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Study objective: To describe the prevalence of hypertension and other cardiovascular risk factors on the adult population of Tirana City (Albania). Design: Cross sectional survey. Setting: Tirana City in mid-2001. Participants: 1120 adults aged 25 years and over (response rate=72.7%). Main results: Overall, hypertension prevalence (blood pressure =140 and/or 90 mm Hg, or known hypertensive receiving anti-hypertensive treatment) was 31.8% (36.6% and 27.4% in men and women respectively). Age standardised prevalence of hypertension (adjusted to the adult population of Tirana) was 30.2% (99% confidence intervals 29.8% to 30.6%) in men and 22.7% (22.3% to 23.1%) in women. Men were significantly more likely to be hypertensive than women (p value=0.001). Of those who had been diagnosed with hypertension, 87% were receiving anti-hypertensive therapy and more than half of them (52%) were adequately controlled. The prevalence of hypertension increased with increasing age and was more common in the obese in both sexes. While the prevalence of hypertension matched that in other industrialised and transition countries, the combination of hypertension with other cardiovascular risk factors was rather less common. Conclusion: These findings provide important new evidence on the prevalence of hypertension and its association with other cardiovascular risk factors in Albania. Albania is in a state of rapid transition, with evidence that risk factors for non-communicable diseases have already increased considerably over the past two decades. These finding provide a unique baseline against which future change can be compared.

These results may be taken as a sign of the resilience of many who survived this conflict but they also imply that there is still a substantial need for good health and social care in a significant proportion. Psychosocial interventions are likely to be an important part of the treatment programme.

Objective: This paper reports the distribution and determinants of body mass index (BMI) and obesity in Tirana City (Albania). Design: Cross-sectional survey conducted in mid-2001. Setting: Tirana City. Subjects: One thousand one hundred and twenty adults aged 25 years and over (response rate 72.7%), selected using multi-stage cluster sampling. Results: Over three-quarters of male and female respondents had an excess body weight. The overall population prevalence of obesity in Tirana was estimated to be 22.0% in men and 30.9% in women. Obesity affected both genders (age-standardised prevalence in males 22.0%, females 30.9%; age-adjusted odds ratio (OR) 1.89; 99% confidence interval (CI) 1.33-2.67) and all age groups, but most particularly middle-aged women. The age-standardised overall prevalence of central obesity was 21.6% in men and 29.4% in women (age-adjusted OR 1.58; 99% CI 1.11-2.25), increasing with age ðP , 0:01Þ: In women, the likelihood of being obese was inversely related to educational achievement (trend P ¼ 0:001) and alcohol consumption (trend P ¼ 0:009). Income, smoking and leisure-time physical activity were not associated with obesity. Conclusions: Excess weight and obesity are major public health problems in the adult population of Tirana, but most particularly in middle-aged women. The high obesity prevalence observed along with the recent decrease in physical activity, dietary changes and increase in smoking prevalence make it probable that there will be substantial increases in many non-communicable diseases in Albania in the coming decades. Health promotion strategies are needed that prevent excess weight gain in the Albanian population.

The prevalence of diabetes in Albania has increased rapidly, consistent with what has been seen in other countries undergoing rapid modernization. It is likely to increase further in the future, with important implications for health policy.