Prehypertension and hypertension among older adults: prevalence, awareness, treatment, control and associated factors - findings from Iranian STEPS survey (2016 and 2021).

Hypertension prevalence increased among Iranian adults aged 60 and older between 2016 and 2021 for both sexes.

• Hypertension rates rose from 54.74% to 60.57% in males between 2016 and 2021.
• Hypertension rates rose from 65.54% to 71.76% in females between 2016 and 2021.
• Participants were classified as hypertensive based on ESC/ESH guidelines.
• Data analyzed from 3874 participants in STEPS 2016 and 4020 participants in STEPS 2021.

Hypertension treatment rates increased among older Iranian adults from 2016 to 2021 in both sexes.

• Treatment increased from 26.53% to 36.03% in males.
• Treatment increased from 39.25% to 53.70% in females.
• Females had consistently higher treatment rates than males in both survey years.

Hypertension control rates improved between 2016 and 2021 in both male and female older adults.

• In 2016, hypertension control rates were 23.06% in males and 24.03% in females.
• In 2021, control rates rose to 34.28% in males and 36.13% in females.
• Despite improvement, control rates remained below 40% in both sexes by 2021.

Obesity was strongly associated with hypertension among older Iranian adults.

• Obesity was associated with hypertension with an odds ratio of 2.75 (p < 0.001).
• This finding was identified through analysis using the survey package in R statistical software.
• The association was described as 'strongly associated' in the abstract.

Higher education was inversely associated with hypertension among older Iranian adults.

• Higher education appeared to be inversely associated with hypertension with an odds ratio of 0.64 (p < 0.001).
• The study suggests that promoting higher educational attainment may contribute to better long-term control of hypertension.
• Sex and socioeconomic disparities were observed in awareness, treatment, and control of hypertension.

The study used a nationally representative surveillance design covering all provinces of Iran across two time points.

• Data were drawn from the Iranian STEP-wise Approach to Non-Communicable Disease Risk Factor Surveillance (STEPS) conducted in 2016 and 2021.
• Surveys were conducted across all provinces of Iran.
• Total combined sample included 3874 participants from 2016 and 4020 participants from 2021.
• Analysis was performed using the survey package in R statistical software.