Social, lifestyle and demographic inequalities in hypertension care.
OBJECTIVE
Recent nationwide in-depth analyses on inequalities in hypertension prevalence and care are scarce. This study assessed sociodemographic and lifestyle factors associated with the prevalence, awareness, treatment and control of hypertension in Finland.


METHODS
A representative nationwide sample (participation rate 58%) of the Finnish adult population underwent a health examination and interview in 2011. After excluding participants with missing data, 4230 people were included in the analyses. Weighted regression modelling was used to explore the associations of sociodemographic and lifestyle factors with the prevalence, awareness, treatment and control of hypertension.


RESULTS
The prevalence, awareness, treatment and control rates of hypertension (blood pressure ⩾140/90 mmHg or antihypertensive medication) in Finland were 47%, 57%, 51% and 48%, respectively. Older age, male sex, lower education, retirement, higher BMI, never-smoking and heavy alcohol use were associated with a higher prevalence of hypertension (p<0.05). In contrast, younger age, non-retirement, lower BMI, smoking and high physical activity were associated with lower awareness and treatment rates (p<0.05). In addition, male sex was associated with lower awareness rates (p<0.01). Hypertension control was better in younger participants (p<0.05).


CONCLUSIONS
In addition to high prevalence and moderate treatment rates of hypertension, serious sociodemographic and lifestyle inequities in hypertension care exist in Finland. Hypertension is more prevalent in older people of lower socio-economic status with adverse lifestyles. However, hypertension is more often unrecognised and untreated among people with low risk of hypertension.
Department of Health, National Institute for Health and Welfare, Finland Department of Medicine, Turku University Central Hospital, Finland ssesiv@utu.fi.
Sam Se
SS
Sivén
Department of Health, National Institute for Health and Welfare, Finland.
Teemu J
TJ
Niiranen
Department of Health, National Institute for Health and Welfare, Finland.
Arpo
A
Aromaa
Department of Health, National Institute for Health and Welfare, Finland.
Seppo
S
Koskinen
Department of Health, National Institute for Health and Welfare, Finland.
Antti M
AM
Jula
D000328:Adult; D000368:Aged; D005260:Female; D005387:Finland / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000628:therapy*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors
Hypertension; awareness; blood pressure; control; lifestyle; prevalence; socio-economic; treatment