High prevalence of hypertension and early vascular aging: a screening program in pharmacies in Upper Austria

Cardiovascular mortality is the leading cause of death in Austria, with uncontrolled blood pressure (BP) as a major risk factor. Increased arterial stiffness can indicate high cardiovascular risk. In a screening project, we acquired brachial waveforms with automated oscillometric devices in 45 public pharmacies and at 2 public health events in Upper Austria. Brachial BP was measured, and aortic pulse wave velocity (aoPWV) was estimated, using age, systolic BP, and waveform characteristics, with the validated ARCSolver algorithm. Using age-specific percentiles from a previous population study, we defined healthy (HVA) and early (EVA) vascular aging. In a subgroup, 24-h ambulatory BP monitoring was performed to verify hypertension status. Overall, 10,973 individuals (age 20-94 years) participated. Mean BP was 133/83 mm Hg. In all, 38.1% of participants had elevated BPs (≥140/90 mm Hg), 57.3% out of 3980 participants with known hypertension, and 29.5% out of 6066 participants without known hypertension. In all, 1.0% of participants had aoPWV below 10th reference percentile (HVA), with a negligible proportion above 60 years. In total, 37.3% were above the 90th reference percentile (EVA), with proportions rising from one-quarter in youngest partcipants to one-half in oldest participants. In participants with EVA, BP in the pharmacy was elevated in 79.5%. We were able to motivate a high number of customers at pharmacies to participate in a screening program by combining the measurements of BP and vascular aging. However, awareness and control of arterial hypertension in Austria remains suboptimal, and the high prevalence of EVA is alarming.