scholarly journals Hypertension Diagnosis, Treatment, and Control among Older Chinese: Trends in the Hypertension Care Cascade

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 610-610
Author(s):  
Erfei Zhao ◽  
Qiao Wu ◽  
Yuan Zhang ◽  
Eileen Crimmins
Keyword(s):  
Blood Pressure ◽  
Urban Areas ◽  
Delayed Diagnosis ◽  
Population Level ◽  
Care Cascade ◽  
Hypertension Diagnosis ◽  
Nationally Representative ◽  
Older Chinese ◽  
And Control ◽  
Poor Management

Abstract Hypertension is a major risk factor for cardiovascular disease, which is the leading cause of death in China. Older persons are at higher risk of elevated blood pressure and are more likely to have insufficient hypertension care, including delayed diagnosis and poor management. However, we know little about hypertension care among older Chinese at a population level. We use a nationally representative sample of older adults from the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2015 (n = 9,083), to clarify the hypertension care cascade for the older population in China by specifying the level of diagnosis, treatment, and control of hypertension. We then examine the characteristics of those (1) who received appropriate hypertension care and (2) whose care improved over time. Diagnosis and care improved between 2011 and 2015. Among those with hypertension, 55% and 67% were diagnosed in 2011 and 2015 respectively; 46% and 60% were treated with modern medication; and 20% and 29% were effectively controlled. Those who had higher income (OR=1.52; P<0.01) or obese (OR=2.43; P<0.001) were relatively more likely to be diagnosed, while those living in the western region (OR=0.65; P<0.01) or living in urban areas with a rural hukou (OR=0.54; P<0.01) were less likely. Persons age 75+ (OR=0.55; P<0.05) were less likely to have their blood pressure controlled, while those who had higher income (OR=1.50; P<0.05) were more likely. The improvement from 2011 to 2015 in hypertension care was concentrated among those that are obese or living in the West.

scholarly journals Hypertension among Young Adults in the Shopping Malls of Kathmandu

2013 ◽  
Vol 9 (1) ◽  
pp. 33-36 ◽  
Author(s):  
S Shakya ◽  
M Timilsina ◽  
K Timilsina ◽  
M Lamsal ◽  
S Dhakal ◽  
...  
Keyword(s):  
Public Health ◽  
Blood Pressure ◽  
Urban Areas ◽  
Cross Sectional Study ◽  
Shopping Malls ◽  
Cross Sectional ◽  
Health Challenge ◽  
Study Population ◽  
Public Health Challenge ◽  
And Control

Background Hypertension is a major public health challenge in the world. Developing countries share the major burden of it. Unlike thought before, hypertension is increasing among poor, young and women. Methods It was a cross sectional study carried out in The Hypertension Screening and Awareness Program conducted in the shopping malls at the heart of Kathmandu on the occasion of World Hypertension Day 2012 by Shahid Gangalal National Heart Center, Kathmandu. The blood pressure was measured according to World Heart Organization’s guideline by registered nurses. There were total 486 participants with the mean age of 29.51±10.77years. Majority of the participants were male (67.1%). Most of the participants were less or equal to 40 years (84.6%). Mean systolic blood pressure was 112.3±14.69mmHg and mean diastolic blood pressure was 75.09±11.89 mmHg. Average mean blood pressure was 87.41±12.28mmHg in the study population. Results Despite majority of participants were at young age, prevalence of hypertension was 23.7%, pre-hypertension was 30% and 46.3% had ideal blood pressure according to JNC-7 Classification. Prevalence of hypertension was higher among male (30.39% vs. 10%). Almost two third of the hypertensive subjects were less or equal to 40 years (64.35%). Awareness, treatment and control of hypertension were 39.13%, 18.26% and 7.38% respectively. Conclusion In conclusion, Hypertension is an emerging public health challenge in urban areas of Nepal. Most importantly, it may be increasing among young population. Moreover, awareness, treatment and control rates are not satisfactory. DOI: http://dx.doi.org/10.3126/njh.v9i1.8346 Nepalese Heart Journal Vol.9(1) 2012 pp.33-36

scholarly journals May Measurement Month 2019: an analysis of blood pressure screening results from the Democratic Republic of the Congo

2021 ◽  
Vol 23 (Supplement_B) ◽  
pp. B52-B54
Author(s):  
Jean-René M’Buyamba-Kabangu ◽  
Fortunat K Katamba ◽  
Mireille L Ntambwe ◽  
Georges N Ngoyi ◽  
Trésor M Tshiswaka ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ad Hoc ◽  
Democratic Republic ◽  
High Rate ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Republic Of The Congo ◽  
Low Levels ◽  
Nationally Representative ◽  
And Control

Abstract Hypertension, the foremost cause of global morbi-mortality, is linked with a high mortality from numerous cardiovascular endpoints. The May Measurement Month (MMM) campaign is an annual initiative of the International Society of Hypertension (ISH) to collect information on blood pressure (BP) and other risk factors for cardiovascular disease (CVD) in adults. MMM2019 in the Democratic Republic of the Congo (DRC) was an opportunistic cross-sectional survey of volunteers aged ≥18 years that took place in Kinshasa and Mbuji-Mayi after the training of observers to familiarize with the ISH ad hoc methods. We screened 29 857 individuals (mean age: 40 years; 40% female). Hypertension was present in 7624 (25.5%) individuals. Of them, 2520 (33.1%) were aware, 1768 (23.2%) on treatment with 910 (51.5%) controlled BP (systolic BP <140 mmHg and/or diastolic BP <90 mmHg). Of all hypertensives screened, 11.9% had controlled BP. Of all respondents, 16.7% had participated in MMM18 and 60.5% did not have their BP verified during the last year. Fasting, pregnancy, and underweight status were linked with lower BP levels whilst smoking, drinking, antihypertensive medication, previous stroke, diabetes as well as being overweight/obese were associated with higher BP levels. Our results reflect the high rate of hypertension in the DRC with low levels of awareness, treatment, and control. A nationally representative sample is required to establish the nationwide hypertension prevalence.

scholarly journals Hypertension care cascade in the Ingwavuma rural community, uMkhanyakude District, KwaZulu-Natal province of South Africa

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12372
Author(s):  
Herbert Chikafu ◽  
Moses Chimbari
Keyword(s):  
South Africa ◽  
Blood Pressure ◽  
High Blood Pressure ◽  
Rural Areas ◽  
Substantial Reduction ◽  
Diagnostic Tools ◽  
Care Cascade ◽  
Kwazulu Natal ◽  
Hypertension Screening ◽  
And Control

Background Treatment and control of hypertension are associated with a substantial reduction in adverse cardiovascular disease outcomes. Although South Africa aims to reduce the burden of cardiovascular diseases, there is limited evidence on the hypertension care cascade (HCC) performance in rural areas where stroke and hypertension are high. This study estimated HCC performance and identified predictors of hypertension screening among adults in the Ingwavuma community of KwaZulu-Natal, South Africa. Methods This was a cross-sectional study. Data were collected using the WHO STEPwise approach to surveillance (STEPS) questionnaire from 400 adult participants, excluding pregnant women and those with physical or cognitive impairments. Three hundred and ninety-three participants had complete data, and 131 had high blood pressure. We calculated progression rates for screening, diagnosis, treatment and control of hypertension from the sub-sample of participants with high blood pressure and assessed the bivariate association between HCC stages and participant characteristics and their effect sizes. We used binary and multivariable logistic regression to identify predictors of hypertension screening. Results Eighty-eight per cent of participants reported prior screening for hypertension. However, only 53.5% of patients under pharmacological treatment for hypertension had controlled blood pressure. In bivariate regression, employed participants were 80.3% (COR = 0.197, 95% CI [0.042–0.921]) more likely to be screened. In multivariable regression, the likelihood of hypertension screening was 82.4% (AOR = 0.176, 95% CI [0.047–0.655]) lower among participants in a cohabiting union than single participants. Similarly, employed participants were 87.4% (AOR = 0.129, 95% CI [0.017–0.952]) less likely to be screened than their unemployed counterparts. Conclusions The considerable attrition from the HCC across socio-demographic categories indicates a need for community-wide interventions. Empowering health care workers for community-based health promotion and hypertension management through point-of-care diagnostic tools could improve HCC performance. Efforts to improve the HCC should also focus on social determinants of health, notably gender and formal educational attainment.

scholarly journals Blood Pressure Screening Campaign in Jamaica: May Measurement Month 2017

2019 ◽  
Vol 32 (12) ◽  
pp. 1186-1191
Author(s):  
Magdalene Nwokocha ◽  
Cesar A Romero ◽  
Cheryl Holder ◽  
Natalie Whylie ◽  
Hiu Wong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Urban Areas ◽  
Disease Burden ◽  
Antihypertensive Drugs ◽  
Demographic Data ◽  
Hypertensive Patients ◽  
High Prevalence ◽  
Patients With Diabetes ◽  
And Control ◽  
Significant Disease

Abstract BACKGROUND Hypertension (HTN) is responsible for a significant disease burden in Jamaica. We are reporting the results of the 2017 blood pressure (BP) screening campaign May Measurement Month in Jamaica that aimed to increase the awareness of HTN. METHODS Adults, 18 years old and older, from different parishes of Jamaica were invited to participate during May to June 2017. Demographic data were collected. BP, weight, and height were measured and recorded. RESULTS Five hundred sixty-six participants (n = 566) were enrolled, 91.6% (519) from urban areas, and 72.6% (410) were females. The average age was 53.7 (18–95) years old and body mass index was 28.2 ± 6.6 kg/m2. The prevalence of HTN was 47.3% (267/566), without gender or living areas differences (both P > 0.1). Prevalence of HTN was lower in those who self-identified as Interracial ethnicity, in comparison with Afro-Caribbean (33% vs. 48.3%; P = 0.04). About third of the hypertensive patients were not aware of the high BP (89/267; 35.6%). Between hypertensive patients, 64.4% (172/267) were receiving antihypertensive drugs. The rate of BP control was 32% of the hypertensive patients and 50% of those receiving antihypertensive medication. Significant lower BP control was observed between diabetic vs. nondiabetic patients (34.3% vs. 60%; P < 0.001). CONCLUSION We found a high prevalence of HTN in this population, especially in patients with diabetes or previous cardiovascular diseases. We report an increase in HTN awareness in Jamaica but more advances need to be performed to increase HTN treatment and control.

scholarly journals HYPERTENSION

2015 ◽  
Vol 22 (02) ◽  
pp. 250-255
Author(s):  
Nasim Ilyas ◽  
Kashif Rahim ◽  
Azka Waqar
Keyword(s):  
Blood Pressure ◽  
Family History ◽  
Urban Areas ◽  
Preventive Measures ◽  
Causative Factor ◽  
Rural And Urban Areas ◽  
Frequent Use ◽  
Rural And Urban ◽  
History Of ◽  
And Control

Hypertension is a common term to define a state of raised blood pressure, and theraised blood pressure is 140 mm Hg mean systolic blood pressure of and mean diastolic bloodpressure of at least 90 mm Hg. Objectives: To assess awareness about Hypertension amongpatients attending Medical OPD at THQ Hospital Hassan Abdal. Materials and Methods: A totalof 150 male, female patients belonging to both rural and urban areas attending Medical OutPatient Department at THQ Hospital Hassan Abdal using a self constructed mixed questionnaire(In English and Urdu). Results: Following findings were observed among patients attendingTHQ hospital, Hassan Abdal: Family history of HTN was found to be 49% and 26% was unawareof family history of HTN. 33% found to have diabetes, 38% were unaware of having or not.29.3% found to have HTN, 48.6% were unaware of having HTN or not. 34% of hypertensivepatients showed compliance to the anti-hypertensive treatment while (66%) showed noncompliance.60.6%, 78%, 62%, 74%, 68% considered the obesity, lack of exercise, cigarettesmoking, anxiety and high cholesterol respectively as causative factor of HTN. Excessive intakeof salt was considered by 56% as causative factor of HTN. 29% considered diabetes Mellitus ascausative factor of HTN. 42%, 31%, 46% and 34% considered the cardiac disease, renal failure,brain hemorrhage and loss vision respectively as complication of HTN. Stroke was consideredcomplication by (54%). 55%, 65%, 53% and 58% considered the regular exercise reduced saltintake, no smoking and keeping weight under-Control respectively as preventive measures ofHTN. Less than half of the respondents considered frequent use of vegetables, excessive intakeof sweets, as the preventive measures of HTN. Conclusions: The assessment of awarenessabout Hypertension among population of various areas can be beneficial in effective planningfor disease prevention and control.

scholarly journals Opportunistic screening for hypertension in the general population in Greece: International Society of Hypertension May Measurement Month 2019

2021 ◽  
Vol 23 (Supplement_B) ◽  
pp. B66-B69
Author(s):  
George S Stergiou ◽  
Ariadni Menti ◽  
Michael Doumas ◽  
Eugenia Gkaliagkousi ◽  
Charalampos Grassos ◽  
...  
Keyword(s):  
International Society ◽  
Urban Areas ◽  
Antihypertensive Drugs ◽  
Population Level ◽  
Public Health Issue ◽  
Opportunistic Screening ◽  
Older Individuals ◽  
Hypertension Awareness ◽  
Training Programmes ◽  
And Control

Abstract Hypertension remains a major public health issue with inadequate control worldwide. The May Measurement Month (MMM) initiative by the International Society of Hypertension was implemented in Greece in 2019 aiming to raise hypertension awareness and control. Adult volunteers (≥18 years) were recruited through opportunistic screening in five urban areas. Information on medical history and triplicate sitting blood pressure (BP) measurements were obtained using validated automated upper-arm devices. Hypertension was defined as systolic BP ≥140 mmHg and/or diastolic ≥90 mmHg, and/or self-reported use of drugs for hypertension. A total of 5727 were analysed [mean age 52.7 (SD 16.6) years, men 46.5%, 88.3% had BP measurement in the last 18 months]. The prevalence of hypertension was (41.6%) and was higher in men and in older individuals. Among individuals with hypertension, 78.7% were diagnosed, 73.1% treated, and 48.3% controlled. Awareness, treatment, and control of hypertension were higher in women and in older individuals. Hypertensives had a higher body mass index (BMI) and were more likely to have diabetes, myocardial infarction and stroke, and less likely to smoke than normotensives (all P &lt; 0.001). Among treated hypertensives, 65.1% were on monotherapy, and with increasing number of antihypertensive drugs the BP levels were higher and hypertension control rates lower. The prevalence of hypertension in Greece is high, with considerable potential for improving awareness, treatment, and control. Screening programmes, such as MMM, need to be widely implemented at the population level, together with training programmes for healthcare professionals aiming to optimise management and control.

scholarly journals Prevalence, awareness, treatment, and control of hypertension in Bangladesh: Findings from National Demographic and Health Survey, 2017-18

2021 ◽  
Author(s):  
Md. Nuruzzaman Khan ◽  
John C. Oldroyd ◽  
Enayet K. Chowdhury ◽  
Mohammad Bellal Hossain ◽  
Juwel Rana ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Survey ◽  
Demographic And Health Survey ◽  
Hypertension Control ◽  
Control Blood Pressure ◽  
Factors Associated ◽  
Robust Variance ◽  
Control Programmes ◽  
Nationally Representative ◽  
And Control

AbstractObjectiveTo estimate the age-standardised prevalence, awareness, treatment and control of hypertension; and to identify their risk factors in Bangladeshi adults 18 years and above using the Bangladesh Demographic and Health Survey (BDHS) 2017-18 data.MethodsData from 12, 904 Bangladeshi adults aged 18 years and older available from the most recent nationally representative BDHS 2017-18 were used. Hypertension was defined as having systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg, and/or taking anti-hypertensive drugs to control blood pressure. Age-standardised prevalence of hypertension and control were estimated with direct standardisation, and a multilevel mixed-effects Poisson regression model with a robust variance was used to identify factors associated with hypertension and its awareness, treatment, and control.ResultsThe overall age-standardised prevalence of hypertension was 40.0% (95% CI, 38.9-42.2); (men: 37.1%, women: 42.0%). Among those with hypertension (n=3531), 44.3% were aware that they had the condition and 39.1% were taking anti-hypertensive medication. Among those treated for hypertension (n=1306), only 41% had controlled hypertension. Factors independently associated with hypertension were increasing age, higher body mass index, being women, having diabetes, and residing in selected administrative divisions. A declining trend of hypertension control was observed with increasing age and those not being educated.ConclusionHypertension is highly prevalent (4 out of 10) in Bangladeshi adults, while awareness, treatment, and control are low. Irrespective of risks associated with hypertension and its management, awareness and control programmes should be given high priority in reducing hypertension, and improving hypertension control in Bangladesh.

scholarly journals Temporal variation in prevalence, awareness and control of hypertension in urban and rural areas in Northeast Brazil between 2006 and 2016

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Nathália Paula de Souza ◽  
Eduarda Ângela Pessoa Cesse ◽  
Wayner Vieira de Souza ◽  
Annick Fontbonne ◽  
Maria Nelly Sobreira de Carvalho Barreto ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Abdominal Obesity ◽  
Rural Areas ◽  
Urban Areas ◽  
Adult Population ◽  
Disease Rate ◽  
Northeast Brazil ◽  
Cross Sectional ◽  
Urban And Rural Areas ◽  
And Control

Abstract: To assess the evolution in prevalence, awareness and control of hypertension for over 10 years in Pernambuco State, Northeast Brazil, two cross-sectional studies were conducted based on random samples of households in urban and rural areas, in 2006 and 2015/2016, involving adults aged 20 years or older. Hypertension was defined as systolic blood pressure of at least 140mmHg or diastolic blood pressure of at least 90mmHg as well as the reported use of antihypertensive medication. A logistic regression analysis was conducted to estimate the influence of the social, behavioral and anthropometric determinants on hypertension. Although social and behavioral factors improved in this 10-year period, overweight and abdominal obesity increased. Approximately one third of the adult population of Pernambuco had hypertension in 2006 and this prevalence was maintained in 2015/2016. In rural areas, awareness concerning hypertension rose from 44.8% in 2006 to 67.3% in 2015/2016, and control from 5.3% to 27.1%, so that awareness and control were similar in urban and rural areas in 2015/2016. After an adjustment for potential confounding factors, the likelihood of having hypertension more than doubled among men (OR = 2.03; p < 0.001), middle (OR = 4.41; p < 0.001) and old-age subjects (OR = 14.44; p < 0.001), and those who had abdominal obesity (OR = 2.04; p < 0.001) in urban areas and among middle-aged (OR = 2.56; p < 0.001), less educated individuals (OR = 2.21; p = 0.006) and those who were overweight (OR = 2.23; p < 0.001) in rural areas. Despite the favorable evolution in the management of hypertension in Pernambuco, public health measures focused in vulnerable populations are still required, mainly in rural areas, to improve primary prevention and decrease the disease rate.

scholarly journals Prevalence and inequality in persistent undiagnosed, untreated, and uncontrolled hypertension: Evidence from a cohort of older Mexicans

2021 ◽  
Vol 1 (12) ◽  
pp. e0000114
Author(s):  
C. M. Dieteren ◽  
O. O’Donnell ◽  
I. Bonfrer
Keyword(s):  
Blood Pressure ◽  
Diagnosis And Treatment ◽  
Uncontrolled Hypertension ◽  
Adult Health ◽  
Calculated Concentration ◽  
Premature Deaths ◽  
Long Term Treatment ◽  
Hypertension Diagnosis ◽  
And Control ◽  
Older Mexicans

Hypertension is the leading risk factor for cardiovascular diseases (CVDs) and substantial gaps in diagnosis, treatment and control signal failure to avert premature deaths. Our aim was to estimate the prevalence and assess the socioeconomic distribution of hypertension that remained undiagnosed, untreated, and uncontrolled for at least five years among older Mexicans and to estimate rates of transition from those states to diagnosis, treatment and control. We used data from a cohort of Mexicans aged 50+ in two waves of the WHO Study on Global AGEing and adult health (SAGE) collected in 2009 and 2014. Blood pressure was measured, hypertension diagnosis and treatment self-reported. We estimated prevalence and transition rates over five years and calculated concentration indices to identify socioeconomic inequalities using a wealth index. Using probit models, we identify characteristics of those facing the greatest barriers in receiving hypertension care. More than 60 percent of individuals with full item response (N = 945) were classified as hypertensive. Over one third of those undiagnosed continued to be in that state five years later. More than two fifths of those initially untreated remained so, and over three fifths of those initially uncontrolled failed to achieve continued blood pressure control. While being classified as hypertensive was more concentrated among the rich, missing diagnosis, treatment and control were more prevalent among the poor. Men, singles, rural dwellers, uninsured, and those with overweight were more likely to have persistent undiagnosed, untreated, and uncontrolled hypertension. There is room for improvement in both hypertension diagnosis and treatment in Mexico. Clinical and public health attention is required, even for those who initially had their hypertension controlled. To ensure more equitable hypertension care and effectively prevent premature deaths, increased diagnosis and long-term treatment efforts should especially be directed towards men, singles, uninsured, and those with overweight.

Hypertension in Delhi: prevalence, awareness, treatment and control

2007 ◽  
Vol 37 (3) ◽  
pp. 142-145 ◽  
Author(s):  
S Chaturvedi ◽  
M Pant ◽  
G Yadav ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Coronary Disease ◽  
Urban Areas ◽  
The Elderly ◽  
National Committee ◽  
Cross Sectional ◽  
Significant Difference ◽  
And Control ◽  
Slum Areas

Two cross-sectional, population-based studies were conducted to assess the prevalence, awareness, treatment and control of hypertension, among people aged 20-59 years and those over 60 years in Delhi. Study 1 (20-59 years): in total,1213 subjects from 120 clusters spread across Delhi were studied. The prevalence of hypertension was 27.5%. Of the hypertensives, 53.3% were aware of their diagnosis; 42.8% were taking treatment and only10.5% had controlled blood pressure. About 9.0% of the hypertensives had coexisting diabetes mellitus and 8.4% were suffering from coronary disease. The prevalence of hypertension was significantly higher in urban areas, but there was no significant difference in levels of awareness, treatment and control between urban and slum areas. The prevalence of hypertension was comparable in both sexes. Women, however, were more likely to be aware of their condition. Study 2 (6-10 years): in total,1105 subjects from 110 clusters were studied. Prevalence of hypertension was 63.8%. Isolated systolic hypertension (ISH) was found in 15.3% of the subjects. About 54% of the hypertensives were aware of their diagnosis; 43.4% were taking treatment and only 8.5% had controlled blood pressure. Prevalence of hypertension and ISH were comparable among sexes. Women were more aware and better treated. About 21.3% hypertensives had coexisting diabetes mellitus, and 14.3% were suffering from coronary disease. There was no significant difference between sexes. Urban and slum areas were also found to be comparable. Over 3% of the elderly were controlling their raised blood pressure by non-pharmacological measures. They belonged to the 'aware' category yet could not be labelled as 'hypertensives', highlighting an operational fault in the Joint National Committee definition.

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