Table 1
Characteristics of study population according to hypertension presence, awareness, treatment, and control.
| VARIABLES | HYPERTENSION | AWARENESS | TREATMENT | CONTROL | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NORMOTENSIVE (N = 5977) | HYPERTENSIVE (N = 4543) | P-VALUE* | UNAWARE (N = 2118 | AWARE(N = 2425) | P-VALUE* | UNTREATED (N = 2281) | TREATED (N = 2262) | P-VALUE* | UNCONTROLLED (N = 593) | CONTROLLED (N = 1669) | P-VALUE* | ||||
| Diastolic BP (mmHg) | 74.3 ± 10 | 80.5 ± 11 | <0.001 | 76.9 ± 10 | 83.6 ± 10 | <0.001 | 81.1 ± 11 | 79.9 ± 10 | <0.001 | 92.1 ± 7 | 75.5 ± 8 | <0.001 | |||
| Systolic BP (mmHg) | 113.5 ± 14 | 124.8 ± 18 | <0.001 | 116.8 ± 14 | 131.1 ± 17 | <0.001 | 124.9 ± 18 | 124 ± 17 | 0.1 | 145.8 ± 15 | 116.3 ± 11 | <0.001 | |||
| Age (year) | 49.5 ± 8 | 54.1 ± 9 | <0.001 | 52.2 ± 8 | 55.6 ± 8 | <0.001 | 53.4 ± 9 | 54.7 ± 8 | <0.001 | 56.9 ± 8 | 53.9 ± 8 | <0.001 | |||
| Urban (%) | 2427(40.6%) | 2186(48.1%) | <0.001 | 1131(53.4%) | 1055(43.5%) | <0.001 | 1213(53.2%) | 973(43%) | <0.001 | 232(39.1%) | 741(44.4%) | 0.01 | |||
| High school or less education level (%) | 2108(35.3%) | 1995(43.9%) | <0.001 | 1044(49.3 %) | 917(37.8 %) | <0.001 | 1022(44.8%) | 973(43%) | 0.1 | 288(48.6%) | 685(41%) | 0.001 | |||
| Male (%) | 2983(49.9%) | 1904(41.9%) | <0.001 | 1123(53%) | 781(32.2%) | <0.001 | 938(41.1%) | 966(42.7%) | 0.1 | 261(44%) | 705(42.2%) | 0.2 | |||
| BMI (kg/m2) | 27.6 ± 5 | 28.7 ± 5 | <0.001 | 27.5 ± 4 | 29.8 ± 5 | <0.001 | 28.8 ± 5 | 28.6 ± 5 | 0.2 | 29.6 ± 5 | 28.3 ± 5 | <0.001 | |||
| Waist circumference (cm) | 97.3 ± 12 | 100.7 ± 12 | <0.001 | 96.8 ± 11 | 104 ± 1 ± 11 | <0.001 | 100.5 ± 12 | 100.9 ± 12 | 0.2 | 103 ± 11 | 100 ± 11 | <0.001 | |||
| Physical activity(METs/hour/day) | 42.2 ± 9 | 39.9 ± 8 | <0.001 | 41.3 ± 8 | 38.6 ± 7 | <0.001 | 40.1 ± 8 | 39.7 ± 8 | 0.09 | 38.6 ± 7 | 40.1 ± 8 | <0.001 | |||
| Use of Alcohol (%) | 941(15.7%) | 574(12.6%) | <0.001 | 336(15.9%) | 238(9.8%) | <0.001 | 269(11.8%) | 305(13.5%) | 0.04 | 73(12.3%) | 232(13.9%) | 0.1 | |||
| Smoking (%) | 1498(25.1%) | 1086(23.9%) | 0.09 | 618(29.2%) | 468(19.3%) | <0.001 | 525(23%) | 561(24.8%) | 0.8 | 136(22.9%) | 425(25.5%) | 0.1 | |||
| Diabetic | 936(15.7%) | 1595(35.1%) | <0.001 | 601(28.4%) | 994(41%) | <0.001 | 661(29%) | 934(41.3%) | <0.001 | 270(45.5%) | 664(39.8%) | 0.01 | |||
| Has cardiovascular disease | 175(2.9%) | 580(12.8%) | <0.001 | 163(7.7%) | 417(17.2%) | <0.001 | 201(8.8%) | 379(16.8%) | <0.001 | 97(16.4%) | 282(16.9%) | 0.4 | |||
| Has Psychiatric disorder | 715(12%) | 914(20.1%) | <0.001 | 316(14.9%) | 598(24.7%) | <0.001 | 443(19.4%) | 471(20.8%) | 0.1 | 126(21.2%) | 345(20.7%) | 0.4 | |||
| Positive Family history of hypertension | 3587(60%) | 3317(73%) | <0.001 | 1412(66.7%) | 1905(78.6%) | <0.001 | 1665(73%) | 1652(73%) | 0.5 | 122(20.6%) | 488(29.2%) | <0.001 | |||
| TC (mmol/L) | 193.1 ± 38 | 192.3 ± 39 | 0.3 | 193 ± 38 | 191.3 ± 40 | 0.07 | 195.1 ± 39 | 189.6 ± 40 | <0.001 | 192 ± 40 | 188.5 ± 40 | 0.02 | |||
| TG (mmol/L) | 155.3 ± 10 | 166.6 ± 10 | <0.001 | 164.1 ± 10 | 168 ± 10 | 0.1 | 165.8 ± 10 | 167.4 ± 10 | 0.6 | 176.4 ± 11 | 164.2 ± 10 | 0.01 | |||
| HDL-C (mmol/L) | 48.5 ± 11 | 48.1 ± 10 | 0.1 | 48.5 ± 10 | 47.8 ± 10 | 0.06 | 48.4 ± 10 | 47.9 ± 10 | 0.1 | 47.7 ± 10 | 48 ± 10 | 0.6 | |||
| LDL-C (mmol/L) | 113.9 ± 30 | 111.3 ± 33 | <0.001 | 112.6 ± 31 | 110.2 ± 34 | 0.01 | 113.8 ± 32 | 108 ± 33 | <0.001 | 110 ± 34 | 108 ± 33 | 0.09 | |||
| Serum creatinine (µmol/L) | 0.89 ± 0.1 | 0.9 ± 0.1 | <0.001 | 0.89 ± 0.1 | 0.9 ± 0.1 | <0.001 | 0.9 ± 0.1 | 0.9 ± 0.1 | 0.3 | 0.91 ± 0.1 | 0.9 ± 0.1 | 0.08 | |||
[i] * Statistical significance based on the independent Student’s t tests for continuous variables or Chi-square or Fisher’s Exact test for categorical variables.
Abbreviations: BP: blood pressure; BMI: body mass index; METs: metabolic equivalent rates; TC: total cholesterol; TG: triglyceride; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol.
Definitions: Hypertension: systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg and/or a prior diagnosis of hypertension by a health professional or being on antihypertensive medication; Awareness: hypertensive patient who self-reported any prior diagnosis of hypertension by a health care professional; Treatment: hypertensive patient who were receiving prescribed antihypertensive drugs for high BP controlling; control: hypertensive patient on antihypertensive medication with systolic BP < 140 mm Hg and diastolic BP < 90 mm.
Figure 1
Geographic distribution of Hypertension prevalence, awareness, treatment and control in urban and rural area of Guilan cohort study. (The map depicted in figure is our own work).
Data are expressed as mean ± standard deviation or number (percentages).
Table 2
Multivariable logistic regression analysis of variables associated with hypertension presence, awareness, treatment, and control.
| VARIABLES | HYPERTENSION PRESENCE | AWARENESS | TREATMENT | CONTROL | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AOR* | (95%CI) | P-VALUE | AOR* | (95%CI) | P-VALUE | AOR* | (95%CI) | P-VALUE | AOR* | (95%CI) | P-VALUE | ||||
| Age(year) | |||||||||||||||
| 35–50(ref) | 1 | 1 | 1 | 1 | |||||||||||
| 51–70 | 2.1 | 1.9–2.3 | <0.001 | 1.8 | 1.6–2.1 | <0.001 | 1.2 | 1.1–1.3 | 0.002 | 0.6 | 0.5–0.8 | <0.001 | |||
| Residence | |||||||||||||||
| Rural (ref) | 1 | 1 | 1 | 1 | |||||||||||
| Urban | 1.4 | 1.2–1.5 | <0.001 | 0.7 | 0.6–0.8 | <0.001 | 0.6 | 0.5–0.7 | <0.001 | 1 | 0.8–1.2 | 0.6 | |||
| Educational level | |||||||||||||||
| high school or less(ref) | 1 | 1 | – | 1 | |||||||||||
| diploma or more | 0.8 | 0.7–0.9 | <0.001 | 1.4 | 1.3–1.6 | <0.001 | – | – | – | 1.4 | 1.2–1.8 | <0.001 | |||
| Sex | |||||||||||||||
| Male(ref) | 1 | 1 | – | – | |||||||||||
| Female | 1 | 0.8–1.1 | 0.6 | 1.3 | 1.1–1.6 | 0.008 | – | – | – | – | – | – | |||
| BMI | |||||||||||||||
| Normal(ref) | 1 | 1 | – | 1 | |||||||||||
| Overweight | 1.2 | 1.1–1.3 | 0.001 | 1.4 | 1.2–1.7 | <0.001 | – | – | – | 0.6 | 0.5–0.9 | 0.008 | |||
| Obese | 1.4 | 1.2–1.6 | <0.001 | 1.8 | 1.4–2.2 | <0.001 | – | – | – | 0.4 | 0.3–0.6 | <0.001 | |||
| Waist circumference | |||||||||||||||
| normal(ref) | 1 | 1 | – | 1 | |||||||||||
| Abdominal obesity | 1 | 0.9–1.2 | 0.4 | 1.6 | 1.3–2 | <0.001 | – | – | – | 0.8 | 0.5–1.1 | 0.2 | |||
| Physical activity (METs/hour/day) | |||||||||||||||
| <34.8(Q1)(ref) | 1 | 1 | – | 1 | |||||||||||
| 34.8–38.8(Q2) | 0.9 | 0.8–1.1 | 0.5 | 0.7 | 0.6–0.9 | 0.006 | – | – | – | 1.2 | 0.9–1.5 | 0.1 | |||
| 38.8–45.8(Q3) | 0.7 | 0.7–0.8 | <0.001 | 0.6 | 0.5–0.7 | <0.001 | – | – | – | 1.2 | 0.9–1.5 | 0.1 | |||
| ≥45.8(Q4) | 0.6 | 0.5–0.6 | <0.001 | 0.6 | 0.5–0.8 | <0.001 | – | – | – | 1.6 | 1.2–2.2 | 0.001 | |||
| Alcohol use | |||||||||||||||
| No(ref) | 1 | 1 | 1 | – | |||||||||||
| Yes | 1 | 0.8–1.1 | 0.6 | 0.8 | 0.7–1.1 | 0.8 | 1.1 | 0.9–1.4 | 0.07 | – | – | – | |||
| Smoking | |||||||||||||||
| No(ref) | – | 1 | – | – | |||||||||||
| Yes | – | – | – | 0.9 | 0.8–1.1 | 0.8 | – | – | – | – | – | – | |||
| Diabetes | |||||||||||||||
| No | 1 | 1 | 1 | ||||||||||||
| Prediabetes | 1.4 | 1.2–1.6 | <0.001 | 0.9 | 0.8–1.1 | 0.6 | 1 | 0.8–1.2 | 0.4 | 1 | 0.7–1.3 | 0.8 | |||
| Diabetic | 2.1 | 1.9–2.3 | <0.001 | 1.5 | 1.2–1.7 | <0.001 | 1.6 | 1.4–1.9 | <0.001 | 1.1 | 0.9–1.4 | 0.1 | |||
| Cardiovascular disease | |||||||||||||||
| No(ref) | 1 | 1 | 1 | – | |||||||||||
| Yes | 3.1 | 2.5–3.7 | <0.001 | 2 | 1.6–2.4 | <0.001 | 1.8 | 1.5–2.2 | <0.001 | – | – | – | |||
| Psychiatric disorder | |||||||||||||||
| No(ref) | 1 | 1 | – | – | |||||||||||
| Yes | 1.5 | 1.3–1.6 | <0.001 | 1.5 | 1.2–1.7 | <0.001 | – | – | – | – | – | – | |||
| Family history of hypertension | |||||||||||||||
| No(ref) | 1 | 1 | – | 1 | |||||||||||
| Yes | 1.8 | 1.6–1.9 | <0.001 | 1.8 | 1.6–2.1 | <0.001 | – | – | – | 1.6 | 1.2–2 | <0.001 | |||
| TC (mmol/L) | |||||||||||||||
| Normal | – | – | 1 | 1 | |||||||||||
| Raised | – | – | – | – | – | – | 0.9 | 0.8–1.2 | 0.9 | 0.9 | 0.8–1.1 | 0.07 | |||
| TG (mmol/L) | |||||||||||||||
| Normal | 1 | – | – | ||||||||||||
| Raised | 1.1 | 0.9–1.2 | 0.06 | – | – | – | – | – | – | 1 | 0.8–1.1 | 0.8 | |||
| LDL-C (mmol/L) | |||||||||||||||
| Normal | 1 | 1 | 1 | – | |||||||||||
| Raised | 1 | 0.8–1.06 | 0.6 | 0.9 | 0.8–1.07 | 0.5 | 0.8 | 0.7–1.1 | 0.07 | – | – | – | |||
| Serum creatinine (µmol/L) | |||||||||||||||
| Normal | 1 | 1 | – | – | |||||||||||
| Raised | 5.1 | 2.1–12 | <0.001 | 2 | 0.9–4.4 | 0.06 | – | – | – | – | – | – | |||
[i] * Adjusted Odds ratio: Adjusted for all variables that were significant in univariate analyses.
CI: confidence interval.
Abbreviations: BP: blood pressure; BMI: body mass index; METs: metabolic equivalent rates; TC: total cholesterol; TG: triglyceride; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol.
Definitions: Hypertension: systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg and/or a prior diagnosis of hypertension by a health professional or being on antihypertensive medication; Awareness: hypertensive patient who self-reported any prior diagnosis of hypertension by a health care professional; Treatment: hypertensive patient who were receiving prescribed antihypertensive drugs for high BP controlling; control: hypertensive patient on antihypertensive medication with systolic BP < 140 mm Hg and diastolic BP < 90 mm.