Prevalence and Correlates of Pre-hypertension and Hypertension Results-II: A Screening Plan in a Selected Military Community in Central Saudi Arabia

Abstract

Background: Follow-up of patients destined to develop primary hypertension (HTN) demonstrates that blood pressure (BP) readings gradually increase over time. Aim: Determine and analyze the prevalence and correlates of both pre-HTN and HTN among recruits serving in Wadi Al-Dawasir (WD) military district, central Saudi Arabia. Methodology: Part of a “community diagnosis” plan led by the preventive medicine and family departments of the Armed Forces Hospital- WD (AFHWD), recruits were screened. A predesigned questionnaire and clinical interview were used to achieve study aim. Results: The median age of participates was 34y (IQR 11.75); median systolic blood pressure (SBP) 120 mmHg (IQR 20), and diastolic BP (DBP) 80 mmHg (IQR 15). In screening, 531 recruits, all male, were surveyed. Forty-nine percent (253/516) were found with SBP 120-139 mmHg, compatible with “prehypertension;” 208/ (82.2%) of them were unaware they have prehypertension. Also, 12.2% (63/516) were found with SBP≥140 mmHg, meeting HTN diagnosis, 42 (66.7%) of whom were newly diagnosed. The participants’ body mass index (BMI) averaged 27.6±5.4 kg/m2, and 66.4% participants were overweight-obese. Abnormally high BMI levels were significant risk for high BP [Fisher’s exact 64.6, p<0.0001]. “Now-smokers accounted 17.0% (n= 81); smoking impacted their hypertension (42.9%) and pre-hypertensive (25.4%) states [χ2(df 2)=6.5, p=0.039]. Age significantly impacted BP level [χ2(df 2)=14.3 p=0.001]; same as education [Fisher’s exact 17.8, p=0.03]. Importantly, the recruits’ SBP level differed between random plasma glucose (RPG) groups [U=4745, p=0.002]. Among chronic-disease comorbidities, having diabetes mellitus (DM) was significantly associated with hypertension (OR 2.93, 95% CI 134.6-637.6). Dyslipidemia also impacted high BP reporting [Fisher’s exact =10.6, p=0.004]. The presence of family history of coronary heart disease (CHD) was significantly related to HTN among participants [χ2(df 2)= 14.9, p=0.001]. Conclusions: Prehypertension, virtually the undiagnosed, is alarmingly prevalent in this study’s population; hypertension, too, is less likely present. Most hypothesized risks were significant high BP correlates. With current insight, the main focus should be directed first to high BP and comorbid risks control; and continued screening to evaluate the effectiveness of intervention approaches on the recruits’ lifestyle modifications and the impact of treatment policy on minimizing the risk of subsequent cardiovascular, stroke, and other systemic complications.