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Objective: This study analysed the prevalence of hypertension and its associated risk factors in Czech adults aged 25-64 using data from the 2019 European Health Examination Survey (EHES). Given the limited number of large-scale studies in Central Europe, this study provides crucial evidence to inform public health strategies. Examining gender differences and applying updated control thresholds, it provides valuable insights into hypertension management in Czechia. Subject and Methods: We conducted a cross-sectional analysis using EHES 2019 data. Participants underwent a medical examination assessing cardiovascular health, including blood pressure and blood tests. 1,056 participants were included, aged 25-64 years (mean age of 44.4±0.73) years and with a mean body mass index (BMI) of 27.6±0.35 kg/m2. Hypertension was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) (mean of the second and the third measurements,1 min apart) ≥ 140/90 mmHg and/or current antihypertensive treatment. Awareness was determined by self-reporting prior diagnosis. Control was assessed as blood pressure <130/80 mmHg (control 1) or <140/90 mmHg. (control 2). Results: Hypertension prevalence was 36.3%, with higher rates in males (46.0%) than in females (26.3%, p < 0.001). Awareness was 64.8% greater in females (72.0% vs. 60.9%, p = 0.027). Treatment was received by 47.6% of hypertensives, more by women (57.7% vs. 42.0%, p <0.001). Control rates were 10.4% (control 1) and 49.4% (control 2). Conclusion: Hypertension is common in Czech adults, with gender differences in prevalence, awareness, and treatment. Despite high awareness, treatment and control remain suboptimal, indicating the need for targeted interventions.

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