Abstract
BACKGROUND: Arterial hypertension is a major risk factor for morbidity and mortality in Germany. No current data are available on trends in the incidence of hypertension. METHODS: The incidence of diagnosed hypertension (ICD codes I10.- to I15.-) and the utilization of 24-hour ambulatory blood pressure measurement (ABPM) and antihypertensive drugs were determined in an analysis of anonymized routine data on 4.8 million persons covered by the statutory health insurance system in Germany. The data were linked to the German Index of Socioeconomic Deprivation on the basis of the subjects' place of residence and evaluated with stratification by age group, sex, and regional socioeconomic deprivation. RESULTS: In 2017, the age-standardized incidence of diagnosed hypertension was 20.6 per 1000 persons. It fell in the first year of the COVID-19 pandemic, rose again in 2021, and reached 20.7 per 1000 in 2023. In 2023, the incidence of diagnosed hypertension was markedly higher in regions with high socioeconomic deprivation than in low-deprivation regions (24.6 versus 17.9 per 1000). Among persons who received a diagnosis of hypertension in 2023, 82.3% received medication and 30.1% underwent ABPM within one year of their diagnosis. CONCLUSION: The high incidence of diagnosed hypertension underscores the need for a well-developed preventive strategy. The downward trend that was observed over the past decade is no longer evident. This matter should be investigated further with a nationwide investigative survey that also takes undiagnosed hypertension into account.