Financial cost as an obstacle to hypertension therapy.

A home health interview, including blood pressure measurements, was conducted on 4,688 adults representing the noninstitutionalized population of Georgia. Subjects with diastolic blood pressure greater than or equal to 90 mm Hg or on antihypertensive medication were considered hypertensive. The prevalence of uncontrolled moderate or severe hypertension (diastolic greater than or equal to 105 mm Hg) was 1.9 per cent. With the exception of White women, all race-sex groups with uncontrolled moderate or severe hypertension reported substantially lower per capita income than their mild or controlled hypertensive counterparts. A larger percentage of the uncontrolled moderate to severe hypertensives on medication, as compared to their mild or controlled counterparts, reported economic barriers to pharmacologic and medical care on cost of medicines (36 per cent vs 22 per cent); refills (36 per cent vs 16 per cent); and office visits (26 per cent vs 16 per cent). Black women reported these barriers more than Whites. These findings suggest that costs of antihypertensive care may be an obstacle in blood pressure control for certain population subgroups.     

Three-year incidence of hypertension in thirteen U.S. communities: On behalf of the hypertension detection and follow-up program cooperative group

In 1973–1974, the Hypertension Detection and Follow-up Program (HDFP) conducted a two-stage screening (home, clinic) for high blood pressure in fourteen communities. A similar two-stage screening was repeated in 1976–1977 for a stratified probability sample of those persons whose blood pressures were not definitely elevated at the 1973–1974 survey. This sample included: normotensives (not on antihypertensive medication), labile hypertensives (hypertensive at home visit but normotensive at the subsequent clinic visit) and controlled hypertensives (on medication with DBP less than 95 mm Hg at home screen). Of this sample, 86.1% were reexamined. A hypertensive in 1976–1977 was defined as an individual having DBP 95 mm Hg or greater or receiving physician-prescribed antihypertensive medication. The three-year incidence rate of hypertension was estimated to be 11.8% after one stage (home) screening and 9.0% after a two-stage (home and clinic) screening, with a black/white ratio > 2. Black men had higher rates than black women, but white women had higher rates than white men. The three-year incidence of hypertension was directly related to the initial blood pressure level. More than 51% of the new hypertensives were receiving treatment at the time of rescreening, and almost 90% of those treated were under control (DBP < 95 mm Hg). Among individuals under treatment in 1973–1974, 81.2% were still on treatment three years later. Of those who discontinued treatment prior to the 1976–1977 rescreening, blacks had higher blood pressure levels than whites.     

Prevalence, awareness, treatment, and control of hypertension in Japanese rural communities]

BACKGROUND: In Japan, a national survey indicated that only 7% of hypertensive patients had a blood pressure less than 140/90 mmHg. There have been no reports of studies investigating all of the prevalence of hypertension, the percentage of subjects who are aware of hypertension, the percentage being treated, and the percentage that are well-controlled (awareness, treatment and control, respectively) among hypertensives in the Japanese general population. OBJECTIVE: To investigate the prevalence of hypertension, and awareness, treatment and control of hypertension among hypertensives in a Japanese rural population. DESIGN: A cross-sectional analysis of base-line data of the Jichi Medical School Cohort Study. SETTING: Twelve rural communities is 8 prefectures in Japan. PARTICIPANTS: Community-dwelling people who participated in the health examination program in 1992-1995. MAIN OUTCOME MEASURES: Blood pressure (BP) measured once in the sitting position after a 5-minute rest using oscillometric automatic BP monitors (BP203RV-II; Nippon Colin, Japan), and history of hypertension assessed using a self-administered questionnaire. RESULTS: We analyzed data from 11,302 subjects (4,415 men and 6,887 women). The mean (standard deviation) age was 55(12) years for men and 55(11) years for women. Mean systolic BP and diastolic BP levels were, respectively, 131(21) mmHg and 79(12) mmHg for men and 128(21) mmHg and 76(12) mmHg for women. Prevalence of hypertension (systolic BP > or = 140 mmHg or diastolic BP > or = 90 mmHg or on antihypertensive medication) was 37% for men and 33% for women. Percentages for awareness (on medication or present past history), treatment and control (both systolic BP < 140 mmHg and diastolic BP < 90 mmHg) were, respectively, 39%, 27% and 10% for men and 46%, 38% and 13% for women. CONCLUSIONS: About one third of the study popUlation were hypertensive, and awareness, treatment and control of hypertension among the hypertensives were 43%, 34% and 12%, respectively. Less than half of the hypertensives were well-controlled even when measurement bias was considered. In the rural Japanese population, improvements are required with regard to awareness, treatment and control of hypertension.     

Prevalence,awareness, treatment,and control of hypertension in the inner city

This article reports on the prevalence, awareness, treatment, and control of hypertension in a predominantly black population residing in the inner city of Detroit, Michigan. The data reported come from a cross-sectional survey of approximately 800 adults conducted in the fall of 1978. The prevalence of hypertension in the population studied, 38%, was similar for men and women below age 55; above age 55, women were more likely to have high blood pressure than men. Hypertension was positively related to the respondent's age and weight, but was not associated with having a family history of hypertension, or with the amount of cigarettes smoked daily. Compared with estimates of awareness, treatment, and control status of hypertensives derived from community surveys conducted in the 1960s, our findings indicate substantial improvement in hypertension management among a predominately black, urban population during the past decade. Of the hypertensives identified in our sample, 80% were aware of their hypertension before participation in the survey, 86% of those previously detected were being treated for their hypertension, and 26% of those being treated were adequately controlled (BP < 140/90 mm Hg). Awareness, treatment, and control rates appear to be age-related, with younger respondents less likely to be aware of their hypertension, on antihypertensive therapy, and successfully controlled. Below age 54, women were much more likely to be aware of their hypertension condition than men. Because of the lower detection rates among younger age groups it is recommended that future blood pressure screening efforts in the inner city be directed at younger adults (between the ages of 18 to 44), especially men.     

Prevalence and control of hypertension in a large cohort of occupationally-active Israelis examined during 1985-1987: the Cordis Study.

In view of the many changes in the approach to the detection and management of hypertension that have occurred, the paucity of current data on this subject in Israel limits the possibilities of making international comparisons or evaluating trends. This study contributes recent information on the occupationally-active population. Between 1985 and 1987, blood pressures were measured and interview data obtained on awareness and treatment of hypertension in a sample of 3677 male and 1573 female employees in 21 Israeli industries, examined in the CORDIS Study. In the age group 35-64 years, the age-standardized prevalence of hypertension (greater than or equal to 160/95 mm Hg or treated) using the same standard population as the WHO MONICA Study was 17.1% for men and 16.1% for women. The prevalence for men was somewhat below the median country compared with the MONICA centres, whereas for women it was closer to the median. Marked ethnic differences were evident, with those of Western origin having the highest prevalence, and those of Asian origin, the lowest. Of the hypertensives, 35.6% of the men and 33.3% of the women were unaware of their condition. Among men aware, 82.8% were receiving treatment and 59.8% of them were under control; the corresponding percentages for women were 86.2% and 72.8%. Older people were more likely to be aware of their hypertension and receiving treatment. Beta-blockers and diuretics were the predominant drugs of choice.(ABSTRACT TRUNCATED AT 250 WORDS)     

Sodium, potassium, body mass, alcohol and blood pressure in three United Kingdom centres (the INTERSALT study)

Standardised data on blood pressure, 24 h urinary electrolyte excretion, body mass index (BMI) and alcohol intake were collected as part of the INTERSALT study in 598 men and women aged 20-59 years, selected randomly from three population groups in the United Kingdom. For the three centres combined, mean systolic blood pressure was 121.4 mm Hg and diastolic pressure 72.1 mm Hg, urinary sodium excretion 152.1 mmol/24 h, urinary potassium excretion 61.0 mmol/24 h, urinary sodium/potassium ratio 2.64 and BMI 25.2 kg/m2. Prevalence of heavy alcohol drinking in men (greater than or equal to 300 ml/week) was 27.5 per cent. Applying overall INTERSALT regression coefficients to the United Kingdom data suggested that modest changes in average sodium and potassium intakes, together with reductions in the prevalence of obesity and (in men) of heavy alcohol drinking could lead to important reductions in average population blood pressures and the prevalence of hypertension. The potential of this multifactorial approach to blood pressure control was illustrated by stratifying individuals within each of the United Kingdom centres by sodium and potassium excretion, BMI and alcohol intake. The 20 (out of 299) men considered at 'lower risk' for high blood pressure with respect to the above variables had systolic pressure lower by 11 mm Hg (P less than 0.01); for the 27 (out of 299) 'lower risk' women, systolic pressure was lower by 5 mm Hg (P = 0.06). These non-pharmacological approaches towards more favourable blood pressure levels could be accompanied by reductions in mortality from stroke and coronary heart disease.     

The Edgecombe County High Blood Pressure Control Program: I. Correlates of uncontrolled hypertension at baseline.

To guide the planning of a multifacetted hypertension control program in Edgecombe County, North Carolina, a baseline survey of a stratified (by township) random sample of 1,000 households was conducted. All adults (greater than or equal to 18 years) were interviewed and had their blood pressures (BP) measured. Five hundred thirty-nine individuals, 27 per cent of the survey population, had diastolic BP greater than or equal to 90 mm Hg or were receiving anti-hypertensive drug therapy. The 539 hypertensives were divided into seven subgroups reflecting successive stages in the control of hypertension based on the awareness, treatment, and control of their hypertension. Unaware hypertensives were further subdivided into three groups according to the recency of their last BP check, and those aware but untreated were subdivided by whether they had previously received treatment. The seven subgroups of hypertensives were compared, separately for women and men, with respect to sociodemographic characteristics, health behaviors, and health status. In general, the progression from undetected hypertension to treatment and control appeared to be associated with being older, female, and White. This progression was further associated with greater educational levels and higher family incomes among women and increasing self-reported morbidity among men. The implications for intervention of these and other described associations are discussed.     

中国成年人高血压患病率、知晓率、治疗和控制状况

目的　评估中国成年人高血压的患病率、高血压知晓率、治疗和控制状况。方法　亚洲国际心血管病合作研究 (InterASIA)于 2 0 0 0～ 2 0 0 1年进行 ,应用多阶段抽样方法选择有代表性的样本。共调查了 35～ 74岁的成年人 15 838人。测量血压时 ,先让调查对象休息 5min ,由经过培训合格的调查人员应用标准水银柱血压计测量 3次血压。应用标准问卷询问高血压病史及高血压的治疗情况。高血压定义为收缩压≥ 140mmHg、舒张压≥ 90mmHg或正在服用降压药。结果　 35～ 74岁的中国成年人的高血压患病率为 2 7 2 %,即全国约有 1 3亿高血压患者。 35～ 44、45～ 5 4、5 5～ 6 4和 6 5～ 74岁年龄组的高血压患病专率分别为男性 17 4%、 2 8 2 %、 40 7%和 47 3 %;女性为 10 7%、2 6 8%、38 9%和 5 0 2 %。在高血压病人中 ,44 7%知道自己患有高血压 ,2 8 2 %正在服用降压药 ,8 1%的人血压得到了控制 ( <140 / 90mmHg)。在过去 10年中 ,高血压知晓、治疗和控制率的增长百分率分别为 86 2 %、92 6 %和 145 4%。结论　在过去的 10年中 ,高血压知晓、治疗和控制率有显著的提高。中国成年人高血压的患病率比较高 ,而高血压的知晓率偏低 ,治疗率和控制率又非常低。在我国迫切需要改善高血压的预防、检测和治疗状况     

Screening for hypertension in a middle-aged population in Southwest Finland

The occurrence and treatment of hypertension were investigated and the benefit of screening for hypertension was evaluated in a middle-aged population in two rural districts in southwest Finland. A total of 1223 (93.2%) of the women and 1042 (93.1%) of the men, 40–64 years of age, participated in the hypertension screening program. With the criterion of ? 105 mm Hg, the prevalence of hypertension based on three separate measurements was 12.5 and 8.4% for the women and men, respectively, when those already being treated were included. If in the present study a single blood pressure reading had been considered sufficient, the prevalence of “hypertension” would have been almost twofold (20.4%) that based on three measurements for women and it would have been more than twofold for men (21.4%). Seventy-three percent of the female hypertensives and 59% of the male hypertensives were being treated. Only 10% of the female and 15% of the male hypertensives were unaware of their hypertension. The majority (75%) of these persons had consulted a doctor or a nurse during the previous year without their hypertension being detected. Because the majority of the hypertensives were already being treated and, moreover, most of those untreated were already aware of their disease, a systematic screening of the rural middle-aged population in southwest Finland is not considered necessary, especially since community plans for health care services in Finland should double the contact between the physicians in the community health centers and the residents during the next few years.     

中国中年人群高血压患病率及知晓率、治疗率、控制率的演变趋势

目的 了解中年人群高血压患病率及知晓率、治疗率和控制率的演变趋势。方法 利用国家“八五”(1992～1994年)和“九五”(1998年)期间年龄在35～59岁的13组可比人群资料进行分析。结果 高血压的标化患病率有小幅增加,“九五”期间达到24.0％。城市的增幅要大于乡村。高血压知晓率“九五”期间较“八五”期间增加了5.3％,达到42.6％;治疗率“八五”期间27.3％、“九五”期间为31.1％;控制率“九五”期间较“八五”期间增加了近50％,但也只有6.0％。在接受治疗的高血压患者中,不同时期的控制率分别为12.7％、19.9％,为同期整体控制率的3倍多。无论患病率、知晓率、治疗率和控制率,城乡之间、性别之间都存在差异。结论 不断上升的高血压患病率和低水平的知晓率、治疗率、控制率仍是高血压防治面临的主要现状。必须认真开展有效的措施以降低高血压的患病率,提高治疗率和控制率。     

Hypertension prevalence and the status of awareness, treatment, and control in the Hispanic Health and Nutrition Examination Survey (HHANES), 1982-84.

The prevalence rates of hypertension among adult (ages 18-74) Mexican Americans, Cuban Americans, and Puerto Ricans were estimated using data from the 1982-84 Hispanic Health and Nutrition Examination Survey (HHANES). Hypertension is defined as diastolic greater than or equal to 90 mm Hg, or systolic greater than or equal to 140 mm Hg, or currently taking antihypertensive medication. Among Mexican Americans in the Southwestern United States, 16.8 percent of the males and 14.1 percent of the females were found to be hypertensive. Among Cuban Americans in Dade County, Florida 22.8 percent of the males and 15.5 percent of the females were hypertensive. Among Puerto Ricans in the New York City area 15.6 percent of the males and 11.5 percent of the females were hypertensive. The age-adjusted rates are significantly lower than comparable rates for Whites and Blacks as measured in the second National Health and Nutrition Examination Survey (NHANES II), 1976-80. Control of hypertension in the HHANES populations fall short of the 1990 Objectives for the Nation established by the US Public Health Service 60 percent (34 percent controlled Mexican American hypertensives, 27.8 percent controlled Cuban American hypertensives, and 29 percent controlled Puerto Rican hypertensives.     

Incidental blood pressure elevations: a MIRNET project

BACKGROUND. A prospective study was undertaken to determine the prevalence of hypertension in office patients with an incidental diastolic blood pressure greater than or equal to 90 mm Hg. METHODS. During routine screening of 14,890 patients, 174 patients with elevated diastolic blood pressures but no previous diagnosis of hypertension were identified over a 3-month period. Only 115 (64%) returned as requested for two subsequent blood pressure readings. RESULTS. Sixty percent of those returning fit the definition for hypertension using the criteria of the Joint National Committee on Detection, Evaluation, and Treatment of Hypertension. Sixty-nine percent (43/62) of the men and 49% (26/53) of the women were hypertensive. Women under 40 years old were less likely to be hypertensive, but age did not predict hypertension in men. Among those patients with a diastolic pressure reading below 105 mm Hg, progressively higher diastolic readings on the first visit did not predict a higher probability of hypertension. Among those patients with a diastolic pressure reading above 105 mm Hg, however, 90% (9/10) were hypertensive. CONCLUSIONS. Physicians should take incidental elevation of diastolic pressure seriously because of the high prevalence of confirmed hypertension in this group of patients.     

Changing trends in hypertension detection and control: the Chicago experience.

Of 177,692 persons screened in 1977 as part of an ongoing City-Wide Hypertension Screening Program in Chicago, 14,988 (8.4%) had diastolic blood pressure (BP) greater than or equal to 95 mm Hg as compared to 13.2% of a similar population in 1976. Only 7% (3,910) of the hypertensive population (diastolic BP greater than or equal to 95 mm Hg or presently on antipressor drugs) had previously undetected hypertension in contrast to 11.9% (4,184) the year before and 48.7% in the same community in 1972. Conversely, 73.2% (40,738) had adequately controlled blood pressure as contrasted to 59.3% (20,897) the previous year and 20.6% in 1972. Of the remaining hypertensives, 7.5% (4,201) were known but not treated and 12.3% (6,824) were under treatment but not controlled in contrast to 12.1% (4,251) and 16.8% (5,905) respectively the year before. This upward trend in controlled hypertension was present in all strata of the population.     

Knowledge,treatment and control of hypertension. Results of a multicenter study of patients hospitalized for cardiac ischemia

The study objective was to assess the prevalence, level of treatment, and control of hypertension in CHDs patients. We conducted a cross-sectional survey on 1109 patients hospitalised for a first episode of MI in the main hospitals of the District of Tunis during the period 1999-2000. Hypertension and control level are defined according to the JNC recommendations. HBP is defined as SBP > = 140 and or DBP > = 90 mm Hg and the use of blood pressure-lowering medication for the indication of hypertension. Hypertension is controlled by medication if SBP < 140 and DBP < 90 mm Hg. We conduct analysis by socio demographic variables, medical history and CHDs risk factors. 54.9% men and 72.1% women were hypertensive. The prevalence of hypertension increases with age in both genders. The logistic regression have shown that the age-adjusted odds ratios were statically significant for diabetes, obesity, high cholestrolemia and cigarettes smoking. Only 68.9% of the hypertensive were aware of having hypertension, women were more aware than men (84.6% versus 61.7%, p < 0.001). Awareness increase with age and education level. Among hypertensive, 94.4% were treated but only 41.3% were controlled. The study highlights the problem of the hypertension, and contributes to identify the iceberg of this CHDs risk factor. An effort must be done to involve the health personnel for educating patients, the population for changing their life style and manager for enhancing the availability of drugs. The question is how much will be the cost of HBP and CVDs control for a country which has a limited resources.     

Alcohol and blood pressure: results from the Luebeck Blood Pressure Study

Data from the Luebeck Blood Pressure Study, a cross-sectional study on a random sample (n = 3,100) of the 30- to 69-year-old population of Luebeck, were analyzed with regard to alcohol consumption and blood pressure. Putative confounders such as obesity, smoking, physical activity, and educational attainment were controlled for by multiple regression analyses. Luebeck men who consumed more than 40 g of alcohol per day revealed 5-6 mm Hg higher mean systolic and 4-5 mm Hg higher mean diastolic blood pressure values. A J-shaped relationship between alcohol consumption and systolic blood pressure was seen in Luebeck men. According to our calculations, about 7% of hypertension among Luebeck men is due to alcohol consumption of greater than or equal to 40 g/day. Among women, strong interactions between age and alcohol consumption were found, therefore two age groups, 30-44 and 45-69 years, were analyzed separately. In the younger age group the alcohol-blood pressure relationship was not pronounced. In the older age group a strong interaction between alcohol consumption and smoking was found. For female smokers steep increases in the adjusted mean diastolic (5.2 mm Hg) and systolic (9.6 mm Hg) blood pressure values were seen for the alcohol consumption category greater than or equal to 20 g/day. For female nonsmokers a flat curve was seen with regard to mean diastolic and systolic blood pressure values. The data from the Munich Blood Pressure Study show a very similar relationship between alcohol consumption and mean systolic and diastolic blood pressure values.     

Prevalence, detection, and control of hypertension in a biethnic community. The San Antonio Heart Study

A survey was carried out on a random sample of 1,288 Mexican Americans and 929 Anglos living in three socially distinct neighborhoods in San Antonio, Texas. Hypertension was defined as diastolic blood pressure greater than or equal to 95 mmHg or currently taking antihypertensive medication. Overall age-adjusted prevalence rates of hypertension were similar for Mexican-American and Anglo men (10.0 and 9.8%, respectively); for women, the Mexican-American rate was slightly lower than that for Anglos (7.8 and 9.7%, respectively). After adjustment for obesity differences, Mexican Americans have a tendency toward lower hypertension rates than Anglos of the same socioeconomic level. Only among women was a decline in the prevalence of hypertension with increasing socioeconomic status observed. Mexican Americans have a higher proportion of newly diagnosed hypertension, and, among previously diagnosed cases, a lower proportion are on antihypertensive medication than Anglos. The rates of hypertension control found in this survey are among the highest reported in the United States at the community level. Despite this, Mexican Americans still lag somewhat behind Anglos of the same socioeconomic level in awareness, treatment, and degree of hypertension control, suggesting the possibility of sociocultural barriers to adequate medical care.     

Distribution of blood pressures in Gemlik District,north-west Turkey

The objectives of the present study were to evaluate the prevalence, awareness and control of hypertension among individuals over 30 years of age and to plan a follow-up programme for the same age group. A community-based sample of 1992 individuals (952 men and 1,040 women) was selected randomly. Out of the total study population, 1,388 (69.7%) individuals had normal blood pressure according to World Health Organisation criteria (systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg), and the rest (n = 604, 30.3%) had hypertension to varying degrees. Since 61 individuals with normal blood pressure were using antihypertensive medication, the overall hypertension prevalence was 33.4%. Among the study subjects with hypertension, 44.4% were aware of their condition, 37.7% were using medication and 9.2% had controlled hypertension. One out of five individuals (n = 399, 20.0%) had never had their blood pressure measured before. Females had a higher hypertension prevalence than males (36.7% and 29.7%, respectively). Hypertension prevalence increased with age and individuals with a body mass index > 25 were at greater risk. The present findings suggest that there is a need to implement an effective, community-based and low-cost management programme.     

Prevalence, awareness, treatment, and control of hypertension in a Spanish population

A cross-sectional population survey using a random, stratified sample into phases was conducted in order to assess the prevalence, awareness, treatment, and control of hypertension in Albacete (a south-eastern province in Spain) with 248 000 inhabitants over 18 years of age. The sample size was of 1322 people. Both systolic and diastolic BP were higher in men than in women and showed an increasing trend with age independently of gender. Assuming a cut-off for hypertension of <140/90 mm Hg and <160/95 mm Hg, we found a prevalence of hypertension of 32.7% and 23.1%, respectively. Overall, 56.5% of hypertensive subjects were aware of their condition. The degree of this awareness was significantly higher in women and in the elderly. The percentage of patients who were receiving antihypertensive treatment was 49.1%. This proportion was also higher among women, elderly people, and subjects living in urban areas. High BP was successfully controlled in 10.9% of the total hypertensive population which accounted for 24.4% of the treated patients. The corresponding figures for the <160/95 mm Hg cut-off were 38.5% and 60.6%, respectively. In the logistic regression model, male gender and size of the local community were significantly associated with a better pharmacological control of hypertension. We found a high prevalence of hypertension with low degree of awareness and control, despite the general progress made in the diagnosis and treatment of hypertension in Spain. Specific intervention programs are necessary to increase the extent of control of hypertension in our country.     

Prevalence, awareness, treatment and control of hypertension in a general population sample of 26,913 adults in the Greek EPIC study

BACKGROUND: Premature mortality from cardiovascular diseases could be prevented by the effective control of hypertension. Nationwide data for the status of hypertension in the adult Greek population are not available. METHODS: In the context of the Greek component of the European Prospective Investigation into Cancer and nutrition (EPIC), 26 913 volunteers, aged 20-86 years, were recruited from several regions of Greece. Blood pressure measurements were taken by trained physicians and standard interviewing procedures were used to record medical history, and socio-demographic and lifestyle characteristics. The data were modelled through multiple regression. RESULTS: The prevalence of hypertension (based on two arterial blood pressure measurements on a single occasion) is 40.2% for men and 38.9% for women (age-adjusted to the adult Greek population of 2001). In the sample examined, awareness among hypertensives is 54.4%, pharmaceutical treatment among those aware is 83.9%, and effective control among hypertensives is 15.2%. Prevalence of hypertension increases with age and is higher in rural areas and among individuals of lower education. Awareness and control of hypertension is higher among older individuals, among women and among the highly educated. Moreover, awareness of hypertension is higher among rural residents, whereas control of hypertension is more effective among urban residents. CONCLUSIONS: In a large sample of the general Greek population, the prevalence of hypertension among men is lower than the average among the EU countries, whereas the corresponding prevalence among women is higher. Awareness and control of hypertension is lower in Greece than in other western countries, making them public health priorities.     

Analysis of risk factors for hypertension in Colima, Mexico]

OBJECTIVE: To evaluate the possible association that age, sex, excess weight, family history of hypertension, alcoholism, and sedentary lifestyle have with hypertension in the adult population of the city of Colima, Mexico. METHODS: This was a population-based analytic cross-sectional study. A structured survey was used with 280 adults older than 30 years of age who were living in the city of Colima in 2001 and 2002. The variables studied were sex, age, weight, height, family history of hypertension, engaging in physical exercise, smoking, and consuming alcohol. Blood pressure (BP) was measured with the auscultatory method. Borderline or doubtful measurements were checked again four or five days later. Hypertension was defined as systolic BP > or = 140 mm Hg and diastolic blood pressure > or = 90 mm Hg, or as the person being under antihypertensive treatment. The odds ratios (ORs) of the variables studied were calculated, along with their 95% confidence intervals (95% CIs). The association between the variables and hypertension was estimated through logistic regression, and their interaction through the coefficient of the interaction products. RESULTS: The overall prevalence of hypertension was 28.6%. The prevalence was higher in men than in women (42.1% vs. 19.2%; OR = 3.04, 95% CI: 1.8 to 5.2) and in people older than 49 years than in people 30 to 49 years old (36.8% vs. 21.9%; OR = 2.07, 95% CI: 1.22 to 3.50). A family history of hypertension and excess weight were associated with hypertension, while physical exercise had a protective effect (OR = 0.45; 95% CI: 0.23 to 0.86). There was interaction between hypertension and age > or = 50 years, a family history of hypertension, overweight, and physical exercise, especially among women. CONCLUSIONS: The prevalence of hypertension in Colima is very similar to that for Mexico as a whole. The strong association that hypertension had with male gender, regardless of the other variables, emphasizes the need for promoting prevention campaigns that focus more on men.