Among untreated hypertensive adults globally, isolated systolic hypertension was present in 28.4%, with prevalence increasing with age and showing significant sex and regional disparities (P<0.001).
Cross-Sectional (n=97,825)
Yes
Isolated systolic hypertension accounts for 28.4% of untreated hypertension globally, with prevalence strongly driven by older age, female sex, and geographic region.
p-value: p=<0.001
Objective: Isolated systolic hypertension (ISH) is a common hypertension phenotype driven by artery stiffness and recognized as central to vascular aging and cardiovascular risks. Despite global screening efforts by May Measurement Month (MMM), large-scale data specifically characterizing the prevalence and burden of ISH among untreated adults across diverse global regions remains limited. Design and method: We analysed cross-sectional data from the MMM 2022 campaign involving untreated hypertensive adults (>=18 years) across 56 countries. Participants were categorized into three phenotypes: ISH (systolic BP >=140mmHg and diastolic BP =140 mmHg and diastolic BP >=90 mmHg), and isolated diastolic hypertension (IDH, systolic BP =90 mmHg) based on the mean of the second and third of three seated BP readings. Multilevel multinomial logistic regression was used to identify sociodemographic and clinical associates of hypertension phenotypes. Results: Among 97,825 untreated hypertensive adults 27,772 (28.4%) had ISH, 39,189 (40.1%) had SDH and 30,864 (31.6%) had IDH. The crude proportion of ISH increased with age, reaching 49.2% in those >=70 years. After age-standardization, proportions with ISH were higher in females than in males and were highest in North Africa & Middle East (45.5%) and lowest in East Asia (18.1%). Multivariate analysis within the hypertensive population identified older age (Figure), lower education levels (1–6 years), and diabetes as factors positively associated with the ISH phenotype relative to SDH and IDH. After covariate adjustment, significant interactions were observed between sex and age (P<0.001) and sex and region (P<0.001) for the ISH phenotype. Specifically, while the adjusted proportion of ISH increased with age in both sexes, in females it surpassed that of males after 42 years. Furthermore, sex-based differences in the adjusted proportion of ISH varied geographically and were most pronounced in East Asia. Conclusions: ISH represents a significant unmet clinical need globally, displaying stark epidemiological disparities that diverge sharply by age, sex and geography. These findings highlight the importance of age-tailored, sex-sensitive and region-specific screening and intervention programs to manage the natural epidemiologic burden of ISH.
Wang et al. (Fri,) conducted a cross-sectional in Untreated hypertension (n=97,825). Sociodemographic and clinical factors (age, sex, region, education, diabetes) vs. Reference groups was evaluated on Prevalence of isolated systolic hypertension (ISH) (p=<0.001). Among untreated hypertensive adults globally, isolated systolic hypertension was present in 28.4%, with prevalence increasing with age and showing significant sex and regional disparities (P<0.001).