Impact of the Gubbio population study on community control of blood pressure and hypertension

Abstract

Awareness and treatment of hypertension have markedly increased in the last 30 years in most parts of the world, but a satisfactory control of blood pressure is still infrequent. To describe trends in community control of hypertension and blood pressure levels in the small town of Gubbio, Italy. Large samples of the populations (aged 30–79 years) were examined 6 years apart for measurement of blood pressure, other cardiovascular risk factors and knowledge, attitude and practice towards control of hypertension. Data were available from a total of 1125 men and 1445 women with two examinations and 1566 men and 1658 women with at least one examination. Two different definitions of hypertension were used (old definition: systolic blood pressure (SBP) ≥ 160 mmHg or diastolic blood pressure (DBP) ≥ 95 mmHg or use of anti-hypertensive drugs; recent definition: SBP ≥ 140 mmHg or DBP ≥ 90 mmHg or use of anti-hypertensive drugs). Awareness, treatment and control of hypertension increased from one survey to the other, whatever definition of hypertension was used. Control rose from 41 to 63% (old definition) and from 12 to 24% (recent definition). In a 6-year period, the average population SBP declined 2–8 mmHg and DBP declined 2–3 mmHg depending on type of analysis, against an expected rise of 9 mmHg for SBP and 2 mmHg for DBP. These trends are partly explained by a marked decline in alcohol consumption and by more common and intensive anti-hypertensive treatment, while change in body mass index, which showed a slight but systematic increase, cannot be considered as a contributor to this trend. An epidemiological study has motivated a population group and its medical profession towards a better control of hypertension.