Hypertension and associated factors in the Islamic Republic of Iran: A population-based study

Background: Hypertension is a major risk factor for cardiovascular diseases and has a high prevalence in the Eastern Mediterranean Region. Aims: To estimate the prevalence and awareness of hypertension and its associated factors in a central province of the Islamic Republic of Iran. Methods: This cross-sectional study was conducted among 2320 adults aged 40-80 years in Yazd, Islamic Republic of Iran, in 2010-2011. Multivariable logistic regression analysis was performed to calculate the odds ratios (ORs) for exploring the association between hypertension and associated risk factors. Of eligible subjects, 2098 participated in clinical examinations (response rate: 90.4%). Results: The sex- and age-standardized prevalence of hypertension was 52.8% [95% confidence interval (CI): 49.6-56.1%]. Of 1170 participants with hypertension, 421 were diagnosed for the first time in this survey; therefore, the unawareness proportion was 36.0% (95% CI: 33.2-38.8%). Among known cases (749 of 1170), 68.5% (95% CI: 65.0-71.8%) had uncontrolled blood pressure. Age (OR 70-80 vs. 40-50 years=7.01, 95% CI: 4.01-12.24), obesity (OR=2.78, 95% CI: 2.06-3.75), diabetes (OR=1.46, 95% CI: 1.12-1.89), hyperlipidaemia (OR=1.60, 95% CI: 1.26-2.03) and living in a rural area (OR=1.57, 95% CI: 1.0-2.45) were significantly associated with hypertension. Conclusions: Although age is an inevitable risk factor for hypertension, the high unawareness proportion, uncontrolled hypertension and modifiable risk factors such as obesity, hyperlipidaemia and diabetes demand effective preventive and curative strategies.