Isolated Diastolic Hypertension among Adults in Saudi Arabia: Prevalence, Risk Factors, Predictors and Treatment. Results of a National Survey

Abstract

Background:In the past, diastolic hypertension was the main criterion for treatment, but currently, systolic pressure is the main criterion because it was thought that Isolated Diastolic Hypertension (IDH) is not associated with complications. Studies later revealed that IDH carries significant risks. Quantifying the magnitude and risk factors of IDH in the community is essential for all intervention strategies. Aims: This study aims to determine the prevalence, risk factors, predictors, treatment modalities and lifestyle practices of IDH adult patients in the Kingdom of Saudi Arabia (KSA). Study Design: Cross-sectional study. Methods: A community-based cross-sectional study using STEPwise approach among adults using a multistage, stratified, cluster random sample was carried out. Data were collected using questionnaires which included socio-demographics, blood pressure, biochemical, anthropometric measurements and lifestyle practices. Statistical analysis included calculating means and standard deviations, proportions, univariate and multiple logistic regression analysis. Results: Of a total 4562 subjects, 180 (3.95%) suffered from IDH, which was significantly related to age, gender, employment, smoking, diabetes mellitus, obesity and hypercholesterolemia. More than 93% were using some form of treatment, with 77.2% on prescribed drugs, 63% using diet, and 23% using exercise. Significant predictors of IDH were retirement and hypercholesterolemia. Conclusion: IDH is associated with some sociodemographic characteristics and co-morbidity. Given the risk of cardiovascular disease associated with IDH, the findings of this study emphasize the need for diagnosing the disease in middle-aged persons focusing on the modifiable risk factors of IDH.

Predictors of isolated systolic hypertension among type 2 diabetes mellitus patients in Jimma University Specialized Hospital, Southwest Ethiopia

“…Educational status of ≤ grade 8 were 2.9 times more likely to develop ISH than those in College and above level. This finding is similar with a study in Australia which reported that, decreased education level was associated with increased hypertension [34], Boston [33] and Saudi [19]. The probable reason for higher ISH in lower education level might be lack of awareness about lifestyle modification among patients who attained lower educational level.…”

“…ISH ranges from 20.3% in primary care patients to 35% in general population [18]. A study in Saudi revealed 7.6% of ISH among adults associated with education, obesity, DM, and dyslipidemia [19]. Prevalence of 43.6% was reported in Nigerian adults associated with increased age [20].…”

Impact of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline on the prevalence of hypertension in young Saudi women

“…This figure increases to 48.4% mong university students (33), and further increases are expected with time (34). While many prior studies from Saudi Arabia have recommended focusing on the modifiable risk factors for hypertension as a preventive and therapeutic measure (15,31,33,35), this goal remains far from reach due to the huge gap between knowledge and attitudes and practices among young adults. Despite having good knowledge, few young Saudis actually adopt healthy lifestyle measures to reduce their cardiovascular risk (33).…”

Prevalence of Nonadherence to Antihypertensive Medications among Adults Attending Primary Healthcare Clinics in Al-Hasa Region: A Cross-Sectional Study

“…In 2014, the prevalence of hypertension worldwide in adults was around 22%, and that was responsible for 9.4 million deaths [2]. In Saudi Arabia, the prevalence of hypertension in adults was reported to be 21% in 2016 [3]. In addition, cardiovascular diseases account for around 46% of mortality rate in Saudi Arabia, but 24% of this rate is attributed to hypertension [2,4].…”