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A cross-national comparative study of blood pressure levels and hypertension prevalence in Canada and Hungary

Steiner, Sabine; Helis, Eftyhia; Chen, Li; Turton, Penelope; Leenen, Frans H.H.; Sonkodi, Sandor; Sonkodi, Balazs; D’Angelo, Monika S.; Fodor, Jiri G.

doi: 10.1097/HJH.0b013e3283589ec3

Purpose: Hungary has one of the highest cardiovascular (CV) mortality and stroke rates compared to other countries in Europe and North America. Data from two recent blood pressure (BP) screening projects in Hungary and Canada provided us with the opportunity to compare potential differences in the prevalence of hypertension between these countries.

Methods: From the Ontario Blood Pressure Survey, 880 white Canadians between 20 and 62 years old with white-collar occupation were selected and compared with a total of 1000 Hungarian bank employees in the same age range. Identical methods were employed for CV risk factor screening and BP measurements using the BpTRU instrument. Hypertension was defined by elevated BP measurement (SBP ≥140 mmHg and/or DBP ≥90 mmHg) or current intake of antihypertensive medication.

Results: Canadian participants were on average 10 years older with a higher rate of obesity, diabetes and high cholesterol. Smoking was more prevalent among Hungarians (29.4 vs. 22.5%, P < 0.001). Despite being younger, Hungarians exhibited significantly higher SBP (121.3 ± 4.3 vs. 111.6 ± 14.1, P < 0.001) and DBP (78.5 ± 10.5 vs. 70.8 ± 9.5, P < 0.001), which remained significant after adjustment for age and use of antihypertensive medication as well as sex and CV risk factors. Age-adjusted prevalence of hypertension was significantly higher and poorly controlled among Hungarians (P < 0.001).

Conclusion: The increased prevalence of hypertension among young and middle-aged Hungarians compared with Canadians could represent an essential contributor to the high CV mortality and stroke rates in Hungary. BP awareness, treatment and control require improved medical attention and should be addressed early among young Hungarians.

aDivision of Prevention and Rehabilitation

bCardiovascular Research Methods Centre

cHypertension Unit, University of Ottawa Heart Institute, Ottawa, Ontario, Canada

dSZTE, AOK, I. Belgyógyászati Klinika, Szeged

eOXIVIT Medical Group, Budapest, Hungary

Correspondence to Jiri G. Fodor, Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Room H-2101, Ottawa, ON K1Y 4W7, Canada. Tel: +1 613 761 4785; fax: +1 613 761 5238; e-mail:

Abbreviations: BP, blood pressure; CV, cardiovascular; HR, heart rate; ON-BP Survey, Ontario Blood Pressure Survey

Received 28 September, 2011

Revised 16 July, 2012

Accepted 27 July, 2012

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.