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Regional variations in hypertension prevalence and management in Germany: results from the German Health Interview and Examination Survey (DEGS1)

Diederichs, Claudia; Neuhauser, Hannelore

doi: 10.1097/HJH.0000000000000211

Objective: This study analyzed regional differences in blood pressure (BP) distribution and management in Germany 2008–2011 in a nationwide study.

Methods: The analyses were based on standardized BP measurements and anatomical therapeutic chemical classification-coded medication from the population-based German Health Interview and Examination Survey (DEGS1) 2008–2011 (N = 7074, 18–79 years, 180 study points, five regions: Central-East, South, Central-West, North-West, and North-East). Regional differences were tested between the region with the highest and lowest values.

Results: Regional variations were observed in mean SBP, mean DBP, and the prevalence of hypertension in both sexes, as well as awareness, treatment, and control in men. Differences in blood pressure (in mmHg) between Central-East, the region with the highest BP level and the region with the lowest BP level, were SBP 3.2 and DBP 2.5 in men and SBP 4.5 and DBP 2.4 in women. In Central-East 39% of men and 40% of women had hypertension, versus 30% of men in the North-West and 26% of women in the South. The percentage of aware, treated, and controlled men ranged between 92, 78, and 56% in the North-East and 74, 59, and 41% in the South, respectively. After multivariate adjustment for sociodemographic variables and hypertension risk factors, geographical differences persisted for hypertension prevalence in women and hypertension awareness and treatment in men.

Conclusion: So far, national surveys allowed only BP comparisons along the former East–West border and showed more elevated BP in the East. New analyses suggest regional differences with both the most and the least favorable results in the two neighboring parts of former East Germany.

Robert Koch Institute

German Centre for Cardiovascular Research (DZHK), Partner Site, Berlin, Germany

Correspondence to Claudia Diederichs, Robert Koch Institute, General-Pape-Strasse 62-66, 12101 Berlin, Germany. Tel: +49 30 18754 3218; fax: +49 30 18754 3555; e-mail:

Abbreviations: BP, blood pressure; DEGS1, German Health Interview and Examination Survey; ISCED, International Standard Classification of Education; KORA, Kooperative Gesundheitsforschung in der Region Augsburg Study; NHIES98, National Health Interview and Examination Survey; SHIP, Study of Health in Pomerania

Received 19 December, 2013

Revised 17 March, 2014

Accepted 18 March, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins