Prevalence, awareness, treatment and control of hypertension in a general population sample of 26,913 adults in the Greek EPIC study.

BACKGROUND Premature mortality from cardiovascular diseases could be prevented by the effective control of hypertension. Nationwide data for the status of hypertension in the adult Greek population are not available. METHODS In the context of the Greek component of the European Prospective Investigation into Cancer and nutrition (EPIC), 26 913 volunteers, aged 20-86 years, were recruited from several regions of Greece. Blood pressure measurements were taken by trained physicians and standard interviewing procedures were used to record medical history, and socio-demographic and lifestyle characteristics. The data were modelled through multiple regression. RESULTS The prevalence of hypertension (based on two arterial blood pressure measurements on a single occasion) is 40.2% for men and 38.9% for women (age-adjusted to the adult Greek population of 2001). In the sample examined, awareness among hypertensives is 54.4%, pharmaceutical treatment among those aware is 83.9%, and effective control among hypertensives is 15.2%. Prevalence of hypertension increases with age and is higher in rural areas and among individuals of lower education. Awareness and control of hypertension is higher among older individuals, among women and among the highly educated. Moreover, awareness of hypertension is higher among rural residents, whereas control of hypertension is more effective among urban residents. CONCLUSIONS In a large sample of the general Greek population, the prevalence of hypertension among men is lower than the average among the EU countries, whereas the corresponding prevalence among women is higher. Awareness and control of hypertension is lower in Greece than in other western countries, making them public health priorities.

[1]  S. Priori,et al.  2003 European Society of Hypertension-European Society of Cardiology Guidelines for the Management of Arterial Hypertension , 2004, Heart Drug.

[2]  Eric J Topol,et al.  Prevalence of conventional risk factors in patients with coronary heart disease. , 2003, JAMA.

[3]  D. Panagiotakos,et al.  Status and management of hypertension in Greece: role of the adoption of a Mediterranean diet the Attica study , 2003, Journal of hypertension.

[4]  Tina Costacou,et al.  Adherence to a Mediterranean diet and survival in a Greek population. , 2003, The New England journal of medicine.

[5]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, JAMA.

[6]  H. Hense,et al.  Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. , 2003, JAMA.

[7]  JoAnn E. Manson,et al.  Prospective Study of Sudden Cardiac Death Among Women in the United States , 2003, Circulation.

[8]  D. Mtasiwa,et al.  Assessing the prevalence of hypertension in populations: are we doing it right? , 2003, Journal of hypertension.

[9]  N E Day,et al.  European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection , 2002, Public Health Nutrition.

[10]  A. Miller,et al.  Overweight, obesity and fat distribution in 50- to 64-year-old participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) , 2002, Public Health Nutrition.

[11]  A. Ferro-Luzzi,et al.  The high-fat Greek diet: a recipe for all? , 2002, European Journal of Clinical Nutrition.

[12]  James F Sallis,et al.  AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update: Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patients Without Coronary or Other Atherosclerotic Vascular Diseases. American Heart Association Science Advisory and Coordinating Committee. , 2002, Circulation.

[13]  G. Mancia,et al.  Systolic vs diastolic blood pressure control in the hypertensive patients of the PAMELA population. Pressioni Arteriose Monitorate E Loro Associazioni. , 2002, Archives of internal medicine.

[14]  Peter E. Hilsenrath,et al.  The World Health Report 2000 , 2002 .

[15]  A Trichopoulou,et al.  Physical activity and energy intake selectively predict the waist-to-hip ratio in men but not in women. , 2001, The American journal of clinical nutrition.

[16]  N. Poulter,et al.  Improved Hypertension Management and Control: Results From the Health Survey for England 1998 , 2001, Hypertension.

[17]  N. Nagelkerke,et al.  Estimating the prevalence of hypertension corrected for the effect of within-person variability in blood pressure. , 2000, Journal of clinical epidemiology.

[18]  A. Lagiou,et al.  Body mass index in relation to energy intake and expenditure among adults in Greece. , 2000, Epidemiology.

[19]  E. Feskens,et al.  The Relation between Blood Pressure and Mortality Due to Coronary Heart Disease among Men in Different Parts of the World , 2000 .

[20]  M. Thamm.  [Blood pressure in Germany--current status and trends]. , 1999, Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)).

[21]  G. Stergiou,et al.  Prevalence, awareness, treatment, and control of hypertension in Greece: the Didima study. , 1999, American journal of hypertension.

[22]  F. Rodríguez‐Artalejo,et al.  Blood pressure in Spain: distribution, awareness, control, and benefits of a reduction in average pressure. , 1998, Hypertension.

[23]  V. Salomaa,et al.  Trends in blood pressure levels and control of hypertension in Finland from 1982 to 1997 , 1998, Journal of hypertension.

[24]  N. Poulter,et al.  Blood pressure screening, management and control in England: results from the health survey for England 1994 , 1998, Journal of hypertension.

[25]  M. Joffres,et al.  Awareness, treatment, and control of hypertension in Canada. , 1997, American journal of hypertension.

[26]  J. Tuomilehto,et al.  Stroke incidence and mortality correlated to stroke risk factors in the WHO MONICA Project. An ecological study of 18 populations. , 1997, Stroke.

[27]  A. Nissinen,et al.  Comparison of multivariate predictive power of major risk factors for coronary heart diseases in different countries: results from eight nations of the Seven Countries Study, 25-year follow-up , 1996 .

[28]  P Whelton,et al.  Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1991. , 1995, Hypertension.

[29]  S. Bennett,et al.  Blood pressure measurement error: its effect on cross-sectional and trend analyses. , 1994, Journal of clinical epidemiology.

[30]  Ethnikē Statistikē Hypēresia tēs Hellados.  Statistical yearbook of Greece , 1994 .

[31]  J. Hopper,et al.  Blood pressure in subjects from rural Greece, comparing individuals migrating to Melbourne, Australia with non-migrant relatives. , 1993, Journal of human hypertension.

[32]  S. Nanas,et al.  Coronary heart disease risk factors in a random sample of Athenian adults. The Athens Study. , 1987, American journal of epidemiology.