Prehypertension and hypertension among older adults: prevalence, awareness, treatment, control and associated factors - findings from Iranian STEPS survey (2016 and 2021)

BACKGROUND: Hypertension is a major public health issue and especially in the older adults, it is a leading cause of morbidity and mortality. AIMS: This study assessed the prevalence, awareness, treatment, and control of Hypertension among Iranian adults aged 60 years and older. METHODS: we analyzed data from the Iranian STEP-wise Approach to Non-Communicable Disease Risk Factor Surveillance (STEPS) conducted in 2016 and 2021 across all provinces of Iran. Participants were marked as hypertensive based on the ESC/ESH guidelines. 3874 participants from STEPS 2016 and 4020 participants from STEPS 2021 were included and analyzed using survey package in R statistical software. RESULTS: Hypertension rates rose between 2016 and 2021 from 54.74% to 60.57% in males and from 65.54% to 71.76% in females. Hypertension treatment increased from 26.53% to 36.03% in males and from 39.25% to 53.70% in females. In 2016, hypertension control rates were 23.06% in males and 24.03% in females. In 2021 these levels rose to 34.28% in males and 36.13% in females. Obesity was strongly associated with hypertension (odds ratio (OR): 2.75, p < 0.001), whereas higher education appeared to be inversely associated with hypertension (OR: 0.64, p < 0.001). DISCUSSION: Despite the improvement in treatment and control of hypertension among older adults in Iran, hypertension prevalence remains high and on the rise. To address this problem, efforts should focus on weight management, enhanced health education, and expanded screening programs. CONCLUSION: Given observed sex and socioeconomic disparities in awareness, treatment, and control, equity-oriented publicci and improved access to care warrant further evaluation in prospective or implementation studies. Additionally, promoting higher educational attainment may contribute to better long-term control of hypertension.