Gaps in Hypertension Guidelines in Low- and Middle-Income Versus High-Income Countries

Owolabi, Mayowa; Olowoyo, Paul; Miranda, J. Jaime; Akinyemi, Rufus; Feng, Wuwei; Yaria, Joseph; Makanjuola, Tomiwa; Yaya, Sanni; Kaczorowski, Janusz; Thabane, Lehana; Olmen, Josefien Van; Mathur, Prashant; Chow, Clara K; Kengne, André Pascal; Saulson, Raelle; Thrift, Amanda G.; Joshi, Rohina; Bloomfield, Gerald S.; Gebregziabher, Mulugeta; Parker, Gary; Agyemang, Charles; Modesti, Pietro Amedeo; Norris, Shane A.; Ogunjimi, Luqman; Farombi, Temitope; Melikam, Ezinne Sylvia; Uvere, Ezinne; Salako, Babatunde Lawal; Ovbiagele, Bruce

doi:10.1161/hypertensionaha.116.08290

Cited by 62 publications

(65 citation statements)

References 42 publications

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“…Hypertension care is a pressing health problem in Rwanda. While there are treatment guidelines to strengthen care, selecting, adapting, and implementing these guidelines in low-middle-income countries is challenging [13]. One of the barriers in improving the quality of care for hypertension treatment is the limited capacity and infrastructure for T4 translational research.…”

Section: Discussionmentioning

confidence: 99%

The TDR MOOC training in implementation research: evaluation of feasibility and lessons learned in Rwanda

Hooley

Baumann

Mutabazi

et al. 2020

Pilot Feasibility Stud

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Background: Hypertension (HTN) affects nearly 1 billion people globally and is a major cause of morbidity and mortality. In low-and middle-income countries (LMICs), HTN represents an unmet health care gap that can be addressed by strengthening national health care systems. The National Heart, Lung, and Blood Institute recently funded the T4 Translation Research Capacity Building Initiative in Low Income Countries (TREIN) program to build capacity in dissemination and implementation (D&I) research in HTN in LMICs. The Special Programme for Research and Training in Tropical Diseases (TDR) at the World Health Organization (WHO) recently developed a massive open online course (MOOC) to train in D&I. Herein, we report on the use of the TDR WHO MOOC in D&I for the TREIN program in Rwanda, assessing feasibility of the MOOC and D&I competencies after MOOC training. Methods: Participants in one-group MOOC training completed pre-and post-training questionnaires to assess dissemination and implementation (D&I) competency outcomes and feasibility. D&I competencies were measured by use of a scale developed for a US-based training program, with the change in competency scores assessed by paired t test. Feasibility was measured by completion of homework and final project assignment and analyzed using descriptive statistics. Results: Of the 92 trainees enrolled, 35 (38%) completed all MOOC components. D&I competency scores showed strong evidence of improvements from pre-to post-test. The full-scale average score improved by an average of 1.09 points, representing an effect size of 1.25 (CI 0.48-2.00); all four subscales also showed strong evidence of improvements. Trainees reported challenges to MOOC course completion that included technological issues (i.e., limited internet access) and competing demands (i.e., work, family).

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Section: Discussionmentioning

confidence: 99%

The TDR MOOC training in implementation research: evaluation of feasibility and lessons learned in Rwanda

Hooley

Baumann

Mutabazi

et al. 2020

Pilot Feasibility Stud

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“…Several groups had a methodological focus such as process evaluation methods, task shifting or sharing as a health strengthening tool, frameworks for determining barriers, and enablers to implementation [2,3]. The COUNCIL (Control UNique to Cardiovascular diseases In LMIC) initiative started with the aim of reviewing the relevance of current cardiovascular disease guidelines for LMIC settings and developing an implementation pipeline for pragmatic solutions to the cardiovascular disease burden in LMICs [4]. The COUNCIL initiative has now also included other chronic NCDs including diabetes [5], stroke [6], obesity, chronic obstructive pulmonary disorder, and depression.…”

Section: Special Interest Working Groupsmentioning

confidence: 99%

Strategic, Successful, and Sustained Synergy: The Global Alliance for Chronic Diseases Hypertension Program

Parker¹,

Héritier

Joshi

et al. 2019

Self Cite

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“…Several studies in LMICs have identified modifiable risk factors of hypertension, including overweight/obesity, sedentary lifestyle, smoking, alcohol consumption, and low fruit and vegetable consumption [5,6]. Some LMICs have published hypertension guidelines, which refer to the importance of these lifestyle components in terms of prevention and control of hypertension [7]. Despite these efforts, more research is needed to inform preventive efforts that are cost-effective and easy to implement in LMICs where financial and medical resources are limited.…”

Section: Introductionmentioning

confidence: 99%

Healthy lifestyle index and its association with hypertension among community adults in Sri Lanka: A cross-sectional study

et al. 2020

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Objectives To investigate the association between a healthy lifestyle index (HLI) (i.e., a composite score comprising multiple lifestyle factors) and hypertension among community adults living in Sri Lanka. Methods The present study used baseline information of a cluster randomized controlled trial among 456 adults aged 27-65 years in a semi-urban community in Colombo, Sri Lanka. The HLI was constructed by summing a number of low-risk lifestyle factors: low body mass index, sufficient physical activity, non-smoking, low alcohol consumption, and sufficient fruit and vegetable consumption. Hypertension was defined as systolic blood pressure �140 mmHg, diastolic blood pressure �90 mmHg, or the use of antihypertensive medication. A logistic regression model was used to investigate the association between the HLI (low: 0-2; middle: 3; high: 4-5) and hypertension. Results A total of 178 (39%) participants were hypertensive. Compared with the low HLI group, multivariate-adjusted odds ratios (95% confidence intervals) of hypertension were 0.72 (0.44-1.19) and 0.28 (0.15-0.54) for the middle and high HLI groups, respectively (p-trend <0.001).

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Gaps in Hypertension Guidelines in Low- and Middle-Income Versus High-Income Countries

Cited by 62 publications

References 42 publications

The TDR MOOC training in implementation research: evaluation of feasibility and lessons learned in Rwanda

The TDR MOOC training in implementation research: evaluation of feasibility and lessons learned in Rwanda

Strategic, Successful, and Sustained Synergy: The Global Alliance for Chronic Diseases Hypertension Program

Healthy lifestyle index and its association with hypertension among community adults in Sri Lanka: A cross-sectional study

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