Abstract
Background
Hypertension awareness and control are understudied among older adults in middle-income countries, particularly contextualized according to interpersonal, institutional, and community factors. Research on hypertension in Latin America is acknowledged as insufficient.
Methods
We analyzed International Mobility in Aging Study data of 803 community-dwelling adults 65–74 years from study sites in the two most populous countries in South America: Brazil and Colombia. The study framework was the socioecological model, positing individual health outcomes are influenced by various behavioral, interpersonal, institutional, and community factors. Logistic regression models identified factors associated with hypertension awareness and control.
Results
At over 70% of participants, hypertension was prevalent in both samples, and awareness was high (> 80%). In contrast, blood pressure control among diagnosed respondents was low: 30% in Brazil and 51% in Colombia. Factors across the socioecological model were associated with awareness and control. Those with diabetes (OR 4.19, 95%CI 1.64–10.71) and with insufficient incomes (OR: 1.85, 95%CI 1.03–3.31) were more likely to be aware of their hypertension. In Colombia, those reporting no community activity engagement were less likely to be aware of their condition compared to those reporting community activities. In Brazil, it was the opposite. Women (OR 1.66, 95%CI 1.12–2.46) and those reporting strolling shops and stores (OR 1.80, 95% CI 1.09-3.00) were significantly more likely to have their hypertension under control. In Brazil, those 70–75 were significantly less likely to have their hypertension under control compared to their younger counterparts. In Colombia, there was no significant difference in the likelihood of hypertension control by age group.
Conclusions
There were notable differences in some factors across countries, highlighting the importance of theory-based studies within unique Latin American contexts on hypertension and other critical public health problems. Potential solutions for countries in the LAC region to improve hypertension outcomes for older adults include continuing to build access to health care to increase awareness and emphasizing social activities, including strolling in shops, that may support hypertension control as well as other desirable public health outcomes (e.g., exercise, social networks).
Factors associated with hypertension prevalence, awareness, treatment and control among participants in the International Mobility in Aging Study (IMIAS)