International Society of Hypertension Low and Middle Income Countries Committee

Fagard, Robert; Grassi, G.; Hall, John E.; Harrap, Stephen B; Lindholm, Lars; Schiffrin, Ernesto L.; Heagerty, AM

doi:10.1097/01.hjh.0000368700.79444.c1

Cited by 6 publications

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“…33,34 Improving hypertension control should be a priority to achieve the UN Millennium Development Goals for non-communicable diseases in low- and middle-income countries. 35,36 …”

Section: Discussionmentioning

confidence: 99%

Global Disparities of Hypertension Prevalence and Control

et al. 2016

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Background Hypertension is the leading preventable cause of premature death worldwide. We examined global disparities of hypertension prevalence, awareness, treatment, and control in 2010 and compared secular changes from 2000 to 2010. Methods We searched MEDLINE from 1995 through 2014 and supplemented with manual searches of retrieved article references. We included 135 population-based studies of 968,419 adults from 90 countries. Sex-age-specific hypertension prevalences from each country were applied to population data to calculate regional and global numbers of hypertensive adults. Proportions of awareness, treatment, and control from each country were applied to hypertensive populations to obtain regional and global estimates. Results In 2010, 31.1% (95% confidence interval, 30.0-32.2%) of the world's adults had hypertension; 28.5% (27.3-29.7%) in high-income countries and 31.5% (30.2-32.9%) in low- and middle-income countries. An estimated 1.39 (1.34-1.44) billion people had hypertension in 2010; 349 (337-361) million in high-income and 1.04 (0.99-1.09) billion in low- and middle-income countries. From 2000 to 2010, the age-standardized prevalence of hypertension decreased by 2.6% in high-income countries but increased by 7.7% in low- and middle-income countries. During the same period, the proportions of awareness (58.2% vs 67.0%), treatment (44.5% vs 55.6%), and control (17.9% vs. 28.4%) increased substantially in high-income countries, whereas awareness (32.3% vs 37.9%) and treatment (24.9% vs 29.0%) increased less, and control (8.4% vs 7.7%) even slightly decreased in low- and middle-income countries. Conclusions Global hypertension disparities are large and increasing. Collaborative efforts are urgently needed to combat the emerging hypertension burden in low- and middle-income countries.

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“…33,34 Improving hypertension control should be a priority to achieve the UN Millennium Development Goals for non-communicable diseases in low- and middle-income countries. 35,36 …”

Section: Discussionmentioning

confidence: 99%

Global Disparities of Hypertension Prevalence and Control

et al. 2016

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“…За последние десятилетия АГТ сыграла важную роль в снижении сердечно-сосудистой смертности в США и других развитых странах [7]. Улучшение контроля АГ выделено Международным обществом по гипертонии в качестве приоритетного направления в области политики управления неинфекционными заболеваниями [8].…”

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Hypertension in working age population: influence of gender and education

Максимова

Максимов

2020

Kardiologiia

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Introduction Hypertension is the most common cardiovascular disease (CVD) and a major cause of premature death. Study of age/gender-related and social aspects of the disease, and the assessment of the efficacy of antihypertensive treatment are essential elements of the epidemiological monitoring of hypertension and support a reasonable approach to planning further therapeutic and preventive interventions.Objective Assess the prevalence of hypertension in the working-age population, examine the relationship between hypertension patterns and level of education of respondents taking into account age, gender, and the main aspects of lifestyle.Materials and Methods The study included industrial workers who underwent a routine medical examination in September–November 2015. A total of 2432 subjects (59% males and 41% of females) were surveyed. The study design is cross-sectional, analytic. Methods used: anonymous questionnaire surveys using the WHO STEPS questionnaire, anthropometric measurements, BP measurement. Questions about hypertension included awareness of the presence of the disease and the administration of antihypertensive drugs. Hypertension was diagnosed with systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg, or in the case of the administration of antihypertensive drugs. The efficacy of treatment was assessed by the percentage of patients who had reached the target BP values (<140/90 mm Hg), including treated with antihypertensive drugs. The control of hypertension was judged by the percentage of patients with the target BP levels among all respondents with hypertension.Results Hypertension was diagnosed in 40% of the study subjects. The disease was more prevalent in males (odds ratio (OR) = 1.21), overweight, and obese patients (OR = 2.5) and less prevalent in subjects with higher education (OR = 0.6). No significant association of lifestyle (smoking, alcohol abuse, eating fruits and vegetables, physical activity) with the prevalence of hypertension was revealed. 76% of respondents with hypertension knew about their disease (51% among those who did not take antihypertensive drugs). Awareness was higher in patients with severe hypertension (OR = 2.5), overweight and obese patients (OR = 1.96), and respondents with higher education (OR = 1.55), being significantly lower in males (OR = 0.44). 50% of respondents with hypertension (52% of those with severe hypertension) took antihypertensive drugs with males twice less often than females (OR = 0.49). The target BP levels were detected in 39% of patients taking antihypertensive drugs, less frequently in males (OR = 0.63) and overweight patients (OR = 0.48), and significantly more frequently in patients with higher education (OR = 2.28), regardless their lifestyle.Conclusion The prevalence of hypertension in working patients was 40%. Males were more likely to suffer hypertension and less aware of their disease. The target blood pressure levels were less frequently observed in males during the treatment. On the other hand, patients with higher education had a lower prevalence of hypertension, significantly higher awareness of the disease and efficacy of the treatment than those who had secondary or primary school education. Overall, the study confirmed that the sample of industrial workers could be a reliable source for monitoring hypertension. The significant gender differences and an independent protective effect of the level of education were identified in the epidemiology of hypertension, which should be taken into account in further studies.

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“…Despite having several effective interventions to prevent and control hypertension,4–6 its management has been challenging 7 8. Randomised controlled trials (RCTs) have demonstrated that weight loss programmes,9 physical activity10 11 and a diet rich in fruits and vegetables and low-fat dairy12 13 can reduce BP.…”

Section: Introductionmentioning

confidence: 99%

Cluster randomised trial to evaluate comprehensive approach to hypertension management in Nepal: a study protocol

et al. 2023

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IntroductionDespite having effective approaches for hypertension management including use of antihypertensive medication, monitoring of blood pressure and lifestyle modification many people with hypertension in Nepal remain undetected and untreated. A comprehensive intervention which provides personalised counselling on lifestyle modification, medication adherence together with support for regular monitoring of blood pressure is expected to achieve well controlled blood pressure.Methods and analysisThis is a community-based, non-blinded, parallel group, two-arm cluster randomised controlled trial, with an allocation ratio of 1:1, conducted in Budhanilkantha municipality, Nepal. Ten health facilities and their catchment area are randomly allocated to either of the two arms. 1250 individuals aged 18 years and older with an established diagnosis of hypertension will be recruited. The intervention arm receives a comprehensive hypertension management package that includes blood pressure audit by health workers, home-based patient support by community health workers to engage patient and family members in providing tailored educational counselling on behavioural and lifestyle changes in addition to routine care. The control arm includes routine hypertension care. Trained enumerators will ensure consent and collect data. Outcome data on blood pressure, weight, waist and hip circumference will be measured and self-reported data on diet, lifestyle, medication adherence and hypertension knowledge will be registered at 11 months’ follow-up. The change in outcome measures will be compared by intention to treat, using a generalised linear mixed model. A formative assessment will be conducted using semistructured interviews and focus group discussions to explore factors affecting hypertension management. A mix-method approach will be applied for process evaluation to explore acceptability, adoption, fidelity, feasibility and coverage.Ethics and disseminationEthics approval was obtained from Nepal Health Research Council (682/2021) and Regional Committee for Medical and Health Research Ethics, Norway (399479). The findings will be disseminated in peer-reviewed journal articles and with decision makers in Nepal.

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International Society of Hypertension Low and Middle Income Countries Committee

Cited by 6 publications

References 0 publications

Global Disparities of Hypertension Prevalence and Control

Global Disparities of Hypertension Prevalence and Control

Hypertension in working age population: influence of gender and education

Cluster randomised trial to evaluate comprehensive approach to hypertension management in Nepal: a study protocol

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