30-YEAR TRENDS IN BLOOD PRESSURE, PREVALENCE, AWARENESS, TREATMENT AND CONTROL OF HYPERTENSION IN WOMEN OF REPRODUCTIVE AGE. THE CZECH MONICA AND CZECH POST-MONICA STUDIES

Objective: To assess trends in BP levels and epidemiology of hypertension in women of reproductive age in representative population samples in the Czech Republic. Design and methods: A total of seven independent cross-sectional population surveys of major CV risk factors were performed in 1985, 1988, 1992, 1997/98, 2000/01, 2007/08 and 2015-18 in a 1% random population sample. This analysis includes 4,913 women aged 25-44 years (mean age 35.6 ± 5.7 years). Hypertension was defined as a mean of 2 BP readings? 140/90 mmHg taken at one visit or being on antihypertensive medication. Hypertension was considered controlled if BP was? 140/90 mmHg (in individuals treated by antihypertensive drugs). Detailed information on treatment is available only since the fourth survey. Design and method: Over a period of 32 years, there was a significant reduction in both systolic BP (from 121.3 ± 15.5 to 117.2 ± 13.7 mmHg; p < 0.001) and diastolic BP (from 78.2 ± 10.1 to 77.2 ± 9.2 mmHg; p < 0.001). The prevalence of hypertension decreased from 19.3% to 11.0% (p < 0.001) with no significant changes in BMI. There was also an increase in the awareness of hypertension (from 42.2% to 66.1%; p < 0.01) and the proportion of individuals treated by antihypertensive drugs (from 14.1% to 37.3%; p < 0.001). Hypertension control improved (from 3.1% to 25.4%; p < 0.001). Most of the women were treated only by one antihypertensive drug (raging between 63.3% and 59.1%), during the third and fourth survey mostly by beta-blockers, replaced later by RAS blockers. Results: Despite significant improvement in all epidemiological parameters, the control rates remain poor, mostly due to a low proportion of women treated by antihypertensive drugs and a low usage of combination therapy. This might be a reflection of a wrong perception that these women are at low risk.