Pattern of blood pressure in Australian adults: Results from a National Blood Pressure Screening Day of 13,825 adults☆
Introduction
As a key contributor to the global increase in cardiovascular disease (CVD), high blood pressure (BP) is a readily detectable and modifiable condition that represents a major target for primary and secondary prevention programs. In 2001, high BP or hypertension (HT) was estimated to contribute to 7.6 million deaths (13.5% of total deaths) and 92 million disability-adjusted life years globally [1]. In Australia, it was the largest contributor to CVD in 2003 and explained 42% of CVD burden (7.6% of total disease burden) [2]. It is also the most commonly managed cardiovascular risk factor by primary care physicians in Australia, accounting for nine in every 100 encounters (three times that of lipid disorder management) [3].
Elevated BP seems to have re-emerged with an even greater effect on premature mortality and disability [3] and despite the availability of effective pharmacological treatments [4]. During the 1980s, the prevalence of high BP in Australia reportedly declined from 38% to 26% but steadily rose again in the 1990s and early 21st Century [5], [6], [7], [8]. The population is ageing and rates of obesity and metabolic disorders are rising [9] which may contribute to increasing rates of HT. Australia has also experienced significant socio-demographic changes, including the overall ageing of the post-war “baby boomer” generation and widening differentials in the socio-economic status of the population, particularly metropolitan versus regional/rural communities. In Australia, regional and remote populations comprise around 32% of the 15 million adult population aged over 18 years [10].
We undertook a National Blood Pressure Screening Day to gain a contemporary “snapshot” of the BP profile of adult Australians. A key objective was to explore differences according to age, sex, geographic location, treatment for those known to have HT and socio-economic status. A secondary aim was to project the prevalence of elevated BP and obesity in adult Australians.
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Participants
A total of 13,825 participants were recruited. This equates to one in every 1000 adult Australians (see Fig. 1 for a profile of the Australian population). People were offered a free BP check if they walked by any of the 100 screening stations distributed throughout Australia on a single day (Saturday 30th June 2007). A weekend day was chosen to allow for a broader mix of age groups and to include members of the workforce as well as non-working adults. On this day, invitation to participate was
Results
A total of 13,825 completed profiles were verified from 99 screening stations. Table 1 summarises the socio-demographic and clinical profile according to gender and locality. Overall, 7666 (55%) were women with an average age of 48.7 ± 15.8 years and 48.0 ± 16.2 years for men. Participants were predominantly Caucasian/European (86%) and one in ten was Asian. Based on the median household income for their residential postcode, the majority of participants were from middle socio-economic backgrounds
Discussion
In the largest study of its kind in Australia, in a single day using a standardized protocol and equipment [13], we examined BP in close to 14,000 adults in 100 locations from every state and territory. Overall, we found that one in three (34%) participants recorded an elevated BP. This figure rose to 44% if individuals with a history of HT, but normotensive at the time, were included. There were key differentials in BP levels; older individuals, men (42% versus 27% of women), regional (40%)
Acknowledgement
We gratefully acknowledge Mr. Neil Covey for co-ordinating the National Blood Pressure Screening Day. We thank the nurses for carrying out the survey and Traffik Marketing for organising the screening booths, their distribution across Australia and the return of the study data. MJC and SS are supported by the National Health and Medical Research Council of Australia (NHMRC).
The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the
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Sources of support: The National Blood Pressure Screening Day was independently designed and analysed by Baker IDI Heart and Diabetes Institute and generously supported by Schering Plough Pty. Limited. Simon Stewart and Melinda Carrington are supported by the National Health and Medical Research Council of Australia.