Twenty-year dynamics of hypertension in Iranian adults: age, period, and cohort analysis.
Hypertension is a well-known health problem all over the world. Many studies have assessed its prevalence and associated risk factors, but all were cross-sectional and did not evaluate the trend of hypertension through all three different temporal dimensions including age, period, and cohort. So, we aimed to assess the 20-year dynamics of hypertension via the age-period-cohort model. Data from 74,155 subjects aged 25-60 years gathered through five national health surveys (1990-91, 1999, 2003, 2007, and 2011) were used in this study. The age-period-cohort effect on hypertension was analyzed using the intrinsic estimator model. The prevalence of hypertension increased with age for both genders except for males in 2003 and 2011 periods with drops of 3.5% for ages 55-60 and 8.1% for ages 50-60, respectively. As for the period effect, the prevalence of hypertension was almost constant in all age groups for both genders from 1990-1999. The cohort-based prevalence of hypertension showed a declining trend in all cohorts for females except for 2011 in birth cohort of 1950-1955 which remains stationary. The trend of prevalence for males also follows a decreasing trend except for periods of 2003, 2007, and 2011; birth cohorts of 1945-1949, 1975-1980, and 1950-1960 increase by 3.5%, 1.9%, and 8.1%, respectively. The age effect on the prevalence of hypertension showed an almost monotonic increasing trend. The period effect increased the total prevalence of hypertension from 1992 to 1997. The cohort effect also showed a monotonic decrease in hypertension prevalence except for a few discrepancies.
Chronic Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Mostafa
M
Hosseini
Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Mahmoud
M
Yousefifard
Department of Neurology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Masoud
M
Baikpour
Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran.
Ali
A
Rafei
Department of Epidemiology and Biostatistics, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mohammad
M
Fayaz
Chronic Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Ramin
R
Heshmat
Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran; Department of Community Medicine, Iran University of Medical Sciences, Tehran, Iran; Saveh Medical University, Saveh, Iran.
Jalil
J
Koohpayehzadeh
Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran.
Fereshteh
F
Asgari
Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran; Department of Epidemiology, School of Public Health, Sahid Beheshti University of Medical Sciences, Tehran, Iran.
Koorosh
K
Etemad
Center for Disease Control, Ministry of Health and Medical Education, Tehran, Iran.
Mohammad Mehdi
MM
Gouya
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: mohamadk@tums.ac.ir.
Kazem
K
Mohammad
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001795:Blood Pressure Determination / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013997:Time Factors; D016896:Treatment Outcome
D000959:Antihypertensive Agents
Age–period–cohort analysis; Iran; blood pressure; prevalence