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Prevalence and determinants of undertreatment of hypertension in the Netherlands

Journal of Human Hypertension volume 18, pages 317–324 (2004)Cite this article

Abstract

The objective of this study was to determine the prevalence, treatment, and control of hypertension, and the determinants of undertreatment in the Dutch population. The study design was cross-sectional. A population-based survey on cardiovascular disease risk factors in the Netherlands from 1996 to 2002 was the setting of the study. A total of 10 820 men and women, aged 30–59 years, were included in the study. The main outcome measures of the study were: Prevalence of hypertension, treatment, and control of hypertension and determinants of undertreatment of hypertension. Hypertension was defined as: systolic blood pressure (SBP) ⩾140 mmHg and/or diastolic blood pressure (DBP) ⩾90 mmHg, and/or the use of antihypertensive medication. Treated and controlled hypertension was defined as SBP <140 mmHg and DBP <90 mmHg. Multivariate logistic regression was used to assess the determinants of undertreatment. The prevalence of hypertension in men was 21.4% and in women 14.9%, and 17.9% of the hypertensive men and 38.5% of the hypertensive women were receiving antihypertensive medication. Of the untreated hypertensives, 21.9% of the men and 13.6% of the women were eligible for treatment with antihypertensive medication according to Dutch guidelines. Female gender and the use of cholesterol-lowering medication were associated with an increased chance of being treated. Subjects who were physically active, on a low salt diet, and current smokers had an increased chance of being untreated. Taking cholesterol-lowering medication and no asthma or allergy were factors associated with better control of blood pressure. In conclusion, a considerable proportion of hypertensives were untreated and uncontrolled. Therefore, the detection and control of hypertension in the Netherlands needs to improve. Several groups of hypertensives were identified that need additional care and attention.

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Acknowledgements

The management team for the MORGEN-project consisted of Dr HB Bueno de Mesquita, Dr HA Smit, Dr WMM Verschuren, and Professor Dr JC Seidell. Logistic support was provided by A Jansen and J Steenbrink MSc, and data management was performed by A Blokstra MSc, AWD van Kessel MSc, and PE Steinberger MSc. Project leader for the Doetinchem Cohort Study is Dr WMM Verschuren, with logistic support by J Steenbrink MSc and P Vissink, secretarial assistance by EP van der Wolf, and data management by A Blokstra MSc, AWD van Kessel MSc, and PE Steinberger MSc. We thank the epidemiologists and field workers of the Municipal Health Services in Amsterdam, Doetinchem, and Maastricht for their contribution to the data collection for this study. This study is supported by the Netherlands Heart Foundation, Grant number: 2001.064. This study was financially supported by the Ministry of Health, Welfare and Sport of the Netherlands and the National Institute for Public Health and the Environment. Potential conflicts of interest: none.

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Authors and Affiliations

  1. Department of Epidemiology & Biostatistics, Erasmus MC, Rotterdam, The Netherlands

    H Schelleman & BHCh Stricker

  2. Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands

    H Schelleman, O H Klungel & A de Boer

  3. Division of Nutrition and Consumer Safety, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

    D Kromhout

  4. Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

    W M M Verschuren

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  1. H Schelleman
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  4. A de Boer
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  6. W M M Verschuren
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Correspondence to H Schelleman.

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Schelleman, H., Klungel, O., Kromhout, D. et al. Prevalence and determinants of undertreatment of hypertension in the Netherlands. J Hum Hypertens 18, 317–324 (2004). https://doi.org/10.1038/sj.jhh.1001672

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