Blood pressure pattern in urban and rural areas in Isfahan, Iran.

Hypertension is a serious public health problem in many societies due to its high prevalence and the associated increases in the risks of cardiovascular and renal disease. Some epidemiologic surveys on hypertension in eastern Mediterranean countries have reported prevalence rates among adults of up to 30%, in urban areas. To investigate the effects of an urban vs a rural environment on blood pressure (BP), this population-based survey was carried out in the city of Isfahan and its surrounding villages in Iran. The study sample comprised 8639 men and women aged 19-70 years obtained by random cluster sampling. A questionnaire was completed and BP was measured three times for each individual by trained medical interns using standard methods. Results show significant differences between mean systolic and diastolic BP and the prevalence of hypertension among urban and rural populations (P < 0.001). BP increased significantly with increasing age in both populations (P < 0.001). Total prevalence of hypertension (BP > or =160/95 mmHg or using antihypertensive drugs) was 21% for urban populations and 7% for rural ones. Urban women had higher and rural women had a lower prevalence of hypertension compared to urban and rural men, respectively (P < 0.001). Diabetes and hypercholesterolemia were more prevalent among urban people (P < 0.001) but no significant difference in relation to smoking among the two populations was found (P > 0.05). Although these differences were not adjusted for body mass index (BMI), dietary habits and other factors, it seems that environmental factors are important determinants of BP, so a change in lifestyle may be effective in lowering BP among urban people.