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Prevalence, awareness, treatment and control of hypertension in Portugal: the PAP study

Macedo, Mário Espigaa,b; Lima, Maria Ja,c; Silva, António Oc; Alcantara, Paulad; Ramalhinho, Vitord; Carmona, Josée

doi: 10.1097/
Original papers: Epidemiology

Background The objective of this study was to estimate the prevalence and distribution of hypertension and to determine the status of hypertension awareness, treatment and control in the Portuguese adult population.

Methods This study was conducted in 2003, and a multistage cluster sampling method was used to select a national representative sample. A total of 5023 adults, age 18–90 years, were examined. Three blood pressure measurements were obtained by trained observers using an OMROM M4-I sphygmomanometer after a 5-min sitting rest. Information on the history of hypertension and the use of antihypertensive medications was obtained by use of a standard questionnaire.

Results Hypertension was defined as a mean systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, or the use of antihypertensive medications. Overall, 42.1% of the Portuguese adult population aged 18–90 years, representing 3 311 830 people, had hypertension. The age-specific prevalence of hypertension in the three age groups studied — younger than 35 years, 35–64 years old and older than 64 years — was 26.2, 54.7 and 79% in men and 12.4, 41.1 and 78.7% in women, respectively. Among hypertensive patients, only 46.1% were aware of their high blood pressure, 39.0% were taking antihypertensive medication and 11.2% achieved blood pressure control (< 140/90 mmHg).

Conclusions Our results indicate that hypertension is highly prevalent in Portugal. The percentages of those with hypertension that are aware, treated and controlled are unacceptably low. These results underscore the urgent need to develop national strategies to improve prevention, detection and treatment of hypertension in Portugal.

aService of Medicine B, Oporto School of Medicine, Porto

bIBMC, Institute of Molecular and Cellular Biology, Porto

cService of Medicine A, Hospital S. João, Porto

dService of Medicine I, Hospital STa Maria, Porto

eService of Cardiology, Hospital Egas Moniz, Lisbon, Portugal

Received 2 February, 2005

Revised 22 March, 2005

Accepted 12 April, 2005

Sponsorship: The work was supported by a grant from the program ‘Saúde XXI’, and also with the support of The Portuguese Society of Hypertension and the Institute of Molecular and Cellular Biology.

Correspondence and requests for reprints to Mario Espiga Macedo, Serviço de Medicina B, piso 3, Faculdade de Medicina do Porto, Alameda Hêrnani Monteiro 4200-319, Portugal. Tel: +35 1 934909000; fax: +35 1 226101560; e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.