Abstract
BackgroundArterial hypertension (AH) is a main risk factor for the risk from cardiovascular (CVD) and stroke mortality. Only few data was published on prevalence, awareness and management of AH in Lithuania. Development of objective approaches to the treatment and control of AH reduces the risk of mortality. The aim of this study was to evaluate time trends, the prevalence, awareness, treatment and control of AH and risk of mortality among Lithuanian urban population aged 45–64 years during the period of 1983–2009.MethodsTime trends of AH and risk of mortality were examined in three MONICA health surveys in 1983, 1986, 1992, and in one health survey according to MONICA protocol in 2002 included randomly recruited of 2,218 men and 2,491 women. AH was defined as systolic blood pressure (BP) ≥140 mmHg and/or diastolic BP of ≥90 mmHg or current use of antihypertensive medication. The main outcome measures were all-cause mortality, mortality from CVD, coronary heart disease (CHD) and stroke. The mean duration of follow-up was 11.8 ± 9.2 years. All survey periods were age standardized to the year 2006 of Kaunas population. The estimates of hazard ratio and 95% confidence interval were based on the multivariate Cox proportional hazards regression.ResultsIn men during 1983–2002 period hypertension prevalence was 52.1–58.7% and did not significantly change whereas in women decreased from 61.0 to 51.0%. There was a significant increase in hypertension awareness among hypertensive men and women (45.0 to 64.4% and 47.7 to 72.3%, respectively) and in treated hypertensives (55.4 to 68.3% in men and 65.6 to 86.2% in women). Adjusted Cox proportional hazard regression analyses revealed a strong dose–response association between blood-pressure level and all-cause, CVD, CHD and stroke-mortality risk in both men and women groups.ConclusionIn Lithuanian urban population the prevalence of hypertension remains high. Despite positive changes in hypertension awareness and treatment, hypertension control remains poor. A strong dose–response association between the level of BP and all-cause, CVD, CHD and stroke mortality risk was indicated.
Highlights
Arterial hypertension (AH) is a main risk factor for the risk from cardiovascular (CVD) and stroke mortality
Epidemiological data have showed that women have a better awareness of AH than do men and their AH is controlled better, but the low rate of control for both sexes calls for further improvements [9,10]
In women during 19 year period mean systolic blood pressure (BP) decreased from 158 (20.3) to 154 (18.9) mmHg (p < 0.05) and mean Body mass index (BMI) decreased in men from 32.1 (5.63) to 30.5 (5.36) kg/m2 comparing 1983–1984 and 1992–1993 random samples (p < 0.05)
Summary
Arterial hypertension (AH) is a main risk factor for the risk from cardiovascular (CVD) and stroke mortality. The aim of this study was to evaluate time trends, the prevalence, awareness, treatment and control of AH and risk of mortality among Lithuanian urban population aged 45–64 years during the period of 1983–2009. The review of population-based studies of the prevalence and mortality in Eastern European countries pointed out that the burden of cardiovascular diseases (CVD), coronary heart disease (CHD), and cerebrovascular diseases is high and shows no tendency to decrease in future decades [1]. The main elements of effective control include an improvement in the awareness of AH among both health professionals and the general population – especially among individuals with high BP. Effective treatment and control of AH reduces risk of mortality from CVD and stroke [7]. The effective populationbased and personal interventions should be targeted towards low-income and middle-income countries
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