Determinants of awareness, treatment and control of hypertension in a Portuguese population

Introduction: Hypertension is quantitatively the largest risk factor for cardiovascular diseases and it is highly prevalent in Portugal. It is important to understand which factors explain awareness, treatment and control of hypertension in Portugal, in order to identify barriers to prevention. Methods: This study consisted of a cross-sectional evaluation of 2310 adults (61.5% women) randomly selected from the population of Porto, Portugal, in 1999-2003. Hypertension was defined as blood pressure >= 140/90 mmHg and/or being medicated with antihypertensive drugs. Results: The prevalence of hypertension was 42.7% in women and 46.7% in men. The prevalence of awareness was 58.9% among women and 41.3% among men. Among aware hypertensives, 71.7% and 60.2% were treated, while 23.0% and 22.8% of treated hypertensives were controlled among women and men, respectively. Awareness of hypertension was more frequent in older subjects, those with high body mass index (BMI), diabetic women and women with high serum triglycerides, and lower among women who use private health care services, single/widowed/divorced men and among men with higher levels of alcohol consumption. In both genders, treatment was directly associated with age and BMI, while education and renal dysfunction were only directly associated among men. Physical activity was inversely associated with treatment in women. Age and BMI were associated with a lower likelihood of blood pressure control in both genders. In women, control of hypertension was observed less often among those with higher levels of alcohol consumption. Conclusions: The concurrent presence of additional cardiovascular risk factors was generally not associated with treatment and control, although the proportional contribution to this situation of patients and the health care system could not be assessed.