| Abstract [eng] |
Background: Although arterial hypertension is considered the most significant modifiable risk factor for cardiovascular disease (CVD), it frequently remains undiagnosed worldwide. Lithuania is characterised by one of the highest CVD burdens in Europe, yet comprehensive data regarding diagnostic gaps in arterial hypertension are still lacking, as previous epidemiological studies conducted in Lithuania involved only small or geographically limited study populations. Objective: To determine the prevalence of undiagnosed arterial hypertension in the middle-aged Lithuanian population and to evaluate its associations with cardiometabolic risk. Methods: A retrospective analysis was performed using data collected from patients who participated in the Lithuanian primary cardiovascular disease prevention programme between 2009 and 2022. The primary inclusion criterion for the programme was age: 40-55 years for men and 50-65 years for women. Undiagnosed arterial hypertension was defined as blood pressure ≥ 140/90 mmHg in individuals with no prior diagnosis of hypertension and not taking antihypertensive medications. Simultaneously, cardiometabolic indicators were evaluated: body mass index (BMI), waist circumference, serum lipid concentrations, and fasting glycaemia. The prevalence of cardiovascular risk factors was also assessed, including unbalanced diet, physical inactivity, smoking, metabolic syndrome, general and abdominal obesity, diabetes status, dyslipidaemia, and family history of early ischaemic heart disease. For statistical comparisons, the t-test, Mann-Whitney U test, Pearson‘s chi-square (χ²) test, and Fisher‘s exact test were applied. The significance level was set at p <0.05. Results: The study included 171,819 patients (42.2% men, median age 52.09 ± 6.35 years). The overall frequency of undiagnosed cases among individuals with arterial hypertension was 16.55% and was twice as high among men compared to women (24.41% vs. 11.84%). Between 2009 and 2022, the prevalence of undiagnosed hypertension among individuals aged 40-65 years increased consistently from 12.27 to 24.52% (p < 0.05). In both gender groups, undiagnosed hypertension status was statistically significantly associated with higher BMI, waist circumference, fasting glycaemia, and serum lipid concentrations (all p < 0.001). It was also linked to a higher prevalence of dyslipidaemia, metabolic syndrome, and general and abdominal obesity. Additionally, in the male group, a higher prevalence of smoking, diabetes mellitus, and a positive family history of early ischaemic heart disease was observed among those with undiagnosed hypertension, while in the female group, physical inactivity was also more prevalent in the undiagnosed hypertension group (all p < 0.05). Conclusions: One in six middle-aged individuals with arterial hypertension in Lithuania remains undiagnosed, with the condition being twice as common in men as in women. An increase in undiagnosed hypertension cases was observed during the 2009-2022 period. Undiagnosed hypertension in both men and women was associated with a more unfavorable cardiometabolic profile. |
