mindset, are distinctly Korean. But there are several elements that other countries can replicate: regular health check-ups, subsidised medication, reduced salt intake and strong data.

“There is no universal solution for hypertension control… but the first thing is to identify the problems in any specific country,” said Prof Kwang-il Kim, president of the Korean Society of Hypertension and a professor of internal medicine at Seoul National University College of Medicine.

“In South Korea, we developed our own data and analysed the dataset,” he added. “So we know what the control rate is, the awareness rate and the treatment rate, and can make changes when needed. Data is the initiation point.”

This was made easier in 2000, when the government consolidated the health insurance system under one single scheme. This covers virtually the entire population, and means people have affordable access to both public and private medical facilities with low out-of-pocket costs. It also means the government has access to population-level health data.

This has fed into another key pillar: free and mandatory health checks.

At least every two years adults have preventative screenings, which has included hypertension checks since the late 1990s – if someone has elevated blood pressure, the data system prompts them to visit a clinic for further checks and treatment. It is not possible to get medication from a pharmacy without seeing a doctor for monitoring and a prescription.

Seven years ago, after experts noticed hypertension rates rising among young people, the age eligibility for these screenings also dropped from 40 to 20. Meanwhile private companies, incentivised by the government, offer health checks within their benefits packages.

But screening and awareness alone are not enough, said Dr Park Sung-ha, a professor of cardiology at Yonsei University College of Medicine in Seoul. Medications are also heavily subsidised by the government, and costs are also kept lower because of the country’s thriving generic drug market, while access to healthcare is prompt.

“It’s extremely easy to see a doctor in Korea,” said Dr Park. “The co-payment system [with the government] means people only pay 10-20 per cent of the cost, and access to affordable generic medications makes it very cheap. The 2025 data shows 60 per cent of Korean hypertension patients receive combination therapies of two or three medications.”

But alongside regular health checks, affordable medication and accessible doctors, South Korea has also made huge strides to tackle salty foods – daily salt intake has dropped by 43 per cent between 2005 and 2022.

Working with the food industry, the government pushed to reduce sodium levels in processed foods – especially instant noodles and sauces – and also kimchi, perhaps one of the most popular comfort foods in the East Asian country. Prof Kim added that, since 2010, a campaign to reduce salt in school meals has proved effective.

“In Korea all of the schools give meals, it’s mandatory – unlike the US or UK, children don’t bring a pack lunch or pay for food,” he said. “That means the government can use this to reduce salt intake for children, as well as working to reduce sodium in restaurants and high salt foods like kimchi and soups.”

But Korea is not perfect. There are concerns about lower detection and treatment rates among younger adults and people from lower socioeconomic backgrounds, while the prospect of a ticking time bomb as rates of obesity and physical inactivity rise among teenagers.

Still, there are three key lessons for other countries around the world, according to Prof Hyeon Chang Kim, a professor in the department of preventive medicine at Yonsei University College of Medicine.

“The first lesson is that hypertension control should be treated as a health-system priority. People need to know their blood pressure, but they also need affordable access to diagnosis, treatment, and follow-up.

“The second lesson is the importance of data… without data, it is difficult to know where the system is failing,” he said. “The third lesson is that hypertension control requires continuity – screening alone is not enough. Diagnosis must be linked to treatment, treatment must be affordable, and patients must be supported to continue medication and lifestyle management over many years.”

There are already signs that some other places are starting to make headway, including lower income countries.

Roughly 40 countries across the globe have adopted the WHO’s HEARTS strategy – which focuses on boosting healthy lifestyles (H), evidence-based treatment options (E), access to medicines and technologies (A), tackling other risks like smoking and diabetes (R), team-based care including nurses and community health workers (T) and data systems (S).

For instance in Bangladesh, which launched a pilot programme to boost awareness of an individual’s blood pressure levels, reduce drug costs and tackle medicines stockouts in 300 district level clinics.

The WHO’s latest hypertension report said the project has boosted the blood pressure control rate from 20 per cent to 59 per cent among 500,000 patients using these facilities. Nationally, this figure stands at only around 15 per cent.

But despite progress like this, as well as in countries including the Philippines and Sri Lanka, the WHO has warned that the global picture remains “sobering”.

“It’s really prudent that countries get blood pressure under control, or the healthcare costs will skyrocket and productivity will decrease substantially,” said Dr Frieden. “The gains are enormous – not just in health but also in the economy – and the risks of not doing anything are also enormous.”

He added: “South Korea is a remarkable example of the transformation possible with a focus on healthcare systems, treatment and affordability. They’ve succeeded by keeping things simple and tracking numbers… and it’s absolutely replicable.”

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