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

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.

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Risk factors associated with hypertension awareness, treatment, and control in a multi-ethnic Asian population

Journal of Hypertension ◽

10.1097/hjh.0b013e328317c8c3 ◽

2009 ◽

Vol 27 (1) ◽

pp. 190-197 ◽

Cited By ~ 51

Author(s):

Yi Wu ◽

E Shyong Tai ◽

Derrick Heng ◽

Chee Eng Tan ◽

Lip Ping Low ◽

...

Keyword(s):

Risk Factors ◽

Asian Population ◽

Factors Associated ◽

Hypertension Awareness ◽

And Control

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Factors associated with hypertension awareness, treatment and control among ethnic groups in Amsterdam, The Netherlands: The SUNSET study

Journal of Human Hypertension ◽

10.1038/sj.jhh.1002073 ◽

2006 ◽

Vol 20 (11) ◽

pp. 874-881 ◽

Cited By ~ 40

Author(s):

C Agyemang ◽

I van Valkengoed ◽

R Koopmans ◽

K Stronks

Keyword(s):

The Netherlands ◽

Ethnic Groups ◽

Factors Associated ◽

Hypertension Awareness ◽

And Control

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Prevalence of Mild Cognitive Impairment in Rural Thai Older People, Associated Risk Factors and their Cognitive Characteristics

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000506279 ◽

2020 ◽

Vol 10 (1) ◽

pp. 38-45 ◽

Cited By ~ 2

Author(s):

Jiranan Griffiths ◽

Lakkana Thaikruea ◽

Nahathai Wongpakaran ◽

Peeraya Munkhetvit

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Older People ◽

Significant Risk ◽

Depression Scale ◽

Cross Sectional ◽

Factors Associated ◽

Low Education ◽

Rural Thailand

Introduction: Mild cognitive impairment (MCI) is a transitional stage between normal cognition and dementia. A review showed that 10–15% of those with MCI annually progressed to Alzheimer’s disease. Objective: This study aimed to investigate the prevalence and risk factors associated with MCI as well as the characteristics of cognitive deficits among older people in rural Thailand. Methods: A cross-sectional study in 482 people who were 60 years old and over was conducted in northern Thailand. The assessments were administered by trained occupational therapists using demographic and health characteristics, Mental Status Examination Thai 10, Activities of Daily Living – Thai Assessment Scale, 15-item Geriatric Depression Scale and the Montreal Cognitive Assessment-Basic (MoCA-B, Thai version). Results: The mean age of MCI was 68.3 ± 6.82 years, and most had an education ≤4 years. The prevalence of MCI in older people was 71.4% (344 out of 482), and it increased with age. Low education and diabetes mellitus (DM) were the significant risk factors associated with cognitive decline. Older people with MCI were more likely to have an education ≤4 years (RR 1.74, 95% CI 1.21–2.51) and DM (RR 1.19, 95% CI 1.04–1.36) than those who did not. The 3 most common cognitive impairments according to MoCA-B were executive function (86%), alternating attention (33.1%) and delayed recall (31.1%). Conclusion: The prevalence of MCI in older Thai people in a rural area is high compared with that in other countries. The explanation might be due to low education and underlying disease associated with MCI. A suitable program that can reduce the prospects of MCI in rural Thailand is needed.

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Factors associated with hypertension awareness, treatment and control in rural Chinese

Journal of Human Hypertension ◽

10.1038/sj.jhh.1002303 ◽

2007 ◽

Vol 22 (5) ◽

pp. 366-369 ◽

Cited By ~ 6

Author(s):

G Dong ◽

Z Sun ◽

L Zheng ◽

J Li ◽

X Zhang ◽

...

Keyword(s):

Factors Associated ◽

Hypertension Awareness ◽

And Control

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Risk Factors for Zoonotic Tuberculosis at the Wildlife–Livestock–Human Interface in South Africa

Pathogens ◽

10.3390/pathogens8030101 ◽

2019 ◽

Vol 8 (3) ◽

pp. 101 ◽

Cited By ~ 3

Author(s):

Petronillah R. Sichewo ◽

Anita L. Michel ◽

Jolly Musoke ◽

Eric M.C. Etter

Keyword(s):

Risk Factors ◽

Multiple Correspondence Analysis ◽

Significant Risk ◽

Molecular Techniques ◽

Infected Herd ◽

Cross Sectional ◽

Factors Associated ◽

Human Interface ◽

Milk Samples ◽

Nasal Swabs

A cross-sectional study was conducted to investigate the risk factors associated with zoonotic tuberculosis in humans and its transmission to people living at the wildlife–livestock–human interface. A questionnaire was administered to collect information on food consumption habits, food handling practices, and knowledge of zoonotic TB. Sputum samples were also collected from 150 individuals that belonged to households of cattle farmers with or without a bTB infected herd. In addition, 30 milk samples and 99 nasal swabs were randomly collected from cattle in bTB infected herds for isolation of Mycobacterium bovis (M. bovis). The sputum samples were screened for TB using the GeneXpert test and this was followed by mycobacterial culture and speciation using molecular techniques. No M. bovis was isolated from TB positive sputum samples and only one sample was confirmed as Mycobacterium tuberculosis (M. tuberculosis). M. bovis was isolated from 6.6% (n = 2/30) milk samples and 9% (n = 9/99) of nasal swabs. Ownership of a bTB infected herd and consumption of milk were recognized as highly significant risk factors associated with a history of TB in the household using multiple correspondence analysis (MCA) and logistic regression. The findings from this study have confirmed the potential for zoonotic TB transmission via both unpasteurized milk and aerosol thus, the role of M. bovis in human TB remains a concern for vulnerable communities.

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