Longitudinal trends in blood pressure, prevalence, awareness, treatment, and control of hypertension in the Czech population. Are there any sex differences?

Background Hypertension is the most common cardiovascular disease which substantially increases cardiovascular morbidity and mortality. Despite the broad availability of antihypertensive medication, control of hypertension is not satisfactory worldwide. Objective The study aim was to assess longitudinal trends in blood pressure, prevalence, awareness, treatment, and control of hypertension in a representative population sample of the Czechia from 1985 to 2016/2017, focusing on sex differences. Methods A total of 7,606 men and 8,050 women aged 25–64 years were screened for major CV risk factors in seven independent cross-sectional surveys run consistently in the same six country districts of the Czechia between 1985 and 2016/2017. The population samples were randomly selected. Results Over a study period of 31/32 years, there was a significant decline in systolic and diastolic blood pressure in both sexes, whereas the prevalence of hypertension decreased only in women. There was an increase in hypertension awareness in both sexes over the entire study period with consistently higher rates in women. The proportion of individuals treated with antihypertensive drugs increased significantly in both sexes throughout the study, again with consistently higher rates in women. Control of hypertension increased significantly over the study period with consistently higher rates in women. The age-adjusted trends in blood pressure, prevalence, awareness, and treatment of hypertension were significantly different in men and women, always in favor of women. The age-adjusted trends in control of hypertension in treated patients were equally poor in both sexes. Conclusion There are significant differences in longitudinal trends in blood pressure, prevalence, awareness, treatment, and control of hypertension between men and women, always in favor of women except for the control of hypertension in treated patients, where it is equally poor in both sexes.

[1]  Gretchen A. Stevens,et al.  Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants , 2021, The Lancet.

[2]  A. Rosengren,et al.  Trends in blood pressure, blood lipids, and smoking from 259 753 patients with hypertension in a Swedish primary care register: results from QregPV. , 2021, European journal of preventive cardiology.

[3]  M. Ezzati,et al.  Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension , 2021, Nature Reviews Cardiology.

[4]  Deepak L. Bhatt,et al.  Association of Socioeconomic Disadvantage With Long-term Mortality After Myocardial Infarction: The Mass General Brigham YOUNG-MI Registry. , 2021, JAMA cardiology.

[5]  Deepak L. Bhatt,et al.  Women who experience a myocardial infarction at a young age have worse outcomes compared with men: the Mass General Brigham YOUNG-MI registry. , 2020, European heart journal.

[6]  Dan J Stein,et al.  Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 , 2020, Lancet.

[7]  Byron C. Jaeger,et al.  Trends in Blood Pressure Control Among US Adults With Hypertension, 1999-2000 to 2017-2018. , 2020, JAMA.

[8]  G. Mancia,et al.  Sex differences in the adherence of antihypertensive drugs: a systematic review with meta-analyses , 2020, BMJ Open.

[9]  J. Filipovský,et al.  30-year trends in major cardiovascular risk factors in the Czech population, Czech MONICA and Czech post-MONICA, 1985 – 2016/17 , 2020, PloS one.

[10]  Ji-Soo Kim,et al.  Gender Differences in Hypertension Treatment and Control in Young Adults , 2020, The journal of nursing research : JNR.

[11]  M. Delgado-Rodríguez,et al.  Systematic review and meta-analysis. , 2017, Medicina intensiva.

[12]  A. Moran,et al.  Trends in the Prevalence, Awareness, Treatment, and Control of Hypertension Among Young Adults in the United States, 1999 to 2014 , 2017, Hypertension.

[13]  Craig M. Hales,et al.  Hypertension Prevalence, Awareness, Treatment, and Control Among Adults Aged ≥18 Years — Los Angeles County, 1999–2006 and 2007–2014 , 2017, MMWR. Morbidity and mortality weekly report.

[14]  N. Samani,et al.  Risk Factors for Nonadherence to Antihypertensive Treatment , 2017, Hypertension.

[15]  H. Kim,et al.  Sex differences in hypertension prevalence and control: Analysis of the 2010-2014 Korea National Health and Nutrition Examination Survey , 2017, PloS one.

[16]  Hynek Pikhart,et al.  Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants , 2017, The Lancet.

[17]  A. Semplicini.  Faculty Opinions recommendation of Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants. , 2016 .

[18]  S. Anderson,et al.  Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis , 2016, The Lancet.

[19]  W. Freidl,et al.  Prevalent Long-Term Trends of Hypertension in Austria: The Impact of Obesity and Socio-Demography , 2015, PloS one.

[20]  J. Jansson,et al.  Long term trends in control of hypertension in the Northern Sweden MONICA study 1986–2009 , 2015, BMC Public Health.

[21]  K. Kuulasmaa,et al.  Differences in participation rates and lessons learned about recruitment of participants – The European Health Examination Survey Pilot Project , 2015, Scandinavian journal of public health.

[22]  H. Neuhauser,et al.  Hypertension prevalence, awareness, treatment and control in Germany 1998 and 2008–11 , 2014, Journal of Human Hypertension.

[23]  A. Semplicini.  Faculty Opinions recommendation of Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1·25 million people. , 2014 .

[24]  Harry Hemingway,et al.  Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1·25 million people , 2014, The Lancet.

[25]  D. Lukšienė,et al.  Trends in prevalence, awareness, treatment, and control of hypertension, and the risk of mortality among middle-aged Lithuanian urban population in 1983–2009 , 2012, BMC Cardiovascular Disorders.

[26]  E. Mohammadi,et al.  Barriers and facilitators related to the implementation of a physiological track and trigger system: A systematic review of the qualitative evidence , 2017, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[27]  D. Aarsland,et al.  Hypertension is a potential risk factor for vascular dementia: systematic review , 2011, International journal of geriatric psychiatry.

[28]  M. Tremblay,et al.  Changes in the rates of awareness, treatment and control of hypertension in Canada over the past two decades , 2011, Canadian Medical Association Journal.

[29]  R. Cífková,et al.  Longitudinal trends in major cardiovascular risk factors in the Czech population between 1985 and 2007/8. Czech MONICA and Czech post-MONICA. , 2010, Atherosclerosis.

[30]  N J Wald,et al.  Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies , 2009, BMJ : British Medical Journal.

[31]  M. Law.  Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies , 2009 .

[32]  G. Fodor,et al.  Results of the Ontario Survey on the Prevalence and Control of Hypertension , 2008, Canadian Medical Association Journal.

[33]  Vincent Mooser,et al.  The CoLaus study: a population-based study to investigate the epidemiology and genetic determinants of cardiovascular risk factors and metabolic syndrome , 2008, BMC cardiovascular disorders.

[34]  A. Dobson,et al.  Effect on Trend Estimates of the Difference between Survey Respondents and Non-respondents: Results from 27 Populations in the WHO MONICA Project , 2005, European Journal of Epidemiology.

[35]  H. Tunstall-Pedoe,et al.  Contribution of trends in survival and coronar y-event rates to changes in coronary heart disease mortality: 10-year results from 37 WHO MONICA Project populations , 1999, The Lancet.

[36]  H. Tunstall-Pedoe,et al.  Contribution of trends in survival and coronary-event rates to changes in coronary heart disease mortality: 10-year results from 37 WHO MONICA project populations. Monitoring trends and determinants in cardiovascular disease. , 1999, Lancet.

[37]  P Whelton,et al.  Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population. Data from the health examination surveys, 1960 to 1991. , 1995, Hypertension.