Abstract:The continuous presence of elevated blood pressure (BP) when young is a strong predictor of future cardiovascular risk. This study aimed to elucidate the prevalence, awareness, treatment and control of young-onset hypertension (YOH) in Malaysia during the period 2006–2015. Data on respondents aged 18–39 diagnosed with YOH according to the 7th Joint National Committee Report (USA) were extracted from three National Health and Morbidity Surveys (2006, 2011, and 2015). The prevalence of YOH remained stable: 17.7%… Show more
“…2 ; and Online Resource, Supplementary Table S4 for the HDI ranking of Asian countries). Where trends over time were available, they showed that BP control rates are improving [ 137 , 142 , 143 , 157 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Not all these factors have been studied, but our search did identify some studies showing better BP control among certain subgroups of patients (Table 5 ). Nonmodifiable factors that influenced BP control included sex/gender [ 137 , 139 – 141 , 145 , 146 , 149 , 150 , 153 , 158 ], ethnicity [ 137 , 144 , 145 , 154 ], age [ 137 , 141 , 142 , 144 , 149 , 154 , 158 ], family history [ 154 ], time since diagnosis [ 139 ] and the presence of cardiovascular disease [ 159 ] or comorbidities [ 143 , 145 ]. Socio-economic factors that affected BP control included living in an urban versus rural area [ 137 , 138 , 146 , 154 ], household income [ 139 , 141 , 144 – 146 , 149 , 150 ], education level [ 141 , 144 , 145 , 150 , 154 ], marital status [ 145 , 146 , 149 , 150 ], employment status [ 144 , 146 ] and health insurance [ 139 ].…”
This article reviews available evidence regarding hypertension management in the Asia-Pacific region, focussing on five research questions that deal with specific aspects: blood pressure (BP) control, guideline recommendations, role of renin–angiotensin–aldosterone system (RAAS) inhibitors in clinical practice, pharmacological management and real-world adherence to guideline recommendations. A PubMed search identified 2537 articles, of which 94 were considered relevant. Compared with Europeans, Asians have higher systolic/diastolic/mean arterial BP, with a stronger association between BP and stroke. Calcium channel blockers are the most-commonly prescribed monotherapy in Asia, with significant variability between countries in the rates of angiotensin-converting enzyme inhibitors (ACEis)/angiotensin-receptor blockers (ARBs) and single-pill combination (SPC) use. In clinical practice, ARBs are used more commonly than ACEis, despite the absence of recommendation from guidelines and clinical evidence supporting the use of one class of drug over the other. Ideally, antihypertensive treatment should be tailored to the individual patient, but currently there are limited data on the characteristics of hypertension in Asia-Pacific individuals. Large outcome studies assessing RAAS inhibitor efficacy and safety in multi-national Asian populations are lacking. Among treated patients, BP control rates were ~ 35 to 40%; BP control in Asia-Pacific is suboptimal, and disproportionately so compared with Western nations. Strategies to improve the management of hypertension include wider access/availability of affordable treatments, particularly SPCs (which improve adherence), effective public health screening programs targeting patients to drive health-seeking behaviours, an increase in physician/patient awareness and early implementation of lifestyle changes. A unified Asia-Pacific guideline on hypertension management with pragmatic recommendations, particularly in resource-limited settings, is essential.
Supplementary Information
The online version contains supplementary material available at 10.1007/s40256-023-00625-1.
“…2 ; and Online Resource, Supplementary Table S4 for the HDI ranking of Asian countries). Where trends over time were available, they showed that BP control rates are improving [ 137 , 142 , 143 , 157 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Not all these factors have been studied, but our search did identify some studies showing better BP control among certain subgroups of patients (Table 5 ). Nonmodifiable factors that influenced BP control included sex/gender [ 137 , 139 – 141 , 145 , 146 , 149 , 150 , 153 , 158 ], ethnicity [ 137 , 144 , 145 , 154 ], age [ 137 , 141 , 142 , 144 , 149 , 154 , 158 ], family history [ 154 ], time since diagnosis [ 139 ] and the presence of cardiovascular disease [ 159 ] or comorbidities [ 143 , 145 ]. Socio-economic factors that affected BP control included living in an urban versus rural area [ 137 , 138 , 146 , 154 ], household income [ 139 , 141 , 144 – 146 , 149 , 150 ], education level [ 141 , 144 , 145 , 150 , 154 ], marital status [ 145 , 146 , 149 , 150 ], employment status [ 144 , 146 ] and health insurance [ 139 ].…”
This article reviews available evidence regarding hypertension management in the Asia-Pacific region, focussing on five research questions that deal with specific aspects: blood pressure (BP) control, guideline recommendations, role of renin–angiotensin–aldosterone system (RAAS) inhibitors in clinical practice, pharmacological management and real-world adherence to guideline recommendations. A PubMed search identified 2537 articles, of which 94 were considered relevant. Compared with Europeans, Asians have higher systolic/diastolic/mean arterial BP, with a stronger association between BP and stroke. Calcium channel blockers are the most-commonly prescribed monotherapy in Asia, with significant variability between countries in the rates of angiotensin-converting enzyme inhibitors (ACEis)/angiotensin-receptor blockers (ARBs) and single-pill combination (SPC) use. In clinical practice, ARBs are used more commonly than ACEis, despite the absence of recommendation from guidelines and clinical evidence supporting the use of one class of drug over the other. Ideally, antihypertensive treatment should be tailored to the individual patient, but currently there are limited data on the characteristics of hypertension in Asia-Pacific individuals. Large outcome studies assessing RAAS inhibitor efficacy and safety in multi-national Asian populations are lacking. Among treated patients, BP control rates were ~ 35 to 40%; BP control in Asia-Pacific is suboptimal, and disproportionately so compared with Western nations. Strategies to improve the management of hypertension include wider access/availability of affordable treatments, particularly SPCs (which improve adherence), effective public health screening programs targeting patients to drive health-seeking behaviours, an increase in physician/patient awareness and early implementation of lifestyle changes. A unified Asia-Pacific guideline on hypertension management with pragmatic recommendations, particularly in resource-limited settings, is essential.
Supplementary Information
The online version contains supplementary material available at 10.1007/s40256-023-00625-1.
“…The age of 18 to 64 years is the most productive age for working and maintaining their family's needs [7]. Unfortunately, younger age adults were associated with low awareness of CVD risk as found by previous local studies[8], [9].…”
Background
Cardiovascular diseases (CVDs) is prevalent globally and it is increasing tremendously. The article aimed to determine the prevalence and the odds ratio of seven type of diseases/ risk factors which contribute to CVDs among working people (18–64 years) in Malaysia.
Methods
A cross-sectional study among a nationally representative sample in Malaysia was conducted using a validated questionnaire. Clinical procedures were done by registered nurses to measure glucose, cholesterol, body mass index and blood pressure. The prevalence and prevalence odds ratio were calculated via complex samples data analysis of IBM SPSS Statistics version 25.
Results
The overall prevalence of CVD risks among working people were 14.1%, 17.3%, 24.5%, 28.8%, 31.7%, 45.9% and 94.2%, for diabetes, obesity, hypertension, physically inactive, tobacco smoker, hypercholesterolemia and inadequate fruit and vegetable (FV) intake, respectively. This study found that older age was associated with the odds of having the most CVD risks. Males were associated with higher odds of having hypertension and tobacco smoker, whereas females were more likely to have hypercholesterolemia, obesity, and physical inactivity. Those who worked as the manager & senior officials, clerical workers and services & sales workers were physically inactive while workers from the lower educational level were more likely to smoke tobacco. Workers in public sector were more likely to have a higher prevalence of diabetes, hypertension, hypercholesterolemia, smoking and obesity than workers in private sector.
Conclusions
This study highlighted that working people have significant CVD risks and the best intervention should be conducted at workplace settings.
“…The age range of 18 to 64 years is the most productive age for working and maintaining their family's needs [7]. Unfortunately, younger adults were associated with low awareness of CVD risk, as found by previous local studies [8,9].…”
Background: Cardiovascular diseases (CVDs) are prevalent globally and are increasing tremendously. This article aimed to determine the prevalence and prevalence odds ratio of seven CVD risks among working people (18-64 years) in Malaysia.Methods: A cross-sectional study among a nationally representative sample in Malaysia was conducted using a validated questionnaire. Clinical procedures were performed by registered nurses to measure glucose, cholesterol, body mass index and blood pressure. The prevalence and prevalence odds ratio were calculated via complex sample data analysis of IBM SPSS Statistics version 25.Results: The overall prevalence of CVD risks among working people was 14.1%, 17.3%, 24.5%, 28.8%, 31.7%, 45.9% and 94.2% for diabetes, obesity, hypertension, physical inactivity, tobacco smoking, hypercholesterolemia and inadequate fruit and vegetable (FV) intake, respectively. This study found that older age was associated with the odds of having the most CVD risks. Males were associated with higher odds of having hypertension and tobacco smoking, whereas females were more likely to have hypercholesterolemia, obesity, and physical inactivity. Those who worked as manager & senior officials, clerical workers and services & sales workers were physically inactive, while workers from the lower educational level were more likely to smoke tobacco. Workers in the public sector were more likely to have a higher prevalence of diabetes, hypertension, hypercholesterolemia, smoking and obesity than workers in the private sector.Conclusions: This study highlighted that working people have significant CVD risks and a regular medical screening should be conducted at workplace settings.
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