The Egyptian National Hypertension Project (NHP): Design and rationale

Hypertension and its complications appear to be increasingly common in Egypt. The National Hypertension Project (NHP) is a collaborative Egyptian-American effort with the following objectives: (1) to determine the prevalence of hypertension and blood pressure-related preclinical and clinical complications in Egyptian adults, (2) to identify environmental factors associated with high blood pressure, and (3) to build an infrastructure for research and education in cardiovascular disease prevention in Egypt. The NHP surveys were conducted in six of Egypt's 26 governorates, representing distinct geographic regions. In each of these six governorates, a probability sample of 600 households was surveyed. NHP was conducted in two phases. In phase I a team of specially trained physicians conducted household surveys in which all adult residents (age ≥25 years) were screened for hypertension. In phase II hypertensive adults identified in phase I (ie, those with systolic pressure ≥140 mm Hg and/or diastolic pressure ≥90 mm Hg and/or those receiving antihypertensive drug therapy) along with a randomly selected sample of normotensive control subjects were asked to participate in a more extensive evaluation. This included a detailed history and clinical examination, an electrocardiogram, an echocardiogram, laboratory studies, and skin color reflectance (on a subsample). As the first systematic, national survey of hypertension and its complications in an Arab country, NHP should provide data of great interest to the scientific, provider, and public health communities.