Awareness , Treatment and Control of Pre- hypertension and Hypertension among Adults in Iran

BACKGROUND: Hypertension is a major risk factor for non-communicable diseases. Yet, Nation-wide prevalence and trend reports in developing countries are sparsely available. METHODS: Data from three cycles of Survey of Risk Factors of Non-communicable Diseases (SuRFNCD) 2005 & 2011 were aggregated. In 2011, 8218 adults aged 25 – 70 years were enrolled. For trend analysis 68850, 4184, and 7416 adults aged 25 – 64 years were included from 2005, 2007, and 2011 surveys, respectively. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg, diastolic blood pressure (DBP) ≥ 90 mmHg, or receiving anti-hypertensive medication. Pre-hypertension was defined as SBP between 120 – 139 or DBP between 80 – 89 mmHg. The status of awareness, non-pharmacologic treatment (management), pharmacologic treatment, and control (SBP < 140 mmHg, and DBP < 90 mmHg) among hypertensive individuals were also determined. RESULTS: 25.6% (95%CI: 23.5 – 27.5) of the adults aged 25 – 70 years had hypertension and 39.8% (95%CI: 37.8 – 41.9) had pre-hypertension. The prevalence of hypertension was greater among older adults (P < 0.001), women (P = 0.013), and urban-dwellers (P = 0.027). In 2005 – 2011, the proportion of adults with hypertension (25.7% to 24.1%) and pre-hypertension (45.5% to 40.4%) significantly decreased. In 2011, rates for awareness, management, treatment, and control among hypertensives were 43.2% (95%CI: 40.0 – 46.4), 40.3% (95%CI: 37.0 – 43.6), 34.8% (95%CI: 31.5 – 38.2), and 38.6% (95%CI: 33.1 – 44.2), respectively. Over time, status of awareness, management, treatment and control was significantly improved and was more salient among men (P < 0.05 for all analyses). CONCLUSIONS: The prevalence of hypertension and pre-hypertension is gradually declining. Despite improvements in awareness, management, treatment and control, these decline rates are still low and initiative strategies need to be implemented to further improve the current status.