Trends in hypertension prevalence, awareness, treatment, and control among Polish adults 75 years and older during 2007–2014
Abstract
Background: The aim of this study was to assess changes in the prevalence, awareness, and treatment of hypertension and its effectiveness between 2007 (WOBASZ Senior study) and 2013–2014 (WOBASZ II) in a sample of the Polish population over the age of 75 years.
Methods: Sampling had three stages, stratified according to voivodeships, type of community, and gender. Finally, the WOBASZ II study included 467 persons (290 women and 177 men). For a comparison of the data, 1096 persons (538 women and 554 men) examined in the WOBASZ Senior study were used.
Results: Systolic and diastolic blood pressures significantly decreased from 153.0 ± 23.9 mmHg to 142.9 ± 22.3 mmHg and from 85.2 ± 11.9 mmHg to 78.4 ± 11.3 mmHg, respectively, from 2007 to 2014 (p < 0.0001). Prevalence of hypertension among people included in WOBASZ studies slightly decreased from 83.8% to 77.9% (rate ratio [RR]: 0.95; 95% confidence interval [CI]: 0.78–1.16) in men, and from 75.4% to 71.8% (RR: 0.93; 95% CI: 0.8–1.09) in women. Hypertension awareness was improved from 59.2% to 72.9% (RR: 1.23; 95% CI: 0.97–1.56) in men, and from 74,8% to 93% (RR: 1.26; 95% CI: 1.01–1.58) in women. The proportion of men and women, with implemented hypertension treatment, increased from 48.4% to 61.1% (RR: 1.26; 95% CI: 1.01–1.58), and from 63.2% to 82.0% (RR: 1.3; 95% CI: 1.1–1.53), respectively. The effectiveness of the treatment was improved over two-fold, there was an increase from 10.3% to 26.8% (RR: 2.65; 95% CI: 1.81–3.89) in men, and from 13.8% to 33.5% in women (RR: 2.44; 95% CI: 1.81–3.3).
Conclusions: The prevalence of hypertension in Polish seniors remains high, but has decreased slightly in the perspective of the last 7 years. Although treatment and control has improved over the last decade, it remains below expectations. Efforts to improve the diagnosis and effective treatment of hypertension in Polish seniors should be intensified.
Keywords: elderlyhealth examination surveysclinical epidemiologyprevalence of hypertensionawareness of hypertensiontreatment of hypertensioncontrol of hypertension
References
- http://ec.europa.eu/eurostat/statistics-explained/index.php/Population_structure_and_ageing.
- http://stat.gov.pl/cps/rde/xbcr/gus/L_ludnosc_stan_struktura_2007.zip (access 9-01-2018).
- stat.gov.pl/download/gfx/portalinformacyjny/pl/defaultaktualnosci/5468/6/17/1/ludnosc_stan_i_struk_lud_oraz_ruch_natur_w_przekroju_teryt_w_2014_stan_31_xii.pdf (access 9-01-2018).
- http://stat.gov.pl/download/gfx/portalinformacyjny/pl/defaultaktualnosci/5468/24/1/1/ludnosc_w_wieku_60._struktura_demograficzna_i_zdrowie.pdf (access 9-01-2018).
- stat.gov.pl/download/gfx/portalinformacyjny/pl/defaultaktualnosci/5468/18/1/1/ludnosc_w_starszym_wieku.pdf (access 9-01-2018).
- Lewington S, Clarke R, Qizilbash N, et al. Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002; 360(9349): 1903–1913.
- Staessen JA, Gasowski J, Wang JG, et al. Risks of untreated and treated isolated systolic hypertension in the elderly: meta-analysis of outcome trials. Lancet. 2000; 355(9207): 865–872.
- Bejan-Angoulvant T, Saadatian-Elahi M, Wright JM, et al. Treatment of hypertension in patients 80 years and older: the lower the better? A meta-analysis of randomized controlled trials. J Hypertens. 2010; 28(7): 1366–1372.
- Kąkol M, Zdrojewski T, et al. Kozicka Kąkol Prevalence, awareness and treatment efficacy of arterial hypertension in elderly in and: estimates based on a representative survey. Geront Pol. 1999; 2: 23–28.
- Antikainen RL, Kastarinen MJ, Jousilahti P, et al. Despite evidence-based guidelines, systolic blood pressure remains inadequately controlled in older hypertensive adults. J Hum Hypertens. 2010; 24(7): 439–446.
- Psaltopoulou T, Orfanos P, Naska A, et al. Prevalence, awareness, treatment and control of hypertension in a general population sample of 26,913 adults in the Greek EPIC study. Int J Epidemiol. 2004; 33(6): 1345–1352.
- Joffres M, Falaschetti E, Gillespie C, et al. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: a cross-sectional study. BMJ Open. 2013; 3(8): e003423.
- Falaschetti E, Mindell J, Knott C, et al. Hypertension management in England: a serial cross-sectional study from 1994 to 2011. Lancet. 2014; 383(9932): 1912–1919.
- Diederichs C, Neuhauser H. Regional variations in hypertension prevalence and management in Germany: results from the German Health Interview and Examination Survey (DEGS1). J Hypertens. 2014; 32(7): 1405–1414.
- Tykarski A, Posadzy-Małaczyńska A, Wyrzykowski B, et al. [Prevalence of hypertension and effectiveness of its treatment in adult residents of our country. Results of the WOBASZ program]. Kardiol Pol. 2005; 63(6 Suppl 4): S614–S619.
- Zdrojewski Ł, Zdrojewski T, Rutkowski M, et al. Prevalence and control of cardiovascular risk factors in Poland. Assumptions and objectives of the NATPOL 2011 Survey. Kardiol Pol. 2013; 71(4): 381–392.
- Zdrojewski T, Wizner B, Więcek A, et al. Prevalence, awareness, and control of hypertension in elderly and very elderly in Poland: results of a cross-sectional representative survey. J Hypertens. 2016; 34(3): 532–8; discussion 538.
- Zdrojewski T, Broda G, Piotrowski W, et al. Badanie WOBASZ Senior — ocena epidemiologii czynników ryzyka chorób serca i naczyń u starszych Polaków. In: Kopeć G, Jankowski P, Pająk A, Drygas W. Epidemiologia i prewencja chorób układu krążenia. Medycyna Praktyczna, Kraków. 2015: 93–99.
- Drygas W, Niklas AA, Piwońska A, et al. Multi-centre National Population Health Examination Survey (WOBASZ II study): assumptions, methods, and implementation. Kardiol Pol. 2016; 74(7): 681–690.
- Rywik S, Kupść W, Piotrowski W, et al. Programu WOBASZ. [Multicenter national Polish population health status tests: WOBASZ project. Establishment of methods and logistics]. Kardiol Pol. 2005; 63(6 Suppl 4): S605–S613.
- http://www.ehes.info/manuals/EHES_manual/EHES_manual.htm (access 9-01-2018).
- Mancia G, Fagard R, Narkiewicz K, et al. ESH/ESC Task Force for the Management of Arterial Hypertension, Task Force Members. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013; 31(7): 1281–1357.
- Gee ME, Campbell N, Sarrafzadegan N, et al. Standards for the uniform reporting of hypertension in adults using population survey data: recommendations from the World Hypertension League Expert Committee. J Clin Hypertens (Greenwich). 2014; 16(11): 773–781.
- Morris JA, Gardner MJ. Calculating confidence intervals for relative risks (odds ratios) and standardized. ratios and rates. Br Med J. 1988; 296(7 May): 1313–1316.
- http://stat.gov.pl/download/gfx/portalinformacyjny/pl/defaultaktualnosci/5468/12/5/1/podstawowe_informacje_o_rozwoju_demograficznym_polski_do_2014.pdf (access 9-01-2018).
- Bledowski P, Mossakowska M, Chudek J, et al. Medical, psychological and socioeconomic aspects of aging in Poland: assumptions and objectives of the PolSenior project. Exp Gerontol. 2011; 46(12): 1003–1009.
- Danaei G, Finucane MM, Lin JK, et al. Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Pressure). National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5·4 million participants. Lancet. 2011; 377(9765): 568–577.
- McDonald M, Hertz RP, Unger AN, et al. Prevalence, awareness, and management of hypertension, dyslipidemia, and diabetes among United States adults aged 65 and older. J Gerontol A Biol Sci Med Sci. 2009; 64(2): 256–263.
- Lacruz ME, Kluttig A, Hartwig S, et al. Prevalence and Incidence of Hypertension in the General Adult Population: Results of the CARLA-Cohort Study. Medicine (Baltimore). 2015; 94(22): e952.
- Piotrowicz K, Prejbisz A, Klocek M, et al. Subclinical mood and cognition impairments and blood pressure control in a large cohort of elderly hypertensives. J Am Med Dir Assoc. 2016; 17(9): 864.e17–864.e22.
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2017 [Epub ahead of print].
- Chobanian AV, Bakris GL, Black HR, et al. National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003; 289(19): 2560–2572.
- Muntner P, Carey RM, Gidding S, et al. Potential US Population Impact of the 2017 ACC/AHA High Blood Pressure Guideline. Circulation. 2018; 137(2): 109–118.
- Stepaniak U, Micek A, Waśkiewicz A, et al. Prevalence of general and abdominal obesity and overweight among adults in Poland. Results of the WOBASZ II study (2013-2014) and comparison with the WOBASZ study (2003-2005). Pol Arch Med Wewn. 2016; 126(9): 662–671.
- Kwaśniewska M, Pikala M, Bielecki W, et al. Ten-Year Changes in the Prevalence and Socio-Demographic Determinants of Physical Activity among Polish Adults Aged 20 to 74 Years. Results of the National Multicenter Health Surveys WOBASZ (2003-2005) and WOBASZ II (2013-2014). PLoS One. 2016; 11(6): e0156766.
- Pająk A, Szafraniec K, Polak M, et al. Changes in the prevalence, treatment, and control of hypercholesterolemia and other dyslipidemias over 10 years in Poland: the WOBASZ study. Pol Arch Med Wewn. 2016; 126(9): 642–652.
- Jarosz M, Wolańska D, Stolińska H, et al. Nutrition and lifestyle in patients pharmacologically treated due to hypertensionally treated due to hypertension. Cardiol J. 2016 [Epub ahead of print]; 23(5): 491–496.
- Wu L, He Y, Jiang B, et al. Trends in prevalence, awareness, treatment and control of hypertension during 2001-2010 in an urban elderly population of china. PLoS One. 2015; 10(8): e0132814.
- Tian S, Dong GH, Wang Da, et al. Prevalence, awareness, treatment, control, and risk factors associated with hypertension in urban adults from 33 communities of China: the CHPSNE study. J Hypertens. 2011; 29(7): 1303–1310.
- Wu Yi, Tai ES, Heng D, et al. Risk factors associated with hypertension awareness, treatment, and control in a multi-ethnic Asian population. J Hypertens. 2009; 27(1): 190–197.
- Agyemang C, Bruijnzeels MA, Owusu-Dabo E. Factors associated with hypertension awareness, treatment, and control in Ghana, West Africa. J Hum Hypertens. 2006; 20(1): 67–71.
- He J, Muntner P, Chen J, et al. Factors associated with hypertension control in the general population of the United States. Arch Intern Med. 2002; 162(9): 1051–1058.
- Chen R, Tunstall-Pedoe H, Morrison C, et al. Trends and social factors in blood pressure control in Scottish MONICA surveys 1986-1995: the rule of halves revisited. J Hum Hypertens. 2003; 17(11): 751–759.
- Agyemang C, van Valkengoed I, Koopmans R, et al. Factors associated with hypertension awareness, treatment and control among ethnic groups in Amsterdam, the Netherlands: the SUNSET study. J Hum Hypertens. 2006; 20(11): 874–881.
- Tian S, Dong GH, Wang Da, et al. Factors associated with prevalence, awareness, treatment and control of hypertension in urban adults from 33 communities in China: the CHPSNE Study. Hypertens Res. 2011; 34(10): 1087–1092.
- Chiu YH, Wu SC, Tseng CD, et al. Progression of pre-hypertension, stage 1 and 2 hypertension (JNC 7): a population-based study in Keelung, Taiwan (Keelung Community-based Integrated Screening No. 9). J Hypertens. 2006; 24(5): 821–828.
- Wang H, Zhang X, Zhang J, et al. Factors associated with prevalence, awareness, treatment and control of hypertension among adults in Southern China: a community-based, cross-sectional survey. PLoS One. 2013; 8(5): e62469.