Profiling individuals living with hypertension in Saudi Arabia 2021: a nationwide descriptive study

Hypertension is a major global health challenge affecting 1.3 billion adults, increasing risks of cardiovascular diseases, strokes, and kidney failure. Using data from a nationally representative surveillance system in Saudi Arabia, this study profiles adults living with treated or aware hypertension vs. the rest of the population and examines co-occurring sociodemographic, behavioral, and clinical factors in 2021.

We analyzed data from the 2021 Sharik Health Indicators Surveillance System (SHISS), a nationwide cross-sectional phone survey employing proportional quota sampling across all 13 regions (n = 14,007; response rate = 68.3%). Hypertension status was defined as self-reported physician diagnosis with current treatment; blood pressure was not directly measured, and the survey relied entirely on self-report. Weighted descriptive statistics summarized prevalence, and multivariable logistic regression estimated adjusted odds ratios (AORs, 95% CIs) for factors associated with hypertension. The mean participant age was 36.7 ± 13.7 years.

Overall, 12.3% of respondents reported treated/aware hypertension. Among these, common comorbidities included hypercholesterolemia (47.9%), diabetes (42.8%), overweight/obesity (75.2%), heart disease (20.2%), and elevated depression risk (23.8%). In adjusted models, higher age (AOR 1.06 per year, 95% CI 1.05-1.06), education below bachelor's (AOR 1.31, 1.14-1.50), smoking (daily AOR 1.23, 1.03-1.48; occasional AOR 1.64, 1.28-2.08), overweight (AOR 1.93, 1.20-3.11), and obesity (AOR 2.53, 1.57-4.08) were significantly associated with hypertension. Strong associations were also observed with hypercholesterolemia (AOR 4.09, 3.56-4.71), heart disease (AOR 3.54, 2.84-4.42), and diabetes (AOR 2.64, 2.28-3.05).

Adults aware of and treated for hypertension in Saudi Arabia exhibit a high burden of behavioral risks and multimorbidity. These findings can guide targeted primary care screening, integrated chronic disease management, and population-level risk reduction programs (e.g., smoking cessation, weight control), with priority to older adults, individuals with lower educational attainment, and those with co-existing diabetes or dyslipidemia.