Systolic Blood Pressure and Its Determinants: Study in a Population Attending Pharmacies in a Portuguese Coastal City

Authors: M. J. Reis Lima, J. Oliveira, M. Brito, C. Lemos, A. Mascarenhas, E. Teixeira Lemos

Abstract:

Hypertension is a common condition causing cardio and cerebrovascular complications. Portugal has one of the highest mortality rates from stroke and a high prevalence of hypertension. Systolic Blood Pressure (SBP) is an important risk factor for cardiovascular events (myocardial infarction and stroke) and premature mortality, particularly in the elderly population. The present study aims to estimate the prevalence of hypertension in a Portuguese population living in a coastal city and to identify some of its determinants (namely gender, age, the body mass index and physical activity frequency). A total of 91 adults who attended three pharmacies of a coastal city in the center of Portugal, between May and August of 2013 were evaluated. Attendants who reported to have diabetes or taking antihypertensive drugs in the 2 previous weeks were excluded from the study. Sociodemographic factors, BMI, habits of exercise and BP were assessed. Hypertension was defined as blood pressure ≥140/90 mmHg. The majority of the studied population was constituted by women (75.8%), with a mean age of 54.2±1.6 years old, married or living in civil union and that had completed secondary school or had higher education (40%). They presented a mean BMI of 26.2±4.76 Kg/m2., and were sedentary. The mean BP was 127.0±17.77mmHg- 74.69 ± 9.53. In this population we found 4.3% of people with hypertension and 16.1% with normal high blood pressure. Men exhibit a tendency to present higher systolic blood pressure values than women. Of all the factors considered, SBP values also tended to be higher with age and higher BMI values. Despite the fact that the mean values of SBP did not present values higher than 140 mmHg we must be concerned because the studied population is undiagnosed for hypertension. Although this is a preliminary study, it might be a prelude to the upcoming research about the underlying factors responsible for the occurrence of SBP.

Keywords: Hypertension, age, exercise, obesity, gender.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1109882

References:

[1] World Health Organization. Causes of death 2008: data sources and methods. Geneva: World Health Organization; 2008. Available from: http://www.who.int/healthinfo/global_burden_disease/cod_sources_met hods.pdf/inter-ref.
[2] S. S. Lima, T. T. Vos and A. D. Flaxman, “A Comparative Risk Assessment of Burden of Disease and Injury Attributable to 67 Risk Factors and Risk Factor Clusters in 21 Regions, 1990–2010: A Systematic Analysis for the Global Burden of Disease Study 2010”, Lancet, 380, pp. 2224-60, 2012.
[3] World Health Organization. Risk Factors: Blood Pressure. Global Health Observatory Data Repository. Geneva: World Health Organization; 2008. Available from: http://apps.who.int/gho/data/node.main.A874?lang=en[4] World Health Organization. Global Status Report on Non Communicable Diseases 2010. Geneva: World Health Organization; 2011. Available from: http://whqlibdoc.who.int/publications/2011/9789240686458_e ng.pdf[5] G. Danaei, M. M. Finucane and J. K. Lin. “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, 377, pp. 568-577, 2011.
[6] Instituto Nacional de Estatística. The Demographic Changes in Portugal. Lisboa: Instituto Nacional de Estatística; 2008.
[7] M. E. Macedo, M. J. Lima, A. O. Silva, P. Alcântara, V. Ramalhinho and J. Carmona. “Prevalence, Awareness, Treatment and Control of Hypertension in Portugal. The PAP Study”, Rev Port Cardiol, 26, pp. 21-39, 2007.
[8] European Society of Cardiology. European Cardiovascular Disease Statistics 2012. Brussels: European Heart Network AISBL, 2012.
[9] M. Pereira, H. Carreira, C. Vales, V. Rocha, A. Azevedo and N. Lunet “Trends in Hypertension Prevalence (1990–2005) and Mean Blood Pressure (1975–2005) in Portugal: A Systematic Review”, Blood Press., 21, pp. 220-226, 2012.
[10] J. Perk, G. De Backer and H. Gohlke, “European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by Representatives of Nine Societies and by Invited Experts)”, European Heart Journal 33, pp. 1635–1701, 2012.
[11] A. Dart, C. Silagy, E. Dewar, C. Jennings and J. McNeil, “Aortic Distensibility and Left Ventricular Structure and Function in Isolated Systolic Hypertension”, Eur. Heart J., 14, pp.1465-1470, 1993.
[12] D. G. Beevers, “Epidemiological, Pathophysiological and Clinical Significance of Systolic, Diastolic and Pulse Pressure”, J. Hum. Hypertens, 18(8), pp. 531-533, 2004.
[13] D. T. Lackland and B, M. Egan, “The Dominant Role of Systolic Hypertension as a Vascular Risk Factor: Evidence from the Southeastern United States”, Am J Med Sci., 318(6), pp. 365-368, 1999.
[14] World Health Organization (WHO). BMI Classification 2013: Availablefromhttp://apps.who.int/bmi/index.jsp?introPage=intro_3.htm.
[15] Direcão Geral de Saúde. Norma 020/2011 Hipertensão Arterial: Definição e classificação. Lisboa: Direcão Geral de Saúde.
[16] R. Inoue, T. Ohkubo, M. Kikuya, H. Metoki, K. Asayama, T. Obara, T. Hirose, A. Hara, H. Hoshi, J. Hashimoto, K. Totsune, H. Satoh, Y. Kondo and Y. Imai, “Stroke Risk in Systolic and Combined Systolic and Diastolic Hypertension Determined Using Ambulatory Blood Pressure. The Ohasama Study”, Am J Hypertens, 20(10), pp. 1123-1125, 2003.