The study examined prevalence, awareness, treatment and control of hypertension (HTN), and associated factors and to evaluate the trend in hypertension between 2009 (period 2) and 1994–1998 (period 1). A national sample of 4117 adults aged 25 years and older was selected. Prevalence rate of HTN (SBP ≥ 140 or DBP ≥ 90 or on antihypertensive therapy) was 32.3% and was higher than the 29.4% prevalence rate reported in period 1. Prevalence rate was significantly higher among males, older age groups, least educated, obese, and diabetics than their counterparts. The rate of awareness among hypertensives was 56.1% and was higher than the 38.8% rate reported form period 1 data. Awareness was positively associated with age, smoking, and diabetes for both men and women, and with level of education and body mass index for men. Rate of treatment for HTN among aware patients was 63.3% and was significantly higher than the 52.8% rate reported in period1. Control rate of HTN among treated hypertensives was 39.6%; significantly higher than the 27.9% control rate in period 1. Control of HTN was positively associated with age but only for women. In conclusion, HTN is still on the rise in Jordan, and levels of awareness and control are below the optimal levels. 1. Introduction HTN is a major public health problem of worldwide distribution and is the most common cardiovascular disease (CVD) risk factor [1]. It is responsible for one half of coronary heart disease (CHD) and about two thirds of cerebrovascular accidents [2]. By 2030, 23 million cardiovascular deaths are projected to have HTN, with about 85% occurring in low and middle-income countries [1]. Research published between 1980 and 2002 indicate the prevalence of HTN in developing countries increased at a higher rate than in developed countries [3]. Prevention of HTN is possible, and early detection and treatment can reduce the incidence of complications including stroke, CHD, heart failure, and kidney disease [4], and yet the levels of control of hypertension are low worldwide. Economically developed countries have higher rates of HTN than in developing countries [5]. However, data reported in the last decade indicate that the prevalence, awareness, treatment, and control of hypertension in economically developing countries are coming closer to those in economically developed countries [6]. Recent epidemiological studies on prevalence, awareness, treatment, and control of HTN in Jordan are scarce. The few community-based studies [7, 8] conducted between 1994 and 1996 in Jordan demonstrated a 16.1 and 16.3%
References
[1]
A. Damasceno, A. Azevedo, C. Silva-Matos, A. Prista, D. Diogo, and N. Lunet, “Hypertension prevalence, awareness, treatment, and control in mozambique: urban/rural gap during epidemiological transition,” Hypertension, vol. 54, no. 1, pp. 77–83, 2009.
[2]
J. A. Cutler, P. D. Sorlie, M. Wolz, T. Thom, L. E. Fields, and E. J. Roccella, “Trends in hypertension prevalence, awareness, treatment, and control rates in United States adults between 1988–1994 and 1999–2004,” Hypertension, vol. 52, no. 5, pp. 818–827, 2008.
[3]
P. M. Kearney, M. Whelton, K. Reynolds, P. Muntner, P. K. Whelton, and J. He, “Global burden of hypertension: analysis of worldwide data,” The Lancet, vol. 365, no. 9455, pp. 217–223, 2005.
[4]
Z. H. Israili, R. Hernández-Hernández, and M. Valasco, “The future of antihypertensive treatment,” American Journal of Therapeutics, vol. 14, no. 2, pp. 121–134, 2007.
[5]
P. M. Kearney, M. Whelton, K. Reynolds, P. K. Whelton, and J. He, “Worldwide prevalence of hypertension: a systematic review,” Journal of Hypertension, vol. 22, no. 1, pp. 11–19, 2004.
[6]
M. Pereira, N. Lunet, A. Azevedo, and H. Barros, “Differences in prevalence, awareness, treatment and control of hypertension between developing and developed countries,” Journal of Hypertension, vol. 27, no. 5, pp. 963–975, 2009.
[7]
H. Y. Jaddou, A. M. Bateiha, and K. M. Ajlouni, “Prevalence, awareness and management of hypertension in a recently urbanised community, eastern Jordan,” Journal of Human Hypertension, vol. 14, no. 8, pp. 497–501, 2000.
[8]
H. Y. Jaddou, A. M. Batiehah, and K. M. Ajlouni, “Prevalence and associated factors of hypertension: results from a three community-based survey, Jordan,” Journal of Human Hypertension, vol. 10, no. 12, pp. 815–821, 1996.
[9]
World Health Organization/International Society for Hypertension, “Hypertension guidelines,” Journal of Hypertension, vol. 17, pp. 151–183, 1999.
[10]
A. V. Chobanian, G. L. Bakris, H. R. Black et al., “The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report,” Journal of the American Medical Association, vol. 289, no. 19, pp. 2560–2572, 2003.
[11]
A. Batieha, Y. Khader, H. Y. Jaddou et al., “Vitamin D status in Jordan: dress style and gender discrepancies,” Annals of Nutrition and Metabolism, vol. 58, no. 1, pp. 10–18, 2011.
[12]
Y. Khader, A. Batieha, H. Y. Jaddou, M. El-Khateeb, and K. Ajlouni, “Metabolic syndrome and its individual components among jordanian children and adolescents,” International Journal of Pediatric Endocrinology, vol. 2010, Article ID 316170, 7 pages, 2010.
[13]
H. Y. Jaddou, A. M. Bateiha, M. S. Al-Khateeb, and K. M. Ajlouni, “Epidemiology and management of hypertension among Bedouins in Northern Jordan,” Saudi Medical Journal, vol. 24, no. 5, pp. 472–476, 2003.
[14]
M. M. Al-Nozha, M. Abdullah, M. R. Arafah et al., “Hypertension in Saudi Arabia,” Saudi Medical Journal, vol. 28, no. 1, pp. 77–84, 2007.
[15]
A. Bener, J. Al-Suwaidi, K. Al-Jaber, S. Al-Marri, and I. E. A. Elbagi, “Epidemiology of hypertension and its associated risk factors in the Qatari population,” Journal of Human Hypertension, vol. 18, no. 7, pp. 529–530, 2004.
[16]
M. M. Ibrahim, H. Rizk, L. J. Appel et al., “Hypertension prevalence, awareness, treatment, and control in Egypt: results from the Egyptian National Hypertension Project (NHP),” Hypertension, vol. 26, no. 6, pp. 886–890, 1995.
[17]
C. G. Suresh, M. Zubaid, L. Thalib, W. Rashed, and T. David, “Racial variation in risk factors and occurrence of acute myocardial infarction: comparison between Arab and south Asian men in Kuwait,” Indian Heart Journal, vol. 54, no. 3, pp. 266–270, 2002.
[18]
M. Dorobantu, R. O. Darabont, E. Badila, and S. Ghiorghe, “Prevalence, awareness, treatment, and control of hypertension in romania: results of the SEPHAR study,” International Journal of Hypertension, vol. 2010, Article ID 970694, 6 pages, 2010.
[19]
R. Cífková, Z. ？kodová, V. Lánská et al., “Prevalence, awareness, treatment, and control of hypertension in the Czech Republic: results of two nationwide cross-sectional surveys in 1997/1998 and 2000/2001, Czech Post-MONICA study,” Journal of Human Hypertension, vol. 18, no. 8, pp. 571–579, 2004.
[20]
N. Danon-Hersch, P. Marques-Vidal, P. Bovet et al., “Prevalence, awareness, treatment and control of high blood pressure in a Swiss city general population: the CoLaus study,” European Journal of Cardiovascular Prevention and Rehabilitation, vol. 16, no. 1, pp. 66–72, 2009.
[21]
K. Wolf-Maier, R. S. Cooper, J. R. Banegas et al., “Hypertension prevalence and blood pressure levels in 6 European vountries, Canada, and the United States,” Journal of the American Medical Association, vol. 289, no. 18, pp. 2363–2369, 2003.
[22]
C. Prugger, P. U. Heuschmann, and U. Keil, “Epidemiology of hypertension in Germany and worldwide,” Herz, vol. 31, no. 4, pp. 287–293, 2006.
[23]
E. D. Janus, S. J. Bunker, A. Kilkkinen et al., “Prevalence, detection and drug treatment of hypertension in a rural Australian population: the Greater Green Triangle Risk Factor Study 2004–2006,” Internal Medicine Journal, vol. 38, no. 12, pp. 879–886, 2008.
[24]
X.-J. Meng, G.-H. Dong, D. Wang et al., “Prevalence, awareness, treatment, control, and risk factors associated with hypertension in urban adults from 33 communities of China: the CHPSNE study,” Journal of Hypertension, vol. 29, no. 7, pp. 1303–1310, 2011.
[25]
V. M. Bharati and K. S. Ajayi, “Hypertension in the developing world: challenges and opportunities,” American Journal of Kidney Diseases, vol. 55, no. 3, pp. 590–598, 2010.
[26]
R. Gupta, “Trends in hypertension epidemiology in India,” Journal of Human Hypertension, vol. 18, no. 2, pp. 73–78, 2004.
[27]
S. K. Das, K. Sanyal, and A. Basu, “Study of urban community survey in India: growing trend of high prevalence of hypertension in a developing country,” International Journal of Medical Sciences, vol. 2, no. 2, pp. 70–78, 2005.
[28]
P. M. Kearney, M. Whelton, K. Reynolds, P. K. Whelton, and J. He, “Worldwide prevalence of hypertension: a systematic review,” Journal of Hypertension, vol. 22, no. 1, pp. 11–19, 2004.
[29]
I. Jo, Y. Ahn, J. Lee, K. R. Shin, H. K. Lee, and C. Shin, “Prevalence, awareness, treatment, control and risk factors of hypertension in Korea: the Ansan study,” Journal of Hypertension, vol. 19, no. 9, pp. 1523–1532, 2001.
[30]
C. Gasse, H. W. Hense, J. Stieber, A. D？ring, A. D. Liese, and U. Keil, “Assessing hypertension management in the community: trends of prevalence, detection, treatment, and control of hypertension in the MONICA Project, Augsburg 1984–1995,” Journal of Human Hypertension, vol. 15, no. 1, pp. 27–36, 2001.
[31]
R. M. Korth, “Gender, obesity, alcohol use, hyperlipidemia, hypertension and decline of renal endothelial barriers,” Journal of Men's Health and Gender, vol. 3, no. 3, pp. 279–289, 2006.
[32]
S. Gupta and S. Kapoor, “Sex differences in blood pressure levels and its association with obesity indices: who is at greater risk,” Ethnicity and Disease, vol. 20, no. 4, pp. 370–375, 2010.
[33]
M. Huisman, A. E. Kunst, M. Bopp et al., “Educational inequalities in cause-specific mortality in middle-aged and older men and women in eight western European populations,” The Lancet, vol. 365, no. 9458, pp. 493–500, 2005.
[34]
M. A. Winkleby, D. E. Jatulis, E. Frank, and S. P. Fortmann, “Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease,” American Journal of Public Health, vol. 82, no. 6, pp. 816–820, 1992.
[35]
C. E. Ross and Chia-Ling Wu, “The links between education and health,” American Sociological Review, vol. 60, no. 5, pp. 719–745, 1995.
[36]
R. Perez-Fernandez, A. F. Mari？o, C. Cadarso-Suarez et al., “Prevalence, awareness, treatment and control of hypertension in Galicia (Spain) and association with related diseases,” Journal of Human Hypertension, vol. 21, no. 5, pp. 366–373, 2007.
[37]
T. J. Orchard, “The impact of gender and general risk factors on the occurrence of atherosclerotic vascular disease in non-insulin-dependent diabetes mellitus,” Annals of Medicine, vol. 28, no. 4, pp. 323–333, 1996.
[38]
W. L. Lee, A. M. Cheung, D. Cape, and B. Zinman, “Impact of diabetes on coronary artery disease in women and men: a meta-analysis of prospective studies,” Diabetes Care, vol. 23, no. 7, pp. 962–968, 2000.
[39]
F. A. McAlister, K. Wilkins, M. Joffres et al., “Changes in the rates of awareness, treatment and control of hypertension in Canada over the past two decades,” Canadian Medical Association Journal, vol. 183, no. 9, pp. 1007–1013, 2011.
[40]
A. Alsuwaida and M. Alghonaim, “Gender disparities in the awareness and control of hypertension,” Clinical and Experimental Hypertension, vol. 33, no. 5, pp. 354–357, 2011.
