JoH: Europe needs new strategies to combat hypertension epidemic
Elevated blood pressure is still a looming problem in Europe, according to results from the IMMIDIET trial, published Nov. 11 in the Journal of Hypertension. The study also found that many hypertensive Europeans do not know about their condition; and even among those who have been diagnosed, more than half have their blood pressure not under optimal control.

The IMMIDIET study examined 1,604 citizens from three European geographical areas: southwest London in England, Limburg, Belgium, and Abruzzo, Italy. All participants underwent a medical exam, including blood pressure measurement and answered a questionnaire about their lifestyle and perception of health status.

Overall, the researchers found that 24 percent of the population appeared to be hypertensive.

Lead author Simona Costanzo, from Catholic University of Campobasso in Italy, saidthat “awareness was far from optimal.” They found that a significant proportion of patients (56 percent) did not know they had high blood pressure.

Also, less than half of diagnosed patients, according to the IMMIDIET results, have their blood pressure falling within desired internationally recognized levels.

The researchers also examined the differences between the three regions. Previously, it was believed that the risk of cardiovascular disease was higher in northern than in southern Europe—the so-called “gradient.” However, IMMIDIET showed that the picture is changing. Average blood pressure in British people was lower than in Belgians and Italians, according to the results.

“When we consider that also smoking showed the same trend, we could argue that the more we go south, the higher the cardiovascular risk. "It is something like turning upside down the old gradient,” Costanzo noted.

"This inversion is surprising; it may reflect the ongoing changes of lifestyle habits. Paradoxically, northern European countries, where cardiovascular risk was higher than in Italy, are now modifying their habits, getting closer to the ancient Italian food and lifestyle culture, thus living a healthier life. On the contrary, in Italy traditional habits are being lost, and we may be observing the negative effects on health,” according to Licia Iacoviello, also from Catholic University of Campobasso and coordinator of IMMIDIET.

European women appeared to do better than men. In all three areas studied, they were more aware of hypertension than men and, when on treatment, they tended to have lower blood pressure levels, a sign of a better management of the condition. According to the authors, this could be related, in part, to the fact that women have more frequent contacts with healthcare practitioners.

“We fear Europe is facing a dangerous situation. Hypertension is a critical causative factor for serious diseases like myocardial infarction (heart attacks) and stroke, but it is still grossly underestimated. So we need urgent and intensive initiatives in this field, introducing new and effective strategies in controlling this threat,” Iacoviello said.