What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=8296). Intervention: Hypertension. Primary outcome: Weighted prevalence of hypertension (95% CI 34.5-38.5).

January 1, 2022Open Access

Prevalence, Awareness, Treatment, and Control of Hypertension among Adult Residents of Tehran: The Tehran Cohort Study

AOAlireza OraiiHospital of the University of Pennsylvania ASAkbar ShafieeTehran University of Medical Sciences AJArash JalaliVancouver Clinic

Key Result

The weighted prevalence of hypertension among adult residents of Tehran was 36.5%, with suboptimal rates of awareness (68.2%), treatment (53.3%), and control (40.4%).

Study Design

Type

Cross-Sectional (n=8,296)

Structured PICO

Population

8,296 adults aged 35 years and older residing in Tehran were assessed to determine the prevalence, awareness, treatment, and control of hypertension.

Outcome

Prevalence, awareness, treatment, and control of hypertension (defined by 2018 ESC/ESH guidelines as systolic BP ≥140 mmHg, diastolic BP ≥90 mmHg, self-report, or current antihypertensive medication use)

Despite a high prevalence of hypertension in Tehran (36.5%), treatment and control rates remain inadequate, highlighting a need for improved public health strategies.

Limitations

Enrolled only adults aged ≥35 years, limiting generalizability to younger populations.
Blood pressure measurements were performed at a single session, which could overestimate prevalence due to white coat hypertension.

Abstract

Background: High levels of blood pressure (BP) remain undetected and poorly controlled in large segments of the population leading to an enormous burden in terms of disease and mortality. Objective: We aimed to assess the prevalence, awareness, treatment, and control of hypertension in Tehran. Methods: We used the data of 8,296 adults aged ≥35 years from the Tehran Cohort Study who were enrolled between May 2016 and February 2019. Hypertension was defined as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg, self-report, and/or current antihypertensive medication use. The age- and sex-weighted prevalence of hypertension and high normal BP was calculated using the 2016 national census. Furthermore, awareness, treatment, and control of hypertension were analyzed. Results: The mean age of the participants was 53.8 ±12.75 years, and 54.0% were women. The weighted prevalence of hypertension and high normal BP were 36.5% and 12.2%, respectively. Among hypertensive individuals, 68.2% were aware of hypertension, 53.3% were receiving medication, and 40.4% had adequate BP control. The awareness, treatment, and control of hypertension were significantly higher in women (72.2% vs. 63.4% P < 0.001, 55.1% vs 51.1% P = 0.020, and 42.7% vs. 37.7% P = 0.004, respectively) and this gap considerably increased with advancing age. Hypertension was more prevalent in northern Tehran but with a better treatment rate and control in the same regions. Conclusion: Despite the high prevalence of hypertension in the adult population of Tehran, the rates of awareness, treatment, and control of hypertension are unsatisfactory and demand comprehensive strategies to improve this situation, especially in younger men.

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