Skip to main content
SpringerLink
Log in

Prevalence, awareness, treatment and control of hypertension in a working Bulgarian population

  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

Arterial hypertension is a major risk factor for coronary heart disease and stroke mortality. Few data exist on prevalence, awareness, and management of hypertension in Bulgaria, precluding development of potentially beneficial risk reduction initiatives. Between September 1996 and July 1997, an age-sex stratified sample of 847 male and 771 female employees (age 18–64 y) of the national transport industry resident in Sofia was recruited during their annual physical examination. A structured interview was conducted and resting blood pressure (BP) measured. Prevalence: Elevated BP (mean of two consecutive readings SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg) was observed among 24% of women and 58% of men (p < 0.001). Prevalence increased with age in both men and women. Awareness: Among 722 employees with elevated BP, 49% of women and 33% of men (p < 0.001) reported history of hypertension. Awareness increased with age. Management: Among 345 employees with history of hypertension, 37% of women and 36% of men (p > 0.05) reported taking antihypertensive treatment. The proportion under management increased with age. Control: Normal BP was measured in only 6% of men and 7% of women taking antihypertensive medication (p > 0.05; no consistent trends by age). Elevated BP is widespread and hypertension is underdiagnosed and poorly controlled in this urban working-age Bulgarian population, especially among those under 40 y. This may contribute to the high rates of coronary heart disease and stroke incidence and mortality in Bulgaria.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute, National Institutes of Health. NIH Publication No. 98–4080.

  2. Pisa Z, Uemura K. Trends of mortality from ischaemic heart disease and other cardiovascular diseases in 27 countries 1968–1977. Wrld Hlth Stat Quart 1982; 35: 11–47.

    Google Scholar 

  3. Uemura K, Pisa Z. Trends in cardiovascular disease mortality in industrialized countries since 1950. Wrld Hlth Stat Quart 1988; 41: 155–178.

    Google Scholar 

  4. MRC Medical Research Council Working Party: MRC trial of treatment of mild hypertension, principal results. Br Med J 1992; 304: 405–412.

    Google Scholar 

  5. SHEP-Systolic Hypertension in the Elderly Program. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results. JAMA 1991; 265: 3255–3264.

    Google Scholar 

  6. Staessen J, Fagard R, Thijs L, et al. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. Lancet 1997; 350: 757–764.

    Article  PubMed  Google Scholar 

  7. STOP Hypertension. Swedish Trial in Older Patients with Hypertension. Morbidity and mortality in the Swedish trial. Lancet. 1991; 338: 1281–1285.

    Google Scholar 

  8. Pisa Z, Uemura K. International differences in developing improvements in cardiovascular health. Ann Medicine 1989; 21: 193–197.

    Google Scholar 

  9. Sans S, Kesteloot H, Kromhout D. The burden of cardiovascular diseases mortality in Europe. Eur Heart J 1997; 12: 1231–1248.

    Google Scholar 

  10. Murray CJL, Lopez AD. Global Health Statistics. Global burden of disease and injury series, volume 2. Boston MA, 1996: Harvard University Press.

    Google Scholar 

  11. Burt VL, Whelton P, Rocella EJ, et al. Prevalence of hypertension in the US adult population. Hypertension 1995; 25: 305–313.

    PubMed  Google Scholar 

  12. Ibrahim MM, Rizk H, Appel LJ, et al. Hypertension prevalence, awareness, treatment, and control in Egypt. Results from the Egyptian National Hypertension Project (NHP). Hypertension 1995; 26(part 1): 886–890.

    PubMed  Google Scholar 

  13. Puras A, Sanchis C, Artigao LM, et al. Prevalence, awareness, treatment and control of hypertension in a Spanish population. Eur J Epidemiol 1998; 14: 31–36.

    PubMed  Google Scholar 

  14. Stein AD, Mincheva V, Stoyanovsky V, et al. Prevalence of risk factors for cardiovascular disease in a working Bulgarian population. CVD Prevention 1998; 1: 217–224.

    Google Scholar 

  15. National High Blood Pressure Education Program Working Group. National High Blood Pressure Education Program Working Group report on primary prevention of hypertension. Arch Intern Med 1993; 153: 186–208.

    Google Scholar 

  16. Stamler J, Stamler R, Neaton JD. Blood pressure, systolic and diastolic, and cardiovascular risks. Arch Intern Med 1993; 153: 598–615.

    PubMed  Google Scholar 

  17. Puska P, Nissinen A, Tuomilehto J, et al. The community-based strategy to prevent coronary heart disease: conclusions from the ten years of the North Karelia project. Ann Rev Public Health 1985; 10: 147–193.

    Google Scholar 

  18. Farquhar JW, Fortmann SP, Flora JA, et al. Effects of communitywide education on cardiovascular disease risk factors: The Stanford Five-City Project. JAMA 1990; 264: 359–365.

    PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Aryeh D. Stein

    Present address: Department of International Health, Rollins School of Public Health of Emory University, Atlanta, GA, USA)

Authors and Affiliations

  1. Department of Epidemiology, Michigan State University, East Lansing, MI, USA

    Aryeh D. Stein

  2. Department of Cardiology, Transport Medical Institute, Sofia, Bulgaria

    Vassil Stoyanovsky, Valentina Mincheva, Emil Dimitrov, Donka Hodjeva, Anton Petkov & Veska Tsanova

Authors
  1. Aryeh D. Stein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vassil Stoyanovsky
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Valentina Mincheva
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Emil Dimitrov
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Donka Hodjeva
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Anton Petkov
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Veska Tsanova
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stein, A.D., Stoyanovsky, V., Mincheva, V. et al. Prevalence, awareness, treatment and control of hypertension in a working Bulgarian population. Eur J Epidemiol 16, 265–270 (2000). https://doi.org/10.1023/A:1007601107752

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1007601107752

Search

Navigation