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.

scholarly journals Patients with more comorbidities have better detection of chronic conditions, but poorer management and control: findings from six middle-income countries

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Grace Sum ◽  
Gerald Choon-Huat Koh ◽  
Stewart W. Mercer ◽  
Lim Yee Wei ◽  
Azeem Majeed ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
World Health Organisation ◽  
World Health ◽  
Uncontrolled Hypertension ◽  
Adult Health ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Increased Risk ◽  
And Control

Abstract Background The burden of non-communicable diseases (NCDs) is rising rapidly in middle-income countries (MICs), where NCDs are often undiagnosed, untreated and uncontrolled. How comorbidity impacts diagnosis, treatment, and control of NCDs is an emerging area of research inquiry and have important clinical implications as highlighted in the recent National Institute for Health and Care Excellence guidelines for treating patients suffering from multiple NCDs. This is the first study to examine the association between increasing numbers of comorbidities with being undiagnosed, untreated, and uncontrolled for NCDs, in 6 large MICs. Methods Cross-sectional analysis of the World Health Organisation Study of Global Ageing and Adult Health (WHO SAGE) Wave 1 (2007–10), which consisted of adults aged ≥18 years from 6 populous MICs, including China, Ghana, India, Mexico, Russia and South Africa (overall n = 41, 557). Results A higher number of comorbidities was associated with better odds of diagnosis for hypertension, angina, and arthritis, and higher odds of having treatment for hypertension and angina. However, more comorbidities were associated with increased odds of uncontrolled hypertension, angina, arthritis, and asthma. Comorbidity with concordant conditions was associated with improved diagnosis and treatment of hypertension and angina. Conclusion Patients with more comorbidities have better diagnosis of chronic conditions, but this does not translate into better management and control of these conditions. Patients with multiple NCDs are high users of health services and are at an increased risk of adverse health outcomes. Hence, improving their access to care is a priority for healthcare systems.

scholarly journals Awareness, treatment, and control of hypertension and related factors in adult Iranian Population

2020 ◽  
Author(s):  
Mohsen Mirzaei ◽  
Masoud Mirzaei ◽  
Behnam Bagheri-Fahraji ◽  
Ali Dehghani
Keyword(s):  
Blood Pressure ◽  
Health Workers ◽  
Public Awareness ◽  
Public Health Problem ◽  
Iranian Population ◽  
Uncontrolled Hypertension ◽  
National Committee ◽  
Female Sex ◽  
History Of ◽  
And Control

Abstract Background: Hypertension, known as the silent killer, is a major risk factor for cardiovascular disease. Awareness and treatment of hypertension is not appropriate in the world, and this has led to an increase in mortality and morbidity caused by uncontrolled hypertension.This study aims to estimate awareness, treated, and controlled hypertensive and relevant predictors in an adult Iranian population.Methods: This cross-sectional study was conducted on 10000 adults aged 20-69 years in Yazd, Iran. They were selected through multi-stage random cluster sampling in 2015-2016. Blood pressure was measured three-time with standard protocol by trained health workers. Those with a positive history of hypertension and using anti-hypertensive drugs, prescribed by a physician, were considered hypertensive. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic BP of ≥90 mmHg. Uncontrolled hypertension was defined in accordance with recommended treatment targets by the Joint National Committee (JNC7). Logistic regression was used to assess the predictors of hypertension awareness, treatment and control.Results: The prevalence of hypertension was 37.3%, and the prevalence of pre-hypertension was 46.4%. 49.7% of People with hypertension were aware of their disease, and 71.5% of them were using antihypertensive drugs prescribed by physicians. Blood pressure was controlled in 38.9% of the treated patients. In the adjusted model, older age, female sex, and history of diabetes mellitus were positively associated with higher awareness. High physical activity, tobacco smoking, and diabetes are the only predictors of treated high blood pressure. Younger age, female sex, and higher education were determinants of controlled hypertension. Having health insurance was significantly correlated with awareness and control of hypertension.Conclusion: Hypertension is a public health problem in this population, which is not well controlled. Half of the patients were unaware. Intervention for increased screening coverage is needed. It should plan to raise public awareness about hypertension and improve hypertension control under the supervision of physicians. Implement a family physician program is recommended in the health system.

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 The Effect of self-efficacy education based on self-care behaviors of self-administered hypertension groups

2021 ◽  
Author(s):  
Zahra Asa Kohne Forody ◽  
Mehdi Gholian Aval ◽  
Hadi Tehrani ◽  
Habibollah Esmaily
Keyword(s):  
Blood Pressure ◽  
Self Efficacy ◽  
Self Care ◽  
Analysis Of Covariance ◽  
Control Groups ◽  
Self Help ◽  
Long Term Treatment ◽  
Significant Difference ◽  
Self Help Groups ◽  
And Control

Introduction: High blood pressure is a chronic disease that requires long-term treatment; despite being asymptomatic, it leads to fatal complaints and complications. Therefore, the present study was conducted to determine the effect of education based on self-efficacy theory on self-care behaviors of hypertensive self-help groups in comprehensive health service centers in Mashhad in2020.  Methods: This study is a quasi-experimental study in which 80 female patients with hypertension were randomly divided into experimental and control groups. The educational intervention was based on the theory of self-efficacy for the experimental group. Data collection tools were a three-part questionnaire including: demographic information and a standard questionnaire of self-efficacy and self-care of blood pressure. Data were analyzed using independent t-test, Mann-Whitney, Chi-square, Fisher's exact test, Friedman test and repeated measures and analysis of covariance by SPSS software version 20 with a significance level of 0.05 Results: There was a significant difference in self-efficacy (P <0.001) and self-care (P <0.001) scores and controlled blood pressure between the experimental and control groups. The self-care score increased by 0.84 which was also statistically significant (p <0.001) Conclusion: Intervention based on the theory of self-efficacy can be effective in promoting self-care and self-efficacy of blood pressure self-help groups. Therefore, it is suggested that this theory be used in educational planning for patients and blood pressure self-help groups.

scholarly journals Awareness, treatment, and control of hypertension and related factors in adult Iranian Population

2020 ◽  
Author(s):  
Mohsen Mirzaei ◽  
Masoud Mirzaei ◽  
Behnam Bagheri-Fahraji ◽  
Ali Dehghani
Keyword(s):  
Blood Pressure ◽  
Health Workers ◽  
Public Awareness ◽  
Public Health Problem ◽  
Iranian Population ◽  
Uncontrolled Hypertension ◽  
National Committee ◽  
Female Sex ◽  
History Of ◽  
And Control

Abstract Background: Hypertension, known as the silent killer, is a major risk factor for cardiovascular disease. Awareness and treatment hypertension is not appropriate in the world, and this has led to an increase in mortality and morbidity caused by uncontrolled hypertension.This study aims to estimate awareness, treated, and controlled hypertensive and relevant predictors in an adult Iranian population.Methods: This cross-sectional study was conducted on 10000 adults aged 20-69 years in Yazd, Iran. They were selected through multi-stage random cluster sampling in 2015-2016.Blood pressure was measured three-time with standard protocol by trained health workers. Those with a positive history of hypertension and using anti-hypertensive drugs, prescribed by a physician, were considered hypertensive. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic BP of ≥90 mmHg. Uncontrolled hypertension was defined in accordance with recommended treatment targets by the Joint National Committee (JNC7). Logistic regression was used to assess the predictors of hypertension awareness, treatment and control.Results: The prevalence of hypertension was 37.3%, and the prevalence of pre-hypertension was 46.4%. 49.7% of People with hypertension were aware of their disease, and 71.5% of them were using antihypertensive drugs prescribed by physicians. Blood pressure was controlled in 38.9% of the treated patients. In the adjusted model, older age, female sex, and history of diabetes mellitus were positively associated with higher awareness. High physical activity, tobacco smoking, and diabetes are the only predictors of treated high blood pressure. Younger age, female sex, and higher education were determinants of controlled hypertension. Having health insurance was significantly correlated with awareness and control of hypertension.Conclusion: Hypertension is a public health problem in this population, which is not well controlled. Half of the patients were unaware. Intervention for increased screening coverage is needed. It should plan to raise public awareness about hypertension and improve hypertension control under supervision of physicians. Implement a family physician program is recommended in the health system.

scholarly journals Improving Treatment Adherence and Control Rate of Patient with Hypertension Using Aweb-Based Management System in a Rural Community in China

2021 ◽  
Author(s):  
Yanxia Zhu ◽  
Liangm Guo ◽  
Tianran Wu ◽  
Xingli Wu
Keyword(s):  
Blood Pressure ◽  
Treatment Adherence ◽  
Management System ◽  
Intervention Group ◽  
Uncontrolled Hypertension ◽  
Adherence Rate ◽  
Control Group ◽  
Web Based ◽  
And Control ◽  
The Web

Abstract The control rates of patients with hypertension remain extremely low in Chinese rural communities, therefor we aimed to improve treatment adherence and control rate for patients with hypertension by using a web-based management system, which included modeles of the user’s personal information, health education, adherence alerting, communication between physician and statistics analysis and data print functions. 350 patients with uncontrolled hypertension were included in the study through a multi-stage stratified sampling, and were divided radomis1y into the web-based intervention group and control group. Comparing with those in the control group, there was a significant improvement in the control rate of the blood pressure in the intervention group (93.7% vs 50.9%, p < 0.001) and a remarkable decrease in blood pressure (systolic blood pressure declined by 25.0 mmHg, < 0.001; diastolic blood pressure declined by 8.7 mmHg, p < 0.001) after 12 months follow-up. The medication adherence rate in intervention groups was improved significantly than that in the control group p < 0.01)，and the adherence scale correlated negatively with blood pressure (r=-0.518, P < 0.001), and positively correlated with control rate (0.623, P < 0.001). This study suggested that the web-based hypertension management system is worth spreading in rural areas in developing countries.

scholarly journals P1216EPIDEMIOLOGY OF HYPERTENSION IN PERITONEAL DIALYSIS USING CLINIC AND AMBULATORY BLOOD PRESSURE MONITORING

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Vasilios Vaios ◽  
Panagiotis Georgianos ◽  
Georgia Vareta ◽  
Antonios Karpetas ◽  
Evangelia Ntounousi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Uncontrolled Hypertension ◽  
White Coat Hypertension ◽  
Maintenance Hemodialysis ◽  
Antihypertensive Medications ◽  
Gold Standard Method ◽  
And Control

Abstract Background and Aims Earlier studies that were based on routine clinic blood pressure (BP) recordings suggested that the prevalence of hypertension is lower in patients on peritoneal dialysis (PD) than in those receiving maintenance hemodialysis. These studies, however, did not incorporate the “gold-standard” method of ambulatory BP monitoring (ABPM). The aim of the present study was to quantify the prevalence and control of hypertension in a cohort of 81 peritoneal dialysis (PD) patients using clinic and ambulatory BP recordings. Method Triplicate BP recordings were obtained after a 5-minute seated rest at clinic with the validated monitor HEM-705 CP (Omron, HealthCare). 24-hour ABPM was subsequently performed with the Mobil-O-Graph device (IEM, Germany). Hypertension was defined as (i) average clinic BP ≥140/90 mmHg or antihypertensive drug use and (ii) 24-hour BP ≥130/80 mmHg or current use of antihypertensive drugs. Results The prevalence of hypertension was 92.6% with clinic BP recordings and 93.8 with ABPM. In all, 75 participants (92.6%) were receiving therapy with an average of 2.4 antihypertensive medications. The rates of adequate control of hypertension were 49.3% with the use of clinic BP recordings and 39.5% with ABPM, respectively. In all, 6.2% of participants were classified as normotensives, 33.3% had concordant control of hypertension with both techniques, 40.7% had concordant lack of control confirmed by both techniques, 5% had “white coat” hypertension and 14.8% had masked uncontrolled hypertension. Conclusion This study suggests that the burden of hypertension among patients on PD is very high and that the wider use of ABPM is important to confirm the BP control status of these patients.

scholarly journals May Measurement Month 2019: an analysis of blood pressure screening results from Venezuela, Latin America

2021 ◽  
Vol 23 (Supplement_B) ◽  
pp. B151-B153
Author(s):  
Rafael Hernández-Hernández ◽  
Neil R Poulter ◽  
Mónica L Gúzman-Franolic ◽  
Yuly Rawik ◽  
José Andrés Octavio-Seijas ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Uncontrolled Hypertension ◽  
Previous Pregnancy ◽  
Raising Awareness ◽  
History Of ◽  
Global Initiative ◽  
Lipid Abnormalities ◽  
And Control ◽  
Tobacco Usage

Abstract Cardiovascular diseases are the main cause of death in Venezuela. Raised blood pressure (BP) accompanied by diabetes mellitus, obesity, lipid abnormalities, and tobacco usage are the biggest contributors to mortality. The May Measurement Month (MMM) campaign is a global initiative aimed to raising awareness of hypertension, which has been conducted in Venezuela since 2017. MMM2019 included 24 672 subjects (mean age: 54.7 years, SD 25.2, 63.1% female). The proportion with hypertension was 48.9%; 14.3% were unknown hypertensives, 35.5% of those who receiving treatment had uncontrolled hypertension (systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg); when considering all hypertensives, 53.3% were controlled. Sixty per cent of those on anti-hypertensive medication were on monotherapy, 27.7% were on two, and 7.7% were on three or more drugs. Body mass index, calculated for the total population, was on average 25.6 (SD: 4.8) kg/m2. 16.2% of participants were classified as obese, 34.0% as overweight, and 4.0% were classified as underweight. Diabetes mellitus was reported by 9.4%, smoking by 7.3%, and 10.5% reported drinking alcohol regularly. Conditions associated with higher BP levels were obesity, diabetes mellitus, and women with a history of hypertension during a previous pregnancy. These results are consistent with the two previous MMM campaigns and indicate that repeated screening can routinely identify hypertension. There is an urgent need for Venezuela to implement programmes of detection, treatment, and control not only for hypertension but also for other common cardiovascular risk factors.

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