Abstract
BACKGROUND: Hypertension is a leading cause of cardiovascular diseases, stroke, and kidney failure worldwide. Despite being a preventable and manageable condition, hypertension often remains undiagnosed or poorly controlled, contributing to substantial health burdens. This study aims to estimate the prevalence of hypertension among adults in Saudi Arabia and identify key sociodemographic and behavioral risk factors associated with the condition. METHODS: This study utilized data from the 2019 Kingdom of Saudi Arabia World Health Survey (KSAWHS 2019), a nationally representative survey conducted by the Ministry of Health. The original sample included 8,912 individuals aged 15 years and older. After data cleaning, the analytical sample consisted of 8,618 individuals in this age group. For the present analysis, a subset of 8,266 adults aged 18 years and older with valid blood pressure measurements was used. Hypertension prevalence was estimated as both crude and age-standardized rates, with standardization based on the WHO 2000-2025 standard population. Poisson regression with robust variance was employed to assess associations between hypertension and a range of demographic, clinical, behavioral, and biochemical factors. RESULTS: Among adults aged 18 years and older, the crude prevalence of hypertension was 12.69%. Hypertension prevalence increased markedly with age, reaching over 50% among adults aged 80 years and older. Males had a higher prevalence of hypertension than females (14.1% vs. 11.2%). Among adults aged 30-79 years, the crude prevalence of hypertension was 19.41%, with 47.96% of affected individuals receiving antihypertensive treatment; the corresponding age-standardized prevalence and treatment coverage were 22.26% and 43.97%, respectively. In multivariable analyses, hypertension was significantly associated with older age, kidney disease (PR = 2.05), obesity (PR = 1.72), dyslipidemia (PR = 1.57), diabetes (PR = 1.34), and ever smoking (PR = 1.19). Among adults with hypertension, only 34.8% were aware of their condition. CONCLUSION: Hypertension remains a major public health challenge in Saudi Arabia. Additionally, hypertension awareness in Saudi Arabia is critically low, representing the most important gap in hypertension control. Key risk factors such as obesity, smoking, and diabetes significantly contribute to the burden of the disease. Strengthening routine blood pressure screening, expanding community-based detection initiatives, and integrating hypertension awareness into national programs are essential to improve early diagnosis and long-term cardiovascular outcomes.