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High blood pressure: prevalence and adherence to guidelines in a population-based cohort
Diana Walther1, Ivan Curjuric1, Julia Dratva1
1Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
Insights
Many Swiss adults have undiagnosed or uncontrolled high blood pressure (hypertension), indicating a need for improved management strategies and adherence to treatment guidelines.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- High blood pressure is a leading global health risk factor for morbidity and mortality.
- Understanding hypertension prevalence and management in Switzerland is crucial for public health initiatives.
Purpose of the Study:
- To assess the prevalence of diagnosed and undiagnosed high blood pressure in Switzerland.
- To evaluate adherence to hypertension management guidelines within the Swiss population.
Main Methods:
- Analysis of 3962 participants from the Swiss Cohort Study on Air Pollution and Lung and Heart Disease in Adults (2001-2011).
- High blood pressure defined as ≥140/90 mm Hg; doctor-diagnosed hypertension determined via questionnaire.
- Prevalence of unawareness, diagnosis, treatment, and control of hypertension assessed.
Main Results:
- 34.9% of participants had high blood pressure, with 49.1% unaware of their condition.
- Only 40.8% of those with diagnosed hypertension achieved blood pressure control (<140/90 mm Hg).
- Substantial nonadherence to comorbidity-specific guidelines and high rates of unawareness/uncontrolled hypertension compared to the USA were observed.
Conclusions:
- Significant improvements are needed in hypertension management in Switzerland.
- Population-based studies are vital for identifying healthcare gaps.
- Linking cohort data with medical records is essential to understand the root causes of suboptimal hypertension control.
Questions Under Study:
High blood pressure, the single leading health risk factor worldwide, contributes greatly to morbidity and mortality. This study aimed to add to the understanding of diagnosed and undiagnosed high blood pressure in Switzerland and to evaluate adherence to hypertension guidelines.
Methods:
Included were 3962 participants from the first (2001-2003) and second (2010-2011) follow-ups of the population-based Swiss Cohort Study on Air Pollution and Lung and Heart Disease in Adults. High blood pressure was defined as blood pressure ≥140/90 mm Hg and the prevalence of doctor-diagnosed hypertension was based on questionnaire information.
Results:
High blood pressure was found in 34.9% of subjects, 49.1% of whom were unaware of this condition; 30.0% had doctor-diagnosed hypertension and, although 82.1% of these received drug treatments, in only 40.8% was blood pressure controlled (<140/90 mm Hg). Substantial first-line beta-blocker use and nonadherence to comorbidity-specific prescription guidelines were observed and remained mostly unexplained. Age-adjusted rates of unawareness and uncontrolled hypertension were more than 20% higher than in the USA.
Conclusions:
There is room for improvement in managing hypertension in Switzerland. Population-based observational studies are essential for identifying and evaluating unmet needs in healthcare; however, to pinpoint the underlying causes it is imperative to facilitate linkage of cohort data to medical records.
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Prepare for the Procedure:
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