HIGH PREVALENCE OF NEW HYPERTENSION AND EARLY VASCULAR AGING: A REPORT FROM MAY MEASUREMENT MONTH 2019 SCREENING PROGRAMME IN BULGARIA

Abstract

Objective: Hypertension remains a major public health issue with inadequate control worldwide. The May Measurement Month (MMM) initiative by the International Society of Hypertension was implemented in Bulgaria in 2019 aiming to raise hypertension awareness and control. Increased arterial stiffness may indicate high cardiovascular risk, but little is known about its prevalence at the population level. Design and method: Adult volunteers (>18 years) were recruited through opportunistic screening in 21 of 28 administrative areas in the country. Information on medical history and triplicate sitting blood pressure (BP) measurements were obtained using validated automated upperarm devices. Aortic pulse wave velocity (aoPWV) was estimated, using age, systolic BP, and waveform characteristics. Using age-specific percentiles from a nonhypertensive group, we defined healthy (HVA) and early (EVA) vascular aging. Results: A total of 3678 participants were analyzed [mean age 58.8±16.5 years, men 37.2%, 71.2% had BP measurement in the last 12 months]. Mean BP was 135/82 mm Hg. In all, 45.4% of participants had elevated BPs (>140/90 mm Hg), 58.3% out of 1910 participants with known hypertension, and 31.4% out of 1768 participants without known hypertension. In all, 4,67% of participants had aoPWV below 10th reference percentile (HVA), with a negligible proportion above 50 years. In total, 40.5% were above the 90th reference percentile (EVA), with proportions rising from one-quarter in youngest partcipants bellow 50 to one-half in oldest participants. In participants with EVA, BP was elevated during the measurement in 82.6%. Among participants without established HTN, according to European guidelines in 18.4 % BP was elevated, when measured during the campaign. The lowest proportion of newly diagnosed hypertension was found in HVA group – 4.8% and the highest 30% in EVA group. Figure 1 gives information for blood pressure measured according to quintiles of vascular aging groups. Conclusions: The prevalence of hypertension in Bulgaria is high, with considerable potential for improving awareness, treatment, and control. The high prevalence of early vascular aging and higher incidence of newly diagnosed hypertension in this group of patient at early age is alarming.