Blood pressure in adult rural INDEPTH population in Asia

Abstract

IntroductionHigh blood pressure (BP) is a well-known major risk factor for cardiovascular diseases and is a leading contributor to cardiovascular mortality and morbidity worldwide. Reliable population-based BP data from low–middle income countries are sparse.ObjectiveThis paper reports BP distributions among adults in nine rural populations in five Asian countries and examines the association between high BP and associated risk factors, including gender, age, education, and body mass index.MethodsA multi-site cross-sectional study of the major non-communicable disease risk factors (tobacco and alcohol use, fruit and vegetable intake, physical activity patterns) was conducted in 2005 in nine Health and Demographic Surveillance System (HDSS) sites in five Asian countries, all part of the INDEPTH Network. In addition to the self-report questions on risk factors, height and weight, and BP were measured during household visits using standard protocols of the WHO STEPwise approach to Surveillance.ResultsIn all the study sites (except among men and women in WATCH and among women in Chililab), the mean levels of systolic BP were greater than the optimal threshold (115 mmHg). A considerable proportion of the study populations – especially those in the HDSS in India, Indonesia, and Thailand – had high BP (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg or on treatment with BP medications). A more conservative definition of high BP (systolic BP ≥ 160 mmHg or diastolic BP ≥ 100 mmHg) substantially reduced the prevalence rate. The marked differences in the proportion of the populations on high BP medication (range between 0.6 and 10.8%) raised problems in comparing the prevalence of high BP across sites when using the commonly used definition of high BP as in this study. In the four HDSS in Bangladesh, women had a higher prevalence of high BP than men; the reverse was true in the other sites (Chililab, Filabavi in Vietnam; Kanchanaburi, Thailand; and Vadu, India) where men experienced higher prevalence than women. Overweight and obesity were significantly associated with high BP, with odds ratio ranging from two in Chililab to five in Filabavi (both in Vietnam HDSS).ConclusionThe patterns of BP in these nine cross-sectional surveys were complex, reflecting the fact that the Asian countries are at different stages of the epidemiological transition. Actions to prevent the rise of BP levels are urgently required. An emphasis should be placed on cost-effective interventions to reduce salt consumption in the population as an immediate priority.

Blood pressure class and carotid artery intima–media thickness in a population at the secondary epidemiological transition

“…Our study population had an incidence of grade I and II hypertension of over 35%, which is relatively high compared to multiple studies in rural areas in Asia and Africa [15,16]. In addition, 17-37% of the 180 patients with '(high) normal' BP may progress to hypertension if the data in literature apply to the individuals now studied in Flores Island [17].…”

Prevalence, awareness, treatment and control of hypertension in Vietnam—results from a national survey

“…These results show higher prevalences than in previous studies (11.2% in 1992, 14 16.3% in 2001, 15 16.9% among subjects aged 24-64 years in 2002, 16 14.1% in a rural community of Vietnam in 2002, 17 and 18.3% in 2005. 18 These findings indicate an increasing problem.…”

How is Indonesia coping with its epidemic of chronic noncommunicable diseases? A systematic review with meta-analysis

“…Fig 6 shows that most of the 130 included studies considered age (n = 115) [14–17, 22–29, 31–50, 53, 55, 56, 59–64, 66–73, 75–77, 80–92, 95–102, 104–108, 110–129, 131, 133–143, 155, 156] and/or sex (n = 112) [15–19, 21–26, 28, 29, 31–38, 40–50, 53, 55, 56, 58–92, 95–108, 110–112, 114–116, 118–123, 125–129, 131, 133–143, 155, 156] in their analyses. On average around 40% of all studies included some sort of socioeconomic indicator mirroring educational attainment [15, 17, 21–24, 32, 34, 35, 37–…”

“…On average around 40% of all studies included some sort of socioeconomic indicator mirroring educational attainment [15, 17, 21–24, 32, 34, 35, 37–40, 42–44, 47, 48, 50, 55, 56, 60, 63, 66, 68, 69, 71, 73, 75, 76, 79, 81, 83–85, 91, 92, 95, 99, 101, 102, 104–108, 111, 112, 114, 122, 123, 125–127, 129, 131, 133, 135–138, 140, 142, 155, 156], income or wealth [15, 17, 20–22, 25, 28, 37, 39, 43, 47, 52, 55, 56, 60, 63, 66, …”