scholarly journals Hypertension awareness, treatment, and control and their association with healthcare access in the middle-aged and older Indian population: A nationwide cohort study

PLoS Medicine ◽  
2022 ◽  
Vol 19 (1) ◽  
pp. e1003855
Author(s):  
Jinkook Lee ◽  
Jenny Wilkens ◽  
Erik Meijer ◽  
T. V. Sekher ◽  
David E. Bloom ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antihypertensive Medication ◽  
Indian Population ◽  
Economic Status ◽  
Access To Healthcare ◽  
Hypertension Management ◽  
Middle Aged ◽  
Hypertension Awareness ◽  
Hypertension Diagnosis ◽  
And Control

Background Hypertension is the most important cardiovascular risk factor in India, and representative studies of middle-aged and older Indian adults have been lacking. Our objectives were to estimate the proportions of hypertensive adults who had been diagnosed, took antihypertensive medication, and achieved control in the middle-aged and older Indian population and to investigate the association between access to healthcare and hypertension management. Methods and findings We designed a nationally representative cohort study of the middle-aged and older Indian population, the Longitudinal Aging Study in India (LASI), and analyzed data from the 2017–2019 baseline wave (N = 72,262) and the 2010 pilot wave (N = 1,683). Hypertension was defined as self-reported physician diagnosis or elevated blood pressure (BP) on measurement, defined as systolic BP ≥ 140 mm Hg or diastolic BP ≥ 90 mm Hg. Among hypertensive individuals, awareness, treatment, and control were defined based on self-reports of having been diagnosed, taking antihypertensive medication, and not having elevated BP, respectively. The estimated prevalence of hypertension for the Indian population aged 45 years and older was 45.9% (95% CI 45.4%–46.5%). Among hypertensive individuals, 55.7% (95% CI 54.9%–56.5%) had been diagnosed, 38.9% (95% CI 38.1%–39.6%) took antihypertensive medication, and 31.7% (95% CI 31.0%–32.4%) achieved BP control. In multivariable logistic regression models, access to public healthcare was a key predictor of hypertension treatment (odds ratio [OR] = 1.35, 95% CI 1.14–1.60, p = 0.001), especially in the most economically disadvantaged group (OR of the interaction for middle economic status = 0.76, 95% CI 0.61–0.94, p = 0.013; OR of the interaction for high economic status = 0.84, 95% CI 0.68–1.05, p = 0.124). Having health insurance was not associated with improved hypertension awareness among those with low economic status (OR = 0.96, 95% CI 0.86–1.07, p = 0.437) and those with middle economic status (OR of the interaction = 1.15, 95% CI 1.00–1.33, p = 0.051), but it was among those with high economic status (OR of the interaction = 1.28, 95% CI 1.10–1.48, p = 0.001). Comparing hypertension awareness, treatment, and control rates in the 4 pilot states, we found statistically significant (p < 0.001) improvement in hypertension management from 2010 to 2017–2019. The limitations of this study include the pilot sample being relatively small and that it recruited from only 4 states. Conclusions Although considerable variations in hypertension diagnosis, treatment, and control exist across different sociodemographic groups and geographic areas, reducing uncontrolled hypertension remains a public health priority in India. Access to healthcare is closely tied to both hypertension diagnosis and treatment.

scholarly journals Hypertension management: what is the role of case management?

2018 ◽  
Vol 51 (0) ◽  
Author(s):  
Nurhan Ozpancar ◽  
Sezgi Cinar Pakyuz ◽  
Birol Topcu
Keyword(s):  
Chronic Illness ◽  
Case Management ◽  
Antihypertensive Medication ◽  
Control Group ◽  
Chronic Illness Care ◽  
Hypertension Management ◽  
Study Group ◽  
Patient Assessment ◽  
Medication Treatment ◽  
And Control

ABSTRACT Objective The aim of this study was to determine the effect of case management on hypertension management and on adherence to antihypertensive medication and chronic disease care of patients with hypertension. Method This study was conducted as an experimental and randomized controlled study. The sample of the study consisted of randomly selected patients with hypertension who did not have communication problems, who used antihypertensive medication treatment and whose treatment had been continuing for at least six months. The study group was given individual training (Hypertension causes, the risk factors, significance, unwanted side effects, medication treatment, changes in life style) and was applied case management model in hypertension – joint care protocol but no intervention was offered to the control group. Data was collected using the adherence to antihypertensive medication scale, the patient assessment of chronic illness care in the first and six months later interview. Results There was no significant difference between the study and control group according to adherence to antihypertensive medication and patient assessment of chronic illness care in the first interview. Otherwise, there were significant differences between the study and control group according to blood pressure, adherence to antihypertensive medication and patient assessment of chronic illness care in the six months later interview. The adherence to antihypertensive medication total score and the patient assessment of chronic illness care total score were significantly higher in the study group compared with control group in the six months later interview. Conclusion The case management plays an important role the in control of hypertension, and can improve adherence to antihypertensive medication and chronic illness care.

scholarly journals May Measurement Month 2019: an analysis of blood pressure screening results from Colombia

2021 ◽  
Vol 23 (Supplement_B) ◽  
pp. B46-B48
Author(s):  
Patricio Lopez-Jaramillo ◽  
Jose P Lopez-Lopez ◽  
Johanna Otero ◽  
Natalia Alarcon-Ariza ◽  
Margarita Mogollon-Zehr ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Medication ◽  
Hypertension Detection ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Third ◽  
Hypertension Awareness ◽  
Low Levels ◽  
And Control ◽  
Implementing Strategies

Abstract Hypertension awareness and control is poor in low- and middle-income countries. Thus, implementing strategies to increase hypertension detection is needed. Colombia participated as one of the 92 countries involved in the third campaign of the May Measurement Month in 2019. Blood pressure (BP) was measured in 48 324 volunteers from 13 departments in Colombia. In total, 27.9% individuals were identified with hypertension. Of those with hypertension, 63.7% were aware of their condition, 60.0% were on antihypertensive medication, and 38.4% had controlled BP. These results showed low levels of awareness, treatment, and control of hypertension in this sample of subjects volunteered to participate, suggest the urgent necessity of implementing programmes to improve the diagnosis and management of hypertension in Colombia.

scholarly journals May Measurement Month 2019: an analysis of blood pressure screening results from Malaysia

2021 ◽  
Vol 23 (Supplement_B) ◽  
pp. B98-B100
Author(s):  
Yook Chin Chia ◽  
Navin Kumar Devaraj ◽  
Jack Bee Chook ◽  
Ming Tsuey Chew ◽  
Pei Boon Ooi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cause Of Death ◽  
International Society ◽  
Antihypertensive Medication ◽  
Shopping Malls ◽  
Undiagnosed Hypertension ◽  
Hypertension Awareness ◽  
The Mean ◽  
Hypertension Screening ◽  
And Control

Abstract Despite hypertension remaining the leading cause of death worldwide, awareness of hypertension and its control rate is still suboptimal in Malaysia. This study aims to determine the proportion of both diagnosed and undiagnosed hypertension, awareness and its control rate during the yearly May Measurement Month (MMM) campaign that has been coordinated by the International Society of Hypertension. Participants aged ≥18 years were recruited at various screening sites namely universities, health facilities, shopping malls, and other sites. Participant’s socio-demographic, environmental, and lifestyle data were captured using a questionnaire. Three blood pressure (BP) readings as well as anthropometric measurements were obtained from all participants. The mean of the second and third BP readings was used in analyses. Hypertension was defined as a systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or taking antihypertensive medication. A total of 3062 participants were recruited. The proportion with hypertension in our study was 18.7% (n = 572). The proportion who were aware of their BP status was 63.2%. More than half (57.2%) of the hypertensives were on antihypertensive medication and 70.3% of those treated were controlled. In conclusion, in this BP screening campaign, one in five were hypertensive with almost two thirds aware of their hypertensive status. BP control among those who are taking medications was high at 70% but under 60% of hypertensives were on treatment. Hypertension screening programmes are important to promote awareness and control of hypertension as well as to reduce the devastating complications associated with this disorder.

scholarly journals Factors Associated With Hypertension Awareness, Treatment, and Control Among Adults in Kerala, India

2021 ◽  
Vol 9 ◽  
Author(s):  
Yingting Cao ◽  
Thirunavukkarasu Sathish ◽  
Tilahun Haregu ◽  
Yu Wen ◽  
Gabrielli Thais de Mello ◽  
...  
Keyword(s):  
Psychosocial Factors ◽  
Longitudinal Analysis ◽  
Outpatient Service ◽  
Significant Risk ◽  
Hypertension Management ◽  
Longitudinal Analyses ◽  
Cross Sectional ◽  
Factors Associated ◽  
Hypertension Awareness ◽  
And Control

Background: Hypertension, the most significant risk factor for cardiovascular disease, is an increasing contributor to global health burden, particularly in low- and middle-income countries (LMICs) such as India. While the rates of hypertension awareness, treatment, and control in India have been reported in several studies, the factors associated with these rates are less well-understood. Existing studies are predominantly cross-sectional, and the factors examined are limited. Understanding the predictors associated with these rates, using more rigorous study designs, is crucial for the development of strategies to improve hypertension management.Aims: To examine a range of factors associated with hypertension awareness, treatment, and control using both cross-sectional and longitudinal analyses.Methods: Data was derived from a population-based sample of 1,710 participants from Kerala, aged 30–60 years. We examined a comprehensive range of factors, including demographic, behavioral factors, anthropometric, clinical measures, psychosocial factors and healthcare utilization. Multilevel mixed effects logistic regression was used for both cross-sectional and longitudinal analyses (repeated measures for all variables across 2 years) to determine the factors associated with awareness, treatment, and control of hypertension.Results: A total of 467 (27.3%) participants had hypertension at baseline. Among those, the rates of awareness, treatment, and control of hypertension were 54.4, 25.5, and 36.4%, respectively. Being male (OR 0.27, 95% CI 0.14–0.53) and consumption of alcohol (OR 0.49, 95% CI 0.31–0.80) were significant predictors of poorly controlled hypertension (longitudinal analysis). Depression (OR 2.04, 95% CI 1.15–3.61) and fair-to-poor self-perceived health status (OR 1.87, 95% CI 1.15–3.04) were associated with increased hypertension awareness, whereas anxiety (OR 1.97, 95% CI 1.04–3.71) was associated with increased hypertension treatment (cross-sectional analysis). Seeking outpatient service in the past 4 weeks was associated with higher awareness (OR 1.09, 95% CI 1.27–2.87), treatment (OR 1.73, 95% CI 1.20–2.50) and control (OR 1.96, 95% CI 1.37–2.80) (longitudinal analysis).Conclusion: Our findings suggest the importance of considering psychosocial factors and better engagement with health services in hypertension management, as well as giving more attention to body fat control and largely male-related behaviors such as alcohol consumption, taking into account of some Indian specific attributes.

scholarly journals Trends in Awareness, Antihypertensive Medication Use and Blood Pressure Control by Race and Ethnicity Among Adults with Hypertension in the United States: A National Health and Nutrition Examination Analysis from 2011 to 2018

2021 ◽  
Author(s):  
Yuan Lu ◽  
Yuntian Liu ◽  
Lovedeep S Dhingra ◽  
Daisy Singh Massey ◽  
Cesar Caraballo ◽  
...  
Keyword(s):  
United States ◽  
Blood Pressure ◽  
Ethnic Differences ◽  
National Health ◽  
Antihypertensive Medication ◽  
Medication Use ◽  
Health And Nutrition ◽  
Hypertension Awareness ◽  
And Control ◽  
Racial Ethnic

Objective: To examine United States (US) trends in racial/ethnic differences in hypertension awareness and antihypertensive medication use, and whether these differences help explain racial/ethnic differences in hypertension control among adults from 2011 to 2018. Design: Population-based study. Setting: National Health and Nutrition Examination Survey (NHANES), 2011-2018. Participants: A nationally representative sample of US adults aged 18 years or older. Main outcome measures: Hypertension awareness was defined as self-reported physician diagnosis of hypertension. Antihypertensive treatment was based on self-reported use of antihypertensive agents. Blood pressure (BP) control was measured systolic BP <140 mmHg and diastolic BP <90 mmHg. Results: This study included 8,095 adults with hypertension from NHANES 2011-2018. During the study period, age-adjusted hypertension awareness declined from 84.0% (95% confidence interval 79.5 to 86.2) to 77.5% (74.0 to 80.5), hypertension treatment declined from 77.3% (73.4 to 81.1) to 71.4% (69.0 to 73.8) and control rates declined from 51.9% (47.1 to 56.7) to 43.1% (39.7 to 46.5). These declines were consistent for Black, Hispanic, and White individuals, but the three outcomes increased or did not change for Asian individuals. Compared with White individuals, Black individuals did not have a significantly different awareness (odds ratio:1.20 [0.96 to 1.45]) and overall treatment rate (1.04 [0.84 to 1.25]), but received more antihypertensive medications if treated (1.41 [1.27 to 1.56]), and had a lower BP control rate (0.72 [0.61 to 0.83]); Asian and Hispanic individuals had significantly lower awareness rates (0.69 [0.52 to 0.85] and 0.74 [0.59 to 0.89], respectively), overall treatment rates (0.72 [0.57 to 0.88] and 0.69 [0.55 to 0.82]), received fewer medications if treated (0.60 [0.50 to 0.72] and 0.86 [0.75 to 0.96]), and had lower BP control rates (0.66 [0.54 to 0.79] and 0.69 [0.57 to 0.81]). The racial/ethnic differences in awareness, treatment, and BP control persisted over the study period and were consistent across age, sex, and income strata. Lower awareness and treatment were associated with lower BP control in Asian and Hispanic individuals, but not in Black individuals. Conclusions: Hypertension awareness, treatment, and control declined from 2011-2018, and this decline was consistent for Black, Hispanic, and White individuals. BP control was worse for Asian, Black, and Hispanic individuals than for White individuals over the entire study period; this was explained partly by differences in awareness and treatment for Asian and Hispanic individuals, but not for Black individuals.

scholarly journals Government-Expert Joint Intervention with Treatment Algorithm and Improved Hypertension Management and Reduced Stroke Mortality in a Primary-Care Setting

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Mulalibieke Heizhati ◽  
Nanfang Li ◽  
Delian Zhang ◽  
Suofeiya Abulikemu ◽  
Guijuan Chang ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Treatment Algorithm ◽  
Primary Care Providers ◽  
Hypertension Management ◽  
Stroke Mortality ◽  
Hypertension Awareness ◽  
And Control

Hypertension management is suboptimal in the primary-care setting of developing countries, where the burden of both hypertension and cardiovascular disease is huge. Therefore, we conducted a government-expert joint intervention in a resource-constrained primary setting of Emin, China, between 2014 and 2016, to improve hypertension management and reduce hypertension-related hospitalization and mortality. Primary-care providers were trained on treatment algorithm and physicians for specialized management. Public education was delivered by various ways including door-to-door screening. Program effectiveness was evaluated using screening data by comparing hypertension awareness, treatment, and control rates and by comparing hypertension-related hospitalization and total cardiovascular disease (CVD) and stroke mortality at each phase. As results, 313 primary-health providers were trained to use the algorithm and 3 physicians attended specialist training. 1/3 of locals (49490 of 133376) were screened. Compared to the early phase, hypertension awareness improved by 9.3% (58% vs. 64%), treatment by 11.4% (39% vs. 44%), and control rates by 33% (10% vs. 15%). The proportion of case/all-cause hospitalization was reduced by 35% (4.02% vs. 2.60%) for CVD and by 17% (3.72% vs. 3.10%) for stroke. The proportion of stroke/all-cause death was reduced by 46% (21.9% in 2011–2013 vs. 15.0% in 2014–2016). At the control area, the proportion of case/all-cause mortality showed no reduction. In conclusion, government-expert joint intervention with introducing treatment algorithm may improve hypertension control and decrease related hospitalization and stroke mortality in underresourced settings.

scholarly journals Internet Access and Hypertension Management Among the Elderly Population: A Nationally Representative Cross-Sectional Survey in China (Preprint)

2018 ◽  
Author(s):  
Yinzi Jin ◽  
Mingxia Jing ◽  
Luyu Zhang ◽  
Suhang Song ◽  
Xiaochen Ma
Keyword(s):  
Rural Areas ◽  
Elderly Population ◽  
Internet Access ◽  
The Elderly ◽  
The Internet ◽  
Hypertension Management ◽  
Hypertension Awareness ◽  
Urban Rural ◽  
Nationally Representative ◽  
And Control

BACKGROUND Hypertension is a rapidly growing epidemic in China. Yet, it remains inadequately controlled, especially in rural areas. The internet has shown potential for better health management in different settings; however, few studies have investigated its role in hypertension management in China. OBJECTIVE This study aims to examine the association between internet access and hypertension awareness, treatment, and control among elderly Chinese adults and to investigate whether the association between internet access and hypertension management differed between those living in urban and rural areas. METHODS We obtained data from the nationally representative survey of the China Health and Retirement Longitudinal Study in 2011. Hypertension was defined as (1) average systolic blood pressure of ≥140 mm Hg or average diastolic blood pressure of ≥90 mm Hg or (2) currently taking antihypertensive medications. The outcome assessed included hypertension awareness, treatment, and control. The key independent variable was defined as whether one had internet access at home. We performed multivariate logistic regressions for each of the 3 outcomes. RESULTS Among 5135 hypertensive respondents (age 62.4 [SD 9.9] years; 2351/5135, 45.78% men), 12.89% (662/5135) had internet access at home. Compared with those who had no internet access, internet access was positively associated with hypertension awareness (odds ratio [OR] 1.36, 95% CI 1.07-1.73) and treatment (OR 1.38, 95% CI 1.09-1.75), but not with control (OR 1.19, 95% CI 0.90-1.58). Internet access reduced urban-rural disparity in hypertension awareness by 9.6% (P=.02), treatment by 8.3% (P=.05), but not in control. In addition, the moderating effect of internet access on urban-rural disparities in hypertension management was larger among females. The decreased urban-rural disparities were primarily driven by that internet access improved the management level in rural areas. CONCLUSIONS Despite the low rate of internet access among the elderly population, the internet shows its potential as a platform for achieving better hypertension management in China. Strategies for reducing the disparities in hypertension management and overall disease burden of hypertension among the elderly population might consider the internet as a platform.

THE 2019 NOVEL PANDEMIC OF CORONAVIRUS DISEASE (COVID-19): A STUDY OF EXISTING EVIDENCE IN THE INDIAN POPULATION

2020 ◽  
Vol 7 (2) ◽  
pp. 199-204
Author(s):  
Shrikant Verma ◽  
Mohammad Abbas ◽  
Sushma Verma ◽  
Syed Tasleem Raza ◽  
Farzana Mahdi
Keyword(s):  
Disease Transmission ◽  
Indian Population ◽  
Respiratory Infections ◽  
Clinical Signs ◽  
Case Fatality ◽  
Public Health Emergency ◽  
The World ◽  
And Control ◽  
General Wellbeing ◽  
Different Parts

A novel spillover coronavirus (nCoV), with its epicenter in Wuhan, China's People's Republic, has emerged as an international public health emergency. This began as an outbreak in December 2019, and till November eighth, 2020, there have been 8.5 million affirmed instances of novel Covid disease2019 (COVID-19) in India, with 1,26,611 deaths, resulting in an overall case fatality rate of 1.48 percent. Coronavirus clinical signs are fundamentally the same as those of other respiratory infections. In different parts of the world, the quantity of research center affirmed cases and related passings are rising consistently. The COVID- 19 is an arising pandemic-responsible viral infection. Coronavirus has influenced huge parts of the total populace, which has prompted a global general wellbeing crisis, setting all health associations on high attentive. This review sums up the overall landmass, virology, pathogenesis, the study of disease transmission, clinical introduction, determination, treatment, and control of COVID-19 with the reference to India.

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