Impact of cardiovascular risk factors on untreated hypertension in Lithuanians aged 50-54: a 2009-2022 analysis

Abstract Background Arterial hypertension (AH), defined as elevated systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg, is a treatable and highly prevalent risk factor for cardiovascular, cerebrovascular, and chronic kidney diseases globally (1, 2). Elevated blood pressure is responsible for an estimated 7.7 to 10.4 million annual deaths worldwide (3). Despite the wide treatment options available, high blood pressure remains a serious chronic condition that requires appropriate treatment and intensive cardiovascular risk factor management. A research study found that approximately one-third of nearly 42 million study subjects were unaware of having AH and, therefore, were not receiving antihypertensive treatment (4). Purpose The aim of the study was to evaluate untreated arterial hypertension and concomitant cardiovascular risk factor prevalence in the Lithuanian population aged 50-54 years old in the 2009-2022 period. Design: LITHIR is a nationwide primary prevention program financed by the Ministry of Health that has been implemented since 2006 and is designed to identify patients at high risk of CVD. A retrospective study involving 66,468 participants was carried out after gathering and analyzing LITHIR data. Participants who were not enrolled in any treatment but had previous hypertension diagnosis or an abnormal BP measurement (>140 and/or 90 mmHg) during evaluation in a primary health care center were considered as untreated AH. More than 94% of primary healthcare centers participate in the program, covering 44.5% of the studied population in 2023. Therefore, the data reliably reflects the general middle-aged Lithuanian population. Results Untreated hypertension prevalence steadily increased in the 50-54-year-old Lithuanian population from 15.81% in 2009 to 21.51% in 2022 (p < 0.001). Untreated hypertension was significantly more prevalent in the male group compared to women, with a mean difference of 8.35% (22.38% vs. 14.03%; p < 0.001). A total of 11,240 individuals were identified as having untreated hypertension. An unbalanced diet was the most prevalent cardiovascular risk factor in the analyzed group, reaching 59%. Insufficient physical activity, smoking, and increased LDL-C (>3.5 mmol/l) concentration amounted to 51.7%, 29.2%, and 60%, respectively. Despite substantial dyslipidemia prevalence, normal glucose concentration in venous blood was measured in 78.9% of the population. Conclusion(s) The study found that the prevalence of untreated hypertension was steadily growing in the middle-aged Lithuanian population, when the majority of patients with untreated hypertension were male. The most prevalent cardiovascular risk factors in the studied population were inadequate diet and smoking, although normal glucose concentration was obtained in most cases.Untreated hypertension 50-54 years old