Hypertension in working age population: influence of gender and education

Introduction Hypertension is the most common cardiovascular disease (CVD) and a major cause of premature death. Study of age/gender-related and social aspects of the disease, and the assessment of the efficacy of antihypertensive treatment are essential elements of the epidemiological monitoring of hypertension and support a reasonable approach to planning further therapeutic and preventive interventions.
Objective Assess the prevalence of hypertension in the working-age population, examine the relationship between hypertension patterns and level of education of respondents taking into account age, gender, and the main aspects of lifestyle.
Materials and Methods The study included industrial workers who underwent a routine medical examination in September–November 2015. A total of 2432 subjects (59% males and 41% of females) were surveyed. The study design is cross-sectional, analytic. Methods used: anonymous questionnaire surveys using the WHO STEPS questionnaire, anthropometric measurements, BP measurement. Questions about hypertension included awareness of the presence of the disease and the administration of antihypertensive drugs. Hypertension was diagnosed with systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg, or in the case of the administration of antihypertensive drugs. The efficacy of treatment was assessed by the percentage of patients who had reached the target BP values (<140/90 mm Hg), including treated with antihypertensive drugs. The control of hypertension was judged by the percentage of patients with the target BP levels among all respondents with hypertension.
Results Hypertension was diagnosed in 40% of the study subjects. The disease was more prevalent in males (odds ratio (OR) = 1.21), overweight, and obese patients (OR = 2.5) and less prevalent in subjects with higher education (OR = 0.6). No significant association of lifestyle (smoking, alcohol abuse, eating fruits and vegetables, physical activity) with the prevalence of hypertension was revealed. 76% of respondents with hypertension knew about their disease (51% among those who did not take antihypertensive drugs). Awareness was higher in patients with severe hypertension (OR = 2.5), overweight and obese patients (OR = 1.96), and respondents with higher education (OR = 1.55), being significantly lower in males (OR = 0.44). 50% of respondents with hypertension (52% of those with severe hypertension) took antihypertensive drugs with males twice less often than females (OR = 0.49). The target BP levels were detected in 39% of patients taking antihypertensive drugs, less frequently in males (OR = 0.63) and overweight patients (OR = 0.48), and significantly more frequently in patients with higher education (OR = 2.28), regardless their lifestyle.
Conclusion The prevalence of hypertension in working patients was 40%. Males were more likely to suffer hypertension and less aware of their disease. The target blood pressure levels were less frequently observed in males during the treatment. On the other hand, patients with higher education had a lower prevalence of hypertension, significantly higher awareness of the disease and efficacy of the treatment than those who had secondary or primary school education. Overall, the study confirmed that the sample of industrial workers could be a reliable source for monitoring hypertension. The significant gender differences and an independent protective effect of the level of education were identified in the epidemiology of hypertension, which should be taken into account in further studies.

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