Longitudinal trends in cardiovascular mortality and blood pressure levels, prevalence, awareness, treatment, and control of hypertension in the Czech population from 1985 to 2007/2008.
OBJECTIVE
To assess longitudinal trends in cardiovascular mortality and population mean blood pressure, prevalence, awareness, treatment, and control of hypertension in a representative Czech population sample from 1985 to 2007/2008.


METHODS
Source data on mortality rates were provided by the Czech Statistical Office and further processed by the Institute for Health Information and Statistics of the Czech Republic. Six independent cross-sectional population surveys were conducted in 1985, 1988, 1992, 1997/1998, 2000/2001, and 2007/2008 with randomly selected men and women aged 25-64 years and resident in six districts of the Czech Republic (Praha-východ, Benešov, Pardubice, Chrudim, Cheb, and Jindřichův Hradec). The total number of participants was 13 972.


RESULTS
Since 1985, there has been a significant continuous, almost linear decline in standardized total, cardiovascular disease, ischemic heart disease, and stroke mortality (P < 0.001).There was a significant downward trend in the population mean SBP (from 133.6 ± 20.2 to 129.5 ± 18.5 mmHg; P < 0.001) and DBP (from 84.1 ± 11.3 to 82.5 ± 10.0 mmHg; P < 0.001) from 1985 to 2007/2008. This was associated with a significant decrease in the prevalence of hypertension only in women (from 42.5 to 37.2%; P < 0.001). Awareness of hypertension increased in both sexes (men, from 41.4 to 68.4%; women, from 58.9 to 71.4%; both P < 0.001) as did the number of individuals on antihypertensive medication (men, from 21.1 to 58.2%, women: from 38.9 to 58.9%; both P < 0.001). Control of hypertension improved significantly (from 3.9 to 24.6%) over the same period.


CONCLUSIONS
The reduction in population blood pressure and improved hypertension control may have contributed substantially to the decrease in cardiovascular disease mortality in the Czech Republic.
Cífková
Renata
R
Department of Preventive Cardiology, Institute for Clinical and Experimental Medicine, Czech Republic. recf@medicon.cz
Skodová
Zdenka
Z
Bruthans
Jan
J
Holub
Jiří
J
Adámková
Věra
V
Jozífová
Marie
M
Galovcová
Markéta
M
Wohlfahrt
Peter
P
Krajčoviechová
Alena
A
Petržílková
Zdena
Z
Lánská
Věra
V
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002309:Cardiology; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D003430:Cross-Sectional Studies; D018153:Czech Republic; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors