What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Isolated systolic hypertension (n=4634). Primary outcome: Prevalence of isolated systolic hypertension (95% CI 14.88-16.96).

September 27, 2022Open Access

Isolated systolic hypertension and its associated risk factors in Iranian middle age and older population: a population-based study

AHAli HosseinzadehUniversity of British Columbia HEHossein EbrahimiIslamic Azad University, Tehran AKAhmad KhosraviShahroud University of Medical Sciences

Key Result

Isolated systolic hypertension had an overall prevalence of 15.89% in the Iranian middle-aged and older population, with age, BMI, diabetes, and waist-to-hip ratio significantly increasing the odds.

Study Design

Type

Cross-Sectional (n=4,634)

Multicenter

Yes

Structured PICO

Population

5,190 people aged 40 to 70 years from the Shahroud eye cohort study (ShECS) in Iran.

Outcome

Prevalence of isolated systolic hypertension (ISH) and associated risk factors

Isolated systolic hypertension is highly prevalent (15.89%) among middle-aged and older adults in Iran, with significant associations with age, obesity, and diabetes.

Limitations

Cross-sectional design cannot establish causal association
Did not collect data on alcohol intake, salt intake, and physical activity
Some ISH cases may be missed due to antihypertensive medications
Blood pressure was measured in one arm during a single office visit

Abstract

BACKGROUND: Isolated systolic hypertension (ISH), is the most common form of hypertension in older adults. However, the ISH prevalence is not well known in many developing countries such as Iran. This study was conducted to determine the ISH prevalence and its related risk factors in an Iranian population. METHODS: Data were obtained from the second phase of the Shahroud eye cohort study (ShECS) in 2014. ShECS is a longitudinal population-based study which the first phase had been conducted in 2009 using the stratified multistage cluster sampling design on 5190 people aged 40 to 70 years. The ISH prevalence was determined based on the eighth Joint National Commission guidelines for different demographic variables. The associated risk factors were estimated by multiple logistic regression and a two-tailed p-value less than 0.05 was considered significant. RESULTS: The ISH prevalence was 15.89% (95% CI: 14.88-16.96). It was 15.68% (14.12-17.39) and 15.87% (14.54-17.29) for men and women, respectively. The prevalence of ISH increased significantly with increasing age. The 65-70 compared to 45-69 year age group (OR = 4.21), body mass index (OR = 1.03), diabetes (OR = 1.64), retirement, compared to practitioner job (OR = 1.53), and waist to hip ratio (WHR) (OR = 9.81) were significantly associated with ISH prevalence. CONCLUSIONS: ISH is highly prevalent among the older adult population in Iran. Given the risk of cardiovascular disease associated with ISH, it is recommended to conduct education and public health interventions to improve the detection, prevention, and treatment of ISH.

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