The state of hypertension care in 44 low-income and middle-income countries: a cross-sectional study of nationally representative individual-level data from 1·1 million adults

Geldsetzer, Pascal; Manne‐Goehler, Jennifer; Marcus, Maja-Emilia; Ebert, Cara; Zhumadilov, Zhaxybay; Wesseh, Chea Sanford; Tsabedze, Lindiwe; Supiyev, Adil; Sturua, Lela; Bahendeka, Silver; Sibai, Abla Mehio; Quesnel-Crooks, Sarah; Норов, Болормаа; Mwangi, Kibachio Joseph; Mwalim, Omar; Wong-McClure, Roy; Mayige, Mary; Martins, João S; Lunet, Nuno; Labadarios, Demetre; Karki, Kshitij; Kagaruki, Gibson B.; Jorgensen, Jutta M Adelin; Hwalla, Nahla; Houinato, Dismand Stéphan; Houéhanou, Corine; Msaidié, Mohamed; Guwatudde, David; Gurung, Mongal Singh; Gathecha, Gladwell; Dorobanțu, Maria; Damasceno, Albertino; Bovet, Pascal; Bicaba, Brice; Aryal, Krishna Kumar; Andall‐Brereton, Glennis; Agoudavi, Kokou; Stokes, Andrew; Davies, Justine; Bärnighausen, Till; Atun, Rifat; Vollmer, Sebastián; Jaacks, Lindsay M.

doi:10.1016/s0140-6736(19)30955-9

Cited by 361 publications

(370 citation statements)

References 20 publications

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“…Hypertension was defined as systolic blood pressure > 140, and/or diastolic blood pressure > 90, and/or use of anti-hypertensive medications [15].…”

Section: Definition Of Comorbiditiesmentioning

confidence: 99%

Body Composition in Individuals with Obesity According to Age and Sex: A Cross-Sectional Study

Maı̈moun

Mura²,

Avignon

et al. 2020

JCM

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Obesity is characterized by an alteration in body composition (BC); however, it is not known whether this alteration is modified by aging or sex. The aims of this study were to analyze BC in individuals with obesity based on age and sex and to determine the prevalence of sarcopenia. Seven hundred and fifty-five obese individuals were subdivided into four age groups. The hole (WB) and segmental BC were determined using dual-energy X-ray absorptiometry (DXA). In men, the WB lean tissue mass (LTM) and fat mass (FM) adjusted by weight and height were relatively constant with age. In women, the WBLTM was higher and WBFM was lower in the >65 group compared to the 18-34 group. A decrease in the LTM and FM at lower limbs and an increase in the trunk were observed, particularly in women, inducing a lower appendicular lean mass index (ALMI; appendicular LTM/height 2 ) in the >65 group compared to the 18-34 group in both sexes. This study demonstrated that even though the WBLTM and FM are relatively constant with age, individuals with obesity present a localized redistribution of these two components. This body composition change leads to a decrease of the ALMI with age, one of the criteria included in the sarcopenia definition.

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“…Hypertension was defined as systolic blood pressure > 140, and/or diastolic blood pressure > 90, and/or use of anti-hypertensive medications [15].…”

Section: Definition Of Comorbiditiesmentioning

confidence: 99%

Body Composition in Individuals with Obesity According to Age and Sex: A Cross-Sectional Study

Maı̈moun

Mura²,

Avignon

et al. 2020

JCM

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“…18 Using a 130/80 mm Hg threshold for diagnosing hypertension has a marked influence on hypertension prevalence in Mongolia, as has been similarly documented in other countries. 18 Using a 130/80 mm Hg threshold for diagnosing hypertension has a marked influence on hypertension prevalence in Mongolia, as has been similarly documented in other countries.…”

Section: Discussionmentioning

confidence: 84%

“…Compared with the average of LMICs, the prevalence of hypertension (using a 140/90 mm Hg threshold) is higher in Ulaanbaatar but the awareness, treatment, and control rates are also higher. 18 On average, the prevalence, awareness, treatment, and control rates of hypertension for adults living in LMICs are 17.5%, 39.2%, 29.9%, and 10.3%, respectively, while corresponding rates in Ulaanbaatar are 25.6%, 69.7%, 46.8%, and 24.0%, respectively. 18 The rates of hypertension prevalence, awareness, treatment, and control in Ulaanbaatar are in fact similar to the average of HICs (28.5%, 67.0%, 55.6%, and 28.4%, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…18 On average, the prevalence, awareness, treatment, and control rates of hypertension for adults living in LMICs are 17.5%, 39.2%, 29.9%, and 10.3%, respectively, while corresponding rates in Ulaanbaatar are 25.6%, 69.7%, 46.8%, and 24.0%, respectively. 18 The rates of hypertension prevalence, awareness, treatment, and control in Ulaanbaatar are in fact similar to the average of HICs (28.5%, 67.0%, 55.6%, and 28.4%, respectively). 5 In order to explore whether this was due to recent improvement, we obtained data from the 2013 STEPS survey and calculated the hypertension prevalence, awareness, treatment, and control rates among adults aged 20 years or older in Ulaanbaatar using identical analytical methodology.…”

Section: Discussionmentioning

confidence: 99%

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Hypertension prevalence and control in Ulaanbaatar, Mongolia

Potts

Baatarsuren²,

Myanganbayar³

et al. 2020

J of Clinical Hypertension

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This study examines the prevalence, awareness, treatment, and control of hypertension in Ulaanbaatar, Mongolia, using both the American Heart Association and conventional thresholds (130/80 and 140/90 mm Hg, respectively). In this randomized cross-sectional study, two-stage cluster sampling was used to obtain a sample of 4515 individuals aged ≥20 years. Hypertension was defined by the use of antihypertensives in the last 2 weeks or a blood pressure at or above the thresholds of 140/90 and 130/80 mm Hg. The mean age of the participants was 41.1 ± 14.0 years and 54.5% were women. Hypertension prevalence was 25.6% (using 140/90 mm Hg) and 46.5% (using 130/80 mm Hg). Prevalence increased with age and below 50 years men were consistently more likely to be hypertensive. Among hypertensive participants, the rates of awareness, treatment, and control were 69.7%, 46.8%, and 24.0% (using 140/90 mm Hg) and 49.1%, 25.8%, and 6.4% (using 130/80 mm Hg, respectively).Men had lower rates of awareness, treatment, and control compared with women, with the most pronounced differences at younger ages. This study shows that awareness, treatment, and control rates in Ulaanbaatar are better than in most low-and middle-income countries but are still suboptimal. The largest "care gap" was in young men where a regulatory requirement for annual workplace blood pressure screening has the potential to enhance care. A major hypertension control program has just been initiated in Ulaanbaatar.

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“…Initially, the editorial called attention to the fact that awareness, treatment, and control of hypertension (systolic BP [SBP] ≥140 mm Hg, diastolic BP [DBP] ≥90 mm Hg or treatment with antihypertensive drug therapy) is inadequate worldwide but especially so in middle‐ and low‐income countries. This was based on two reports published in the same issue . While disturbing, the findings in these two articles are not surprising.…”

mentioning

confidence: 92%