| Sažetak: | Background <p>In Cuba, hypertension control in primary care has been prioritised as a cost-effective means of addressing premature death from cardiovascular disease (CVD). However, there is little large-scale evidence on the prevalence and management of hypertension in Cuba, and no direct evidence on the expected benefit of such efforts on CVD mortality.</p> Methods <p>Between Jan 1, 1996, and Nov 24, 2002, 146,556 men and women in Cuba were interviewed, measured and followed up for certified causes of death to Jan 1, 2017; 24,345 participants were resurveyed between Jul 14, 2006, and Oct 19, 2008. We calculated the prevalence of hypertension at recruitment (systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or receiving treatment for hypertension) and the proportion of hypertensives who were diagnosed, treated and controlled (systolic <140 mmHg and diastolic <90 mmHg). Cox regressions relate CVD mortality rate ratios (RRs) at ages 35-79 among participants with, versus those without, uncontrolled hypertension. RRs were used to estimate the fraction of CVD deaths attributable to hypertension.</p> Findings <p>After exclusion of those with incomplete data, there were 136 111 participants aged 35-79 at recruitment (mean age 54 [SD 12] and 75 947 [56%] women). Overall, one-third of these participants were hypertensive (34%). Of those with hypertension, two-thirds were diagnosed (67%); of those diagnosed, three-quarters were treated (76%); and, of those treated, about one-third had controlled blood pressure (36%). During 1.7 million person-years of follow-up, there were 5707 CVD deaths. Uncontrolled hypertension at baseline was associated with RRs of 2.15 (95%CI 1.88-2.46), 1.86 (1.69-2.05) and 1.41 (1.32-1.52) at ages 35-59, 60-69 and 70-79, respectively, and accounted for ~20% of premature CVD deaths. </p> Interpretation <p>In this Cuban population, one-third had hypertension. The proportion of hypertensives that were diagnosed and treated was high, and commensurate with some high-income countries. However, the proportion of treated hypertensives with controlled blood pressure was low. In addition to measures to reduce hypertension prevalence, public health programs should address the need for improved blood pressure control among treated hypertensives in Cuba.</p>
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