Hypertension prevalence, awareness, treatment and control in Germany 1998 and 2008-11

Germany was reported to have higher blood pressure (BP) and lower awareness, treatment and control of BP than other western countries based on 1998 data. BP distribution and hypertension management were examined for 1998 and 2008-11 in 7108 adult participants of the German National Health Interview and Examination Survey 1998 (GNHIES98) and in 7095 adult participants the German Health Interview and Examination Survey for Adults 2008-11 (DEGS1) aged 18-79 years. Age- and sex-standardized mean systolic BP (SBP) dropped from 129.0 to 124.1 mm Hg (women 127.3-120.8, men 130.7-127.4), mean diastolic BP (DBP) from 78.3 to 73.2 mm Hg (women 78.0-71.2, men 78.5-75.3). Mean SBP and DBP decreased most in treated hypertensives but were also lower in participants without hypertension. The overall prevalence of hypertension, including controlled hypertension, remained almost unchanged (30% vs 32%). Uncontrolled hypertension (BP⩾140/90 mm Hg) decreased from 23% to 15% (women 22-13%, men 24-18%). Among hypertensives, awareness increased from 69% to 82% (women 74-87%, men 65-78%), treatment increased from 55% to 72% (women 62-79%, men 48-65%) and control increased from 23% to 51% (women 25-58%, men 20-45%). However, men aged 18-29 years had an opposite trend with 1.5 mm Hg higher SBP and increased prevalence of hypertension, which was mostly uncontrolled. These findings suggest that BP has decreased substantially in Germany, while leaving a persistent gender gap in management and room for further improvement of prevention and treatment, particularly in men.