Trends in Prevalence,Awareness, Treatment,and Control of Blood Pressure Recorded From 2004 to 2014 During World Hypertension Day in Italy

Estimates of blood pressure (BP) control in real life are not systematically collected in Italy. We evaluated trends in systolic/diastolic BP levels, as well as prevalence, awareness, treatment, and control rates of hypertension among adult individuals visiting open checkpoints during the 2004 to 2014 annual editions of World Hypertension Day. Hypertension was defined as BP level ≥140/90 mm Hg or use of antihypertensive medication, whereas BP control was defined as BP level <140/90 mm Hg. We included 10,051 individuals (53.2% female, age 56.2±16.8 years, body mass index 25.7±7.6 kg/m², systolic/diastolic BP 131.9±18.6/79.1±10.5 mm Hg). Hypertension prevalence and treatment were substantially unchanged, whereas awareness appears to increase over time. Controlled hypertension in diagnosed treated patients increased from 50.0% in 2004–2010 to 55.5% in 2011–2012 towards 57.6% in 2013–2014. This analysis provides real‐life snapshots of hypertension over the years in the occasion of World Hypertension Day, showing increased awareness and improved control rates among treated hypertensive patients attending open checkpoints during 2004 to 2014 in Italy.     

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.     

Prevalence, awareness, treatment and control of hypertension in North America, North Africa and Asia

Results from national surveys of prevalence, awareness, treatment and control provide the most meaningful basis for assessing the burden of hypertension in the community. National surveys conducted in a variety of countries in North America, Europe, Australia, Asia and Africa have identified a strikingly similar relationship between age and blood pressure (BP), with a progressive and steep increase in systolic BP throughout adult life and a less steep increase in diastolic BP from adolescence until the fifth or sixth decade. In most countries surveyed, there was a high prevalence of hypertension. Approximately, one quarter of all adults in the United States and Egypt had hypertension (systolic BP>/=140 mmHg or diastolic BP>/=90 mmHg or use of antihypertensive medication) in national surveys conducted in 1988-1991 and 1991-1993, respectively. The corresponding percentage was somewhat lower (14.4%) for adults surveyed in China during 1991, but temporal trends indicate that the prevalence of hypertension is increasing rapidly in that country. In the 1988-1991 national survey, more than 25% of US adults were unaware of their diagnosis, only 55% were being treated with antihypertensive medication and only 29% were on antihypertensive medication with a systolic/diastolic BP >140/90 mmHg. The situation was much worse in Egypt and China, with only 8% and <5% of adults with hypertension, respectively, being treated with antihypertensive medication and having a systolic/diastolic BP <140/90 mmHg. These survey results underscore the fact that hypertension is highly prevalent, poorly treated and controlled, and an escalating health challenge in economically developing countries.     

Prevalence, awareness, treatment, control and risk factors of hypertension in Korea: the Ansan study

OBJECTIVES: To determine prevalence, awareness, treatment, and control of hypertension, and its risk factors in an urban Korean population. DESIGN AND SETTING: A cross-sectional survey in Ansan-city, Korea. SUBJECTS AND METHODS: Population-based samples of people aged 18-92 years in Ansan-city, Korea, were selected, yielding 2278 men and 1948 women, and their blood pressures were measured using a highly standardized protocol. Hypertension was defined as a systolic BP > or = 140 mmHg or diastolic BP > or = 90 mmHg or reported treatment with antihypertensive medications, and subclassified according to 1999 WHO-ISH guidelines. Isolated systolic hypertension (ISH) defined as a systolic BP > or = 140 mmHg and diastolic BP < 90 mmHg was also examined. Data were stratified by age and sex. RESULTS: The overall prevalence of hypertension in this study was 33.7%. Among these, 64.9% had Grade 1 hypertension, 22.5% Grade 2, and 12.5% Grade 3. Age-specific prevalence of hypertension increased progressively with age, from 14.19% in 18 to 24 year-olds to 71.39% in those 75 years or older. Hypertension prevalence was significantly higher in men (41.5%) than in women (24.5%) (P < 0.001). Isolated systolic hypertension had significantly lower prevalence (4.33%) within the population, although in the elderly aged 55 years or more it rose by 11.13%. Overall, 24.6% of hypertensive individuals were aware that they had high blood pressure, as much as 78.6% were being treated with antihypertensive medications, and 24.3% were under control. Hypertension awareness as well as treatment and control rates varied by sex, with women higher in all three rates. Multivariate analysis revealed that age, body mass index and abdomen circumference were significantly associated with prevalence of hypertension both in men and women. CONCLUSIONS: Hypertension is highly prevalent in Korea. Despite the high rate of treatment, the rates of awareness and control are relatively low, suggesting the nationwide demand for preventing and controlling high blood pressure in Korea in order to avert an epidemic of cardiovascular disease.     

Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004

Detection of hypertension and blood pressure control are critically important for reducing the risk of heart attacks and strokes. We analyzed the trends in the prevalence, awareness, treatment, and control of hypertension in the United States in the period 1999-2004. We used the National Health and Nutrition Examination Survey 1999-2004 database. Blood pressure information on 14 653 individuals (4749 in 1999-2000, 5032 in 2001-2002, and 4872 in 2003-2004) aged >or=18 years was used. Hypertension was defined as blood pressure >or=140/90 mm Hg or taking antihypertensive medications. The prevalence of hypertension in 2003-2004 was 7.3+/-0.9%, 32.6+/-2.0%, and 66.3+/-1.8% in the 18 to 39, 40 to 59, and >or=60 age groups, respectively. The overall prevalence was 29.3%. When compared with 1999-2000, there were nonsignificant increases in the overall prevalence, awareness, and treatment rates of hypertension. The blood pressure control rate was 29.2+/-2.3% in 1999-2000 and 36.8+/-2.3% in 2003-2004. The age-adjusted increase in control rate was 8.1% (95% CI: 2.4 to 13.8%; P=0.006). The control rates increased significantly in both sexes, non-Hispanic blacks, and Mexican Americans. Among the >or=60 age group, the awareness, treatment, and control rates of hypertension had all increased significantly (P相似文献   

Detection and Control of Hypertension in the Population: The United States Experience

Trends in prevalence, awareness, treatment, and control of hypertension in the adult US population are reported. The data are from the National Health and Nutrition Examination Surveys (NHANES), carried out in four separate surveys, the last being NHANES III, 1988–1991. The age-adjusted prevalence of hypertension at ≥ 160/95 mm Hg declined from 20% to 14%, and at > 140/90 mm Hg it declined from 36.3% to 20.4% in NHANES III. Hypertension awareness increased significantly to as high as 89% for those with blood pressures ≥ 160/95 mm Hg. For all people with blood pressure ≥ 160/95 mm Hg, nearly 64% have it controlled below that level, but only 29% have their blood pressure controlled below 140/90 mm Hg. Although the data from these surveys are encouraging, there are still too many people in the United States with uncontrolled hypertension.     

Secular trends in hypertension and elevated blood pressure among Korean children and adolescents in the Korea National Health and Nutrition Examination Survey 2007‐2015

The prevalence of elevated blood pressure (BP) among US children and adolescents has reportedly declined over the past decade. As no Korean data have been analyzed, we aimed to determine recent trends in BP levels among Korean children and adolescents. This study examines data from the Korea National Health and Nutrition Examination Survey segregated into 3 time periods (2007‐2009, 2010‐2012, and 2013‐2015). A total of 7804 Korean children and adolescents aged 10‐18 years were included in the analysis. Hypertension (≥95th percentile) and elevated BP (>90th percentile) were defined using the sex‐, age‐, and height‐specific BP standards from 2017 American Academy of Pediatrics guidelines. Mean systolic BP from 2007‐2009 to 2013‐2015 increased by 3.9 mm Hg, and there was no significant change in diastolic BP. Body mass index (BMI) z‐scores significantly increased in the total population from 2007‐2009 to 2013‐2015. In 2013‐2015, the prevalence rates of elevated BP and hypertension were 8.8% and 9.0%, respectively. The prevalence of hypertension in 2013‐2015 increased in the total population compared with those in 2007‐2009, especially in the obese subgroup, in which the hypertension prevalence was 27.7% in 2013‐2015. The prevalence of elevated BP increased during these time period. Associated factors were sex, age, BMI z‐score, and survey period for elevated BP; and sex, age, and BMI z‐score for hypertension. During our study, mean systolic BP increased, and the prevalence of hypertension in 2013‐2015 increased in the pediatric population. A possible influencing factor is obesity, and further long‐term data are necessary.     

Prevalence, awareness, treatment, and control of hypertension among Canadian adults with diabetes, 2007 to 2009

Background

Prior national surveys suggested that treatment and control of hypertension were poor in individuals with diabetes. Using measured blood pressures, we estimated prevalence, awareness, treatment, and control of hypertension between 2007 and 2009 among Canadians with diabetes and sought to determine whether a treatment gap still exists for individuals with diabetes.

Methods

Using data from cycle 1 of the Canadian Health Measures Survey, estimates of hypertension prevalence, awareness, treatment, and control were described and compared between individuals with and without self-reported diabetes.

Results

Three-quarters of individuals reporting diabetes also had hypertension; of these, 89% (95% confidence interval [CI], 80%-98%) were aware, 88% (95% CI, 81%-94%) were treated, and 56% (95% CI, 45%-66%) were controlled to < 130/80 mm Hg. Among those treated with pharmacotherapy, 39% (95% CI, 31%-48%) were using monotherapy, 29% (95% CI, 18%-40%) were taking 2 medications, and 31% (95% CI, 22%-39%) were taking 3 or more medications; control to < 130/80 mm Hg was achieved by 63% (95% CI, 53%-74%). Among those treated, individuals with diabetes were significantly less likely to be treated to their recommended target (< 130/80 mm Hg) compared with individuals without diabetes (< 140/90 mm Hg; odds ratio_adjusted 0.3; 95% CI, 0.2-0.6).

Conclusions

Hypertension treatment and control among people with diabetes have improved in Canada during the past 2 decades. Nonetheless, nearly half of people with diabetes are above the treatment target. Health care professionals should continue to increase their efforts in supporting patients with diabetes in achieving blood pressure control, with emphasis on lifestyle management and pharmacotherapy.     

The epidemiology of elevated blood pressure as an estimate for hypertension in Aydin, Turkey.

BACKGROUND: Hypertension is an important public health problem, with some variability of its epidemiological properties in different populations. OBJECTIVES: The purpose of this study was to estimate the prevalence of hypertension and to determine the hypertension awareness, treatment and control rates in Aydin, a Turkish province. METHODS: Of 1600 coincidentally selected people aged over 18 years in Aydin, 1480 (92.5%) had their blood pressure (BP) measured and answered a standard questionnaire in 1995. RESULTS: Estimates of the prevalence of hypertension and its control were computed using two different criteria to define hypertension: BP > or =140/90 mm Hg or on treatment and BP > or =160/95 mm Hg or on treatment. Overall, the estimated prevalence of hypertension was 29.6% (for BP > or =140/90 mm Hg or on treatment). Hypertension prevalence increased progressively with age, from 9% in 18- to 29-year-olds to 70.6% in those 70-79 years of age. Women had a significantly higher prevalence than men (34.1% vs 26.0% respectively). Overall, 57.9% of hypertensive individuals were aware that they had high BP, and 82.1% of aware hypertensives were being treated with antihypertensive medications, but only 19.8% of treated hypertensives were under control (systolic pressure <140 mm Hg and diastolic pressure <90 mm Hg). In addition, housewives, unemployed, and the less educated individuals had greater mean systolic and diastolic BP. CONCLUSIONS: Our results indicate that hypertension is highly prevalent in Aydin, Turkey, and the detection and control of hypertension is unsatisfactory.     

Secular trends of hypertension prevalence based on 2017 ACC/AHA and 2018 Chinese hypertension guidelines: Results from CHNS data (1991‐2015)

This study aimed to assess the impact of the 2017 American College of Cardiology and American Heart Association (ACC/AHA) guideline and the 2018 Chinese hypertension guidelines on the different secular trends for hypertension prevalence. A total of 82 665 eligible individuals aged ≥20 years were selected from nine cross‐sectional study periods (1991‐2015) from the China Health and Nutrition Survey (CHNS). Over the 24‐year period, the long‐term trend for the prevalence of the 2017 ACC/AHA‐defined age‐adjusted hypertension showed an increase from 32.2% (95% confidence interval (CI): 31.0%‐33.3%) in 1991 to 60.0% (95% CI: 58.6%‐61.3%) in 2015 (P_trend < 0.001). According to the 2018 Chinese guideline for hypertension, the weighted hypertension prevalence increased from 10.0% (95% CI: 9.4%‐10.5%) in 1991 to 28.7% (95% CI: 27.9%‐29.6%) in 2015 (P_trend < 0.001). However, slopes of increasing prevalence of hypertension were significantly greater according to the 2017 ACC/AHA guideline than that based on Joint National Committee (JNC 7) report (β = 1.00% vs β = 0.67% per year, respectively, P = 0.041). Based on the 2017 ACC/AHA definition, the prevalence of stage 1 hypertension and elevated blood pressure significantly increase from 22.3% and 6.9% in 1991 to 31.2% and 10.1% in 2015 (all P < 0.05), respectively. The secular trend for the prevalence of hypertension according to the 2017 ACC/AHA guideline showed a greater rate of increase compared with the prevalence based on the 2018 Chinese hypertension guidelines. Public health initiatives should focus on the current status of hypertension in China because of the possible high prevalence of hypertension and concomitant vascular risks.     

Comparison of Diagnosed,Self-Reported,and Physically-Measured Hypertension in Canada

Background

Hypertension is a substantial health concern because it poses significant risks for cardiovascular morbidity and mortality and is highly prevalent in the population. Tracking hypertension is important because it is a risk factor for other conditions, but prevalence estimates might vary depending on the data source used.

Methods

This report describes 3 national population-based data sources for estimating hypertension prevalence in Canada and discusses their strengths and weaknesses to aid in their use for policy and program planning. They are compared based on: sample coverage, case identification, and prevalence estimates.

Results

Each source produces a different measure of hypertension prevalence, as follows: (1) diagnosed hypertension from the Canadian Chronic Disease Surveillance System (CCDSS) (2007/2008); (2) self-reported diagnosed hypertension from the Canadian Community Health Survey (CCHS) (2007-2008); and, (3) physically-measured hypertension from the Canadian Health Measures Survey (CHMS) (2007-2009). Crude rates and counts of hypertension prevalence among individuals aged 20 to 79 years of age, excluding pregnant women, are compared, resulting in prevalence ranging from 18.2% in self-report data to 20.3% in diagnosed data. The data sources differ in terms of target population, case identification, and limitations, which affects the estimates.

Conclusions

Each source has unique strengths and is best suited for addressing particular research questions. For example, diagnosed hypertension can be used to determine health care utilization patterns, self-reported to examine health determinants, and measured high blood pressure to improve awareness, treatment, and control. Combined, they can address multiple issues and increase our knowledge of hypertension in Canada.     

Rising HIV Prevalence Among Married and Unmarried Among Men Who Have Sex with Men: Jinan, China

We report on two waves of bio-behavioral surveillance of MSM in Jinan, Shandong Province, China. HIV prevalence rose from 0.05% in 2007 to 3.1% in 2008. Differences in the two waves of surveys were noted, particularly with respect to marital status, requiring stratified analysis. In multivariable analysis, unmarried, homosexually identified MSM who do not have female sex partners have a greater than sixfold greater chance of being infected with HIV compared to married, non-homosexually identified MSM who do have female partners. Carefully targeted and population-specific messages will be needed for homosexually identified and non-identified MSM in China.     

Prevalence,Awareness, Treatment,and Control of Hypertension among Adult Residents of Tehran: The Tehran Cohort Study

Background:High levels of blood pressure (BP) remain undetected and poorly controlled in large segments of the population leading to an enormous burden in terms of disease and mortality.Objective:We aimed to assess the prevalence, awareness, treatment, and control of hypertension in Tehran.Methods:We used the data of 8,296 adults aged ≥35 years from the Tehran Cohort Study who were enrolled between May 2016 and February 2019. Hypertension was defined as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg, self-report, and/or current antihypertensive medication use. The age- and sex-weighted prevalence of hypertension and high normal BP was calculated using the 2016 national census. Furthermore, awareness, treatment, and control of hypertension were analyzed.Results:The mean age of the participants was 53.8 ±12.75 years, and 54.0% were women. The weighted prevalence of hypertension and high normal BP were 36.5% and 12.2%, respectively. Among hypertensive individuals, 68.2% were aware of hypertension, 53.3% were receiving medication, and 40.4% had adequate BP control. The awareness, treatment, and control of hypertension were significantly higher in women (72.2% vs. 63.4% [P < 0.001], 55.1% vs 51.1% [P = 0.020], and 42.7% vs. 37.7% [P = 0.004], respectively) and this gap considerably increased with advancing age. Hypertension was more prevalent in northern Tehran but with a better treatment rate and control in the same regions.Conclusion:Despite the high prevalence of hypertension in the adult population of Tehran, the rates of awareness, treatment, and control of hypertension are unsatisfactory and demand comprehensive strategies to improve this situation, especially in younger men.     

Prevalence and risk factors for prehypertension and hypertension among adults in Central China from 2000-2011

ABSTRACT

Background: Hypertension is frequently studied in surveys; however, prehypertension, a new blood pressure status between normotension and hypertension, is rarely reported. Methods: All data were derived from the China Health and Nutrition Survey (CHNS) and were analysed by logistic regression for correlation. Results: The prehypertension prevalence was 27.4%, with a hypertension rate of 36.9%. The awareness, treatment, and uncontrolled rates among all hypertension participates were 19.8%, 83.6%, and 55.0%, respectively. The epidemic rate of hypertension increased with increasing age (p < 0.001), and prehypertension appeared to have an epidemic peak in the age group of 38–57 years (p < 0.001). In general, the incidence of hypertension in urban participants was higher than in rural subjects (p < 0.001), and prehypertension in urban subjects was lower than that in rural subjects (p < 0.001). According to the results of logistic regression, hypertension and prehypertension were associated with age, gender, location, body mass index (BMI), body fat rate (BFR), waist circumference (WC), education, and the intake of energy-yielding nutrients<0.05). Conclusion: The current study reveals a high epidemic rate of hypertension and prehypertension in Central China. These results indicate the urgent need to develop strategies to improve the prevention of hypertension and prehypertension in Central China.     

丽水市高血压患病情况流行病学调查

目的:明确丽水市社区高血压患病情况。方法:随机抽样丽水城镇监测区8万名35～64周岁的常住人口,由丽水市心脑血管病防治办公公室拟定全市高血压调查方案,调查一般情况、既往史并进行测量血压。结果:丽水市35～64岁人群高血压1999年患病率为19.8%(男性22.5%,女性17.5%),2003年患病率为:21.9%(男性22.6%,女性21.0%)。高血压患病率随年龄增加呈明显上升(P=0.000)。50岁以后女性患病率显著高于男性(P<0.01)。有高血压家族史及超重人群高血压患病率增加(P均<0.01)。结论:高血压在丽水市社区35～64周岁人群中常见,且患病率仍在不断升高。50岁以后女性,有高血压家族史及超重人群更易发生高血压。     

Prevalence,awareness, treatment,and control of hypertension in Bissau,Western Africa

Hypertension is the leading preventable risk factor for cardiovascular diseases. In Guinea–Bissau there are no previous population‐based hypertension surveys. Therefore, the authors aimed to estimate the prevalence, awareness, treatment, and control of high blood pressure among adults living in Bissau. A sample (n = 973) of dwellers in Bissau, aged 18–69 years, was assembled through stratified and cluster sampling. Patients underwent face‐to‐face interviews and blood pressure measurements following the World Health Organization Stepwise Approach to Chronic Disease Risk Factor Surveillance. The prevalence of hypertension was 26.9%, and 51.4% of hypertensive individuals were aware of their condition, of whom 51.8% reported having received pharmacological treatment in the previous 2 weeks. Among the latter, 49.9% had blood pressure values below 140/90 mm Hg. These findings show that hypertension has become a major public health problem in Guinea‐Bissau, emphasizing the urgent need to develop and implement national strategies for the prevention and management of hypertension.     

Updated hypertension prevalence,awareness, and control rates based on the 2017ACC/AHA high blood pressure guideline

In 2017, the American College of Cardiology/American Heart Association (ACC/AHA) updated the Guideline of Prevention, Detection, Evaluation and Management and Management of High Blood Pressure (HBP) in Adults. The purpose of the current study was to evaluate the potential impact of the 2017ACC/AHA HBP guideline on hypertension prevalence, awareness, and control rates. The data were collected from Physical Examination Center of the Second Hospital of Hebei Medical University from January 2012 to December 2017 (N = 66 977), including demographic information and risk factors of hypertension. The hypertension prevalence, awareness, and control rates of people were evaluated according to the new guideline. Additionally, the factors related to hypertension prevalence were also assessed. According to previous HBP guideline, hypertension prevalence, awareness, and control rate were 30.54%, 44.33%, and 13.04%, respectively. However, when the 2017 ACC/AHA HBP guideline was introduced, the population with hypertension increased from 20 453 to 34 460, the hypertension prevalence rate increased from 30.54% to 51.45%, the awareness rate decreased from 44.33% to 26.31%, and the control rate declined from 13.04% to 2.72%. The most newly diagnosed hypertension patients were from the low‐risk population with young age and without the above histories. The 2017ACC/AHA HBP guideline indicated that high hypertension prevalence rate still existed with a substantial increase, while the awareness and control rates were relatively lowered.     

Worsening Hypertension Awareness,Treatment, and Control Rates in Canadian Women Between 2007 and 2017

BackgroundHypertension continues to be the leading cause of preventable death and disability. The objective of this study was to examine hypertension prevalence, awareness, treatment, and control for women and men in Canada over the last decade.MethodsA nationally representative, cross-sectional study was conducted using the Canadian Health Measures Survey (2007-2017). Using blood pressure readings from each respondent, along with a self-reported history of high blood pressure and active medications, the rates of hypertension prevalence, awareness, treatment, and control were calculated for women and men.ResultsA total of 5,794,641 people were identified to have hypertension from 2007 to 2017, representing 23.1% (95% confidence interval [CI], 21.9%-24.2%) of the Canadian adult population with no appreciable change in prevalence over the decade. Overall awareness, treatment, and control were 83.5% (95% CI, 81.5%-85.4%), 78.9% (95% CI, 76.2%-81.6%), and 65.4% (95% CI, 62.4%-68.4%), respectively, with no significant changes in men from 2007 to 2017. Conversely, in women, substantial deteriorations in awareness (72.2% [95% CI, 64.1%-80.2%] in 2016-2017 vs 85.0% [95% CI, 82.4%-87.7%] in 2007-2015), treatment (65.2% [95% CI, 57.6%-72.8%] vs 82.2% [95% CI, 79.4%-85.1%]), and control (49.2% [95% CI, 39.7%-58.7%] vs 67.0% [95% CI, 63.9%-70.1%]) were found.ConclusionsAfter plateauing early in the 2000s, Canadian hypertension treatment and control rates have declined in the past decade, largely in women. Renewed collaborative efforts by key stakeholders are urgently needed to address this increase in preventable risk for cardiovascular disease.     

Hypertension in developing economies: a review of population-based studies carried out from 1980 to 1998

AIM: Hypertension is an established major risk factor underlying the epidemic of coronary and cardiovascular diseases in most developed countries, and it has been shown to be a public health problem in many developing countries since the 1970s. This review was carried out to illustrate the current situation with regard to blood pressure levels and the prevalence and management of hypertension in developing countries. METHODS: A search for papers published in medical journals from 1991 to 1998 was performed using the MEDLINE database. A total of 40 articles were selected according to previously defined criteria. RESULTS: Hypertension is a public health problem for most of the developing countries reviewed, and it is frequently associated with low levels of awareness, treatment and control. A positive association between the gross national product per capita and the prevalence of hypertension in developing countries is also evident. CONCLUSIONS: Differences in methodology between national surveys make international comparisons difficult. Nevertheless, low-cost hypertension control programmes in developing countries are needed, along with development of the primary prevention of hypertension.     

Large increases in hypertension diagnosis and treatment in Canada after a healthcare professional education program

This study was conducted to compare the self-reported prevalence and treatment of hypertension in adult Canadians before and subsequent to the implementation of the Canadian Hypertension Education Program in 1999. Data were obtained from 5 cycles of the Canadian Health Surveys between 1994 and 2003 on respondents aged > or = 20 years. Piecewise linear regression was used to calculate the average annual increase in rates, before and after 1999. Between 1994 and 2003, the percentage of adult Canadians aware of being diagnosed with hypertension increased by 51% (from 12.37% to 18.74%; P<0.001), and the percentage prescribed antihypertensive drugs increased by 66% (from 9.57% to 15.86%; P<0.001). After 1999, there was approximately a doubling of the annual rate of increase in the diagnosis of hypertension (from 0.52% of the population per year before 1999 to 1.03% per year after 1999; P<0.001) and the percentage prescribed antihypertensive drugs (from 0.54% of the population per year before 1999 versus 0.98% per year after 1999; P<0.001). The proportion of those aware of the diagnosis of hypertension but not being treated with drugs was reduced by half between 1994 and 2003 (from 31.47% untreated to 15.34% untreated; P<0.001). There was a greater increase in awareness of hypertension and use of antihypertensive drugs among men compared with women after 1999. The large increase in the diagnosis and treatment of hypertension in Canada between 1994 and 2003 is consistent with an overall beneficial effect of the Canadian Hypertension Education Program, including a reduced gender gap in hypertension care.