Objective: To assess trends in blood pressure (BP) levels, prevalence, awareness , and control of hypertension in the Czech population from 1985 to 2000/01. Desi gn: Five independent cross sectional population surveys conducted in 1985, 1988 , 1992, 1997/98, and 2000/01. Setting: Six, mostly rural, districts of the Czech Republic (Praha vchod, Beneov, Pardubice, Chrudim, Cheb, and Hradec). Part icipants: Men and women aged 25-64 years randomly selected from six districts u sing the National Population Register/General Health Insurance Company Register (covering, by law, all citizens). The total number of participants was 11 726. M ain outcome measures: We assessed the mean systolic BP, diastolic BP and pulse p ressure, prevalence of hypertension (systolic BP≥140 mmHg and/or diastolic BP≥ 90 mmHg, or current treatment with antihypertensive drugs), awareness, treatment , and control of hypertension. Results: Mean systolic BP, diastolic BP, and puls e pressure decreased significantly over a period of 15/16 years. This was associ ated with a significant decrease in the prevalence of hypertension (from 47.1 to 39.1%, P< 0.001) and with an increase in its awareness (from 49.5 to 67.2%, P < 0.001), use of antihypertensive medication (from 29.3 to 49.3%, P< 0.001), an d hypertension control (from 3.9 to 17.0%, P< 0.001). Despite having lower BP v alues and prevalence of hypertension, females showed higher awareness of the dis ease, and were more frequently taking antihypertensive medication, and their hyp ertension was better controlled. Conclusion: The reduction in population BP and improved control of hypertension may have contributed to the decrease in cerebro vascular and coronary heart disease mortality in the Czech Republic. The positiv e longitudinal changes seen in the MONICA regions need not necessarily reflect t he situation in the country as a whole. The situation is far from being optimal; a major problem is inadequate treatment of hypertension.
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