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. 2016 Dec 2;113(48):809-815.
doi: 10.3238/arztebl.2016.0809.

Hypertension in Germany

Hannelore Neuhauser  1 , Claudia Diederichs, Heiner Boeing, Stephan B Felix, Claus Jünger, Roberto Lorbeer, Christine Meisinger, Annette Peters, Henry Völzke, Cornelia Weikert, Philipp Wild, Marcus Dörr
Affiliations

Hypertension in Germany

Hannelore Neuhauser et al. Dtsch Arztebl Int. .

Abstract

Background: Hypertension is a key risk factor. However, population data based on blood pressure measurements in Germany are scarce.

Methods: Standardized blood pressure (BP) measurements and medication data from seven population-based studies conducted in Germany between 1994 and 2012 (66 845 participants, 25-74 years) were analyzed: the EPICPotsdam study (1994-1998, EPIC), the KORA-S4 Study (1999-2001) in Augsburg, and the Gutenberg Health Study (2007-2012, GHS) in Mainz/Mainz-Bingen provided data for descriptive comparisons. Time trends were analyzed based on identical study regions for the German National Health Interview and Examination Survey 1998 (BGS98) and the German Health Examination Survey for Adults (2008-11, DEGS1) as well as the Study of Health in Pomerania (SHIP) in Northeast Germany (1997-2001) and the SHIP-TREND study (2008-2012). BP data were adjusted for study-specific measurement devices based on calibration studies.

Results: After adjustment for study-specific measurement devices, mean systolic and diastolic BP values were lower and treatment proportions higher in recent (2007-2012) compared to older (1994-2001) studies. Mean BP decrease was most pronounced (systolic ≥ 10 mmHg) in the elderly (55-74 years). The regional SHIP-TREND data for Northeast Germany showed a decrease in mean systolic BP in young men aged 25 to 34 years; on a national level according to the DEGS1 data, however, no such decrease was observed for this group.

Conclusion: New data add evidence for lower BP in Germany. However, the prevention potential remains high. Future research based on population-based data should place a special focus on blood pressure data in young men.

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Figures

Figure 1
Figure 1
Mean systolic blood pressure in men in seven population-based studies 1994–2012 BGS98, German National Health Interview and Examination Survey 1998; DEGS1, German Health Examination Survey for Adults (2008–2011); EPIC, European Prospective Investigation into Cancer and Nutrition study 1994–1998; GHS, Gutenberg Health Study 2007–2012; KORA-S4, Cooperative health research in the Region of Augsburg study 1999–2001; SHIP-0, Study of Health in Pomerania 1997–2001; SHIP-TREND, Study of Health in Pomerania 2008–2012
Figure 2
Figure 2
Mean systolic blood pressure in women in seven population-based studies 1994–2012 BGS98, German National Health Interview and Examination Survey 1998; DEGS1, German Health Examination Survey for Adults (2008–2011); EPIC, European Prospective Investigation into Cancer and Nutrition study 1994–1998; GHS, Gutenberg Health Study 2007–2012; KORA-S4, Cooperative health research in the Region of Augsburg study 1999–2001; SHIP-0, Study of Health in Pomerania 1997–2001; SHIP-TREND, Study of Health in Pomerania 2008–2012
Figure 3
Figure 3
Reduction in mean systolic blood pressure in Germany as a whole (BGS98/DEGS1) and in the Northeast (SHIP-0/SHIP-TREND) BGS98, German National Health Interview and Examination Survey 1998; DEGS1, German Health Examination Survey for Adults (2008–2011); SHIP-0, Study of Health in Pomerania 1997–2001; SHIP-TREND, Study of Health in Pomerania 2008–2012
Figure 4
Figure 4
Increase in treatment among hypertensives in Germany as a whole (BGS98/DEGS1) and in the Northeast (SHIP-0/SHIP-TREND) BGS98, German National Health Interview and Examination Survey 1998; DEGS1, German Health Examination Survey for Adults (2008–2011); SHIP-0, Study of Health in Pomerania 1997–2001; SHIP-TREND, Study of Health in Pomerania 2008–2012
eFigure 1
eFigure 1
Overview of the study regions in Germany BGS98, German National Health Interview and Examination Survey 1998; DEGS1, German Health Examination Survey for Adults (2008–2011); EPIC, European Prospective Investigation into Cancer and Nutrition study 1994–1998; GHS, Gutenberg Health Study 2007–2012; KORA-S4, Cooperative health research in the Region of Augsburg study 1999–2001; SHIP-0, Study of Health in Pomerania 1997–2001; SHIP-TREND, Study of Health in Pomerania 2008–2012
eFigure 2
eFigure 2
Pairwise comparison of mean systolic and diastolic blood pressure levels in Germany as a whole and in the Northeast within more than a decade (comparison of BGS98 and DESG1 and of SHIP-0 and SHIP-TREND) The curves represent the distribution of blood pressure in the population, illustrating that the shift towards lower blood pressure has occurred at all blood pressure levels, not only at levels above treatment thresholds. The dotted lines represent the mean blood pressure, which has also decreased.
See this image and copyright information in PMC

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