Prevalence, awareness, treatment, and control of hypertension and their determinants: Results from the first cohort of non-communicable diseases in a Kurdish settlement

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Abstract

Hypertension is a public health issue in Iran. The study aimed to estimate the prevalence, awareness, treatment, and control of hypertension, and to explore their determinants among 10,040 Kurdish adults from Ravansar Non-Communicable Disease (RaNCD) cohort study in Iran. Univariate, and multivariate analyses were used for statistical analysis. Prevalence of hypertension was 15.7%. Among hypertensive patients, awareness, treatment, and control of hypertension were 80.7%, 73.2%, and 53.3%, respectively. In multivariate analysis, significant associations were found between awareness and female sex, older age, being married rather than being single, literacy, living in rural areas, having family history, and comorbidities, with a higher probability for those who had both diabetes and dyslipidemia. Being married, living in rural areas, being ex-smokers, having less physical activity and individuals who had diabetes and dyslipidemia had higher odds of receiving treatment. Being female had a statistically significant association with the control of hypertension. The Kurdish population had higher awareness, with a greater proportion of treated, and controlled patients compared to populations included in previous studies for the last 20 years in Iran. With the continuing health promotion programs in Iran, it is expected to observe a lower prevalence of hypertension, higher awareness and greater number of treated individuals with controlled hypertension.

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Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States.

Katharina Wolf-Maier, Richard Cooper, José R. Banegas … (2003)

Geographic variations in cardiovascular disease (CVD) and associated risk factors have been recognized worldwide. However, little attention has been directed to potential differences in hypertension between Europe and North America. To determine whether higher blood pressure (BP) levels and hypertension are more prevalent in Europe than in the United States and Canada. Sample surveys that were national in scope and conducted in the 1990s were identified in Germany, Finland, Sweden, England, Spain, Italy, Canada, and the United States. Collaborating investigators provided tabular data in a consistent format by age and sex for persons at least 35 years of age. Population registries were the main basis for sampling. Survey sizes ranged from 1800 to 23 100, with response rates of 61% to 87.5%. The data were analyzed to provide age-specific and age-adjusted estimates of BP and hypertension prevalence by country and region (eg, European vs North American). Blood pressure levels and prevalence of hypertension in Europe, the United States, and Canada. Average BP was 136/83 mm Hg in the European countries and 127/77 mm Hg in Canada and the United States among men and women combined who were 35 to 74 years of age. This difference already existed among younger persons (35-39 years) in whom treatment was uncommon (ie, 124/78 mm Hg and 115/75 mm Hg, respectively), and the slope with age was steeper in the European countries. For all age groups, BP measurements were lowest in the United States and highest in Germany. The age- and sex-adjusted prevalence of hypertension was 28% in the North American countries and 44% in the European countries at the 140/90 mm Hg threshold. The findings for men and women by region were similar. Hypertension prevalence was strongly correlated with stroke mortality (r = 0.78) and more modestly with total CVD (r = 0.44). Despite extensive research on geographic patterns of CVD, the 60% higher prevalence of hypertension in Europe compared with the United States and Canada has not been generally appreciated. The implication of this finding for national prevention strategies should be vigorously explored.

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Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000.

Ihab Hajjar, Theodore Kotchen (2003)

Prior analyses of National Health and Nutrition Examination Survey (NHANES) data through 1991 have suggested that hypertension prevalence is declining, but more recent self-reported rates of hypertension suggest that the rate is increasing. To describe trends in the prevalence, awareness, treatment, and control of hypertension in the United States using NHANES data. Survey using a stratified multistage probability sample of the civilian noninstitutionalized population. The most recent NHANES survey, conducted in 1999-2000 (n = 5448), was compared with the 2 phases of NHANES III conducted in 1988-1991 (n = 9901) and 1991-1994 (n = 9717). Individuals aged 18 years or older were included in this analysis. Hypertension, defined as a measured blood pressure of 140/90 mm Hg or greater or reported use of antihypertensive medications. Hypertension awareness and treatment were assessed with standardized questions. Hypertension control was defined as treatment with antihypertensive medication and a measured blood pressure of less than 140/90 mm Hg. In 1999-2000, 28.7% of NHANES participants had hypertension, an increase of 3.7% (95% confidence interval [CI], 0%-8.3%) from 1988-1991. Hypertension prevalence was highest in non-Hispanic blacks (33.5%), increased with age (65.4% among those aged > or =60 years), and tended to be higher in women (30.1%). In a multiple regression analysis, increasing age, increasing body mass index, and non-Hispanic black race/ethnicity were independently associated with increased rates of hypertension. Overall, in 1999-2000, 68.9% were aware of their hypertension (nonsignificant decline of -0.3%; 95% CI, -4.2% to 3.6%), 58.4% were treated (increase of 6.0%; 95% CI, 1.2%-10.8%), and hypertension was controlled in 31.0% (increase of 6.4%; 95% CI, 1.6%-11.2%). Women, Mexican Americans, and those aged 60 years or older had significantly lower rates of control compared with men, younger individuals, and non-Hispanic whites. Contrary to earlier reports, hypertension prevalence is increasing in the United States. Hypertension control rates, although improving, continue to be low. Programs targeting hypertension prevention and treatment are of utmost importance.

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Author and article information

Contributors

Farid Najafi: fnajafi@kums.ac.ir

Journal

Journal ID (nlm-ta): Sci Rep

Journal ID (iso-abbrev): Sci Rep

Title: Scientific Reports

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2045-2322

Publication date (Electronic): 27 August 2019

Publication date PMC-release: 27 August 2019

Publication date Collection: 2019

Volume: 9

Electronic Location Identifier: 12409

Affiliations

[1 ]ISNI 0000 0001 2012 5829, GRID grid.412112.5, Research Center for Environmental Determinants of Health, Health Institute, , Kermanshah University of Medical Sciences, ; Kermanshah, Iran

[2 ]ISNI 0000 0001 2012 5829, GRID grid.412112.5, Social Development & Health Promotion Research Center, Health Institute, , Kermanshah University of Medical Sciences, ; Kermanshah, Iran

[3 ]College of Medicine, Department of Psychiatry, Charles Drew University of Medicine and Science & University of California at Los Angels (UCLA), Los Angels, USA

[4 ]ISNI 0000 0001 2012 5829, GRID grid.412112.5, Kermanshah Cardiovascular Research Center, Health Institute, , Kermanshah University of Medical Sciences, ; Kermanshah, Iran

Article

Publisher ID: 48232

DOI: 10.1038/s41598-019-48232-y

PMC ID: 6711962

PubMed ID: 31455810

SO-VID: 5f7979c2-b6ef-42da-a92e-4c49b5897e31

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Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 24 January 2019

Date accepted : 25 July 2019

Funding

Funded by: FundRef https://doi.org/10.13039/501100005317, Kermanshah University of Medical Sciences;

Award ID: KUMS.REC.1394.315

Award Recipient : Fatemeh Rajati Behrooz Hamzeh Yahya Pasdar Roya Safari Mehdi Moradinazar Shahrzad Bazargan-Hejazi Hossein Karim Farid Najafi

Funded by: Kermanshah University of Medical Sciences. The registry number is KUMS.REC.1394.315.

Funded by: Kermanshah University of Medical Sciences,The registry number is KUMS.REC.1394.315.

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Keywords: hypertension,epidemiology

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ScienceOpen disciplines: Uncategorized

Keywords: hypertension, epidemiology

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Prevalence, awareness, treatment, and control of hypertension and their determinants: Results from the first cohort of non-communicable diseases in a Kurdish settlement

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Most cited references 50

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States.

Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000.

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