title: High blood pressure: prevalence and adherence to guidelines in a population-based cohort.
abstract: OBJECTIVE
  High blood pressure, the single leading health risk factor worldwide, contributes greatly to morbidity and mortality. This study aimed to add to the understanding of diagnosed and undiagnosed high blood pressure in Switzerland and to evaluate adherence to hypertension guidelines.
  
  
  METHODS
  Included were 3962 participants from the first (2001-2003) and second (2010-2011) follow-ups of the population-based Swiss Cohort Study on Air Pollution and Lung and Heart Disease in Adults. High blood pressure was defined as blood pressure ≥140/90 mm Hg and the prevalence of doctor-diagnosed hypertension was based on questionnaire information.
  
  
  RESULTS
  High blood pressure was found in 34.9% of subjects, 49.1% of whom were unaware of this condition; 30.0% had doctor-diagnosed hypertension and, although 82.1% of these received drug treatments, in only 40.8% was blood pressure controlled (<140/90 mm Hg). Substantial first-line beta-blocker use and nonadherence to comorbidity-specific prescription guidelines were observed and remained mostly unexplained. Age-adjusted rates of unawareness and uncontrolled hypertension were more than 20% higher than in the USA.
  
  
  CONCLUSIONS
  There is room for improvement in managing hypertension in Switzerland. Population-based observational studies are essential for identifying and evaluating unmet needs in healthcare; however, to pinpoint the underlying causes it is imperative to facilitate linkage of cohort data to medical records.
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Diana
authors.initials: D
authors.lastname: Walther
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Ivan
authors.initials: I
authors.lastname: Curjuric
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Dratva
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Schaffner
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Carlos
authors.initials: C
authors.lastname: Quinto
authors.affiliation: Division of Pulmonary Medicine, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Thierry
authors.initials: T
authors.lastname: Rochat
authors.affiliation: Department of Community Medicine and Primary Care, Geneva University Hospitals Geneva, Switzerland.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Gaspoz
authors.affiliation: Department of Internal Medicine, Hôpital Intercantonal de la Broye, Payerne, Switzerland.
authors.forename: Luc
authors.initials: L
authors.lastname: Burdet
authors.affiliation: Department of Pneumology, Hôpital du Valais, Centre Hospitalier du Valais Romand, Sion, Switzerland.
authors.forename: Pierre-Olivier
authors.initials: PO
authors.lastname: Bridevaux
authors.affiliation: Department of Pneumology, Regional Hospital of Lugano, Lugano, Switzerland.
authors.forename: Marco
authors.initials: M
authors.lastname: Pons
authors.affiliation: Division of Pulmonary Medicine, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Margaret W
authors.initials: MW
authors.lastname: Gerbase
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Schindler
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Nicole
authors.initials: N
authors.lastname: Probst-Hensch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000592:standards / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013557:Switzerland / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents