Table 1
Baseline characteristics and prevalence of hypertension in the population of the Tehran Cohort Study.
| TOTAL POPULATION* n = 8296 | NORMAL/OPTIMAL† n = 3962 (48.0) | HIGH NORMAL† n = 1007 (12.2) | HYPERTENSION† n = 3288 (39.8) | P-VALUE‡ | |
|---|---|---|---|---|---|
| Age, year, mean (SD) | 53.8 (12.75) | 48.60 (10.9) | 53.4 (11.77) | 60.2 (12.16) | <0.001 |
| Age, year, n (%) | <0.001 | ||||
| 35–44 | 2329 (28.1) | 1693 (73.1) | 262 (11.3) | 360 (15.6) | |
| 45–54 | 2209 (26.6) | 1190 (54.1) | 312 (14.2) | 696 (31.7) | |
| 55–64 | 1967 (23.7) | 722 (36.8) | 233 (11.9) | 1008 (51.3) | |
| 65–74 | 1222 (14.7) | 265 (21.8) | 152 (12.5) | 800 (65.7) | |
| ≥75 | 569 (6.9) | 92 (16.3) | 48 (8.5) | 424 (75.2) | |
| Sex, n (%) | 0.013 | ||||
| Men | 3818 (46.0) | 1794 (47.2) | 507 (13.3) | 1500 (39.5) | |
| Women | 4478 (54.0) | 2168 (48.7) | 500 (11.2) | 1788 (40.1) | |
| Marital status, n (%) | 0.663 | ||||
| Married | 8210 (99.2) | 3929 (48.0) | 1001 (12.2) | 3258 (39.8) | |
| Non-married | 86 (0.8) | 31 (47.0) | 6 (9.1) | 29 (43.9) | |
| Ethnicity, n (%) | 0.224 | ||||
| Fars | 4026 (48.8) | 1877 (46.6) | 510 (12.7) | 1639 (40.7) | |
| Azari | 2447 (29.7) | 1187 (48.5) | 290 (11.9) | 970 (39.6) | |
| Gilak | 330 (4.0) | 166 (50.3) | 34 (10.3) | 130 (39.4) | |
| Lor | 318 (3.9) | 175 (55.0) | 28 (8.8) | 115 (36.2) | |
| Kurd | 193 (2.3) | 98 (50.8) | 26 (13.5) | 69 (35.8) | |
| Mixed | 680 (8.2) | 331 (48.7) | 79 (11.6) | 270 (39.7) | |
| Other | 206 (2.5) | 102 (49.5) | 32 (15.5) | 72 (35.0) | |
| Immigrants/Refugees | 51 (0.6) | 23 (45.1) | 8 (15.7) | 20 (39.2) | |
| Education, year, n (%) | <0.001 | ||||
| Illiterate | 585 (7.1) | 141 (24.1) | 51 (8.7) | 393 (67.2) | |
| (1–5) | 841 (10.2) | 286 (34.1) | 98 (11.7) | 455 (54.2) | |
| (6–12) | 4306 (52.0) | 2070 (48.2) | 559 (13.0) | 1662 (38.7) | |
| >12 | 2541 (30.7) | 1461 (57.6) | 299 (11.8) | 776 (30.6) | |
| Body mass index, kg/m2, n (%) | <0.001 | ||||
| <20 | 227 (2.8) | 158 (69.6) | 25 (11.0) | 44 (19.4) | |
| 20–24.9 | 2079 (25.3) | 1251 (60.5) | 243 (11.7) | 575 (27.8) | |
| 25–29.9 | 3426 (41.7) | 1661 (48.6) | 438 (12.8) | 1320 (38.6) | |
| 30–34.9 | 1796 (21.9) | 680 (37.9) | 221 (12.3) | 892 (49.7) | |
| ≥35 | 683 (8.3) | 193 (28.3) | 76 (11.1) | 413 (60.6) | |
| Diabetes, n (%) | <0.001 | ||||
| No | 6965 (84.4) | 3640 (52.2) | 895 (12.8) | 2430 (34.9) | |
| Yes | 1292 (15.6) | 322 (24.9) | 112 (8.7) | 858 (66.4) | |
| Hyperlipidemia, n (%) | <0.001 | ||||
| No | 5562 (67.4) | 3122 (56.1) | 759 (13.6) | 1681 (30.2) | |
| Yes | 2694 (32.6) | 839 (31.1) | 248 (9.2) | 1607 (59.7) | |
| Chronic kidney disease, n (%) | <0.001 | ||||
| No | 8187 (99.1) | 3948 (48.2) | 1005 (12.3) | 3234 (39.5) | |
| Yes | 71 (0.9) | 14 (19.7) | 2 (2.8) | 55 (77.5) | |
| Serum Creatinine, mg/dL, median (25th, 75th percentile) | 0.80 (0.70, 0.94) | 0.79 (0.69, 0.90) | 0.80 (0.70, 0.93) | 0.84 (0.71, 1.00) | <0.001 |
| Tobacco user, n (%) | <0.001 | ||||
| Current | 1594 (19.3) | 911 (57.2) | 185 (11.6) | 498 (31.2) | |
| Former | 333 (4.0) | 110 (33.0) | 40 (12.0) | 183 (55.0) | |
| Never | 6325 (76.6) | 2937 (46.4) | 782 (12.4) | 2606 (41.2) | |
| Opium consumption, n (%) | 0.309 | ||||
| No | 7856 (94.7) | 3750 (48.1) | 948 (12.2) | 3091 (39.7) | |
| Yes | 440 (5.3) | 194 (44.4) | 58 (13.3) | 185 (42.3) | |
| Alcohol consumption, n (%) | 0.001 | ||||
| No | 7555 (91.0) | 3540 (47.3) | 919 (12.3) | 3024 (40.4) | |
| Yes | 741 (9.0) | 402 (54.6) | 84 (11.4) | 250 (34.0) | |
| Physical activity, n (%) | <0.001 | ||||
| Low | 1449 (17.6) | 539 (37.3) | 127 (8.8) | 779 (53.9) | |
| Intermediate | 4764 (58.0) | 2311 (48.6) | 592 (12.5) | 1845 (38.9) | |
| High | 2000 (24.4) | 1082 (54.2) | 282 (14.1) | 632 (31.7) |
[i] * Categorical data are reported as number (percentage in the column).
† Categorical data are reported as number (percentage in a row).
‡ P-value is calculated between normal/optimal, high normal, and hypertension subgroups.
Figure 1
a) Prevalence of hypertension stratified by age and sex; b) Prevalence of high normal blood pressure stratified by age and sex. (Hypertension cut-off points based on ESC/ESH guideline was ≥140/90 mm Hg and for ACC/AHA guideline was ≥130/80 mm Hg. High-normal blood pressure range based on ESC/ESH guideline was 130–140/85–90 mmHg and for ACC/AHA systolic: 120–129 mmHg and diastolic blood pressure: <80 mmHg).
Figure 2
Geographic distribution of a) the prevalence of hypertension based on the postal regions of Tehran, b) The prevalence of high-normal blood pressure based on the postal regions of Tehran.
Figure 3
a) Awareness among hypertensive individuals stratified by age and sex; b) Treatment among hypertensive individuals stratified by age and sex; c) Control of blood pressure among hypertensive individuals stratified by age and sex; d) Control of blood pressure among hypertensive individuals receiving antihypertensive medication stratified by age and sex.
Figure 4
Geographic distribution of a) Awareness of hypertension based on the postal regions of Tehran, b) Treatment of hypertension based on the postal regions of Tehran, c) Control of hypertension among treated patients based on the postal regions of Tehran.
Table 2
Prevalence of awareness, treatment, and control of hypertension in the hypertensive population of the Tehran Cohort Study (n = 3288).
| AWARENESS | TREATMENT | CONTROL | CONTROL AMONG TREATED | |
|---|---|---|---|---|
| Overall, n (%) | 2242 (68.2) | 1752 (53.3) | 1328 (40.4) | 1023 (58.4) |
| Age, year, n (%) | ||||
| 35–44 | 143 (39.7) | 76 (21.1) | 76 (21.1) | 47 (61.8) |
| 45–54 | 403 (57.9) | 281 (40.4) | 238 (34.2) | 171 (60.9) |
| 55–64 | 727 (72.1) | 569 (56.4) | 429 (42.6) | 328 (57.6) |
| 65–74 | 624 (78.0) | 529 (66.1) | 391 (48.9) | 317 (59.9) |
| ≥75 | 345 (81.6) | 297 (70.0) | 194 (45.8) | 160 (53.9) |
| p-value | <0.001 | <0.001 | <0.001 | 0.378 |
| Sex, n (%) | ||||
| Men | 951 (63.4) | 766 (51.1) | 565 (37.7) | 451 (58.9) |
| Women | 1291 (72.2) | 986 (55.1) | 763 (42.7) | 572 (58.0) |
| p-value | <0.001 | 0.020 | 0.004 | 0.716 |
| Marital status, n (%) | ||||
| Married | 2224 (68.3) | 1737 (53.3) | 1316 (40.4) | 1013 (58.3) |
| Non-married | 17 (58.6) | 15 (51.7) | 11 (37.9) | 10 (66.7) |
| p-value | 0.266 | 0.864 | 0.788 | 0.514 |
| Ethnicity, n (%) | ||||
| Fars | 1135 (69.3) | 906 (55.3) | 687 (41.9) | 547 (60.4) |
| Azari | 674 (69.5) | 522 (53.8) | 385 (39.7) | 288 (55.2) |
| Gilak | 80 (61.5) | 64 (49.2) | 52 (40.0) | 39 (60.9) |
| Lor | 71 (61.7) | 43 (37.4) | 40 (34.8) | 24 (55.8) |
| Kurd | 49 (71.0) | 40 (58.0) | 30 (43.5) | 26 (65.0) |
| Mixed | 171 (63.3) | 125 (46.3) | 96 (35.6) | 68 (54.4) |
| Other | 48 (66.7) | 41 (56.9) | 31 (43.1) | 25 (61.0) |
| Immigrants/Refugees | 12 (60.0) | 9 (45.0) | 5 (25.0) | 5 (55.6) |
| P-value | 0.166 | 0.002 | 0.301 | 0.580 |
| Education, year, n (%) | ||||
| Illiterate | 315 (80.2) | 261 (66.4) | 160 (40.7) | 129 (49.4) |
| (1–5) | 333 (73.2) | 257 (56.5) | 163 (35.8) | 117 (45.5) |
| (6–12) | 1099 (66.2) | 854 (51.4) | 678 (40.8) | 530 (62.1) |
| >12 | 493 (63.5) | 379 (48.8) | 325 (41.9) | 246 (64.9) |
| P-value | <0.001 | <0.001 | 0.188 | <0.001 |
| Body mass index, kg/m2, n (%) | ||||
| <20 | 27 (61.4) | 19 (43.2) | 17 (38.6) | 10 (52.6) |
| 20–24.9 | 345 (60.1) | 277 (48.2) | 230 (40.0) | 172 (62.1) |
| 25–29.9 | 874 (66.2) | 692 (52.4) | 538 (40.8) | 420 (60.7) |
| 30–34.9 | 656 (73.5) | 514 (57.6) | 359 (40.2) | 282 (54.9) |
| ≥35 | 304 (73.6) | 220 (53.3) | 167 (40.4) | 122 (55.5) |
| P-value | <0.001 | 0.005 | 0.996 | 0.150 |
| Diabetes, n (%) | ||||
| No | 1522 (62.6) | 1130 (46.5) | 880 (36.2) | 653 (57.8) |
| Yes | 720 (83.9) | 621 (72.4) | 447 (52.1) | 369 (59.4) |
| p-value | <0.001 | <0.001 | <0.001 | 0.507 |
| Hyperlipidemia, n (%) | ||||
| No | 919 (54.7) | 702 (41.8) | 473 (28.1) | 357 (50.9) |
| Yes | 1323 (82.3) | 1049 (65.3) | 854 (53.1) | 665 (63.4) |
| P-value | <0.001 | <0.001 | <0.001 | <0.001 |
| Chronic kidney disease, n (%) | ||||
| No | 2193 (67.8) | 1710 (52.9) | 1296 (40.1) | 996 (58.2) |
| Yes | 49 (89.1) | 42 (76.4) | 32 (58.2) | 27 (64.3) |
| P-value | 0.001 | 0.001 | 0.007 | 0.433 |
| Tobacco user, n (%) | ||||
| Current | 300 (60.2) | 232 (46.6) | 185 (37.1) | 146 (62.9) |
| Former | 133 (72.7) | 119 (65.0) | 85 (46.4) | 72 (60.5) |
| Never | 1808 (69.4) | 1399 (53.7) | 1057 (40.6) | 804 (57.5) |
| P-value | <0.001 | <0.001 | 0.082 | 0.262 |
| Opium consumption, n (%) | ||||
| No | 2113 (68.4) | 1640 (53.1) | 1253 (40.5) | 958 (58.4) |
| Yes | 121 (65.4) | 106 (57.3) | 72 (38.9) | 63 (59.4) |
| P-value | 0.402 | 0.262 | 0.663 | 0.836 |
| Alcohol consumption, n (%) | ||||
| No | 2085 (68.9) | 1626 (53.8) | 1230 (40.7) | 941 (57.9) |
| Yes | 146 (58.4) | 115 (46.0) | 87 (34.8) | 72 (62.6) |
| P-value | 0.001 | 0.018 | 0.069 | 0.320 |
| Physical activity, n (%) | ||||
| Low | 606 (77.8) | 493 (63.3) | 342 (43.9) | 268 (54.4) |
| Intermediate | 1262 (68.3) | 967 (52.3) | 737 (39.9) | 563 (58.2) |
| High | 357 (56.5) | 277 (43.8) | 234 (37.0) | 179 (64.6) |
| P-value | <0.001 | <0.001 | 0.028 | 0.022 |
[i] Categorical data are reported as numbers (percentage in the row) among individuals with hypertension.
P-values are calculated for subgroups in each column independently.
Table 3
Prevalence and control of hypertension in the population of the Tehran Cohort Study based on the 2017 ACC/AHA and 2018 ESC/ESH guidelines (n = 8296).
| 2018 ESC/ESH | 2017 ACC/AHA | |
|---|---|---|
| Hypertension, n (%)* | 3288 (39.8) | 5288 (64.0) |
| Age, mean (SD), year | 60.2 (12.16) | 56.8 (12.59) |
| Sex, n (%) | ||
| Men | 1500 (39.5) | 2447 (64.3) |
| Women | 1788 (40.1) | 2841 (63.7) |
| Control, n (%)# | 1328 (40.4) | 586 (11.1) |
| Age, mean (SD), year | 62.4 (11.09) | 63.8 (11.32) |
| Sex, n (%) | ||
| Men | 565 (37.7) | 254 (10.4) |
| Women | 763 (42.7) | 332 (11.7) |
| Control among treated, n (%)† | 1023 (58.4) | 467 (26.7) |
| Age, mean (SD), year | 63.2 (10.81) | 64.4 (11.00) |
| Sex, n (%) | ||
| Men | 451 (58.9) | 209 (27.3) |
| Women | 572 (58.0) | 258 (26.2) |
[i] * Categorical data are reported as numbers (percentage in the row) for each subgroup.
# Percentages calculated from the hypertensive population (n = 3288).
† Percentages calculated from the treated population (n = 1752).