Trends in hypertension prevalence (1990–2005) and mean blood pressure (1975–2005) in Portugal: a systematic review

Abstract

Aims. We aimed to describe the temporal trends of the mean blood pressure and prevalence of hypertension in studies that evaluated Portuguese adults. Methods. Pubmed was searched and 42 eligible studies were identified. Reference screening and data extraction were conducted independently by two researchers. We fitted linear regression models to compute ecological estimates of hypertension prevalence and mean blood pressure, adjusting for sex, age and significant interaction terms. Results. Between 1990 and 2005, the prevalence of hypertension defined as blood pressure ≥140/90 mmHg and/or drug treatment remained approximately constant in young adults and decreased in middle-aged and older adults, whereas the prevalence of self-reported hypertension increased 0.4% per year (95% confidence interval 0.1–0.7) overall. Between 1975 and 2005, mean systolic and diastolic blood pressures decreased in middle-aged and older adults, reaching a 32-mmHg decrease in systolic blood pressure among women at average age 70. Conclusion. The trends in the last decades show a decrease in blood pressure levels, probably attributable to increasing awareness and a higher treatment proportion. Although this absolute trend in blood pressure parallels the observed in other high income European countries, Portugal maintains its position above the mean levels in other Western settings.