Trends in the prevalence, awareness, treatment and control of hypertension: the WHO MONICA Project.
OBJECTIVE
To describe the secular changes in the prevalence, awareness, treatment and control of hypertension.


METHODS
Two independent cross-sectional population surveys using standardized methods conducted between the early 1980s and mid-1990s.


METHODS
Twenty-four geographically defined populations of the WHO MONICA Project.


METHODS
Randomly selected men and women aged 35-64 years. The total number of participants was 69 907.


METHODS
Two definitions of hypertension were used: 160/95 mmHg or above and 140/90 mmHg or above for systolic or diastolic blood pressure. Subjects on antihypertensive drug treatment were considered to be hypertensive regardless of their blood pressure. Treated subjects whose measured blood pressure level was less than 160/95 or 140/90 mmHg according to the two definitions, respectively, were considered to be adequately treated.


RESULTS
The age-adjusted prevalence of hypertension decreased in most and increased in only a few populations. For both definitions of hypertension, the proportion of hypertensive subjects who were aware of their condition increased in three-quarters of the male populations and in two-thirds of the female populations. Furthermore, the proportion of hypertensive individuals on antihypertensive drug treatment increased in three-quarters of the populations. In the final survey, hypertension tended to be better treated and controlled in women than in men. Nevertheless, a large proportion of patients receiving antihypertensive drug therapy still had inadequately controlled blood pressure levels.


CONCLUSIONS
Although awareness and treatment of hypertension according to the data obtained during the late 1980s to the mid-1990s increased in several populations, the effectiveness of antihypertensive treatment showed the continuing need for improvements.
Antikainen
Riitta L
RL
Department of Internal Medicine, University of Oulu and Oulu City Hospital, Oulu, Finland.
Moltchanov
Vladislav A
VA
Chukwuma
Chrysanthus
C
Kuulasmaa
Kari A
KA
Marques-Vidal
Pedro M
PM
Sans
Susana
S
Wilhelmsen
Lars
L
Tuomilehto
Jaakko O
JO
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014944:World Health Organization
D000959:Antihypertensive Agents