This study is aimed to assess the prevalence of awareness, treatment and control of high blood pressure (HBP) and associated factors in a Swiss city.
Design
Population-based cross-sectional study of 6182 participants (52.5% women) aged 35-75 years living in Lausanne, Switzerland.
Methods
HBP was defined as blood pressure ≥ 140/90 mmHg or current antihypertensive medication.
Results
The overall prevalence of HBP was 36% (95% confidence interval: 35-38%). Among participants with HBP, 63% were aware of it. Among participants aware of HBP, 78% were treated, and among those treated, 48% were controlled (BP <140/90 mmHg). In multivariate analysis, HBP prevalence was associated with older age, male sex, low educational level, high alcohol intake, awareness of diabetes or dyslipidaemia, obesity and parental history of myocardial infarction. HBP awareness was associated with older age, female sex, awareness of diabetes or dyslipidaemia, obesity and parental history of myocardial infarction. HBP control was associated with younger age, higher educational level and no alcohol intake. Alone or in combination, sartans were the most often prescribed antihypertensive medication category (41%), followed by diuretics, β-blockers, angiotensin converting enzyme inhibitors and calcium channel blockers. Only 31% of participants treated for HBP were taking ≥ 2 antihypertensive medications.
LawesCMVan Der HoornSLawMRElliottPMacMahonSRodgersA. Blood pressure and the global burden of disease 2000. Part 1: estimates of blood pressure levels. J Hypertens2006; 24:413–422.
2.
SmithWCLeeAJCrombieIKTunstall-PedoeH. Control of blood pressure in Scotland: the rule of halves. Br Med J1990; 300:981–983.
3.
AntikainenRLMoltchanovVAChukwumaCSrKuulasmaaKAMarques-VidalPMSansSTrends in the prevalence, awareness, treatment and control of hypertension: the WHO MONICA Project. Eur J Cardiovasc Prev Rehabil2006; 13:13–29.
4.
KearneyPMWheltonMReynoldsKWheltonPKHeJ. Worldwide prevalence of hypertension: a systematic review. J Hypertens2004; 22:11–19.
5.
Wolf-MaierKCooperRSKramerHBanegasJRGiampaoliSJoffresMRHypertension treatment and control in five European countries, Canada, and the United States. Hypertension2004; 43:10–17.
6.
WangYRAlexanderGCStaffordRS. Outpatient hypertension treatment, treatment intensification, and control in Western Europe and the United States. Arch Intern Med2007; 167:141–147.
7.
HajjarIKotchenTA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000. JAMA2003; 290: 199–206.
8.
Marques-VidalPArveilerDAmouyelPBinghamAFerrièresJ. Sex differences in awareness and control of hypertension in France. J Hypertens1997; 15:1205–1210.
9.
SamalDGreiseneggerSAuffELangWLalouschekW. The relation between knowledge about hypertension and education in hospitalized patients with stroke in Vienna. Stroke2007; 38:1304–1308.
10.
GilesTArandaJMJrSuhDCChoiISPreblickRRochaREthnic/racial variations in blood pressure awareness, treatment, and control. J Clin Hypertens (Greenwich)2007; 9:345–354.
11.
BrindelPHanonODartiguesJFRitchieKLacombeJMDucimetièrePPrevalence, awareness, treatment, and control of hypertension in the elderly: the Three City Study. J Hypertens2006; 24:51–58.
12.
HymanDJPavlikVNVallbonaC. Physician role in lack of awareness and control of hypertension. J Clin Hypertens2000; 2:324–330.
13.
WietlisbachVPaccaudFRickenbachMGutzwillerF. Trends in cardiovascular risk factors (1984–1993) in a Swiss region: results of three population surveys. Prev Med1997; 26:523–533.
14.
GalobardesBCostanzaMCBernsteinMSDelhumeauCHMorabiaA. Trends in risk factors for the major ‘lifestyle-related diseases’ in Geneva, Switzerland, 1993–2000. Ann Epidemiol2003; 13:537–540.
15.
FirmannMMayorVMarques-VidalPBochudMPécoudAHayozDThe CoLaus study: a population-based study to investigate the epidemiology and genetic determinants of cardiovascular risk factors and metabolic syndrome. BMC Cardiovasc Disord2008; 8:6.
16.
WhitworthJA. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens2003; 21:1983–1992.
17.
Tunstall-PedoeHKuulasmaaKTolonenHDavidsonMMendisS. MONICA monograph and multimedia sourcebook. World's largest study of heart disease, stroke, risk factors, and population trends 1979–2002. Geneva: WHO; 2003.
18.
Office fédéral de la statistique. Hypertension artérielle. Enquête suisse sur la santé2002–2006.
19.
Tunstall-PedoeHConnaghanJWoodwardMTolonenHKuulasmaaK. Pattern of declining blood pressure across replicate population surveys of the WHO MONICA project, mid-1980s to mid-1990s, and the role of medication. Br Med J2006; 332:629–635.
20.
SunZZhengLDetranoRZhangDZhangXXuCThe accelerating epidemic of hypertension among rural Chinese women: results from Liaoning Province. Am J Hypertens2008; 21:784–788.
21.
BovetPGervasoniJPRossAGMkambaMMtasiwaDMLengelerCAssessing the prevalence of hypertension in populations: are we doing it right?J Hypertens2003; 21:509–517.
22.
FuentesRIlmaniemiNLaurikainenETuomilehtoJNissinenA. Hypertension in developing economies: a review of population-based studies carried out from 1980 to 1998. J Hypertens2000; 18:521–529.
23.
Marques-VidalPTuomilehtoJ. Hypertension awareness, treatment and control in the community: is the ‘rule of halves’ still valid?J Hum Hypertens1997; 11:213–220.
24.
Orduñez-GarciaPMunozJLPedrazaDEspinosa-BritoASilvaLCCooperRS. Success in control of hypertension in a low-resource setting: the Cuban experience. J Hypertens2006; 24:845–849.
25.
Danon-HerschNChioleroAShamlayeCPaccaudFBovetP. Decreasing association between body mass index and blood pressure over time. Epidemiology2007; 18:493–500.
26.
BorzeckiAMGlickmanMEKaderBBerlowitzDR. The effect of age on hypertension control and management. Am J Hypertens2006; 19:520–527.
27.
BerlowitzDRAshASHickeyECFriedmanRHGlickmanMKaderBInadequate management of blood pressure in a hypertensive population. N Engl J Med1998; 339:1957–1963.
28.
YiannakopoulouECPapadopulosJSCokkinosDVMountokalakisTD. Adherence to antihypertensive treatment: a critical factor for blood pressure control. Eur J Cardiovasc Prev Rehabil2005; 12:243–249.
29.
ChenRTunstall-PedoeHMorrisonCConnaghanJA'BrookR. Trends and social factors in blood pressure control in Scottish MONICA surveys 1986–1995: the rule of halves revisited. J Hum Hypertens2003; 17:751–759.
30.
BovetPBurnierMMadeleineGWaeberBPaccaudF. Monitoring one-year compliance to antihypertension medication in the Seychelles. Bull World Health Organ2002; 80:33–39.
31.
PsaltopoulouTOrfanosPNaskaALenasDTrichopoulosDTrichopoulouA. Prevalence, awareness, treatment and control of hypertension in a general population sample of 26 913 adults in the Greek EPIC study. Int J Epidemiol2004; 33:1345–1352.
32.
Anonymous. 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens2003; 21:1011–1053.
33.
PittrowDKirchWBramlagePLehnertHHoflerMUngerTPatterns of antihypertensive drug utilization in primary care. Eur J Clin Pharmacol2004; 60:135–142.
34.
WolfHKKuulasmaaKTolonenHRuokokoskiE. Participation rates, quality of sampling frames and sampling fractions in the MONICA surveys. WHO MONICA Project 1998 September 15. Available from: URL: http://www.ktl.fi/publications/monica/nonres/nonres.htm.
35.
GaleaSTracyM. Participation rates in epidemiologic studies. Ann Epidemiol2007; 17:643–653.
36.
TaylorAWDalGEGillTChittleboroughCRWilsonDHAdamsRJDo people with risky behaviours participate in biomedical cohort studies?BMC Public Health2006; 6:11.
37.
Marques-VidalPRodondiNBochudMPécoudAHayozDPaccaudFPredictive accuracy and usefulness of calibration of the ESC SCORE in Switzerland. Eur J Cardiovasc Prev Rehabii2008; 15:402–408.
38.
Marques-VidalPRodondiNBochudMChioleroAPécoudAHayozDPredictive accuracy of original and recalibrated Framingham risk score in the Swiss populationInt J Cardiol2008 [Epub ahead of print].
