Abstract
Germany was reported to have higher blood pressure (BP) and lower awareness, treatment and control of BP than other western countries based on 1998 data. BP distribution and hypertension management were examined for 1998 and 2008–11 in 7108 adult participants of the German National Health Interview and Examination Survey 1998 (GNHIES98) and in 7095 adult participants the German Health Interview and Examination Survey for Adults 2008–11 (DEGS1) aged 18–79 years. Age- and sex-standardized mean systolic BP (SBP) dropped from 129.0 to 124.1 mm Hg (women 127.3–120.8, men 130.7–127.4), mean diastolic BP (DBP) from 78.3 to 73.2 mm Hg (women 78.0–71.2, men 78.5–75.3). Mean SBP and DBP decreased most in treated hypertensives but were also lower in participants without hypertension. The overall prevalence of hypertension, including controlled hypertension, remained almost unchanged (30% vs 32%). Uncontrolled hypertension (BP⩾140/90 mm Hg) decreased from 23% to 15% (women 22–13%, men 24–18%). Among hypertensives, awareness increased from 69% to 82% (women 74–87%, men 65–78%), treatment increased from 55% to 72% (women 62–79%, men 48–65%) and control increased from 23% to 51% (women 25–58%, men 20–45%). However, men aged 18–29 years had an opposite trend with 1.5 mm Hg higher SBP and increased prevalence of hypertension, which was mostly uncontrolled. These findings suggest that BP has decreased substantially in Germany, while leaving a persistent gender gap in management and room for further improvement of prevention and treatment, particularly in men.
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References
Lewington S, Clarke R, Qizilbash N, Peto R, Collins R Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360 (9349): 1903–1913.
Danaei G, Finucane MM, Lin JK, Singh GM, Paciorek CJ, Cowan MJ et al. National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5.4 million participants. Lancet 2011; 377 (9765): 568–577.
Wolf-Maier K, Cooper RS, Banegas JR, Giampaoli S, Hense HW, Joffres M et al. Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA 2003; 289 (18): 2363–2369.
Wolf-Maier K, Cooper RS, Kramer H, Banegas JR, Giampaoli S, Joffres MR et al. Hypertension treatment and control in five European countries, Canada, and the United States. Hypertension 2004; 43 (1): 10–17.
Busch M, Heuschmann P, Wiedmann S Recent changes in stroke mortality trends in Germany (Abstract). Eur J Epidemiol 2012; 27 (Suppl 1): S69–S70.
Scheidt-Nave C, Kamtsiuris P, Goesswald A, Hoelling H, Lange M, Busch MA et al. German health interview and examination survey for adults (DEGS)-design, objectives and implementation of the first data collection wave. BMC Public Health 2012; 12 (1): 730.
Neuhauser H, Ellert U, Thamm M, Adler C Calibration of blood pressure data after replacement of standard mercury sphygmomanometer by an oscillometric device and concurrent change of cuffs (in press).
World Health Organization. MONICA Manual, Part II: Population Survey. Section 1: Population survey data component. 4.2. Blood pressure and arm circumference measurement, 1997. http://www.thl.fi/publications/monica/manual/part3/iii-1.htm.
Anwar YA, Tendler BE, McCabe EJ, Mansoor GA, White WB Evaluation of the Datascope Accutorr Plus according to the recommendations of the Association for the Advancement of Medical Instrumentation. Blood Press Monit 1997; 2 (2): 105–110.
ISCED 1997. International Standard Classification of Education. UNESCO 2006. http://www.uis.unesco.org/Library/Documents/isced97-en.pdf.
O'Brien E, Atkins N, Stergiou G, Karpettas N, Parati G, Asmar R et al. European Society of Hypertension International Protocol revision 2010 for the validation of blood pressure measuring devices in adults. Blood Press Monit 2010; 15 (1): 23–38.
Lampert T, Kroll L, Müters S, Stolzenberg H [Measurement of socioeconomic status in the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56 (5-6): 631–636.
Egan BM, Zhao Y, Axon RN US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA 2010; 303 (20): 2043–2050.
Falaschetti E, Mindell J, Knott C, Poulter N Hypertension management in England: a serial cross-sectional study from 1994 to 2011. Lancet 2014; 383 (9932): 1912–1919.
McAlister FA, Wilkins K, Joffres M, Leenen FH, Fodor G, Gee M et al. Changes in the rates of awareness, treatment and control of hypertension in Canada over the past two decades. CMAJ 2011; 183 (9): 1007–1013.
Krug S, Jordan S, Mensink GB, Muters S, Finger J, Lampert T [Physical activity: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56 (5-6): 765–771.
Mensink GB, Truthmann J, Rabenberg M, Heidemann C, Haftenberger M, Schienkiewitz A et al. [Fruit and vegetable intake in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56 (5-6): 779–785.
Powles J, Fahimi S, Micha R, Khatibzadeh S, Shi P, Ezzati M et al. Global, regional and national sodium intakes in 1990 and 2010: a systematic analysis of 24 h urinary sodium excretion and dietary surveys worldwide. BMJ Open 2013 3 (12): e003733.
Mensink GB, Schienkiewitz A, Haftenberger M, Lampert T, Ziese T, Scheidt-Nave C [Overweight and obesity in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56 (5-6): 786–794.
Evans A, Tolonen H, Hense HW, Ferrario M, Sans S, Kuulasmaa K et al. Trends in coronary risk factors in the WHO MONICA project. Int J Epidemiol 2001; 30 (Suppl 1): S35–S40.
Kastarinen MJ, Antikainen RL, Laatikainen TK, Salomaa VV, Tuomilehto JO, Nissinen AM et al. Trends in hypertension care in eastern and south-western Finland during 1982-2002. J Hypertens 2006; 24 (5): 829–836.
Joffres M, Falaschetti E, Gillespie C, Robitaille C, Loustalot F, Poulter N et al. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: a cross-sectional study. BMJ Open 2013; 3 (8): e003423.
Yoon SS, Burt V, Louis T, Carroll MD Hypertension among adults in the United States, 2009-2010. NCHS Data Brief 2012; 107: 1–8.
Galea S, Tracy M Participation rates in epidemiologic studies. Ann Epidemiol 2007; 17 (9): 643–653.
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The study has been financed by the German Federal Ministry of Health and by the Robert Koch Institute.
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Neuhauser, H., Adler, C., Rosario, A. et al. Hypertension prevalence, awareness, treatment and control in Germany 1998 and 2008–11. J Hum Hypertens 29, 247–253 (2015). https://doi.org/10.1038/jhh.2014.82
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DOI: https://doi.org/10.1038/jhh.2014.82
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