Hypertension Prevalence, Awareness, Treatment, and Control in Selected LMIC Communities: Results From the NHLBI/UHG Network of Centers of Excellence for Chronic Diseases

Abstract

Background Hypertension is the leading cause of cardiovascular disease and premature death worldwide. The prevalence of this public health problem is increasing in low-and-middle income countries (LMICs) both in urban and rural communities. Objective To examine hypertension prevalence, awareness, treatment, and control in adults 35-74 years old from urban and rural communities in LMICs in Africa, Asia and South America. Methods We analyzed data from 7 population-based cross-sectional studies in selected communities in nine LMICs that were conducted between 2008 and 2013. Age-gender standardized prevalence of pre-hypertension and hypertension were calculated. The prevalence of awareness, treatment and control of hypertension were estimated overall and by subgroups of age, gender and educational level. Results In selected communities, age-gender standardized prevalence of hypertension (95% confidence interval) among men and women aged 35-74 years was 49.9% (42.3, 57.4) in Kenya, 54.9% (51.3, 58.4) in South Africa, 52.5% (50.1, 54.8) in China, 32.5% (31.7, 33.3) in India, 42.3% (40.4, 44.2) in Pakistan, 45.4% (43.6, 47.2) in Argentina, 39.9% (37.8, 42.1) in Chile, 19.2% (17.8, 20.5) in Peru, and 44.1% (41.6, 46.6) in Uruguay. The proportion of awareness varied from 33.5% in India to 69.0% in Peru; the proportion of treatment among those who were aware of their hypertension varied from 70.8% in South Africa to 93.3% in Pakistan; and the proportion of blood pressure control varied from 5.3% in China to 45.9% in Peru. Conclusions Prevalence of hypertension varies widely in different communities. The rate of awareness, treatment and control also differs in different settings. There is a clear need to focus on increasing hypertension awareness and control in LMICs.

Prevalence, awareness, treatment, and control of hypertension in Cameroonians aged 50 years and older: A community‐based study

“…Complex interactions between metabolic and neurohormonal pathways, with resultant alterations in insulin resistance, the renin-angiotensin-aldosterone system, and sympathetic tone, could explain the occurrence of HTN amongst people who are overweight/obese. [44][45][46][47][48][49] The awareness and treatment rates of 63.4% and 96.7% in our study are similar to the 62.4% and 93.3% rates in Pakistan, and the 69% and 90.8% rates in Peru, reported in a review of HTN in a slightly younger population in 9 LMIC by Irazola et al 31 Our awareness rates were higher than the 44.6% 22 lower than rates reported in high-income countries. 30,32 Our control rates were significantly lower than the 46% and 71% obtained in Pakistan and Peru, respectively, in a review of HTN in a slightly younger population in 9 LMIC by Irazola et al 31 Our rates were considerably higher than those found in an elderly population in other LMICs.…”

“…29,30 These differences could be due to heterogeneity in sampling methods and cut-off age for the elderly population, ranging from 35 to 74 years across various studies. 1,15,26,27,[30][31][32][33] Compared with younger adults, older individuals are at least twice more likely to develop HTN. 33 This is in coherence with global trends, and recent estimates project a further increase in these values.…”

Hypertension in older adults: Assessment, management, and challenges

“…38,39 Since high BP is primarily asymptomatic, structured community programs play an important role in the diagnosis and have proven effective in diagnosis patients unaware they have hypertension. 40,41 3 | CURRENT EVIDENCE AND GUIDELINES Treatment of ISH in older adults was somewhat unclear until randomized studies such as the Systolic Hypertension in the Elderly Program (SHEP), 8 the Systolic Hypertension in Europe trial (Syst-Eur), 42 and the Hypertension in the Very Elderly Trial (HYVET) 43 showed significant CV benefits on lowering SBP in patients with ISH. All these four trials defined ISH as SBP ≥160 and DBP <90 mmHg.…”

El SPRINT en la práctica médica: ¿es momento de modificar el manejo de la hipertensión arterial en Latinoamérica?

“…Una de las mayores limitaciones de la aplicabilidad del SPRINT en Latinoamérica es el uso de equipos para la medición de la PA , dado que en los países latinoamericanos aún es frecuente el uso del esfigmomanómetro de mercurio o aéreo 24 . En el SPRINT, se realizaron 3 mediciones a los pacientes sentados, después de cinco minutos de reposo antes de la medición, sin conversaciones durante el periodo de reposo o medición; condiciones difícilmente alcanzables por el personal de salud en Latinoamérica.…”