Blood Pressure in Spain

Abstract

Distribution of blood pressure (as per US Joint National Committee VI classification and staging criteria) plus awareness, treatment, and control of hypertension were studied in a representative Spanish population sample of 2021 persons (age range, 35 to 64 years). Pressure was determined in accordance with World Health Organization guidelines. A total of 45.1% of subjects were hypertensive (140/90 mm Hg or undergoing drug therapy); 12% had isolated systolic hypertension, and 8.7% had isolated diastolic hypertension. Pulse pressure was 48.7 mm Hg. Heart rate was 81.4 bpm in untreated hypertensives and 78.9 bpm in normotensives (P0.05). A substantial proportion of the community burden of blood pressure was attributable to stage 1 (28.3% of subjects), the most frequent category of hypertension, and to the high-normal blood pressure group (17% of subjects). A percentage breakdown showed that among hypertensives, 44.5% were aware of their condition; of these, 71.9% were undergoing drug therapy, and of those being treated, only 15.5% were controlled (5% of hypertensives). Not only are these figures consistent with the fact that Spain has a higher cerebrovascular mortality than other countries such as the United States, but they represent a great potential for improvement, particularly among those groups registering relatively worse data (younger men, rural residents, and unskilled professionals). A decrease of only 1 to 4 mm Hg in average blood pressure could reduce the prevalence of hypertension in Spain by 12.4% to 15.4%. (Hypertension. 1998;32:998-1002.) Key Words: hypertension, arterial blood pressure prevalence cross-sectional studies awareness A lthough it is well known that arterial hypertension (AHT) is a modifiable risk factor for cardiovascular disease and that there are important differences among developed countries regarding AHT frequency and consequences , countrywide information on awareness, treatment, and control of AHT is still scant. 1-7 Similarly, there is an absence of reporting on new AHT-related cardiovascular risk indicators, such as isolated systolic AHT (ISH), isolated diastolic AHT (IDH), heart rate, and pulse pressure. 2-4 Furthermore, classifications of blood pressure values at progressive levels are used mainly to help in the clinical management of individual patients. 1-4 Yet these same classifications can also serve to highlight the community burden ascribable to the proportions of subjects and blood pressure-related diseases at such levels. 1,5,6 In this regard, US Joint National Committee V and VI (JNC-V and-VI) classifications could prove especially useful because they take into account the fact that blood pressure-related cardiovascular risk is continuous throughout all levels and that risk is thus present at mid-pressure distribution levels, at which the pressures are considered "normal" (high-normal category) or moderately high (stage 1), and in which, because of the high proportion of subjects involved, a sizable percentage of the population's cardiovascular events tend to occur...

Systolic vs diastolic blood pressure: community burden and impact on blood pressure staging

“…11 In brief, our representative general population sample was made up of 2021 individuals (mean age, 49 years; 57% women) selected through random multi-stage sampling stratified by age, sex and habitat of residence. The overall response rate to the survey was 73.3%.…”

Normal blood pressure values as perceived by normotensive and hypertensive subjects

“…The control of hypertension remains unsatisfactory worldwide, ranging from a few percent (6% in England), [1][2][3] to about 10% in Poland, 4 13% in Canada, 5 27% in the US. 6 Apart from other factors (ie economic), patients' awareness of what hypertension is may play an important role.…”

Treatment and blood pressure control in isolated systolic hypertension vs diastolic hypertension in primary care

“…As in many previous surveys in the population, [9][10][11][12][13][14][15][16][17][18][19][20] in primary care [21][22][23][24] and in specalist care, 25 a substantial number of treated patients did not reach target blood pressure, leading to an overall poor blood pressure control. In the current study, blood pressure control was somewhat better in treated patients with isolated systolic hypertension than in those with diastolic hypertension, but the lower prevalence of treatment resulted in a worse overall blood pressure control in isolated systolic hypertension.…”