Trends in the prevalence, awareness, treatment and control of hypertension: the WHO MONICA Project.

OBJECTIVE: To describe the secular changes in the prevalence, awareness, treatment and control of hypertension. DESIGN: Two independent cross-sectional population surveys using standardized methods conducted between the early 1980s and mid-1990s. SETTING: Twenty-four geographically defined populations of the WHO MONICA Project. PARTICIPANTS: Randomly selected men and women aged 35-64 years. The total number of participants was 69 907. MAIN OUTCOME MEASURES: Two definitions of hypertension were used: 160/95 mmHg or above and 140/90 mmHg or above for systolic or diastolic blood pressure. Subjects on antihypertensive drug treatment were considered to be hypertensive regardless of their blood pressure. Treated subjects whose measured blood pressure level was less than 160/95 or 140/90 mmHg according to the two definitions, respectively, were considered to be adequately treated. RESULTS: The age-adjusted prevalence of hypertension decreased in most and increased in only a few populations. For both definitions of hypertension, the proportion of hypertensive subjects who were aware of their condition increased in three-quarters of the male populations and in two-thirds of the female populations. Furthermore, the proportion of hypertensive individuals on antihypertensive drug treatment increased in three-quarters of the populations. In the final survey, hypertension tended to be better treated and controlled in women than in men. Nevertheless, a large proportion of patients receiving antihypertensive drug therapy still had inadequately controlled blood pressure levels. CONCLUSION: Although awareness and treatment of hypertension according to the data obtained during the late 1980s to the mid-1990s increased in several populations, the effectiveness of antihypertensive treatment showed the continuing need for improvements.     

Trends in prevalence, awareness, treatment and control of hypertension in the middle-aged population of China, 1992-1998.

The objective of this study was to analyze the trends in prevalence, awareness, treatment and control of hypertension in the middle-aged population of China. There were about 1,000 participants each from 13 different study populations that were examined in surveys conducted from 1992-1994 (n=18,746) and in 1998 (n=13,504) in conjunction with the China Multi-Center Study of Cardiovascular Epidemiology. Half the subjects were men and half were women; their ages ranged from 35 to 59 years. Hypertension was defined as systolic blood pressure > or =140 mmHg, diastolic blood pressure > or =90 mmHg, and/or current treatment with antihypertensive medications. Hypertension awareness and treatment were assessed with a standardized questionnaire. Hypertension control was defined as blood pressure measurements of less than 140/90 mmHg. The results showed that 24.0% of participants had hypertension in 1998, an increase of 2.3% from 1992-1994 (p <0.05). The prevalence of hypertension was 25.4% higher in urban than in rural areas, and was higher in men than in women. Among hypertensives, 42.6% were aware of their hypertension (a 5.3% increase compared with 1992-1994, p <0.05), 31.1% were treated (a 3.8% increase, p <0.05), and 6.0% were controlled (a 2.6% increase, p <0.05). The rates of awareness, treatment and control were higher in women than men, and higher in urban than rural areas. For treated hypertensives, the rate of control increased from 12.7% in 1992-1994 to 19.9% in 1998 (p <0.05). These findings indicate that hypertension prevalence is increasing in China. Control rates, while improving, still remain low. This implies that effective public health measures are needed to enhance the awareness, treatment, and control rates in the Chinese population.     

Geographic variations in the prevalence,awareness, treatment and control of hypertension in China

OBJECTIVE: To compare the prevalence, awareness, treatment and control of hypertension in north and south, and urban and rural residents of China. DESIGN: A cross-sectional survey conducted in 2000-2001. SETTING AND PARTICIPANTS: A multistage cluster sampling method was used to select a nationally representative sample of 15 540 men and women aged 35-74 years from the general Chinese population. MAIN OUTCOME MEASURES: Three blood pressure measurements were obtained by trained observers using a standardized mercury sphygmomanometer. Information on history of hypertension and use of antihypertensive medications was obtained by use of a standard questionnaire. Hypertension was defined as a mean systolic blood pressure >or= 140 mmHg and/or diastolic blood pressure >or= 90 mmHg and/or use of antihypertensive medications. RESULTS: The age-standardized prevalence of hypertension was significantly higher among residents living in north than in south China (33.8 versus 23.3%, P < 0.001), but similar in those living in urban and rural areas (29.0 versus 28.1%, P = 0.3). Average systolic and diastolic blood pressure levels were consistently higher in north than in south residents. Residents in north China had higher percentages of awareness but lower percentages of control compared with their counterparts in south China. Percentages of awareness, treatment and control of hypertension were significantly higher in urban than in rural residents. CONCLUSIONS: Our study documents a marked north-south gradient in the prevalence of hypertension in China. The previously reported urban-rural difference in the prevalence of hypertension was not noted, perhaps due to a rapid increase in the prevalence of hypertension in rural China.     

Low levels of awareness,treatment, and control of hypertension in Andean communities of Ecuador

The major burden of hypertension (HTN) occurs in low‐middle‐income countries (LMIC) and it is the main modifiable risk factor for cardiovascular diseases (CVD). Few population studies on HTN prevalence have been carried out in Ecuador where there is limited information regarding its prevalence, awareness, treatment, and control. Thus, the aim of the present study was to determine the prevalence, awareness, treatment, and control of HTN and its association with socio‐economic, nutritional, and lifestyle habits in urban and rural Andean communities of Pichincha province in Ecuador. The authors studied 2020 individuals aged 35‐70 years (mean age 50.8 years, 72% women), included in the Ecuadorian cohort of the Prospective Urban and Rural Epidemiology (PURE) study, from February to December 2018. The hypertension prevalence (>140/90 mmHg) was 27% and was greater in urban than in rural communities, more common in men, in individuals older than 50 years of age, in people with low monthly income and low level of education. Higher prevalence was also observed in subjects with obesity, and among former smokers and those who consumed alcohol. Only 49% of those with HTN were aware of their condition, 40% were using antihypertensive medications, and 19% had their blood pressure under control (<140/90 mmHg). These results showed low levels of awareness, treatment, and control of HTN in the Andean region of Ecuador, suggesting the urgent necessity of implementing programs to improve the diagnosis and management of HTN.     

Trends in hypertension prevalence, awareness, treatment, and control rates in United States adults between 1988-1994 and 1999-2004

This study assesses trends in hypertension prevalence, blood pressure distributions and mean levels, and hypertension awareness, treatment, and control among US adults, age >or=18 years, between the third National Health and Nutrition Examination Survey (1988-1994) and the 1999-2004 National Health and Nutrition Examination Survey, a period of approximately 10 years. The age-standardized prevalence rate increased from 24.4% to 28.9% (P<0.001), with the largest increases among non-Hispanic women. Depending on gender and race/ethnicity, from one fifth to four fifths of the increase could be accounted for by increasing body mass index. Among hypertensive persons, there were modest increases in awareness (P=0.04), from 68.5% to 71.8%. The rate for men increased from 61.6% to 69.3% (P=0.001), whereas the rate for women did not change significantly. Rates remained higher for women than for men, although the difference narrowed considerably. Improvements in treatment and control rates were larger: 53.1% to 61.4% and 26.1% to 35.1%, respectively (both P<0.001). The greatest increases occurred among non-Hispanic white men and non-Hispanic black persons, especially men. Mexican American persons showed improvement in treatment and control rates, but these rates remained the lowest among race/ethnic subgroups (47.4% and 24.3%, respectively). Among all of the race/ethnic groups, women continued to have somewhat better awareness, treatment, and control, except for control rates among non-Hispanic white persons, which became higher in men. Differences between non-Hispanic black and white persons in awareness, treatment, and control were small. These divergent trends may translate into disparate trends in cardiovascular disease morbidity and mortality.     

Trends in blood pressure levels, prevalence, awareness, treatment, and control of hypertension in the Czech population from 1985 to 2000/01

OBJECTIVE: To assess trends in blood pressure (BP) levels, prevalence, awareness, and control of hypertension in the Czech population from 1985 to 2000/01. DESIGN: Five independent cross-sectional population surveys conducted in 1985, 1988, 1992, 1997/98, and 2000/01. SETTING: Six, mostly rural, districts of the Czech Republic (Praha-vychod, Benesov, Pardubice, Chrudim, Cheb, and Jindrich?v Hradec). PARTICIPANTS: Men and women aged 25-64 years randomly selected from six districts using the National Population Register/General Health Insurance Company Register (covering, by law, all citizens). The total number of participants was 11 726. MAIN OUTCOME MEASURES: We assessed the mean systolic BP, diastolic BP and pulse pressure, prevalence of hypertension (systolic BP > or = 140 mmHg and/or diastolic BP > or = 90 mmHg, or current treatment with antihypertensive drugs), awareness, treatment, and control of hypertension. RESULTS: Mean systolic BP, diastolic BP, and pulse pressure decreased significantly over a period of 15/16 years. This was associated with a significant decrease in the prevalence of hypertension (from 47.1 to 39.1%, P < 0.001) and with an increase in its awareness (from 49.5 to 67.2%, P < 0.001), use of antihypertensive medication (from 29.3 to 49.3%, P < 0.001), and hypertension control (from 3.9 to 17.0%, P < 0.001). Despite having lower BP values and prevalence of hypertension, females showed higher awareness of the disease, and were more frequently taking antihypertensive medication, and their hypertension was better controlled. CONCLUSION: The reduction in population BP and improved control of hypertension may have contributed to the decrease in cerebrovascular and coronary heart disease mortality in the Czech Republic. The positive longitudinal changes seen in the MONICA regions need not necessarily reflect the situation in the country as a whole. The situation is far from being optimal; a major problem is inadequate treatment of hypertension     

Hypertension in Delhi: prevalence, awareness, treatment and control

Two cross-sectional, population-based studies were conducted to assess the prevalence, awareness, treatment and control of hypertension, among people aged 20-59 years and those over 60 years in Delhi. Study 1 (20-59 years): in total,1213 subjects from 120 clusters spread across Delhi were studied. The prevalence of hypertension was 27.5%. Of the hypertensives, 53.3% were aware of their diagnosis; 42.8% were taking treatment and only 10.5% had controlled blood pressure. About 9.0% of the hypertensives had coexisting diabetes mellitus and 8.4% were suffering from coronary disease. The prevalence of hypertension was significantly higher in urban areas, but there was no significant difference in levels of awareness, treatment and control between urban and slum areas. The prevalence of hypertension was comparable in both sexes. Women, however, were more likely to be aware of their condition. Study 2 (> or =60 years): in total,1105 subjects from 110 clusters were studied. Prevalence of hypertension was 63.8%. Isolated systolic hypertension (ISH) was found in 15.3% of the subjects. About 54% of the hypertensives were aware of their diagnosis; 43.4% were taking treatment and only 8.5% had controlled blood pressure. Prevalence of hypertension and ISH were comparable among sexes. Women were more aware and better treated. About 21.3% hypertensives had coexisting diabetes mellitus, and 14.3% were suffering from coronary disease. There was no significant difference between sexes. Urban and slum areas were also found to be comparable. Over 3% of the elderly were controlling their raised blood pressure by non-pharmacological measures. They belonged to the 'aware' category yet could not be labelled as 'hypertensives', highlighting an operational fault in the Joint National Committee definition.     

Prevalence, correlates, awareness, treatment, and control of hypertension in a middle-aged urban population in Kerala

BACKGROUND: Hypertension is an important cause of cardiovascular morbidity and mortality. METHODS AND RESULTS: We conducted a cross-sectional survey of 314 middle-aged subjects (163 men; age range 40-60 years, mean 49 years) in urban Thiruvananthapuram City. Kerala, to estimate the prevalence of hypertension, examine its correlates, and assess the degree of awareness, treatment, and control of high blood pressure. Blood pressure was measured by a nurse graduate using a mercury column sphygmomanometer and a standardized technique. We used multivariable analyses to examine the sociodemographic and clinical correlates of hypertension. The overall prevalence of hypertension in our sample was 54.5% (men 56.3%, women 52.3%). The factors associated with an increased prevalence of hypertension were higher body-mass index (odds ratio for a value in the top tertile of 2.33, 95% confidence interval: 1.2-4.4), and older age (odds ratio for the age group 55-60 years of 2.65, 95% confidence interval: 1.3-5.6). An occupation involving moderate or greater physical activity was inversely associated with the prevalence of hypertension (odds ratio 0.35, 95% confidence interval 0.13-0.94). Among hypertensives, 39% were aware of the condition, while 29% were treated with blood pressure-lowering medications. Adequate control of elevated blood pressure was achieved in only 30.6% of treated hypertensives. In our community-based sample, over half of all middle-aged individuals were hypertensive, but less than a third were under treatment. Adequate control of hypertension was achieved in less than a third of the treated individuals. CONCLUSIONS: These observations re-emphasize the need for hypertension awareness programs targeting the general public and the increased use of opportunistic blood pressure screening, and underscore the importance of measures to increase the knowledge of current guidelines for the detection and treatment of hypertension among healthcare providers.     

辽宁省农村地区老年人群高血压现状调查

目的评估辽宁省农村地区老年人群高血压患病率、知晓率、治疗率及控制率。方法采用分层整群随机抽样方法，选取辽宁省阜新市农村地区8个乡镇≥60岁10065名农村常住（≥5年）老年人进行调查。由培训过的医师对调查对象进行血压测量和资料的收集。结果辽宁省农村地区老年人群高血压患病率为60．2％，知晓率、治疗率及控制率分别为35．0％、28．7％、0．6％。结论辽宁省阜新市农村地区老年人群高血压患病率较高，但知晓率、治疗率和控制率都非常低，必须积极采取有效的措施以降低高血压的患病率，提高知晓率、治疗率和控制率。     

西藏昂仁县高血压患病率、知晓率、治疗率和控制率的调查

目的调查西藏昂仁县农牧民高血压患病率、知晓率、治疗率和控制率,为西藏地区高血压的防治提供依据。方法采用分层多阶段随机抽样方法,通过调查问卷的形式,在2017年5~9月调查18岁及以上昂仁县农牧区藏族居民的高血压患病情况。结果共调查2158人,平均收缩压为(128.67±25.90)mmHg,平均舒张压为(86.77±16.53)mmHg。高血压患病率为37.81%,知晓率为52.82%,治疗率为45.10%、控制率为6.62%。结论西藏昂仁县农牧民(≥18岁)高血压患病率高,而知晓率、治疗率及控制率较低,需要进一步加强高血压防治工作。     

Prevalence,awareness, treatment,and control of hypertension in china

The objective of this study was to estimate the prevalence and distribution of hypertension and to determine the status of hypertension awareness, treatment, and control in the general adult population in China. The International Collaborative Study of Cardiovascular Disease in ASIA (InterASIA), conducted in 2000-2001, used a multistage cluster sampling method to select a nationally representative sample. A total of 15 540 adults, age 35 to 74 years, were examined. Three blood pressure measurements were obtained by trained observers by use of a standardized mercury sphygmomanometer after a 5-minute sitting rest. Information on history of hypertension and use of antihypertensive medications was obtained by use of a standard questionnaire. Hypertension was defined as a mean systolic blood pressure > or =140 mm Hg, diastolic blood pressure > or =90 mm Hg, and/or use of antihypertensive medications. Overall, 27.2% of the Chinese adult population age 35 to 74 years, representing 129 824 000 persons, had hypertension. The age-specific prevalence of hypertension was 17.4%, 28.2%, 40.7%, and 47.3% in men and 10.7%, 26.8%, 38.9%, and 50.2% in women age 35 to 44 years, 45 to 54 years, 55 to 64 years, and 65 to 74 years, respectively. Among hypertensive patients, only 44.7% were aware of their high blood pressure, 28.2% were taking antihypertensive medication, and 8.1% achieved blood pressure control (<140/90 mm Hg). Our results indicate that hypertension is highly prevalent in China. The percentages of those with hypertension who are aware, treated, and controlled are unacceptably low. These results underscore the urgent need to develop national strategies to improve prevention, detection, and treatment of hypertension in China.     

武汉市社会福利院老年人群高血压现状调查

目的 调查武汉市社会福利院老年人群高血压患病率、知晓率、治疗率和控制率及相关危险因素,为特殊弱势人群中的高血压防治提供新思路.方法 采用问卷调查法对武汉市社会福利院某小区年龄≥60岁68名常住老年人进行调查,由培训过的医师对调查对象进行血压测量、资料收集和健康教育,并按不同年龄段分为3组进行对比分析.结果 武汉市社会福利院老年人群高血压患病率达76.47%,其中单纯收缩期高血压占69.23%.高血压患者的知晓率、治疗率和控制率分别为46.15%、53.85%、15.38%.≥80岁的老年组高血压的治疗率和控制率显著低于其他年龄组(P＜0.05),合并多器官疾病的比例高于其他年龄组(P＜0.05).应用最为广泛的口服降压药物为钙通道阻滞剂和国产复方制剂.Logistic回归分析显示,年龄、肥胖、饮酒、吸烟、心血管病家族史、高盐饮食等危险因素与高血压的发病密切相关.结论 武汉市社会福利院老年人群高血压患病率较高,高血压知晓率、治疗率和控制率仍处于较差水平.社会心理因素在福利院特殊人群高血压的发病和控制中可能起重要作用.社区高血压患者的规范化管理、经常性的健康教育、积极的社会援助和不良生活方式的纠正是福利院老年人群高血压防治的有效措施和手段.     

河北省香河县农村高血压流行与管理水平现状调查

  目的 了解河北省香河县农村高血压患病率、知晓率、治疗率、达标率及影响因素。方法 2011年7—8月对香河县年满35岁的830例农村居民进行血压测量和问卷调查。结果 高血压患病率、知晓率、治疗率和达标率分别为42.4%、54.8%、50.0%与11.9%。logistic回归分析显示影响知晓率和治疗率的主要因素是年龄、BMI、家族史及文化程度,影响达标率的主要因素是年龄、家族史及饮酒。结论 在本调查人群中,高血压患病率高,知晓率、治疗率和达标率低,提示农村高血压防控水平亟待提高。     

Racial disparities in hypertension prevalence, awareness, and management

BACKGROUND: Effectively reducing cardiovascular disease disparities requires identifying and reducing disparities in risk factors. Improved understanding of hypertension disparities is critical. METHODS: Cross-sectional analysis of nationally representative samples of black and white adults 20 years and older who participated in the National Health and Nutrition Examination Survey (NHANES) 1999-2002 (white, n = 4624; black, n = 1837) and NHANES III conducted in 1988-1994 (white, n = 7121; black, n = 4709). We examined differences in hypertension prevalence, awareness, treatment, and blood pressure (BP) control among both treated and prevalent cases across the 2 periods. RESULTS: Hypertension prevalence increased significantly from 35.8% to 41.4% among blacks and from 24.3% to 28.1% among whites and remains significantly higher among blacks. Awareness is higher among blacks (77.7% vs 70.4%; P<.001), as is treatment (68.2% vs 60.4%; P<.001). These results are driven by higher rates in black women. Blood pressure control rates among those treated have increased in both races, primarily as a result of increased BP control in black and white men (27.3% and 44.7%, respectively; P相似文献