gms | German Medical Science

49. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds)
19. Jahrestagung der Schweizerischen Gesellschaft für Medizinische Informatik (SGMI)
Jahrestagung 2004 des Arbeitskreises Medizinische Informatik (ÖAKMI)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie
Schweizerische Gesellschaft für Medizinische Informatik (SGMI)

26. bis 30.09.2004, Innsbruck/Tirol

Prevalence and Determinants of Arterial Hypertension in the Ruhrarea: Results of the Heinz Nixdorf Recall Study

Meeting Abstract (gmds2004)

  • corresponding author presenting/speaker Andreas Stang - Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Duisburg-Essen, Deutschland
  • S. Moebus - Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Duisburg-Essen, Deutschland
  • S. Möhlenkamp - Department of Cardiology, Medical Faculty, University of Duisburg-Essen, Duisburg-Essen, Deutschland
  • A. Schmermund - Department of Cardiology, Medical Faculty, University of Duisburg-Essen, Duisburg-Essen, Deutschland
  • N. Dragano - Institute of Medical Socioloty, University of Duesseldorf, Düsseldorf, Deutschland
  • J. Siegrist - Institute of Medical Socioloty, University of Duesseldorf, Düsseldorf, Deutschland
  • K. Mann - Department of Endocrinology, Medical Faculty, University of Duisburg-Essen, Duisburg-Essen, Deutschland
  • R. Erbel - Department of Cardiology, Medical Faculty, University of Duisburg-Essen, Duisburg-Essen, Deutschland
  • K.H. Jöckel - Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Duisburg-Essen, Deutschland

Kooperative Versorgung - Vernetzte Forschung - Ubiquitäre Information. 49. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 19. Jahrestagung der Schweizerischen Gesellschaft für Medizinische Informatik (SGMI) und Jahrestagung 2004 des Arbeitskreises Medizinische Informatik (ÖAKMI) der Österreichischen Computer Gesellschaft (OCG) und der Österreichischen Gesellschaft für Biomedizinische Technik (ÖGBMT). Innsbruck, 26.-30.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04gmds139

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Veröffentlicht: 14. September 2004

© 2004 Stang et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction

Arterial hypertension defined as repeated blood pressure values of ≥140 mmHg (Systole) or ≥90 mmHg (Diastole) is one of the major independent risk factors for cardiovascular diseases (CVD). Here we present population-based prevalence estimates of hypertension of the urban industrialized Ruhrarea. We separately studied body mass index (BMI), age and social status as potential determinants (or confounders) of hypertension among men and women.

Methods

The Heinz Nixdorf Recall Study is an ongoing population-based cohort study. Details have been published elsewhere [1]. From December 2002 through August 2003, 4.814 subjects participated in the baseline examination including blood pressure recording with two devices (automatic oscillometric [Omron 705 CP] & random zero [Hawksley]), a detailed medical history, assessment of social status, anthropometry, and many other factors. We used the blood pressure values from the automatic oscillometric blood pressure device and supplemented missing blood pressure values by the random zero device. We excluded n=48 subjects (0.9%) because either medical history on hypertension or the measured blood pressure values were missing. In addition, we excluded 323 subjects with a known coronary heart disease leaving 4.443 subjects in the final analysis. We estimated gender- and age-specific (5-year age groups) prevalences of known hypertension and/or elevated measured blood pressure values. We further stratified these estimates by BMI (<25, 25-29.9, ≥30.0 kg/m2) and social status as measured by highest school degree (in German: keiner/Volks-/Hauptschulabschluß; mittlere Reife; (Fach)Abitur; andere Abschlüße) and highest post-school educational degree (in German: keiner; Lehre; (Fach)Handelsschule; (Fach)Hochschule; andere). To yield unconfounded effect estimates, we estimated adjusted prevalence ratios and 95% confidence intervals (95%CI) with log-linear binomial regression using PROC GENMOD. We ran the models separately for men and women. To identify the minimal sufficient adjustment set, we draw a directed acyclic graph (DAG) [Fig. 1]. According to our DAG, we considered BMI one of the modifiable exposures of interest and considered age, and social status as potential confounders.

Results

The prevalence of hypertension was 63% among men and 52% among women aged 45-75 years. The prevalence of hypertension was considerably higher among men than women, overall and in each age-stratum [Tab. 1]. BMI was strongly associated with the prevalence of hypertension within gender- and age groups [Tab. 2]. Social status (highest school degree) had no independent effect on the prevalence ratio of hypertension in neither men nor women [Tab. 3]. A sensitivity analysis that included highest post-school educational degree did not alter our findings.

Discussion

As expected, age and gender were major determinants of the prevalence of hypertension. Within gender- and age strata, BMI, was highly associated with the prevalence of hypertension. Social status as measured by highest school degree and highest post-school educational degree did not show an association with the prevalence of hypertension. This finding is in contrast to the German National Health Examination Survey 1998 [2] which found an inverse association between social status and hypertension among women. The apparent contradiction results from the calculation of crude prevalence estimates only in the National Health Survey. The adjustment for age nearly completely removes the social status effect in our data.

Acknowledgment

This study was funded by a grant from the Heinz Nixdorf Foundation.


References

1.
Schmermund A, Möhlenkamp S, Stang A, Grönemeyer D, Seibel R, Hirche H, Mann, K, Siffert W, Lauterbach K, Siegrist J, Jöckel KH, Erbel R, for the Heinz Nixdorf Recall Study Investigative Group. Assessment of clinically silent atherosclerotic disease and established and novel risk factors for predicting myocardial infarction and cardiac death in healthy middle-aged subjects: rationale and design of the Heinz Nixdorf Recall Study. Am Heart J 2002;144:212-218.
2.
Knopf H, Ellert U, Melchert HU. Sozialschicht und Gesundheit. Gesundheitswesen 1999;61(suppl.):169-177