Trends in prevalence, awareness, treatment and control of arterial hypertension between 1986 and 1996:: the MONICA-Catalonia study

BACKGROUND: To describe temporal trends in blood pressure (BP) and in the prevalence, awareness, treatment and control of arterial hypertension (AH) between 1986-1996 in the MONICA-Catalonia study. SUBJECTS AND METHOD: Three cross-sectional health surveys in independent random samples of the general population aged 25-64, carried out in 1986-88, 1990-92 and 1994-96 according to the WHO-MONICA study protocol. BP was measured twice with a random zero mercury sphygmomanometer. RESULTS: 2,571, 2,934 and 3,485 subjects were examined in each survey with response rates of 74, 67 and 72%, respectively. Age-adjusted mean of systolic BP (SBP) decreased 2 and 4 mmHg (p < 0.001) reaching 120 and 114 mmHg in 1994-96 in men and women, respectively. Diastolic BP (DBP) did not change in men (73-74 mmHg) nor in women (70-71 mmHg). Age adjusted prevalence of AH (<greater than or equal to> 160/95 and/or under pharmacological treatment) was 8% (men; and 10% (women) in 1994-96 and of AH (greater than or equal to 140/90 and/or under pharmacological treatment) was 15% in both sexes. Awareness of hypertension ( AH : 140/90) increased from 67 to 76%. Treated hypertensives increased from 22 to 40% (men) and from 44 to 54% (women). The use of diuretics and betablockers decreased and ACE inhibitors increased. At the end of the period, 52% of hypertensives were controlled. SBP also decreased in normotensives but not DBP. CONCLUSIONS: Between 1986 and 1996, the prevalence of AH in Catalonia remained stable although awareness, treatment and control had substantially improved. SBP decreased but DBP remained stable.