Age-adjusted trends in hypertension prevalence and blood pressure control in Italy from 2000 to 2019

Abstract Background Hypertension (HT) is the main risk factor for cardiovascular (CV) disease and its related morbidity and mortality. To reach and maintaining blood pressure (BP) within targets recomendend by the main HT guidelines is a critical key for reducing the risk of major adverse CV events. This study aimed to evaluate age-standardized trends in HT prevalence and BP control from 2000 to 2019 in Italy. Methods Data were retrieved from the World Health Organization's Non-communicable disease (WHO NCD) dataset to analyze age-standardized prevalence of HT (defined as systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or people taking anti-hypertensive drugs) and controlled HT (defined as systolic BP ≤140 mmHg or diastolic BP ≤90 mmHg) among Italians of 30-79 year-old. For statistics, joinpoint regression analysis and a parallelism test were used to calculate annual trends, including average annual percentage change (AAPC with relative 95% confidence intervals, CIs) and differences (interactions) in the trends, respectively. For this latter test, a significant p-value indicated that the trends, in terms of AAPC, were significantly differents. Results The nationwide age-standardized prevalence of HT decreased from 42.2 (95% CI: 39.8 to 44.6) per 100,000 people in 2000 to 33.8 (95% CI: 29.3 to 38.5) per 100,000 people in 2019 AAPC: -1.2% (95% CI: -1.3 to -1.1), p0.001, with an higher reduction in women compared to men (p-value for parallelism 0.001) (Figure 1, Panel A). The age-standardized BP control increased from 7.7 (95% CI: 6.1 to 9.4) per 100,000 people in 2000 to 28.1 (95% CI: 20.3 to 36.7) per 100,000 people in 2019 AAPC: +7.1% (95% CI: 7.0 to 7.2), p0.001 and it was higher in men AAPC: +7.8% (95% CI: 7.7 to 7.9), p0.001 compared to women AAPC: +6.5% (95% CI: 6.4 to 6.6), p0.001 (p-value for parallelism 0.001) (Figure 1, Panel B). Conclusions Over the last two decades, the age-standardized prevalence of HT and BP control significantly improved in Italy. However, BP control is still an unsolved problem, with heavy consequences on the health care systems. A call to action is required to optimize BP control in the long-term with to aim to reduce the CV risk.Figure 1