Prevalence of hypertension in women under 50 in the PICTURE cohort study

Abstract

Abstract Background Epidemiological data indicate an upward trend in hypertension (HT) prevalence in the recent decades. The risk of elevated blood pressure (BP) significantly increases with age, but it has been observed also in the younger population. Currently it is estimated that nearly 10 million adults in Poland have HT. Despite some improvement in treatment and BP control, they are still below expectations in the Polish population. Common misconception assumes that HT rarely occurs in women in comparison to men, which can lead to lower awareness, lower participation in routine screening and delayed diagnosis, especially in younger women. Purpose To assess the prevalence of hypertension (HT) among women under 50 years of age in the PICTURE cohort study. Methods The analysis is based on 769 women (average age 41.6±4.2 years) participating in "Population Cohort Study of Wroclaw Citizens (PICTURE)" established between 2019 and 2021. HT was diagnosed based on (1) patient-reported HT previously diagnosed by a physician, and/or (2) patient-reported intake of hypotensive medication, and/or (3) the average of two blood pressure measurements of systolic ≥140 mmHg and/or diastolic ≥90 mmHg. Additional analysis included other parameters such as BMI, WHR, attitudes toward tobacco smoking and alcohol consumption. Results HT was diagnosed in 12.5% of women under 50 years of age. More than half (55.2%) of HT cases in this group were previously undiagnosed. Women with hypertension had significantly higher chance of excessive body mass and abdominal obesity in comparison to women with normal BP. Excessive body weight characterized 68.7% of women with HT vs 34.5% without HT (p<0.0001), whereas abdominal obesity characterized 71.9% of women with HT vs 44.8% without HT (p<0.0001). Tobacco smoking was more prevalent among women with HT. A total of 21.3% of women with HT were current tobacco smokers vs 11.8% without HT (p=0.01). Conclusions More than half of HT cases were previously undiagnosed. Majority of HT cases in women were associated with traditional modifiable risk factors including excessive body mass, abdominal obesity and tobacco smoking. Intensive screening programs to increase HT diagnosis should be introduced in younger age groups, also in younger women.