Epidemiologic Profile of Hypertension in Northern Iranian Population: The PERSIAN Guilan Cohort Study (PGCS)

Abstract

Background: Estimates region-related prevalence of hypertension and attempts to identify its related factors at the district levels are required for prevention and management of hypertension. Objective: The aim of this study was to investigate the epidemic features and related factors of hypertension and its awareness, treatment, and control rates among the northern Iranian population. Methods: It was a community based cross-sectional study based on data from PERSIAN Guilan Cohort Study (PGCS). In total, 10,520 participants (aged 35–70 years) from the Guilan Province in northern Iran included in this study, between October 8, 2014, and January 20, 2017. Hypertension was defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg or a prior diagnosis of hypertension or being on antihypertensive medication. Potential correlates of hypertension and its awareness, treatment and control were analyzed by multivariate logistic regression adjusted for demographic factors, anthropometric characteristics, lifestyle variables, past medical history, and laboratory data. Results: The prevalence of hypertension was 43.2% and the hypertension awareness, treatment, and control rate were 53.4%, 49.8%, and 73.7%, respectively. The multivariate logistic regression analyses revealed that older age, urbanization, lower education, overweight and obesity, lower physical activity, prediabetes and diabetes, cardiovascular disease, psychiatric disorder, positive family history of hypertension and raised serum creatinine were independently associated with presence of hypertension. Awareness of hypertension was greater in the female sex, older age, rural residency, higher education and patient with comorbidities. Older age, rural residency and comorbidities were associated with treatment of hypertension. Control of hypertension was better among younger age, higher education, normal weight and higher physical activity. Conclusion: Hypertension is highly prevalent in the northern Iranian population. About half of affected persons are unaware of their disease and untreated. Modifying risk factors (such as weight lose and increase physical activity) and increasing hypertension awareness (by screening) is essential for primary and secondary prevention of high blood pressure in this population, especially in urban areas and among males, younger ages, and less educated.

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“…Hypertension was defined as the prior use of antihypertensive drugs, a systolic blood pressure of "140 mmHg, and/or a diastolic blood pressure of "90 mmHg. 23) Diabetes mellitus was defined as the recent use of antidiabetic drugs, a fasting glucose value of "126 mg/dL, a casual glucose value of "200 mg/dL, and/or an HbA1c percentage of "6.5% (National Glycohemoglobin Standardization Program). 24) Dyslipidemia was defined as the recent use of cholesterol-lowering drugs, a triglyceride value of "150 mg/dL, a low-density lipoprotein cholesterol value of "140 mg/dL, and/or a high-density lipoprotein cholesterol value of < 40 mg/dL.…”