Abstract
Objective
To describe the secular changes in the prevalence, awareness, treatment and
control of hypertension.
Design
Two independent cross-sectional population surveys using standardized methods
conducted between the early 1980s and mid-1990s.
Setting
Twenty-four geographically defined populations of the WHO MONICA Project.
Participants
Randomly selected men and women aged 35–64 years. The total number
of participants was 69 907.
Main outcome measures
Two definitions of hypertension were used: 160/95 mmHg or above and 140/90
mmHg or above for systolic or diastolic blood pressure. Subjects on
antihypertensive drug treatment were considered to be hypertensive
regardless of their blood pressure. Treated subjects whose measured blood
pressure level was less than 160/95 or 140/90 mmHg according to the two
definitions, respectively, were considered to be adequately treated.
Results
The age-adjusted prevalence of hypertension decreased in most and increased
in only a few populations. For both definitions of hypertension, the
proportion of hypertensive subjects who were aware of their condition
increased in three-quarters of the male populations and in two-thirds of the
female populations. Furthermore, the proportion of hypertensive individuals
on antihypertensive drug treatment increased in three-quarters of the
populations. In the final survey, hypertension tended to be better treated
and controlled in women than in men. Nevertheless, a large proportion of
patients receiving antihypertensive drug therapy still had inadequately
controlled blood pressure levels.
Conclusion
Although awareness and treatment of hypertension according to the data
obtained during the late 1980s to the mid-1990s increased in several
populations, the effectiveness of antihypertensive treatment showed the
continuing need for improvements.