Am Heart J. Eur J Cardiovasc Prev Rehabil. Tidsskr Nor Legeforen. Norsk Epidemiologi. Statistical Yearbook of Norway. Petursson H, Getz L, Sigurdsson JA, Hetlevik I: Can individuals with a significant risk for cardiovascular disease be adequately identified by combination of several risk factors?
J Eval Clin Pract. The Framingham heart study. Arch Int Med. J Am Coll Cardiol. Pulsatile blood pressure component as predictor of mortality in hypertension: a meta-analysis of clinical trial control groups. Am J Hypertens. Nutr Metab Cardiovasc Dis. Clin Sci Lond. Arbeids- og velferdsdirektoratet. Konsultationsstatistik for NAV-rapport no 4. Edited by: Nossen JP. World's largest study of heart disease, stroke, risk factors, and population trends A descriptive epidemiological study.
Scand J Prim Health Care. Exp Clin Cardol. World Health Organisation: European health for all database. PloS Med. PhD thesis. Getz L: Sustainable and responsible preventive medicine. Conceputalising ethical dilemmas arising from clinical implementation of advancing medical technology. Download references. You can also search for this author in PubMed Google Scholar. Correspondence to Halfdan Petursson. JAS and LG conceived the study idea. HP analysed the data and wrote the first draft.
All authors participated in further revisions of the paper and approved the final version. This article is published under license to BioMed Central Ltd. Reprints and Permissions. Petursson, H. Current European guidelines for management of arterial hypertension: Are they adequate for use in primary care? BMC Fam Pract 10, 70 Download citation. Received : 17 March Accepted : 30 October Published : 30 October Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article.
Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Research article Open Access Published: 30 October Current European guidelines for management of arterial hypertension: Are they adequate for use in primary care? Abstract Background Previous studies indicate that clinical guidelines using combined risk evaluation for cardiovascular diseases CVD may overestimate risk.
Conclusion The potential workload associated with the European hypertension guidelines could destabilise the healthcare system in Norway, one of the world's most long- and healthy-living nations, by international comparison.
Background The interest in preventive measures for cardiovascular diseases CVD has escalated in the last decades [ 1 ]. Table 1 Participants in the study Full size table. Figure 1. Full size image. Figure 2. Figure 3. Figure 4. Discussion Modelling the implementation of current European guidelines on arterial hypertension [ 13 ] on a general population of Norwegian adults, aged , we found that Conclusion Our findings indicate that the European blood pressure guidelines have an inherent potential to destabilise the healthcare system in Norway, one of the world's most long- and healthy-living nations, by international comparison.
References 1. Article Google Scholar 4. Google Scholar 5. Article PubMed Google Scholar 7. Article Google Scholar 8. Article PubMed Google Scholar 9. Article Google Scholar PubMed Google Scholar Article PubMed Google Scholar Google Scholar Reason for this unexpected, yet replicated, association is not clear.
Our results have to be interpreted within the context of the Swiss health care system. Health insurance is compulsory for all citizens of Switzerland 7 millions and insurance premiums are paid independently of earnings [56] , [57]. Subsidies are paid for citizens with low income. Health insurance covers the costs of medical treatment and hospitalisation of the insured.
In contrast to basic insurance, insurers may refuse applicants for private insurance or only accept them subject to conditions. Switzerland has the highest out of pocket participation within countries of the Organisation for Economic Co-operation and Development [58]. Yet, we found no independent associations between monthly household income — a proxy of an individual financial resources — and hypertension, awareness, treatment, or control.
When interpreting the findings of this study, one has to keep in mind its limitations. Non participants slightly differed from participants with respect to sex, age and Swiss citizenship.
Given that our results suggested that age, smoking status and gender are significant predictors of study outcomes, these differences may somewhat limit the generalisability of our findings. Several informations were determined by the use of questionnaires. By nature of its reliance on self-reported data, this is a source of possible bias. Similarly to other large population-based studies, white coat effect, white coat hypertension, or masked hypertension could not be determined in this analysis.
BP was measured with two different methods; mercury sphygmanometer — and semi-automatic oscillometer — Although semi-automatic oscillometer are calibrated with mercury sphygmanometer, we cannot exclude that some of the differences observed between the two periods are attributable to the method of BP measurement. Yet, it is also possible that the antihypertension guidelines e. The study protocole and procedures remained identical.
Yet, we cannot exclude some interference between the two studies. The strengths of this study are the secular comparison of prevalences using the same definition, in the same source population, using the same number of BP readings. In conclusion, in a representative sample of the canton of Geneva, Switzerland, the prevalence of hypertension remained stable between — and — Population-based primary prevention measures are needed to decrease the burden of hypertension in this region.
While favorable trends in hypertension unawareness and uncontrolled hypertension occurred during this period, about half of hypertensive subjects were not treated or had uncontrolled high BP in the latest — survey period. Factors associated with untreated and uncontrolled hypertension in our analyses could guide the implementation of targeted interventions aimed at reducing these rates.
Flow chart of age-standardized prevalences of hypertension, unawareness, untreated, and uncontrolled hypertension, by survey period. Age-standardized prevalences of the four mutually exclusive categories of participants with hypertension, by survey period.
Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field. Abstract Background There are no time trends in prevalence, unawareness, treatment, and control of hypertension in Switzerland. Conclusions Hypertension prevalence remained stable since in the canton of Geneva. Introduction Hypertension is one of the major causes of disease burden worldwide [1]. Physical Activity and Alcohol Consumption Physical activity levels were quantified using a physical activity frequency questionnaire PAFQ , developed in the Geneva general adult population and validated using heart rate monitoring [18].
Statistical Analyses Statistical analyses were performed using Stata Download: PPT. Table 1. Trends in Hypertension, Unawareness, Untreated and Uncontrolled Hypertension Prevalences The overall age-standardized prevalence of hypertension was Figure 1. Age-standardized prevalences of hypertension, unawareness, untreated, and uncontrolled hypertension, by gender and survey year. Determinants of Hypertension Multivariate associations of characteristics with hypertension are reported by periods in Table 2.
Table 2. Determinants of Hypertension Unawareness In the — period, current smokers were more likely to be unaware of having hypertension compared to never and ex-smokers. Determinants of Untreated Hypertension In the first survey period, sedentarity, hypercholesterolemia, and older age were associated with a lower risk of untreated hypertension.
Determinants of Uncontrolled Hypertension Male gender and sedentarity were associated with increased risk of uncontrolled hypertension in the first survey period, while only male gender remained associated with uncontrolled hypertension in the second survey period.
Prevalence of Hypertension, Unawareness, Untreated and Uncontrolled Hypertension, by Monthly Household Income and Job Position Information on monthly household income and job position collected since was available for 2, Prevalences in Mutually Exclusive Groups Figure S2 illustrated the prevalences of the four mutually exclusive groups among participants with hypertension: unaware; aware, not treated; aware, treated, not controlled; aware, treated, and controlled.
Strengths and Limitations When interpreting the findings of this study, one has to keep in mind its limitations. Supporting Information. Figure S1. Figure S2. Table S1. Table S2. Table S3.
Table S4. Acknowledgments The authors thank the collaborators of the Unit of Population Epidemiology. References 1. Lancet — View Article Google Scholar 2. J Hypertens 11— View Article Google Scholar 3. Arch Intern Med — View Article Google Scholar 4. JAMA — View Article Google Scholar 5. CMAJ — View Article Google Scholar 6. View Article Google Scholar 7. Eur J Cardiovasc Prev Rehabil 66— View Article Google Scholar 8.
Accessed 15 May Accessed 11 March Hypertension — View Article Google Scholar J Hypertens — Cardiovasc Diabetol 8: Hypertens Res — J Hum Hypertens — J Hum Hypertens 23 : — Ibrahim MM , Damasceno A , Hypertension in developing countries.
Gostin LO , Hypertension awareness, treatment and control in Ghana: a cross-sectional study. Ethn Health 1 — High blood presure for people aged more than 60 years in the distrct of Sousse. La Tunisie Medicale 82 : — Among 13, Ghanaians aged 15—49 years, the prevalence of hypertension was The overall increase in prevalence was The increment in prevalence was People aged 40—49 years had the highest prevalence We used multiple logistic regressions to obtain odds ratios.
Urban dwelling, tertiary education, or being in higher wealth status was significantly associated with the odds of hypertension. Scaling up of existing prevention and control strategies for hypertension such as health education through already established community health implementation and planning programs as well as improved screening and diagnostic protocols for hypertension should be prioritized.
Hypertension accounts for about one-third of the global burden of disease according to estimates. For this group of people, lifestyle modification to control BP is recommended to slow down disease progression and complications if they have no history of CVD or low year predicted risk for CVD.
It covered all rural, urban, and noninstitutionalized individuals residing within all 10 administrative regions of Ghana. The GDHS focused on child and maternal health as well as other health issues and provides relevant data for monitoring population health.
In all, clusters were selected: and in urban localities with 5, or more people and rural localities with less than 5, people , 10 respectively. In the second stage, a systematic sampling of households listed in each cluster yielded a nationally representative sample of 9, women and 4, men between the ages 15—49 years and 15—59 years, respectively.
The Institutional Review Board of the University of Maryland, Baltimore, determined that this study met the criteria for nonhuman subject research because of the use of publicly available and de-identified data.
Blood pressure was measured using a digital oscillometric BP measuring device. Supplemental Table 1 shows the definition, categorization, and the method of measurement of all study variables used for estimating the prevalence of hypertension. We limited our analysis to individuals aged 15—49 years to have a uniform age stratum for both men and women and used sampling weights to create nationally representative estimates.
The study participants were described according to their background characteristics. We assessed the normality of continuous variables using standard methods and reported variables with skewed distribution as median and interquartile ranges IQRs as opposed to mean and SD. We categorized SBP and DBP according to both guidelines and estimated the proportion of the study population falling into each category overall and by gender.
The proportion of participants taking BP-lowering drugs was also reported. The differences between the prevalence estimates of both guidelines were also obtained. All analyses were conducted in Stata statistical software version Table 1 describes study participants. Among 13, included respondents, the median age was 29 years IQR: 21—38 and the majority of them were women The participants in the sample were predominantly Christian More than half of the respondents were from urban regions Supplemental Table 2 shows the background characteristics of the respondents before application of weighting; these were similar to the characteristics of the weighted respondents.
According to the JNC7 guideline, The estimated prevalence changed from Men and women had similar absolute changes in crude prevalence, Regardless of the criteria, the prevalence of hypertension increased substantially. The fully adjusted model included age, gender, education, household wealth status, place of residence, and region. Participants aged 40—49 years AOR: 5. Compared with those in the poorest wealth quintile, being in the middle AOR: 1. Compared with urban dwellers, participants living in rural areas were less likely to have hypertension AOR: 0.
Participants living in the Northern AOR: 0. To determine whether the effect of wealth quintile and education level on the odds of having hypertension is modified by the place of residence, we evaluated the interaction between wealth quintiles and education level on the place of residence and found no evidence of interaction, suggesting that place of residence does not modify the effect of wealth or educational level on the odds of hyperattention Supplemental Table 3.
This study highlights the impact of the revised definition of hypertension on the changes in the prevalence of hypertension in Ghana. The prevalence of hypertension is often higher among older adults e.
Accumulating evidence suggests that lifestyle modification 20 , 21 and pharmacologic treatment 22 of prehypertension 5 demonstrate positive benefit in lowering BP and reduction in the risk for CVD, CVD complications, and mortality.
The high prevalence of hypertension observed among people living in urban areas, among those with tertiary-level educations, and among wealthy households is corroborated by studies conducted in Bangladesh.
Tertiary-level education was associated with higher prevalence and the odds of hypertension. Individuals with tertiary education are more likely to be in the richest wealth quintile and may adopt unhealthy eating habits associated with their affluent status. Conversely, there was protective effect of rural habitation, living in the Northern, Upper East, or Upper West regions, on the odds of hypertension.
Our findings have significant policy, public health and clinical practice implications. Lack of access to antihypertensive medications, medication noncompliance, and lack of access to health care may also explain the low rate of therapy among hypertensive individuals observed in our study.
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