|
1
|
Teshome DF, Balcha SA, Ayele TA, Atnafu A, Gelaye KA. Undiagnosed hypertension and its determinants among hypertensive patients in rural districts of northwest Ethiopia: a mediation analysis. BMC Health Serv Res 2023; 23:222. [PMID: 36882833 PMCID: PMC9990316 DOI: 10.1186/s12913-023-09212-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/23/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Early detection of hypertension is associated with improved blood pressure control and a reduced risk of cardiovascular diseases. However, in rural areas of Ethiopia, evidence is scarce where access to healthcare services is low. This study aimed to estimate the proportion of undiagnosed hypertension and identify its determinants and mediators among patients with hypertension in rural northwest Ethiopia. METHODS A community-based cross-sectional study was conducted from September to November 2020. A three-stage sampling technique was used to select a total of 2436 study participants. Blood pressure was measured using an aneroid sphygmomanometer two times, 30 min apart. A validated tool was used to assess participants' beliefs and knowledge of hypertension. The proportion, determinants, and mediators of undiagnosed hypertension were determined among patients with hypertension. The regression-based approach used to calculate the direct and indirect effects of determinants of undiagnosed hypertension. Joint significance testing was used to determine the significance of the indirect effect. RESULTS The proportion of undiagnosed hypertension was 84.0% (95% CI: 81.4-86.7%). Participants aged 25-34 years (AOR = 6.03; 95% CI: 2.11, 17.29), who drank alcohol (AOR = 2.40; 95% CI: 1.37, 4.20), were overweight (AOR = 0.41; 95% CI: 0.18, 0.98), had a family history of hypertension (AOR = 0.32; 95% CI: 0.20, 0.53), and had comorbidities (AOR = 0.28; 95% CI: 0.15, 0.54) were significantly associated with undiagnosed hypertension. The mediation analysis revealed that hypertension health information mediated 64.1% and 68.2% of the effect of family history of hypertension and comorbidities on undiagnosed hypertension, respectively. Perceived susceptibility to hypertensive disease mediated 33.3% of the total effect of age on undiagnosed hypertension. Health facility visits also mediated the effect of alcohol drinking (14.2%) and comorbidities (12.3%) on undiagnosed hypertension. CONCLUSION A higher proportion of hypertensive patients remain undiagnosed. Being young, drinking alcohol, being overweight, having a family history of hypertension, and having comorbidities were significant factors. Hypertension health information, knowledge of hypertensive symptoms, and perceived susceptibility to hypertension were identified as important mediators. Public health interventions aimed at providing adequate hypertension health information, particularly to young adults and drinkers, could improve knowledge and perceived susceptibility to hypertensive disease and reduce the burden of undiagnosed hypertension.
Collapse
Affiliation(s)
- Destaw Fetene Teshome
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Shitaye Alemu Balcha
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asmamaw Atnafu
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
|
2
|
Zheng S, Nie Z, Lv Z, Wang T, Wei W, Fang D, Zou X, Fu Y, Cao T, Liang Z, Lu Q, Huang H, Wen Y, Huang S. Associations between plasma metal mixture exposure and risk of hypertension: A cross-sectional study among adults in Shenzhen, China. Front Public Health 2022; 10:1039514. [PMID: 36582368 PMCID: PMC9794142 DOI: 10.3389/fpubh.2022.1039514] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Background Metal exposure affects human health. Current studies mainly focus on the individual health effect of metal exposure on hypertension (HTN), and the results remain controversial. Moreover, the studies assessing overall effect of metal mixtures on hypertension risk are limited. Methods A cross-sectional study was conducted by recruiting 1,546 Chinese adults who attended routine medical check-ups at the Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen. The plasma levels of 13 metals were measured using inductively coupled plasma mass spectrometry. Multivariate logistic regression model, restricted cubic spline (RCS) model and the Bayesian Kernel Machine Regression (BKMR) model were applied to explore the single and combined effect of metals on the risk of HTN. Results A total of 642 (41.5%) participants were diagnosed with HTN. In the logistic regression model, the adjusted odds ratios (ORs) were 0.71 (0.52, 0.97) for cobalt, 1.40 (1.04, 1.89) for calcium, 0.66 (0.48, 0.90), and 0.60 (0.43, 0.83) for aluminum in the second and third quartile, respectively. The RCS analysis showed a V-shaped or an inverse V-shaped dose-response relationship between metals (aluminum or calcium, respectively) and the risk of HTN (P for non-linearity was 0.017 or 0.009, respectively). However, no combined effect was found between metal mixture and the risk of hypertension. Conclusions Plasma levels of cobalt, aluminum and calcium were found to be associated with the risk of HTN. Further studies are needed to confirm our findings and their potential mechanisms with prospective studies and experimental study designs.
Collapse
Affiliation(s)
- Sijia Zheng
- School of Public Health, Shanxi Medical University, Taiyuan, China,Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhiqiang Nie
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ziquan Lv
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Tian Wang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Weizhou Wei
- Shenzhen Yutian Community Health Service Centre, Shenzhen, China
| | - Daokui Fang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Xuan Zou
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yulin Fu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Tingting Cao
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhaoyi Liang
- School of Public Health, Shanxi Medical University, Taiyuan, China,Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Qi Lu
- School of Public Health, Shanxi Medical University, Taiyuan, China,Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Hui Huang
- Department of Cardiology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Ying Wen
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China,Ying Wen
| | - Suli Huang
- School of Public Health, Shanxi Medical University, Taiyuan, China,Shenzhen Center for Disease Control and Prevention, Shenzhen, China,*Correspondence: Suli Huang
| |
Collapse
|
|
3
|
Anota A, Nedi T. Blood Pressure Control and Associated Factors Among Hypertensive Patients Attending Shashemene Referral Hospital, Oromia, Ethiopia. Hosp Pharm 2022; 57:555-563. [PMID: 35898241 PMCID: PMC9310308 DOI: 10.1177/00185787211061372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
BACKGROUND Hypertension is public health challenge worldwide. It is defined as persistently elevated arterial blood pressure (BP), systolic BP (SBP) ≥140 mmHg and/or diastolic BP (DBP) ≥90 mmHg or use of antihypertensive medication in adults older than 18 years. The aim of this study was to assess blood pressure control and associated factors among hypertensive patients attending the outpatient department of Shashemene Referral Hospital. METHODS Hospital based cross sectional study was conducted to determine level of blood pressure control and associated factors among hypertensive patients on medical follow-up. A medical chart review and interview was conducted from July 1 to October 31 2018. RESULT A total of 325 participants were included in this study with response rate of 320 (98.5%). More than half of study participants were males 171 (53.4%). The mean age of the respondents was 55.10 (SD ± 12.7) years and majority of the respondents 191 (59.7%) were within age of less than 60 years old. The mean Systolic blood pressure (SBP) was 131.80 mmHg (SD ± 20.92) while the mean diastolic blood pressure (DBP) was 82.30 mmHg (SD ± 10.52). About 51.30% of study participants had a controlled SBP and 54.7% had a controlled DBP. The overall control of BP was achieved in 40.3% of the study participants. Multivariable logistic regression analysis showed that age, experience of side effects, frequency of BP measuring, number of antihypertensive drugs used, duration on antihypertensive, source of medication and physical exercise showed significant association with blood pressure control. CONCLUSION Blood pressure control level among chronic hypertensive patients at outpatient department was low. Age of patients, educational level, experience of side effects, and number of antihypertensive drugs used were important determinant factors associated with blood pressure control among study participants.
Collapse
|
|
4
|
Combined effect of obesity and low physical performance on the incidence of hypertension in Chinese community-dwelling older population. J Hum Hypertens 2021; 35:970-977. [PMID: 33208838 DOI: 10.1038/s41371-020-00442-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 08/29/2020] [Accepted: 11/01/2020] [Indexed: 02/03/2023]
Abstract
The combination of having a low physical performance and obesity results in a vicious cycle, but the effect of this combination on the incidence of hypertension is still unknown. This article aims to examine the effect of obesity and low physical performance on the incidence of hypertension in older adults. The sample was comprised of 349 Chinese community-dwelling participants (199 women; mean age 66.30 ± 5.78 years) without hypertension at baseline. Obesity was defined as having a body mass index (BMI) greater than or equal to 28 kg/m2. Participants scoring in the top 20% on the Timed Up and Go Test (TUGT) or in the slowest 20% of the 4-m walking test were defined as having a low physical performance. The outcome was new onset hypertension at the 1-year follow-up. We found that 89 (25.5%) of the 349 participants without hypertension at baseline had developed hypertension at their 1-year follow-up. After multivariate adjustments, it was found that the incidence of hypertension was associated with the combination of obesity and having a low physical performance (OR = 7.30, 95% CI = 1.36-39.11), but not solely with obesity (OR = 1.40, 95% CI = 0.68-2.88) or solely with low physical performance (OR = 0.98, 95% CI = 0.29-3.27). Hence, although obesity and low physical performance did not independently affect the incidence of hypertension after one year, the combination of the two can significantly increase the incidence of hypertension in Chinese community-dwelling older adults.
Collapse
|
|
5
|
Zhang Z, Hu Z, Wang H, Zhou Q, Li C, Hao M. Changes of Multisectoral Collaboration and Service Delivery in Hypertension Prevention and Control before and after the 2009 New Healthcare Reform in China: An Interrupted Time-Series Study. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:8976625. [PMID: 34589192 PMCID: PMC8476259 DOI: 10.1155/2021/8976625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/20/2021] [Accepted: 08/23/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES There is a need to assess the 2009 new healthcare reform in China on hypertension prevention. It helps to control from the perspectives of multisectoral participation, government responsibility assignment, performance assessment, and service delivery. DESIGN Interrupted time-series study. Setting. 31 provinces in mainland China. Primary and Secondary Outcome Measures. Based on the content analysis of publicly available policy documents from 31 provinces regarding hypertension prevention and control, we analyzed the changes brought by the 2009 new healthcare reform through four quantitative indicators, including multisector participation (MP), main department responsibility coverage (MDRC), primary department assessment indicator coverage (MDAIC), and service type coverage (STC). We compared the changing trends of four indicators before and after 2009. RESULTS Nationally, MP, MDRC, and STC grew rapidly and increased to 88.9%, 96.4%, and 77.8%, respectively, in 2017, higher than MDAIC (36.9%). This growth was accelerated by the new healthcare reform, with the highest acceleration in MP (β3 = 6.345, p < 0.001), followed by MDRC (β3 = 3.829, p < 0.01), STC (β3 = 3.799, p < 0.001), and MDAIC (β3 = 3.585, p < 0.001). The MP and MDRC trend changes were higher in the central and western regions than in the east after the reform. CONCLUSIONS Our research showed that the new healthcare reform had a positive effect in promoting multisectoral participation in preventing and controlling hypertension in China, improving the responsibility mechanism, and expanding the types of services provided. The government should lead the coordination and implementation of multidepartmental responsibilities and mobilize nonhealth departments to continuously participate in the prevention and control of chronic diseases by improving incentive and evaluation mechanisms.
Collapse
Affiliation(s)
- Zhifan Zhang
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China
| | - Zhi Hu
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China
- Anhui Medical University, Hefei, Anhui 230032, China
| | - Hua Wang
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China
- Jiangsu Preventive Medicine Association, Nanjing, Jiangsu 210009, China
| | - Qingyu Zhou
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China
| | - Chengyue Li
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China
| | - Mo Hao
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China
| |
Collapse
|
|
6
|
Mosisa G, Regassa B, Biru B. Epidemiology of hypertension in selected towns of Wollega zones, Western Ethiopia, 2019: A community-based cross-sectional study. SAGE Open Med 2021; 9:20503121211024519. [PMID: 34178341 PMCID: PMC8202320 DOI: 10.1177/20503121211024519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/24/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction: Hypertension remains an emerging public health problem globally, particularly in developing countries. Age, income level, obesity, alcohol consumption, smoking, vegetables and fruit consumption, physical activity and chat chewing were some risk factors of hypertension. However, there are limited data on the epidemiology of hypertension in Ethiopia. This study aimed to assess Epidemiology of Hypertension among the community of selected towns of Wollega zones. Methods: A community-based cross-sectional study was conducted from 1 to 30 June 2019 in selected towns of Wollega zones. A multistage sampling technique was used to select 840 study participants. Data were collected using the WHO STEP wise approach. The data were coded and entered into EpiData 3, and exported to SPSS version 20.0 for analysis. Bivariate and multivariable logistic regression analyses were conducted. Statistical significance was declared at p-value < 0.05. Results: The study included a total of 838 respondents with a response rate of 99.7%. The prevalence of hypertension was found to be 189 (22.6%) (95% confidence interval = 19.9%–25.2%). Of this, 108 (12.9%) and 81 (9.7%) of female and male were hypertensive, respectively. Age groups of 30–44 years (adjusted odds ratio = 2.65 (1.43, 4.89)), 45–59 years (adjusted odds ratio = 3.55 (1.79, 7.04)), above 60 years (adjusted odds ratio = 2.97 (1.43, 6.18)), having history of alcohol consumption (adjusted odds ratio = 4.29 (2.4, 7.66)), involving in vigorous physical activity (adjusted odds ratio = 0.096 (0.028, 0.33)), not walking to and from the work (adjusted odds ratio = 13.12 (8.34, 20.67)), being overweight (adjusted odds ratio = 1.98 (1.21, 3.25)), inadequate fruits serving per day (adjusted odds ratio = 2.93 (1.75, 4.88)) were significantly associated with hypertension. Conclusion: The prevalence of hypertension was found to be high in the study area. Older age, alcohol consumption, not engaging in vigorous activity, physical inactivity, being overweight and inadequate intake of fruits were found to be risk factors for hypertension. Therefore, health care providers should provide extensive health education and promotion on recommended lifestyle modification to tackle the burden of hypertension.
Collapse
Affiliation(s)
- Getu Mosisa
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Bikila Regassa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Bayise Biru
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| |
Collapse
|
|
7
|
Lee SF, Luque-Fernandez MA, Chen YH, Catalano PJ, Chiang CL, Wan EYF, Wong ICK, Chen MH, Ng AK. Doxorubicin and subsequent risk of cardiovascular diseases among survivors of diffuse large B-cell lymphoma in Hong Kong. Blood Adv 2020; 4:5107-5117. [PMID: 33085755 PMCID: PMC7594396 DOI: 10.1182/bloodadvances.2020002737] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/09/2020] [Indexed: 02/01/2023] Open
Abstract
Evidence regarding the dose-related impact of doxorubicin on subsequent cardiovascular diseases (CVDs) in Asian patients with diffuse large B-cell lymphoma (DLBCL) without preexisting CVDs is lacking. From a territory-wide electronic database in Hong Kong, we identified adults who were diagnosed with DLBCL and treated with chemotherapy between 2000 and 2018. We evaluated the patients for incident CVDs (including ischemic heart disease, heart failure, and cardiomyopathy). We evaluated the cause-specific cumulative incidence (csCI) of CVD with levels of doxorubicin exposure by using flexible parametric competing risk analysis and adjusting for demographics, comorbidities, therapeutic exposure, cardiovascular risk factors, and lifestyle factors. Controls were age- and sex-matched to DLBCL patients. We analyzed 2600 patients and 13 000 controls. The adjusted cause-specific hazard ratio (HR) for CVD in patients treated with >500 mg doxorubicin compared with non-doxorubicin regimens was 2.65 (95% confidence interval [CI], 1.23-5.74; P = .013). The 5-, 10-, and 15-year csCIs were 8.2%, 11.3%, and 12.8% in patients vs 3.1%, 4.4%, and 5.2% in controls, respectively. Hypertension (HR, 6.20; 95% CI, 0.79-48.44; P = .082) and use of aspirin/angiotensin-converting enzyme inhibitor/beta-blocker at baseline (HR, 2.13-4.63; P < .001 to .002) might confer a higher risk of subsequent CVDs. In this Hong Kong population-based study, doxorubicin exposure (absolute dose >500 mg), together with hypertension or baseline use of medication for cardiovascular risk factors, was found to be associated with an increase in csCIs of CVDs. Tailoring therapeutic strategies to underlying CVD risk factors and risk-adapted monitoring and follow-up of susceptible DLBCL patients are advisable.
Collapse
Affiliation(s)
- Shing Fung Lee
- Department of Clinical Oncology, Tuen Mun Hospital, New Territories West Cluster, Hong Kong
| | - Miguel Angel Luque-Fernandez
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Non-Communicable Disease and Cancer Epidemiology, Instituto de Investigacion Biosanitaria de Granada, University of Granada, Granada, Spain
| | - Yu Hui Chen
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Paul J Catalano
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA
| | | | - Eric Yuk-Fai Wan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, and
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Ian Chi-Kei Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, and
- Centre for Medicines Optimisation Research and Education, Research Department of Policy and Practice, University College London School of Pharmacy, London, United Kingdom
| | - Ming Hui Chen
- Department of Cardiology
- Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, and
| | - Andrea K Ng
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| |
Collapse
|
|
8
|
Liu L, Chen CL, Lo K, Huang JY, Yu YL, Huang YQ, Feng YQ. Trends of Status of Hypertension in Southern China, 2012-2019. Int J Gen Med 2020; 13:599-608. [PMID: 32982377 PMCID: PMC7500839 DOI: 10.2147/ijgm.s267346] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/12/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose Little is known about the recent trends of hypertension in southern China. The aim of the study was to investigate the trends of hypertension in Guangdong Province between 2012 and 2019. Methods We conducted two cross-sectional surveys in 2012 and 2019 in southern China, which included 10,970 and 27,483 participants, respectively, aged 35 to 75 years old using a method of stratified, multistage, and cluster sampling. Hypertension was defined as a mean systolic/diastolic blood pressure (SBP/DBP) ≥140/90mmHg, or a self-reported condition, or any pharmacological treatment in the last 2 weeks. In addition, according to the 2017 ACC/AHA guideline for high blood pressure, we estimated the prevalence and control rate of hypertension. Results According to the 2010 Chinese guideline, the age-standardized rate of hypertension prevalence was 34.7% in 2012 and 36.9% in 2019 with a slight increase, while the prevalence of prehypertension was stable (14.5% vs 14.3%). Over the period of our study, 45.6% and 60.7% of hypertensive patients knew their diagnosis in 2012 and 2019, and 40.8% and 51.5% were using antihypertensive medications, respectively. The control rates increased from 15.1% to 23.6%. Hypertension prevalence was 64.5% in 2012 and 63.2% in 2019, and the control rate increased from 3.0% to 4.8% during the study period under the 2017 ACC/AHA guideline. Conclusion Although the past 7 years have seen some progress in hypertension management, the rates of hypertension awareness, treatment, and control in southern Chinese remained regrettably low, and the prevalence rate was still high.
Collapse
Affiliation(s)
- Lin Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China
| | - Chao-Lei Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China
| | - Kenneth Lo
- Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, RI, USA
| | - Jia-Yi Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China
| | - Yu-Ling Yu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China
| | - Yu-Qing Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China
| | - Ying-Qing Feng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China
| |
Collapse
|
|
9
|
Ho BK, Omar MA, Sooryanarayana R, Ghazali SS, Zainal Abidin SBI, Krishnapillai A, Ariaratnam S, Tohit NM, Majid NLBA, Yusof MFBM. Trends in population blood pressure and prevalence, awareness, treatment and control of hypertension among older persons: The 2006 & 2015 National Health and Morbidity Survey in Malaysia. PLoS One 2020; 15:e0238780. [PMID: 32911521 PMCID: PMC7482969 DOI: 10.1371/journal.pone.0238780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 08/24/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Hypertension is one of the most important risk factors for cardiovascular diseases. Thus, it is an important public health challenge worldwide. In Malaysia, only a few studies have focused on the trends of hypertension specifically for the aging population. In view of the rapid growth of the elderly population in Malaysia, there is an urgent need to explore the condition of hypertension in this aging population. Hence, the objectives of this study were to determine the trends of population mean systolic and diastolic blood pressure (BP) levels, the prevalence, awareness, treatment and control of hypertension, and its' associated factors among older persons in two cross-sectional national surveys that were conducted in 2006 and 2015 in Malaysia. METHODS This was a subanalysis of secondary data collected from the two cross-sectional national population-based surveys conducted in Malaysia in 2006 and 2015. Adults aged 60 and older who had participated in these two surveys were included in the study. RESULTS A total of 4954 (2295 males and 2659 females) and 3790 (1771 males and 2019 females) respondents completed the hypertension module surveys in 2006 and 2015, respectively. The mean age of the respondents was 68.5±6.9 years in 2006 and 68.6±7.1 years in 2015 and the difference was not significant. The prevalence of hypertension significantly reduced from 73.8% in 2006 to 69.2% in 2015 (p<0.001). Among the respondents with hypertension, the awareness, treatment and control of hypertension significantly increased from 49.7% to 60.2%, 86.7% to 91.5% and 23.3% to 44.8%, respectively, from 2006 to 2015. Logistic regression analysis showed that female sex and unemployed/retiree were significantly associated with higher hypertension prevalence in both 2006 and 2015. Being unemployed/ retiree was significantly associated with higher awareness of hypertension in both 2006 and 2015. In both 2006 and 2015, Chinese ethnicity were significantly associated with higher awareness and control of hypertension. CONCLUSIONS The mean population BP levels and hypertension prevalence among the elderly population in Malaysia have reduced significantly over the past decade. Although the awareness, treatment and control of hypertension among older adults have improved significantly, the awareness and control rates remain suboptimal. As population aging is inevitable, appropriate public health programs and optimal treatment strategies targeting this vulnerable group are urgently needed to improve the overall awareness and control of hypertension and to prevent hypertension-related complications.
Collapse
Affiliation(s)
- Bee Kiau Ho
- Bandar Botanic Health Center, Bandar Botanic, Klang, Selangor, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistic & Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | | | - Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Selangor, Malaysia
- Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, Seri Kembangan, Selangor, Malaysia
| | | | - Ambigga Krishnapillai
- Department of Family Medicine, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia
| | - Suthahar Ariaratnam
- Department of Psychiatry, Faculty of Medicine, Universiti Technologi MARA (UiTM), Selayang Campus, Batu Caves, Selangor, Malaysia
| | - Noorlaili Mohd Tohit
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Liana bt Abdul Majid
- Sector for Biostatistic & Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Muhammad Fadhli bin Mohd Yusof
- Sector for Biostatistic & Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| |
Collapse
|
|
10
|
Soo MJ, Chow ZY, Ching SM, Tan CH, Lee KW, Devaraj NK, Salim HS, Ramachandran V, Lim PY, Sivaratnam D, Hoo FK, Cheong AT, Chia YC. Prevalence, awareness and control of hypertension in Malaysia from 1980-2018: A systematic review and meta-analysis. World J Meta-Anal 2020; 8:320-344. [DOI: 10.13105/wjma.v8.i4.320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/22/2020] [Accepted: 08/31/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hypertension is a common public health problem worldwide and is a well-known risk factor for increased risk of cardiovascular diseases, contributing to high morbidity and mortality. However, there has been no systematic review and meta-analysis of a multiethnic population such as that of Malaysia.
AIM To determine the trend in prevalence, awareness and control rate of hypertension in Malaysia.
METHODS Systematic searches were conducted in six databases (PubMed, Scopus, Ovid, CINAHL, Malaysian Medical Repository and Malaysia Citation Index) for articles published between 1980 and 2018. Two authors reviewed the studies and performed quality assessment and data extraction independently. Pooled estimates of hypertension prevalence, awareness and control rate were calculated using the DerSimonian-Laird random-effects model. Subgroup and sensitivity analyses were performed.
RESULTS We included 56 studies involving a total of 241796 participants. The overall pooled prevalence of hypertension aged ≥ 18 years was 29.7%. The prevalence of hypertension was the lowest in the 1980s (16.2%, 95% confidence interval (CI): 13.4, 19.0), increasing up to 36.8% (95%CI: 6.1, 67.5) in the 1990s, then decreasing to 28.7% (95%CI: 21.7, 35.8) in the 2000s and 26.8% (95%CI: 21.3, 32.3) in the 2010s. The prevalence of awareness was 51.4% (95%CI: 46.6, 56.3), while 33.3% (95%CI: 28.4, 38.2) of those on treatment had achieved control of their blood pressure.
CONCLUSION In Malaysia, three in ten adults aged ≥ 18 years have hypertension, while four in ten adults aged ≥ 30 years have hypertension. Five out of ten people are aware of their hypertension status and only one-third of those under treatment achieved control of their hypertension. Concerted efforts by policymakers and healthcare professionals to improve awareness and control of hypertension should be of high priority.
Collapse
Affiliation(s)
- Man Jun Soo
- Department of Family Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | | | - Siew Mooi Ching
- Department of Family Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | | | - Kai Wei Lee
- Department of Family Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Navin Kumar Devaraj
- Department of Family Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Hani Syahida Salim
- Department of Family Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Vasudevan Ramachandran
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Poh Ying Lim
- Department of Community Health, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | | | - Fan Kee Hoo
- Department of Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Ai Theng Cheong
- Department of Family Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Yook Chin Chia
- Department of Medical Sciences, Sunway University, Bandar Sunway 47500, Malaysia
| |
Collapse
|
|
11
|
Oori MJ, Mohammadi F, Norozi K, Fallahi-Khoshknab M, Ebadi A, Gheshlagh RG. Prevalence of HTN in Iran: Meta-analysis of Published Studies in 2004-2018. Curr Hypertens Rev 2020; 15:113-122. [PMID: 30657043 PMCID: PMC6635676 DOI: 10.2174/1573402115666190118142818] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/06/2019] [Accepted: 01/10/2019] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Prevalence of hypertension (HTN) is increasing in the developing countries like Iran. Various studies have reported different rates of HTN in Iran. The purpose of this study was to estimate an overall prevalence of HTN in Iran. METHODOLOGY Using the English and Persian key derived from Mesh, the databases including MagIran, Iran Medex, SID, Web of Sciences, PubMed, Science Direct and Google Scholar as a searching engine were reviewed: from 2004 to 2018. The overall prevalence of MA was estimated using Random effect model. The I2 test was used to assess the heterogeneity of the studies. Additionally, the quality of studies was evaluated using a standard tool. Publication bias was conducted with the Egger test. Meta-regression and analysis of subgroups were analyzed based on variables such as age, marital status, region and tools. Data were analyzed using STATA 12 software. RESULTS Analysis of 58 primary articles with a sample size of 902580 showed that the prevalence of HTN in Iran was 25% (with 95% CI of 22-28). The highest prevalence of HTN was related to elderly (42%). The prevalence of HTN was 25% (95% CI: 19-31) in women and 24% (95% CI: 20-28) in men with no significant difference (p = 0.758). The results also indicated that the prevalence of HTN was not related to the year of studies (p = 0.708) or sample size (p = 769). CONCLUSION Despite the advancements in science and technology, along with health and prevention of diseases, the overall prevalence of HTN raised in Iran. Since HTN is a silent disease with significant health consequences and economic burden, programs designed to better HTN control seem vital to enhance community health.
Collapse
Affiliation(s)
- Mehdi Jafari Oori
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Farahnaz Mohammadi
- Associate Professor of Iranian Research Center on Aging, Department of Nursing Education, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Kian Norozi
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Abbas Ebadi
- Behavioral Sciences Research Center, Life style institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR, Iran
| | - Reza Ghanei Gheshlagh
- Department of Nursing, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran
| |
Collapse
|
|
12
|
Jin Y, He P. Antihypertensive treatment and depressive symptoms in Chinese middle-aged and older hypertensive adults: A population-based longitudinal study. Int J Geriatr Psychiatry 2020; 35:312-320. [PMID: 31833587 DOI: 10.1002/gps.5250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 12/07/2019] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Hypertension is a risk factor for depressive disorders. Although the benefits of lowering blood pressure on the subsequent depressive disorders are supported by biological interpretation, the effect of antihypertensive therapies on depressive disorders is not clear. This study aimed to assess whether blood-pressure-lowering treatment have a protective effect on subsequent depressive symptoms in China. METHODS We used data from the nationally representative survey, including 2428 hypertensive participants free from depressive symptoms at baseline in 2011 to 2012. We assessed the depressive symptoms based on the 10-item Center for Epidemiological Studies Depression scale. We conducted Cox proportional hazards regression models to examine the effect of antihypertensive treatment on the incidence of depressive symptoms in 2011 to 2015. RESULTS In the total sample, all the models resulted in nonsignificant results and an estimated 8% reduction in risk (95% CI, 0·76-1·12) in the model adjusted for all covariates for the antihypertensive treatment takers with blood pressure controlled. In the group of urban residents, the antihypertensive treatment takers with blood pressure controlled had lower odds (HR: 0.68; 95% CI, 0·49-0·96) of depressive disorders. CONCLUSION The protective effect of the antihypertensive therapies might be relative to not only lowering blood pressure per se but also the management of hypertension. We proposed the early intervention to achieve the long-term protective effect of being antihypertensive and the supply of effective and collaborative care of hypertension and depression.
Collapse
Affiliation(s)
- Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Ping He
- China Center for Health Development Studies, Peking University, Beijing, China
| |
Collapse
|
|
13
|
Wu W, Wang W, Gu Y, Xie Y, Liu X, Chen X, Zhang Y, Tan X. Sleep quality, sleep duration, and their association with hypertension prevalence among low-income oldest-old in a rural area of China: A population-based study. J Psychosom Res 2019; 127:109848. [PMID: 31670193 DOI: 10.1016/j.jpsychores.2019.109848] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/29/2019] [Accepted: 10/02/2019] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The relationship among sleep quality, sleep duration and hypertension prevalence is controversial in different age groups and genders. This study aimed to investigate sleep quality, sleep duration and their association with hypertension prevalence among low-income oldest-old in a rural area of China. METHODS A cross-sectional survey was conducted in a representative sample of 1066 adults aged 80-99 years in 2017. Logistic regression analysis was performed. RESULTS Among males, sleep durations of <6 h and 6-<7 h were significantly associated with hypertension prevalence, with odds ratios (ORs) of 3.15 (95% confidence interval (CI) 1.37 to 7.23) and 2.38 (95% CI 1.22 to 4.63), respectively. Among females, only the sleep duration of <6 h was associated with increased OR of hypertension of 3.49 (95% CI 1.50 to 8.09). Poor sleep quality was associated with hypertension for both genders (ORmen 1.67, 95% CI 1.12 to 2.49; ORwomen 1.91, 95% CI 1.29 to 2.82). For women, a combination of poor sleep quality and any group of sleep duration, except for 7-<8 h, was associated with higher hypertension prevalence. For men, only the combination of poor sleep quality and short sleep duration (<7 h) was associated with high hypertension prevalence. CONCLUSION Short sleep duration and poor sleep quality are associated with hypertension prevalence of oldest-old. The prevention of hypertension in older adults should be investigated from the perspective of sleep improvement.
Collapse
Affiliation(s)
- Wenwen Wu
- School of Health Sciences, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China; School of Public Health and Management, Hubei University of Medicine, No.30, Renmin South Road, Shiyan 442000, Hubei Province, China
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, 117597, Singapore
| | - Yaohua Gu
- School of Health Sciences, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Yaofei Xie
- School of Health Sciences, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Xiangxiang Liu
- School of Health Sciences, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Xuyu Chen
- School of Health Sciences, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Yuting Zhang
- School of Health Sciences, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Xiaodong Tan
- School of Health Sciences, Wuhan University, No.115, Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China.
| |
Collapse
|
|
14
|
Hoang VM, Tran QB, Vu THL, Nguyen TKN, Kim BG, Pham QN, Nguyen TL, Lai DT, Nakagawa J, Shin HR, Kim WJ, Riley L, Wadhwani C, Truong DB, Tran DP. Patterns of Raised Blood Pressure in Vietnam: Findings from the WHO STEPS Survey 2015. Int J Hypertens 2019; 2019:1219783. [PMID: 31871783 PMCID: PMC6913158 DOI: 10.1155/2019/1219783] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 09/15/2019] [Accepted: 11/06/2019] [Indexed: 12/03/2022] Open
Abstract
This study aims to describe the prevalence of raised blood pressure and the situation of management for raised blood pressure among the adult population in Vietnam. It also aims to examine the association between diversified socioeconomic and behavioral factors of raised blood pressure and awareness of raised blood pressure. Data were obtained from the STEPS survey conducted in Vietnam in 2015. Survey sample was nationally representative with a total of 3,856 people aged 18-69 years old. The study outcomes included raised blood pressure and awareness of and control of raised blood pressure. Multiple logistic regression was used to examine the association of socioeconomic and behavior risk factors with the outcome variables. The overall prevalence of raised blood pressure in Vietnam in 2015 was 18.9% (95% CI: 17.4%-20.6%). The prevalence of raised blood pressure was higher among men. Significantly correlated factors with raised blood pressure were age, sex, body mass index, and diabetes status. Levels of awareness of raised blood pressure were higher among the older age group and overweight people and lower among ethnic minority groups. Raised blood pressure in Vietnam is a serious problem due to its magnitude and the unacceptably high unawareness rate in the population. Public health actions dealing with the problems of raised blood pressure are urgent, while taking into account its relationship with sex and socioeconomic status. It is clear that the interventions should address all people in society, with a focus on disadvantaged groups which are the rural and ethnic minority peoples.
Collapse
Affiliation(s)
- Van Minh Hoang
- Hanoi University of Public Health (HUPH), Hanoi, Vietnam
| | - Quoc Bao Tran
- Division of Non-Communicable Diseases, General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | | | | | | | - Quynh Nga Pham
- World Health Organization Country Office, Hanoi, Vietnam
| | | | - Duc Truong Lai
- World Health Organization Country Office, Hanoi, Vietnam
| | - Jun Nakagawa
- World Health Organization Country Office, Hanoi, Vietnam
| | - Hai-Rim Shin
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Warrick Junsuk Kim
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Leanne Riley
- World Health Organization, HQ Office, Geneva, Switzerland
| | | | - Dinh Bac Truong
- Division of Non-Communicable Diseases, General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | - Dac Phu Tran
- Division of Non-Communicable Diseases, General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| |
Collapse
|
|
15
|
Zhao Y, Mahal AS, Haregu TN, Katar A, Oldenburg B, Zhang L. Trends and Inequalities in the Health Care and Hypertension Outcomes in China, 2011 to 2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4578. [PMID: 31752338 PMCID: PMC6888605 DOI: 10.3390/ijerph16224578] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 11/06/2019] [Accepted: 11/09/2019] [Indexed: 12/27/2022]
Abstract
Background: Hypertension is one of the most significant and common risk factors for cardiovascular disease, yet it remains poorly controlled in China. This study aims to examine trends and socioeconomic inequalities in the management of hypertension between 2011 and 2015 in China and to investigate the association between antihypertensive medication treatment and reduction of blood pressure, using nationally representative data. Methods: Concentration curve and concentration index were used to assess socioeconomic-related inequalities in hypertension care and health service utilisation. The fixed-effects analysis was performed to measure the impact of medication treatment on reduction of blood pressure among people with hypertension by using linear regression models. Results: Among hypertensive individuals, there were growing trends in the rates of awareness and treatment from 55.87% and 48.44% in 2011, to 68.31% in 2013 and 61.97% in 2015, respectively. The proportion of hypertension control was still below 30%. The fixed-effects models indicated that medication treatment was statistically significant and associated with the patients' systolic blood pressure (β: -13.483; 95% CI: -15.672, -11.293) and diastolic blood pressure (β: -5.367; 95% CI: -6.390, -4.344). Conclusions: China has made good progress in the hypertension diagnosis, medication treatment and coverage of health services over the last 10 years; however, pro-rich inequalities in hypertension care still exist, and there is considerable progress to be made in the prevention, treatment and effective control of hypertension.
Collapse
Affiliation(s)
- Yang Zhao
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne 3010, Australia; (Y.Z.); (A.S.M.); (T.N.H.); (A.K.); (B.O.)
- WHO Collaborating Centre on Implementation Research for Prevention & Control of NCDs, Melbourne 3010, Australia
| | - Ajay Singh Mahal
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne 3010, Australia; (Y.Z.); (A.S.M.); (T.N.H.); (A.K.); (B.O.)
| | - Tilahun Nigatu Haregu
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne 3010, Australia; (Y.Z.); (A.S.M.); (T.N.H.); (A.K.); (B.O.)
- WHO Collaborating Centre on Implementation Research for Prevention & Control of NCDs, Melbourne 3010, Australia
| | - Ameera Katar
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne 3010, Australia; (Y.Z.); (A.S.M.); (T.N.H.); (A.K.); (B.O.)
| | - Brian Oldenburg
- The Nossal Institute for Global Health, The University of Melbourne, Melbourne 3010, Australia; (Y.Z.); (A.S.M.); (T.N.H.); (A.K.); (B.O.)
- WHO Collaborating Centre on Implementation Research for Prevention & Control of NCDs, Melbourne 3010, Australia
| | - Luwen Zhang
- School of Health Services Management, Southern Medical University, Guangzhou 500000, Guangdong, China
| |
Collapse
|
|
16
|
Chow ZY, Jun SM, Ching SM, Tan CH, Lee KW, Devaraj NK, Syahida H, Ramachandran V, Hoo FK, Cheong AT, Chia YC. Prevalence, awareness and control of hypertension in Malaysia 1980 – 2017: A Systematic Review and Meta-Analysis.. [DOI: 10.1101/625004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AbstractBackgroundHypertension is a common public health problem worldwide and is a well-known risk factor for increased risk of cardiovascular diseases, contributing to high morbidity and mortality. However, there is no systematic review and meta-analysis that has been done in a multi-ethnic population like Malaysia. This systematic review aims to determine the trend in prevalence, awareness and control of hypertension in Malaysia.MethodsSystematic searches were conducted in PubMed, Scopus, Ovid, Cumulative Index to Nursing and Allied Health Literature, Malaysian Medical Repository and Malaysia Citation Index published between 1980 and 2017. All original articles in English were included. Studies included were those on adults aged 18 years and above. Studies of prevalence in children and adolescents and pregnancy related hypertension were excluded. Two authors independently reviewed the studies, carried out data extraction and performed quality assessment. Heterogeneity between studies and publication bias was assessed and effect size was pooled by the random effect model.ResultsFifty-six studies with a total of 241,796 subjects were included. The prevalence of hypertension throughout Malaysia varied (I2= 99.3%). The overall pooled prevalence of hypertension over the past 4 decades was 28.2% in adults aged 18 years and older (95% CI: 26.1 – 33.3) and the prevalence in those 30 years and older was 40.0% (95% CI: 35.3-44.8).For subgroup analysis, the prevalence of hypertension in male aged 18 and above was 31.4% (95% CI: 26.5 - 36.2) and 27.8% in female (95% CI: 20.7 – 34.9). The prevalence of hypertension among the ethnic groups aged 18 years and above were 37.3% in Malays (95% CI: 32.9 – 41.7); 36.4% in Chinese (95% CI 31.6 - 41.2) and 34.8% in Indians (95% CI: 31.2-38.4). The prevalence of hypertension was the lowest in the 1980s (16.2%, 95% CI: 13.4-19.0%), increases up to 36.8% in the 1990s (95% CI: 6.1-67.5), then came down to 28.7% (95% CI: 21.7-35.8) in the 2000s and 29.2% (95% CI: 24.0-34.4) in the 2010s. The prevalence of awareness was 38.7% (95% CI: 31.7 – 45.8) whereas the control of hypertension of those on treatment was 33.3% (95% CI: 28.4 – 38.2).ConclusionThree in 10 adults aged 18 years old and above have hypertension, whereas four in 10 adults aged 30 years old and above have hypertension. Four out of 10 are aware of their hypertension status and only one-third of them who were under treatment achieved control of their hypertension. Concerted efforts by policymakers and healthcare professionals to improve the awareness and control of hypertension should be of high priority.
Collapse
|
|
17
|
Qin C, Zhang L, Wang X, Duan Y, Ye Z, Xie M. Evaluation of Carotid Plaque Neovascularization in Patients With Coronary Heart Disease on Contrast-Enhanced Ultrasonography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:823-831. [PMID: 29027678 DOI: 10.1002/jum.14410] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 06/05/2017] [Accepted: 06/16/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To examine the repeatability of quantitative time-intensity curve analysis of neovascularization within carotid plaques with contrast-enhanced ultrasonography (US) and to investigate carotid plaque neovascularization in patients with coronary heart disease using contrast-enhanced US and the correlation between risk factors and acute coronary syndrome (ACS). METHODS Sixty patients with ACS and 60 with stable coronary artery disease (CAD) underwent conventional carotid and contrast-enhanced US, and plaque enhancement was observed and analyzed quantitatively. Carotid contrast-enhanced US was performed within 1 month of ACS occurrence. Interobserver and intraobserver variability of the measurements was assessed. The peak signal intensity was the maximum number of contrast microbubbles that local tissues could accumulate, reflecting the local microvascular density and representing the capillary volume. RESULTS The ACS group had higher low-density lipoprotein cholesterol (mean ± SD, 3.21 ± 0.75 versus 2.53 ± 0.71 mmol/L; P < .01) and high-sensitivity C-reactive protein (CRP; 3.76 ± 0.19 versus 2. 93 ± 0.15 mg/L; P < .01) levels than the stable CAD group. The proportion of soft plaques in the ACS group (81%) was higher than in the stable CAD group (53%). The proportion of plaque enhancement, peak signal intensity, and plaque-to-carotid lumen enhancement intensity ratio were higher in the ACS group than the stable CAD group. The peak signal intensity was correlated with the high-sensitivity CRP value. Logistic regression analyses indicated that age (65-74 years), high-sensitivity CRP, and enhancement intensity were correlated with the occurrence of ACS. The sensitivity and specificity of the peak signal intensity in carotid plaques were 80.0% and 88.3%, respectively (cutoff value, 9.97 dB; area under the receiver operating characteristic curve, 0.865). The time-intensity curve measurements had good repeatability. CONCLUSIONS Carotid plaque enhancement is a potential independent risk factor for ACS occurrence. These results illustrate the correlation of carotid plaque vulnerability with the coronary artery symptomatic state according to the common pathogenetic mechanism of atherosclerosis.
Collapse
Affiliation(s)
- Chuan Qin
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
- Department of Ultrasound, Central Hospital, Karamay, China
| | - Li Zhang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Xinfang Wang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yilian Duan
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Zhou Ye
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Ultrasound, Central Hospital, Karamay, China
| | - Mingxing Xie
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| |
Collapse
|
|
18
|
Chen C, Yuan Z. Prevalence and risk factors for prehypertension and hypertension among adults in Central China from 2000-2011. Clin Exp Hypertens 2018. [PMID: 29513624 DOI: 10.1080/10641963.2018.1431252] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hypertension is frequently studied in surveys; however, prehypertension, a new blood pressure status between normotension and hypertension, is rarely reported. METHODS All data were derived from the China Health and Nutrition Survey (CHNS) and were analysed by logistic regression for correlation. RESULTS The prehypertension prevalence was 27.4%, with a hypertension rate of 36.9%. The awareness, treatment, and uncontrolled rates among all hypertension participates were 19.8%, 83.6%, and 55.0%, respectively. The epidemic rate of hypertension increased with increasing age (p < 0.001), and prehypertension appeared to have an epidemic peak in the age group of 38-57 years (p < 0.001). In general, the incidence of hypertension in urban participants was higher than in rural subjects (p < 0.001), and prehypertension in urban subjects was lower than that in rural subjects (p < 0.001). According to the results of logistic regression, hypertension and prehypertension were associated with age, gender, location, body mass index (BMI), body fat rate (BFR), waist circumference (WC), education, and the intake of energy-yielding nutrients<0.05). CONCLUSION The current study reveals a high epidemic rate of hypertension and prehypertension in Central China. These results indicate the urgent need to develop strategies to improve the prevention of hypertension and prehypertension in Central China.
Collapse
Affiliation(s)
- Chaoying Chen
- a School of Health Sciences , Wuhan University , Wuhan , Hubei , P. R. of China
| | - Zhanpeng Yuan
- a School of Health Sciences , Wuhan University , Wuhan , Hubei , P. R. of China
| |
Collapse
|
|
19
|
Development and evaluation of a nurse-led hypertension management model: A randomized controlled trial. Int J Nurs Stud 2018; 77:171-178. [PMID: 29100199 DOI: 10.1016/j.ijnurstu.2017.10.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 10/11/2017] [Accepted: 10/11/2017] [Indexed: 02/03/2023]
|
|
20
|
Geographical variations in hypertension prevalence, awareness, treatment and control in China. J Hypertens 2018; 36:178-187. [DOI: 10.1097/hjh.0000000000001531] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
|
21
|
Ye J, Li Z, Lv Y, An L, Yu J, Guo X, Yao Y, Yu Y, Jin L. Associations of Blood Pressure with the Factors among Adults in Jilin Province: A Cross-Sectional Study Using Quantile Regression Analysis. Sci Rep 2017; 7:13613. [PMID: 29051578 PMCID: PMC5648827 DOI: 10.1038/s41598-017-14045-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/05/2017] [Indexed: 01/17/2023] Open
Abstract
Hypertension has become a major public health challenge. However, numerous research results reported in the literature focus primarily on risk factors of hypertension, little is known about how the whole continuum of blood pressure (BP) is associated with risk factors of hypertension. This study aims to reveal quantile-specific associations of BP with its risk factors. A cross-sectional survey based on a sample of 23,050 adults aged 18 to 79 years was conducted in Jilin Province in 2012, and some subjects were excluded due to missing values in BP or having BP control according to the purpose of this study. Quantile regression (QR) was employed to investigate the associations between systolic/diastolic blood pressure (SBP/DBP) and the risk factors. The SBP and DBP in males presented statistically higher than females (P < 0.001). High-salt diet for males manifested a slightly increasing positive association with higher SBP only for high quantiles (≥70), but with a higher DBP for middle part of the quantiles (30~75), compared with bland diet. High-salt diet, drinking and high-density lipoprotein cholesterol (HDL-C) were positively associated with BP measures in males. And the coefficient of total cholesterol (TC) in QR increased with BP in females who used to live in town.
Collapse
Affiliation(s)
- Junsen Ye
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Zhongmin Li
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Yaogai Lv
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Lan An
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Jianxing Yu
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Xin Guo
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Yan Yao
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Yaqin Yu
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021
| | - Lina Jin
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, China, 130021.
| |
Collapse
|
|
22
|
Wang YT, Adi D, Yu ZX, Ma YT, Yang YN, Li XM, Ma X, Liu F, Chen BD. The burden and correlates of hypertension among Chinese rural population in Han, Uygur, and Kazak: a cross-sectional study. ACTA ACUST UNITED AC 2017; 11:737-745.e3. [PMID: 29031803 DOI: 10.1016/j.jash.2017.09.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/20/2017] [Accepted: 09/21/2017] [Indexed: 12/13/2022]
Abstract
The present study was conducted to investigate the prevalence, awareness, treatment, control, and associated risk factors of hypertension among rural population in Xinjiang Province in Northwest China. The Cardiovascular Risk Survey study was conducted on a representative sample of the Northwest China adult population. A four-stage stratified cluster random sampling scheme was adopted to recruit representative samples. The data were collected by trained staff. Multivariable logistic regression models were used to identify the associated risk factors. Overall, 8295 study participants aged 35-101 years were enrolled. The overall hypertension prevalence was 35.01%. The prevalence of hypertension in Han, Uygur, and Kazak population was 36.84%, 33.32%, and 52.57%, respectively. The hypertension awareness, treatment, control, and control among treated participants were 56.1%, 44.7%, 10.9%, and 24.3%, respectively. Multivariate logistic regression showed that age, body mass index, central obesity, ethnic, and drinking status were identified as risk factors for hypertension. Hypertension was found to be highly prevalent in rural adults in Xinjiang, China, especially in Kazak population. Although the levels of awareness, treatment, and control have improved, it was still lower than developed countries. Effective measures should be adopted to promote the prevention and control of hypertension.
Collapse
Affiliation(s)
- Yong-Tao Wang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, P.R. China; Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, P.R. China
| | - Dilare Adi
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, P.R. China; Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, P.R. China
| | - Zi-Xiang Yu
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, P.R. China; Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, P.R. China
| | - Yi-Tong Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, P.R. China; Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, P.R. China.
| | - Yi-Ning Yang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, P.R. China; Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, P.R. China
| | - Xiao-Mei Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, P.R. China; Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, P.R. China
| | - Xiang Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, P.R. China; Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, P.R. China
| | - Fen Liu
- Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, P.R. China
| | - Bang-Dang Chen
- Xinjiang Key Laboratory of Cardiovascular Disease Research, Urumqi, P.R. China
| |
Collapse
|
|
23
|
Li J, Shi L, Li S, Xu L, Qin W, Wang H. Urban-rural disparities in hypertension prevalence, detection, and medication use among Chinese Adults from 1993 to 2011. Int J Equity Health 2017; 16:50. [PMID: 28288635 PMCID: PMC5348878 DOI: 10.1186/s12939-017-0545-7] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 03/02/2017] [Indexed: 01/16/2023] Open
Abstract
Background China has experienced a rapid increase in hypertension over the past decade, especially in rural. Therefore, the aim of this research is to examine the dynamic trends in urban-rural disparities in hypertension prevalence, detection, and medication use among Chinese adults from 1993 to 2011. Methods Data were extracted from the seven latest waves of the China Health and Nutrition Survey (CHNS). We used the hukou system to distinguish between urban and rural residents. Chi-square tests were performed to examine urban-rural gaps in hypertension prevalence, detection and medication use. Multiple logistic regressions were used to confirm these disparities and to explore whether the urban-rural gaps have narrowed or widened from 1993 to 2011, after controlling for health-related behaviors, BMI, demographic variables and socioeconomic characteristics. Blinder-Oaxaca decomposition technique was also used to calculate the extent to which urban-rural disparities reflect an endowments effect or a coefficients effect. Results Hypertension prevalence, detection, and medication use among rural adults were significantly lower than urban adults, with the significant level at p < 0.001. The urban-rural gaps in hypertension prevalence and medication use gradually narrowed during the period 1993–2011, whereas the gaps in hypertension detection grew wider. After controlling for confounding variables, urban adults were about 24.5, 49.4, and 89.5% more likely to be hypertensive, detected, and medicated than their rural counterparts (p < 0.01), respectively. The Blinder-Oaxaca decomposition suggested that approximately 22 and 26% of the urban-rural gap in hypertension detection and medication use could be attributed to coefficient difference, respectively. Conclusions Although hypertension prevalence among rural adults was comparable to that of urban adults, hypertension detection and medication use of rural adults were still suboptimal. Unusually large urban-rural gaps and an expanding trend in hypertension detection deserve the attention of health policymakers and researchers.
Collapse
Affiliation(s)
- Jiajia Li
- Shandong University, Jinan, People's Republic of China
| | - Leiyu Shi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
| | - Shixue Li
- Shandong University, Jinan, People's Republic of China
| | - Lingzhong Xu
- Shandong University, Jinan, People's Republic of China
| | - Wen Qin
- Infirmary of Shandong University, Jinan, People's Republic of China
| | - Heng Wang
- The Second Hospital of Shandong University, Jinan, People's Republic of China
| |
Collapse
|
|
24
|
Busingye D, Arabshahi S, Evans RG, Srikanth VK, Kartik K, Kalyanram K, Riddell MA, Zhu X, Suresh O, Thrift AG. Factors associated with awareness, treatment and control of hypertension in a disadvantaged rural Indian population. J Hum Hypertens 2017; 31:347-353. [PMID: 28054571 DOI: 10.1038/jhh.2016.85] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 07/23/2016] [Accepted: 09/15/2016] [Indexed: 11/09/2022]
Abstract
The aim of this study was to identify factors associated with awareness, treatment and control of hypertension in a rural setting in India. Following screening of the population, all individuals with hypertension (blood pressure (BP) ⩾140/90 mm Hg or taking antihypertensive medications) were invited to participate in this study. We measured BP, height, weight, skinfolds, waist and hip circumference, and administered a questionnaire to obtain information regarding socioeconomic and behavioural characteristics. Multivariable logistic regression was used to determine factors associated with awareness, treatment and control of hypertension. We recruited 277 individuals with hypertension. Awareness (43%), treatment (33%) and control (27%) of hypertension were poor. Greater distance to health services (odds ratio (OR) 0.56 (95% confidence interval (CI)) 0.32-0.98) was associated with poor awareness of hypertension while having had BP measured within the previous year (OR 4.72, 95% CI 2.71-8.22), older age and greater per cent body fat were associated with better awareness. Factors associated with treatment of hypertension were having had BP measured within the previous year (OR 6.18, 95% CI 3.23-11.82), age ⩾65 years, physical inactivity and greater per cent body fat. The only factor associated with control of hypertension was greater per cent body fat (OR 1.05, 95% CI 1.01-1.11). Improving geographic access and utilisation of health services should improve awareness and treatment of hypertension in this rural population. Further research is necessary to determine drivers of control.
Collapse
Affiliation(s)
- D Busingye
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - S Arabshahi
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - R G Evans
- Department of Physiology, Cardiovascular Disease Program, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - V K Srikanth
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - K Kartik
- Rishi Valley Rural Health Centre, Rishi Valley, Andhra Pradesh, India
| | - K Kalyanram
- Rishi Valley Rural Health Centre, Rishi Valley, Andhra Pradesh, India
| | - M A Riddell
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - X Zhu
- School of Earth, Atmosphere and Environment, Monash University, Clayton, Victoria, Australia
| | - O Suresh
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.,Rishi Valley Rural Health Centre, Rishi Valley, Andhra Pradesh, India
| | - A G Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.,Florey Neuroscience Institutes, Melbourne, Victoria, Australia
| |
Collapse
|
|
25
|
Yin M, Augustin B, Fu Z, Yan M, Fu A, Yin P. Geographic Distributions in Hypertension Diagnosis, Measurement, Prevalence, Awareness, Treatment and Control Rates among Middle-aged and Older Adults in China. Sci Rep 2016; 6:37020. [PMID: 27841326 PMCID: PMC5107929 DOI: 10.1038/srep37020] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 10/24/2016] [Indexed: 12/22/2022] Open
Abstract
Hypertension is of public health importance in China, but information on geographic distribution on hypertension by map visualization is limited for middle-aged and older adults. Regional geographic variations remain unexplained. Our study is to present geographic distributions at the provincial level and identify provinces and municipalities with high hypertension diagnosis, measurement and prevalence rates and/or low awareness, treatment, control rates among aged 45+ adults in China. We used data collected from the China Health and Retirement Longitudinal Study (n = 13,583) of Chinese people aged 45 years or older. We used weighted rates for our analysis. The rates by provinces and municipalities were compared using map visualization, and explore the main factors of the disparity using ordinal logistic regression. Higher hypertension prevalence rates (56.3%) but lower hypertension awareness, treatment and control rates (37.3%, 21.1% and 14.9%, respectively) were observed in Guizhou. Shanghai and Beijing had the highest hypertension prevalence, awareness and treatment rates (65.0%, 87.8% and 80.0% for Shanghai, 57.5%, 88.6% and 77.5% for Beijing, respectively). Remarkable variations were observed among surveyed provinces and municipalities. Several Chinese regions show particularly higher prevalence rates and/or lack of hypertension awareness and poor control.
Collapse
Affiliation(s)
- Minghui Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Balekouzou Augustin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhen Fu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mingming Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Adan Fu
- Department of Nursing, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| |
Collapse
|
|
26
|
A cross-sectional survey of medication adherence and associated factors for rural patients with hypertension. Appl Nurs Res 2016; 31:94-9. [DOI: 10.1016/j.apnr.2016.01.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/20/2015] [Accepted: 01/14/2016] [Indexed: 11/18/2022]
|
|
27
|
Hu M, Wan Y, Yu L, Yuan J, Ma Y, Hou B, Jiang X, Shang L. Prevalence, awareness, treatment, and control of hypertension and associated risk factors among adults in Xi'an, China: A cross-sectional study. Medicine (Baltimore) 2016; 95:e4709. [PMID: 27559980 PMCID: PMC5400347 DOI: 10.1097/md.0000000000004709] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
To investigate the prevalence, awareness, treatment, and control of hypertension, and the associated risk factors among adults in Xi'an, China.From October to December 2013, participants in Xi'an, China were recruited for the study by using a multiple-stage sampling method. A self-developed questionnaire with an additional health examination was used to collect data on the history of hypertension diagnosis and antihypertensive medication. The status on prevalence, awareness, treatment, and control of hypertension were analyzed and related risk factors were identified by using logistic regression analysis.A total of 8193 participants were included with an overall prevalence of hypertension of 20.4%. Among the hypertensive participants, 63.7% were aware of their conditions, 47.3% took antihypertensive medication, and 17.8% had their blood pressure (BP) controlled within 140/90 mm Hg. More complications and less frequent BP measurements were associated with hypertension. Older participants, non-drinkers, and those with more complications and more frequent BP measurements were more aware of their hypertension. Being older, living in an urban area, and having more frequent BP measurements were all factors for better treatment. Participants who were women, living in an urban area, with a higher educational level and who were not obese were more likely to have their hypertension controlled.The prevalence of hypertension among adults in Xi'an is high with suboptimal low awareness, treatment, and control rates. Further comprehensive integrated strategies based on these risk factors should be taken into account in order to improve the prevention, awareness, treatment, and control of hypertension.
Collapse
Affiliation(s)
- Meiqin Hu
- Xi’an Centre for Disease Control and Prevention
- Department of Health Statistics
| | - Yi Wan
- Department of Health Service, School of Public Health
| | - Lifen Yu
- Xi’an Centre for Disease Control and Prevention
- Department of Health Statistics
| | | | | | - Bin Hou
- Xi’an Centre for Disease Control and Prevention
| | - Xun Jiang
- Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
- Correspondence: Lei Shang, Department of Health Statistics, School of Public Health, Fourth Military Medical University, No.169, Changle West Road, Xi’an 710032, Shaanxi, China (e-mail: ); Xun Jiang, Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University, No.1, Xinsi Road, Xi’an 710038, Shaanxi, China (e-mail: )
| | - Lei Shang
- Department of Health Statistics
- Correspondence: Lei Shang, Department of Health Statistics, School of Public Health, Fourth Military Medical University, No.169, Changle West Road, Xi’an 710032, Shaanxi, China (e-mail: ); Xun Jiang, Department of Pediatrics, Tangdu Hospital, Fourth Military Medical University, No.1, Xinsi Road, Xi’an 710038, Shaanxi, China (e-mail: )
| |
Collapse
|
|
28
|
박지은, 김홍수, Sung-il Cho, 류연희. Factors Associated with Controlled Hypertension by Sex and Macro Level: A Systematic Review. ACTA ACUST UNITED AC 2016. [DOI: 10.15709/hswr.2016.36.2.581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
|
29
|
Li SS, Zhou F, Lu YC, Lyv P, Zhang HF, Yao WM, Gong L, Zhou YL, Yang R, Sheng YH, Xu DJ, Kong XQ, Li XL. Hypertension related knowledge and behaviour associated with awareness, treatment and control of hypertension in a rural hypertensive population: a community based, cross-sectional survey. Blood Press 2016; 25:305-11. [DOI: 10.3109/08037051.2016.1172866] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
|
30
|
The dynamics of hypertension prevalence, awareness, treatment, control and associated factors in Chinese adults: results from CHNS 1991-2011. J Hypertens 2016; 33:1688-96. [PMID: 26136071 DOI: 10.1097/hjh.0000000000000594] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To analyze the trends in blood pressure (BP), and the prevalence, awareness, treatment and control of hypertension and associated factors in Chinese adults from 1991 to 2011. METHODS On the basis of the longitudinal data of China Health and Nutrition Survey, 75 526 records of 24 410 adults were selected according to the eligibility criteria. The age-standardized levels of SBP, DBP, prevalence, awareness, treatment and control of hypertension were calculated by sex and age group within each year. Generalized estimating equation was employed to investigate the associations between demographic factors and status of hypertension, awareness, treatment and control. RESULTS From 1991 to 2011, the BP level elevated (SBP 120.0-124.5 mmHg, DBP 76.7-79.3 mmHg) and the prevalence of hypertension increased from 23.4 to 28.6%. The increasing levels of BP and hypertension prevalence were more apparent among men and older patients. The rates of hypertension awareness, treatment and control also increased while kept at low levels. Factors such as age, sex, smoking habit, drinking habit, household income, health insurance, BMI, residential region, marital status, educational level and nationality were significantly associated with the status of hypertension, awareness, treatment and control. CONCLUSION The BP level and hypertension prevalence have increased among Chinese adults in recent years. However, levels of hypertension awareness, treatment and control were quite low. To reduce the disease burden of the hypertension, improvements in health education programs, detection and treatment strategies are warranted.
Collapse
|
|
31
|
Tan JP, Zhu LQ, Zhang J, Zhang SM, Lan XY, Cui B, Deng YC, Li YH, Ye GH, Wang LN. Awareness Status of Chronic Disabling Neurological Diseases among Elderly Veterans. Chin Med J (Engl) 2016; 128:1293-300. [PMID: 25963347 PMCID: PMC4830306 DOI: 10.4103/0366-6999.156761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The awareness, treatment and prevention of chronic diseases are generally poor among the elderly population of China, whereas the prevention and control of chronic diseases in elderly veteran communities have been ongoing for more than 30 years. Therefore, investigating the awareness status of chronic disabling neurological diseases (CDND) and common chronic diseases (CCD) among elderly veterans may provide references for related programs among the elderly in the general population. Methods: A cross-sectional survey was conducted among veterans ≥60 years old in veteran communities in Beijing. The awareness of preventive strategies against dementia, Alzheimer's disease (AD), Parkinson's disease (PD), sleep disorders, cerebrovascular disease (CVD) and CCD such as hypertension, and the approaches used to access this information, including media, word of mouth (verbal communication among the elderly) and health care professionals, were investigated via face-to-face interviews. Results: The awareness rates for CCD and CVD were approximately 100%, but that for AD was the lowest at <10%. The awareness rates for sleep disorders, PD and dementia, were 51.0–89.4%. Media was the most commonly selected mode of communication by which veterans acquired knowledge about CCD and CVD. Media was used by approximately 80% of veterans. Both health care professionals and word of mouth were used by approximately 50% of veterans. With respect to the source of information about CDND excluding AD, the rates of the use of health care professionals, word of mouth and media were 10.6–28.2%, 56.5–76.5%, and approximately 50%, respectively. Conclusions: The awareness of CDND among elderly veterans was significantly lower than that of CCD. More information about CDND should be disseminated by health care professionals. Appropriate guidance will promote the rapid and extensive dissemination of information about the prevention of CDND by media and word-of-mouth peer education.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Lu-Ning Wang
- Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing 100853, China
| |
Collapse
|
|
32
|
Zavala-Loayza JA, Benziger CP, Cárdenas MK, Carrillo-Larco RM, Bernabé-Ortiz A, Gilman RH, Checkley W, Miranda JJ. Characteristics Associated With Antihypertensive Treatment and Blood Pressure Control: A Population-Based Follow-Up Study in Peru. Glob Heart 2016; 11:109-19. [PMID: 27102028 PMCID: PMC4843839 DOI: 10.1016/j.gheart.2015.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 12/15/2015] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Over one-quarter of the world's adult population has hypertension, yet achieving adequate treatment or control targets remains a challenge. OBJECTIVE This study sought to identify, longitudinally, characteristics associated with antihypertensive treatment and blood pressure (BP) control among individuals with hypertension. METHODS Data from individuals enrolled in the population-based CRONICAS Cohort Study (adults ≥35 years, living in 4 different rural/urban and coastal/high-altitude Peruvian settings) with hypertension at baseline were used. Antihypertensive treatment and BP control were assessed at baseline and at 15 months. Multinomial logistic regressions were used to estimate relative risk ratios (RRR) and 95% confidence intervals (95% CI) of factors associated with antihypertensive treatment and BP control at follow-up. RESULTS At baseline, among 717 individuals with hypertension (53% women, mean age 61.5 ± 12.4 years), 28% were unaware of their hypertension status, 30% were aware but untreated, 16% were treated but uncontrolled, and 26% were treated and controlled. At follow-up, 89% of unaware and 82% of untreated individuals persisted untreated, and only 58% of controlled individuals remained controlled. Positive predictors of receiving treatment and being controlled at follow-up included age (RRR: 0.81; 95% CI: 0.73 to 0.91 for every 5 years) and family history of a chronic disease (RRR: 0.53; 95% CI: 0.31 to 0.92 vs. no history); whereas Puno rural site (RRR: 16.51; 95% CI: 1.90 to 143.56 vs. Lima) and male sex (RRR: 2.59; 95% CI: 1.54 to 4.36) were risk factors. Systolic BP at baseline (RRR: 1.27; 95% CI: 1.16 to 1.39 for every 5 mm Hg) and male sex (RRR: 1.75, 95% CI: 1.02 to 2.98) were risk factors for being treated but uncontrolled at follow-up. CONCLUSIONS Large gaps in treatment of hypertension were observed. Targeting specific populations such as men, younger individuals, or those without family history of disease may increase coverage of antihypertensive treatment. Also, targeting male individuals or those with higher systolic BP could yield better rates of BP control in the short term.
Collapse
Affiliation(s)
- J. Alfredo Zavala-Loayza
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - María Kathia Cárdenas
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Antonio Bernabé-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert H Gilman
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru,Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA,Área de Investigación y Desarrollo, Asociación Benéfica PRISMA, Lima, Peru
| | - William Checkley
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru,Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA,Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - J. Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru,Facultad de Medicina “Alberto Hurtado”, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | |
Collapse
|
|
33
|
Irazola VE, Gutierrez L, Bloomfield G, Carrillo-Larco RM, Dorairaj P, Gaziano T, Levitt NS, Miranda JJ, Ortiz AB, Steyn K, Wu Y, Xavier D, Yan LL, He J, Rubinstein A. Hypertension Prevalence, Awareness, Treatment, and Control in Selected LMIC Communities: Results From the NHLBI/UHG Network of Centers of Excellence for Chronic Diseases. Glob Heart 2016; 11:47-59. [PMID: 27102022 PMCID: PMC4843831 DOI: 10.1016/j.gheart.2015.12.008] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 12/17/2015] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Hypertension is the leading cause of cardiovascular disease and premature death worldwide. The prevalence of this public health problem is increasing in low- and middle-income countries (LMICs) in both urban and rural communities. OBJECTIVE The aim of this study was to examine hypertension prevalence, awareness, treatment, and control in adults 35 to 74 years of age from urban and rural communities in LMICs in Africa, Asia, and South America. METHODS The authors analyzed data from 7 population-based cross-sectional studies in selected communities in 9 LMICs that were conducted between 2008 and 2013. Age- and sex-standardized prevalence rates of pre-hypertension and hypertension were calculated. The prevalence rates of awareness, treatment, and control of hypertension were estimated overall and by subgroups of age, sex, and educational level. RESULTS In selected communities, age- and sex-standardized prevalence rates of hypertension among men and women 35 to 74 years of age were 49.9% (95% confidence interval [CI]: 42.3% to 57.4%) in Kenya, 54.9% (95% CI: 51.3% to 58.4%) in South Africa, 52.5% (95% CI: 50.1% to 54.8%) in China, 32.5% (95% CI: 31.7% to 33.3%) in India, 42.3% (95% CI: 40.4% to 44.2%) in Pakistan, 45.4% (95% CI: 43.6% to 47.2%) in Argentina, 39.9% (95% CI: 37.8% to 42.1%) in Chile, 19.2% (95% CI: 17.8% to 20.5%) in Peru, and 44.1% (95% CI: 41.6% to 46.6%) in Uruguay. The proportion of awareness varied from 33.5% in India to 69.0% in Peru, the proportion of treatment among those who were aware of their hypertension varied from 70.8% in South Africa to 93.3% in Pakistan, and the proportion of blood pressure control varied from 5.3% in China to 45.9% in Peru. CONCLUSIONS The prevalence of hypertension varies widely in different communities. The rates of awareness, treatment, and control also differ in different settings. There is a clear need to focus on increasing hypertension awareness and control in LMICs.
Collapse
Affiliation(s)
- Vilma E Irazola
- Centro de Excelencia en Salud Cardiovascular para el Cono Sur, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
| | - Laura Gutierrez
- Centro de Excelencia en Salud Cardiovascular para el Cono Sur, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | | | - Rodrigo M Carrillo-Larco
- CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Prabhakaran Dorairaj
- Public Health Foundation of India, Gurgaon, India; Centre for Chronic Disease Control, Gurgaon, India
| | - Thomas Gaziano
- Division of Cardiovascular Medicine, Brigham & Women's Hospital, Boston, MA, USA; Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Naomi S Levitt
- Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Division of Diabetic Medicine and Endocrinology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - J Jaime Miranda
- CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Antonio Bernabe Ortiz
- CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Krisela Steyn
- Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Yangfeng Wu
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China; Peking University Clinical Research Institute, Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
| | - Denis Xavier
- St. John's Medical College and Research Institute, St. John's National Academy of Health Sciences, Bangalore, India
| | - Lijing L Yan
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China; Duke Global Health Institute and Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Jiang He
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Adolfo Rubinstein
- Centro de Excelencia en Salud Cardiovascular para el Cono Sur, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| |
Collapse
|
|
34
|
The diminishing socioeconomic disparity in obesity in a Chinese population with rapid economic development: analysis of serial cross-sectional health survey data 2002-2010. BMC Public Health 2015; 15:1282. [PMID: 26701626 PMCID: PMC4690286 DOI: 10.1186/s12889-015-2654-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 12/19/2015] [Indexed: 12/21/2022] Open
Abstract
Background Social changes and economic development are associated with obesity epidemic. This study is to investigate the trends of socio-economic disparity in obesity from 2002 to 2010 in a Chinese population experiencing the world’s fastest economic development. Methods Four standardized surveys were conducted in a population of 85 million residents in Guangdong, China between 2002 and 2010. Multistage random cluster sampling was used to recruit representative samples. Information on socio-economic status (SES), proxied by education, occupation and residential area, was collected by face-to-face interviews. The weight, height and waist circumference of the participants were also measured. Results Women with low education had an increased BMI of 0.85 kg/m2, while women with high education had a decreased BMI of 0.16 kg/m2 (p = 0.032 for interaction test). Similar trends were observed by using occupation and residential area as the SES indicators. Analysis in men yielded similar patterns. Waist circumference increased from 73.7 to 78.4 cm, and the increasing trends of statistical significance (p < 0.01) were observed in both genders and across all SES levels, with the magnitudes of increase in low SES levels being more pronounced. The impact of gradient in food attainment and occupational physical activity across the SES levels may wear off with further economic development, while factors such as health awareness, diet pattern and leisure activity may become increasingly important in driving the disparity. Conclusion The impact of gradient in food attainment and occupational physical activity across the SES levels may wear off with further economic development, while factors such as health awareness, diet pattern and leisure activity may become increasingly important in driving the disparity. Our findings suggest that health education should focus on the disadvantaged populations on health awareness for adopting healthier diet pattern and increasing physical activity.
Collapse
|
|
35
|
Knowledge, Treatment, Control, and Risk Factors for Hypertension among Adults in Southern Iran. Int J Hypertens 2015; 2015:897070. [PMID: 26783454 PMCID: PMC4689970 DOI: 10.1155/2015/897070] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 10/22/2015] [Accepted: 11/02/2015] [Indexed: 11/17/2022] Open
Abstract
Hypertension is the first and the most common risk factor to diseases such as cardiovascular, stroke, and renal diseases. The aim of this study was to determine the factors relevant to hypertension knowledge, treatment, and control in southern Iran. In this cross-sectional study, conducted in Kohgiluye Boyer-Ahmad province, south of Iran, a total of 1836 hypertension patients were randomly selected to participate voluntarily in the study. Hypertension treatment and its control were defined during study. In addition, knowledge about hypertension was measured by hypertension knowledge level scale (HK-LS). Treatment rates were 75.5 and 37.7 percent for female and male, respectively. Habitat, education, income, family history with hypertension, smoking, and time of diagnosis to the disease were found to be related to the treatment of the disease. Control rates were 30.7 and 31.4 for males and females, respectively. Habitat, education, and time of diagnosis to the disease were related to control. Over 50 percent of patients had average knowledge on hypertension. Considering the low rate of control and knowledge on hypertension among patients, health care providers should reinforce their services to improve appropriate knowledge level among elders and, also, plan comprehensive programs to promote health in order to encourage patients change and reform their life style.
Collapse
|
|
36
|
Wang Z, Peng X, Li M, Jin F, Zhang B, Wang H, Wei Y. Is human cytomegalovirus infection associated with essential hypertension? A meta-analysis of 11,878 participants. J Med Virol 2015; 88:852-8. [PMID: 26399974 DOI: 10.1002/jmv.24391] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2015] [Indexed: 01/08/2023]
Affiliation(s)
- Zuoguang Wang
- Department of Hypertension; Beijing Anzhen Hospital; Capital Medical University; Beijing Institute of Heart, Lung, Blood Vessel Diseases; Beijing P.R. China
| | - Xiaoyun Peng
- Department of Hypertension; Beijing Anzhen Hospital; Capital Medical University; Beijing Institute of Heart, Lung, Blood Vessel Diseases; Beijing P.R. China
| | - Mei Li
- Department of Hypertension; Beijing Anzhen Hospital; Capital Medical University; Beijing Institute of Heart, Lung, Blood Vessel Diseases; Beijing P.R. China
| | - Fei Jin
- Department of Hypertension; Beijing Anzhen Hospital; Capital Medical University; Beijing Institute of Heart, Lung, Blood Vessel Diseases; Beijing P.R. China
| | - Bei Zhang
- Department of Hypertension; Beijing Anzhen Hospital; Capital Medical University; Beijing Institute of Heart, Lung, Blood Vessel Diseases; Beijing P.R. China
| | - Hao Wang
- Department of Hypertension; Beijing Anzhen Hospital; Capital Medical University; Beijing Institute of Heart, Lung, Blood Vessel Diseases; Beijing P.R. China
| | - Yongxiang Wei
- Department of Hypertension; Beijing Anzhen Hospital; Capital Medical University; Beijing Institute of Heart, Lung, Blood Vessel Diseases; Beijing P.R. China
| |
Collapse
|
|
37
|
Trends in Prevalence, Awareness, Treatment and Control of Hypertension during 2001-2010 in an Urban Elderly Population of China. PLoS One 2015; 10:e0132814. [PMID: 26241049 PMCID: PMC4524712 DOI: 10.1371/journal.pone.0132814] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 06/18/2015] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE As the most important risk factors of cardiovascular disease, pre-hypertension and hypertension are important public health challenges. Few studies have focused on the trends of pre-hypertension and hypertension specifically for the aging population in China. Given the anticipated growth of the elderly population in China, there is an urgent need to document the conditions of pre-hypertension and hypertension in this aging population. METHODS We conducted two cross-sectional surveys of Chinese adults aged ≥60 years in 2001 and 2010. A total of 2,272 (943 males, 1,329 females) and 2,074 (839 males, 1,235 females) participants were included in the two surveys, respectively. RESULTS The age- and sex-standardized prevalence of hypertension significantly increased from 60.1% to 65.2% from the 2001 to the 2010 survey. Among the participants with hypertension, the awareness, treatment and control of hypertension all significantly increased from 69.8% to 74.5%, 50.3% to 63.7%, and 15.3% to 30.3%, respectively, from 2001 to 2010. A logistic regression showed that a higher education level, a higher BMI, a family history of hypertension and doctor-diagnosed cardiovascular disease were significantly associated with hypertension awareness and treatment. CONCLUSION Hypertension prevalence increased rapidly between the years surveyed. Although the awareness, treatment and control of hypertension improved significantly, the values of these variables remained low. More attention should be given to the elderly because the population is aging worldwide, and urgent action, optimal treatment approaches and proper public health strategies must be taken to prevent and manage hypertension.
Collapse
|
|
38
|
Mi B, Dang S, Li Q, Zhao Y, Yang R, Wang D, Yan H. Association Between Awareness of Hypertension and Health-Related Quality of Life in a Cross-Sectional Population-Based Study in Rural Area of Northwest China. Medicine (Baltimore) 2015; 94:e1206. [PMID: 26200639 PMCID: PMC4603002 DOI: 10.1097/md.0000000000001206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Hypertensive patients have more complex health care needs and are more likely to have poorer health-related quality of life than normotensive people. The awareness of hypertension could be related to reduce health-related quality of life. We propose the use of quantile regression to explore more detailed relationships between awareness of hypertension and health-related quality of life. In a cross-sectional, population-based study, 2737 participants (including 1035 hypertensive patients and 1702 normotensive participants) completed the Short-Form Health Survey. A quantile regression model was employed to investigate the association of physical component summary scores and mental component summary scores with awareness of hypertension and to evaluate the associated factors. Patients who were aware of hypertension (N = 554) had lower scores than patients who were unaware of hypertension (N = 481). The median (IQR) of physical component summary scores: 48.20 (13.88) versus 53.27 (10.79), P < 0.01; the mental component summary scores: 50.68 (15.09) versus 51.70 (10.65), P = 0.03. adjusting for covariates, the quantile regression results suggest awareness of hypertension was associated with most physical component summary scores quantiles (P < 0.05 except 10th and 20th quantiles) in which the β-estimates from -2.14 (95% CI: -3.80 to -0.48) to -1.45 (95% CI: -2.42 to -0.47), as the same significant trend with some poorer mental component summary scores quantiles in which the β-estimates from -3.47 (95% CI: -6.65 to -0.39) to -2.18 (95% CI: -4.30 to -0.06). The awareness of hypertension has a greater effect on those with intermediate physical component summary status: the β-estimates were equal to -2.04 (95% CI: -3.51 to -0.57, P < 0.05) at the 40th and decreased further to -1.45 (95% CI: -2.42 to -0.47, P < 0.01) at the 90th quantile. Awareness of hypertension was negatively related to health-related quality of life in hypertensive patients in rural western China, which has a greater effect on mental component summary scores with the poorer status and on physical component summary scores with the intermediate status.
Collapse
Affiliation(s)
- Baibing Mi
- From the Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an (BM, SD, QL, YZ, HY); Department of Cardiovascular Diseases, Hanzhong People's Hospital, Hanzhong, Shaanxi, People's Republic of China (RY); and Department of Clinical Sciences, Liverpool School of Tropical Medicine Pembroke Place, Liverpool, L3 5QA, UK (DW)
| | | | | | | | | | | | | |
Collapse
|
|
39
|
Chinese herbal therapy and Western drug use, belief and adherence for hypertension management in the rural areas of Heilongjiang province, China. PLoS One 2015; 10:e0123508. [PMID: 25923438 PMCID: PMC4414607 DOI: 10.1371/journal.pone.0123508] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 03/04/2015] [Indexed: 12/02/2022] Open
Abstract
Background Traditional Chinese medicine (TCM) including Chinese herbal therapy has been widely practiced in China. However, little is known about Chinese herbal therapy use for hypertension management, which is one of the most prevalent chronic conditions in China. Thus we described Chinese herbal therapy and western drug users, beliefs, hypertension knowledge, and Chinese herbal and western drug adherence and determinants of Chinese herbal therapy use among patients with hypertension in rural areas of Heilongjiang Province, China. Methodology and Principal Findings This face-to-face cross sectional survey included 665 hypertensive respondents aged 30 years or older in rural areas of Heilongjiang Province, China. Of 665 respondents, 39.7% were male, 27.4% were aged 65 years or older. At the survey, 14.0% reported using Chinese herbal therapy and 71.3% reported using western drug for hypertension management. A majority of patients had low level of treatment adherence (80.6% for the Chinese herbal therapy users and 81.2% for the western drug users). When respondents felt that their blood pressure was under control, 72.0% of the Chinese herbal therapy users and 69.2% of the western drug users sometimes stopped taking their medicine. Hypertensive patients with high education level or better quality of life are more likely use Chinese herbal therapy. Conclusions and Significance Majority of patients diagnosed with hypertension use western drugs to control blood pressure. Chinese herbal therapy use was associated with education level and quality of life.
Collapse
|
|
40
|
Li G, Hu H, Dong Z, Xie J, Zhou Y. Urban and suburban differences in hypertension trends and self-care: three population-based cross-sectional studies from 2005-2011. PLoS One 2015; 10:e0117999. [PMID: 25665069 PMCID: PMC4322055 DOI: 10.1371/journal.pone.0117999] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 01/03/2015] [Indexed: 11/24/2022] Open
Abstract
Objectives This study aimed to compare hypertension trends in the urban and suburban population, and to examine the use of several self-care behaviors among patients who were aware of their hypertension. Methods We examined the data from three cross-sectional adult populations obtained in 2005, 2008, and 2011, in Beijing. Results Our analyses indicated that from 2005 to 2011 the standardized rate of hypertension increased from 31.9% to 36.0% (P <0.001) among urban adults, and was relatively stable (40.8% -40.2%) among suburban adults (P = 0.02). About 10% of the patients reported having taken measures to control their weight for hypertension management. As compared to the other patients, the female patients in the urban areas reported the highest rate of regular BP measurement (52.6%). In addition, the patients who reported taking medication regularly increased among the males and females. Most of the women reported nonsmoking (≥95%) and alcohol abstinence (≥90%). The trend of nonsmoking decreased among the urban males. In contrast, the prevalence of nonsmoking increased among the suburban males, though the trend was not statistically significant (P = 0.055). Further, the patient-reported alcohol abstinence was found to exhibit a decreasing trend among the males. Conclusions We observed an increase in the hypertension prevalence from 2005 to 2011. The rates remained higher for suburban adults than for urban adults. Females generally had better self-care ability as compared to male patients. Further research is needed to promote self-care behaviors in hypertensive patients, especially for male patients.
Collapse
Affiliation(s)
- Gang Li
- Institute of Chronic Diseases Control and Prevention, Beijing Center for Diseases Control and Prevention, Beijing, China
- * E-mail:
| | - Huanhuan Hu
- Lab of Exercise Epidemiology, Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Zhong Dong
- Institute of Chronic Diseases Control and Prevention, Beijing Center for Diseases Control and Prevention, Beijing, China
| | - Jin Xie
- Institute of Chronic Diseases Control and Prevention, Beijing Center for Diseases Control and Prevention, Beijing, China
| | - Ying Zhou
- Institute of Chronic Diseases Control and Prevention, Beijing Center for Diseases Control and Prevention, Beijing, China
| |
Collapse
|
|
41
|
Chen X, Du H, Zhang J, Chen X, Luo G, Que X, Zhang N, Bian Z, Guo Y, Li L, Chen Z, Wu X. Adiposity and blood pressure among 55 000 relatively lean rural adults in southwest of China. J Hum Hypertens 2015; 29:522-9. [PMID: 25652532 PMCID: PMC4537884 DOI: 10.1038/jhh.2014.129] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 12/08/2014] [Accepted: 12/10/2014] [Indexed: 11/09/2022]
Abstract
Obesity is a strong determinant of blood pressure. Uncertainty remains, however, about which indices of adiposity most strongly predict blood pressure, particularly among those who were relatively lean, such as those from rural China. We analyzed cross-sectional data on 55 687 (38.3% men) participants aged 30–79 years who were enrolled into the China Kadoorie Biobank from a rural county in southwest of China during 2004–2008. Measured body mass index (BMI) and waist circumference (WC) were related to blood pressure in multivariable linear regression analyses. The overall mean values of BMI, WC, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 23.3 kg m−2, 78.0 cm, 129.2 mm Hg and 77.2 mm Hg, respectively. There was a strongly positive, and apparently linear, relationship of BMI and WC with blood pressure, with 1 s.d. higher BMI associated with 4.3/2.3 mm Hg higher SBP/DBP and 1 s.d. WC associated with 3.8/2.1 mm Hg (P<0.0001). Additional adjustment for WC only slightly attenuated the association of BMI with blood pressure, whereas additional adjustment for BMI almost completely eliminated the association of WC with blood pressure. Our findings suggest that in relatively lean Chinese adults, general adiposity is more strongly assciated with blood pressure than central adiposity.
Collapse
Affiliation(s)
- X Chen
- 1] West China School of Public Health, Sichuan University, Sichuan Province, China [2] Sichuan Provincial Center of Disease Prevention and Control, Sichuan Province, China
| | - H Du
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - J Zhang
- West China School of Public Health, Sichuan University, Sichuan Province, China
| | - X Chen
- Pengzhou Center of Disease Prevention and Control, Sichuan Province, China
| | - G Luo
- Pengzhou Center of Disease Prevention and Control, Sichuan Province, China
| | - X Que
- Pengzhou Center of Disease Prevention and Control, Sichuan Province, China
| | - N Zhang
- Sichuan Provincial Center of Disease Prevention and Control, Sichuan Province, China
| | - Z Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Y Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - L Li
- 1] Chinese Academy of Medical Sciences, Beijing, China [2] School of Public Health, Peking University, Beijing, China
| | - Z Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - X Wu
- Sichuan Provincial Center of Disease Prevention and Control, Sichuan Province, China
| |
Collapse
|
|
42
|
Ke L, Ho J, Feng J, Mpofu E, Dibley MJ, Li Y, Feng X, Van F, Lau W, Brock KE. Prevalence, awareness, treatment and control of hypertension in Macau: results from a cross-sectional epidemiological study in Macau, China. Am J Hypertens 2015; 28:159-65. [PMID: 25063734 DOI: 10.1093/ajh/hpu121] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Awareness of hypertension, as well as its prevalence, treatment, and control status, has not been comprehensively investigated in Macau Special Administrative Region (SAR), China. METHODS A survey was conducted on a randomly sampled population of 1,410 participants (n = 638 men) aged 18-93 years in 2012. Blood pressure was individually measured twice. Awareness, treatment, and control of hypertension were assessed by interview-administered questionnaire. RESULTS Prevalence of hypertension was 34% in Macau, similar to the United States (30%) and United Kingdom (31%). Among hypertensives, 69% were aware of their condition, 59% were treated, and 30% were adequately controlled. Older age (≥50 years; odds ratio (OR) = 5.3; 95% confidence interval (CI) = 4.6-6.1), being of the male sex (OR = 2.2; 95% CI = 1.9-2.5), having retired (OR = 2.0; 95% CI = 1.8-2.3), being married (OR = 1.5; 95% CI = 1.3-1.9), having a low level of education in women (OR = 1.5; 95% CI = 1.1-2.1), Pinteraction = 0.01), and lack of salt awareness (OR = 1.1; 95% CI = 1.0-1.3) were associated with hypertension. Older age, having retired, and being married were also associated with higher awareness and treatment rates. Those who were older and married were better controlled. These demographic factors differed by sex. Those who had some knowledge of salt intake were more likely to have higher hypertension awareness, treatment, and control rates. CONCLUSIONS The prevalence of hypertension in Macau in 2012 has increased compared with 2006 (28%) and is comparable with prevalence rates in developed countries. Specific health promotion campaigns related to knowledge of risk factors such as salt intake and smoking may be useful for hypertension prevention and to improve hypertension awareness, treatment, and control rates.
Collapse
Affiliation(s)
- Liang Ke
- Macau Hypertension Alliance, Macau SAR, China; Discipline of Behavioural and Social Sciences in Health Faculty of Health Science, University of Sydney, Sydney, Australia
| | - Jacky Ho
- Macau Hypertension Alliance, Macau SAR, China
| | | | - Elias Mpofu
- Discipline of Rehabilitation Counselling, Faculty of Health Science, University of Sydney, Sydney, Australia
| | - Michael J Dibley
- School of Public Health, Faculty of Medicine, University of Sydney, Sydney, Australia
| | - Yan Li
- Department of the Joint Program in Survey Methodology, University of Maryland, College Park, Maryland
| | - Xiuhua Feng
- Macau Hypertension Alliance, Macau SAR, China
| | - Florance Van
- Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Winne Lau
- Macau and the Union General of Community Association, Macau SAR, China
| | - Kaye E Brock
- Discipline of Behavioural and Social Sciences in Health Faculty of Health Science, University of Sydney, Sydney, Australia;
| |
Collapse
|
|
43
|
Cheng NYI, Wong MYE. Knowledge and Attitude of School Teachers towards Promoting Healthy Lifestyle to Students. Health (London) 2015. [DOI: 10.4236/health.2015.71014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
|
44
|
Do HTP, Geleijnse JM, Le MB, Kok FJ, Feskens EJM. National prevalence and associated risk factors of hypertension and prehypertension among Vietnamese adults. Am J Hypertens 2015; 28:89-97. [PMID: 24862960 DOI: 10.1093/ajh/hpu092] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Hypertension has recently been identified as the leading risk factor for global mortality. This study aims to present the national prevalence of hypertension and prehypertension and, their determinants in Vietnamese adults. METHODS Nationally representative data were obtained from the National Adult Overweight Survey 2005. This one visit survey included 17,199 subjects aged 25-64 years, with a mean body mass index (BMI) of 20.7 kg/m(2). RESULTS The overall census-weighted JNC7 (the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure) defined prevalence of hypertension was 20.7% (95% confidence interval (CI) = 19.4-22.1); the prevalence of prehypertension was 41.8% (95% CI = 40.4-43.1). Hypertension and prehypertension were more prevalent in men. Higher age, overweight, alcohol use (among men), and living in rural areas (among women) were independently associated with a higher prevalence of hypertension, whereas higher physical activity and education level were inversely associated. Age, BMI, and living in rural areas were independently associated with an increased prevalence of prehypertension. Among the hypertensives, 25.9% were aware of their hypertension, 12.2% were being treated, and 2.8% had their blood pressure under control; among the treated hypertensives, 32.4% had their blood pressure controlled. CONCLUSIONS Hypertension and prehypertension are prevalent in Vietnam, but awareness, treatment, and control are low. The findings suggest that lifestyle modifications, including the prevention of overweight, the promotion of physical activity particularly in urban areas, and the reduction of high alcohol consumption, may help to prevent hypertension in Vietnam. Furthermore, increased efforts regarding education, detection, and treatment could be important in management of hypertension and cardiovascular disease risk prevention.
Collapse
Affiliation(s)
- Ha T P Do
- Department of Community Nutrition, National Institute of Nutrition, Hanoi, Vietnam; Division of Human Nutrition; Wageningen University, Wageningen, The Netherlands.
| | - Johanna M Geleijnse
- Division of Human Nutrition; Wageningen University, Wageningen, The Netherlands
| | - Mai B Le
- Department of Community Nutrition, National Institute of Nutrition, Hanoi, Vietnam
| | - Frans J Kok
- Division of Human Nutrition; Wageningen University, Wageningen, The Netherlands
| | - Edith J M Feskens
- Division of Human Nutrition; Wageningen University, Wageningen, The Netherlands
| |
Collapse
|
|
45
|
Wang J, Zhang L, Wang F, Liu L, Wang H. Prevalence, awareness, treatment, and control of hypertension in China: results from a national survey. Am J Hypertens 2014; 27:1355-61. [PMID: 24698853 DOI: 10.1093/ajh/hpu053] [Citation(s) in RCA: 298] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Hypertension is one of the major risk factor for cardiovascular disease worldwide. The objective of this study was to investigate the prevalence, awareness, treatment, and control of hypertension in China. METHODS A multistage, stratified sampling method was used to obtain a representative sample of persons aged 18 years or older in the general population of China. Blood pressure (BP) was measured by sphygmomanometer 3 times at 5-minute intervals. Hypertension was defined as a systolic BP ≥ 140mm Hg, or diastolic BP ≥ 90mm Hg, or self-reported use of antihypertensive medications in the last 2 weeks irrespective of the BP. RESULTS Altogether 50,171 subjects finished the survey across the entire country. The adjusted prevalence of hypertension was 29.6% (95% confidence interval (CI) = 28.9%-30.4%) and was higher among men than among women (31.2%, 95% CI = 30.1%-32.4%; vs. 28.0%, 95% CI = 27.0%-29.0%). The awareness, treatment among all hypertensive participants, control among all hypertensive participants, and control among treated hypertensive participants were 42.6%, 34.1%, 9.3%, and 27.4%, respectively. Multiple lifestyle factors were independently associated with presence of hypertension, including physical inactivity, habitual drinking, chronic use of nonsteroidal anti-inflammatory drugs, high body mass index, and central obesity. CONCLUSIONS Hypertension is an important public health burden in China, and control of hypertension is still suboptimal. Several modifiable lifestyle activities were associated with hypertension and thus should be considered potential targets for intervention, with special attention to socioeconomically disadvantaged subpopulations in China.
Collapse
Affiliation(s)
- Jinwei Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China; Peking University Institute of Nephrology, Peking University Health Science Center, Beijing, China
| | - Luxia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China; Peking University Institute of Nephrology, Peking University Health Science Center, Beijing, China;
| | - Fang Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China; Peking University Institute of Nephrology, Peking University Health Science Center, Beijing, China
| | - Lisheng Liu
- Beijing Hypertension League Institute, Beijing, China
| | - Haiyan Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China; Peking University Institute of Nephrology, Peking University Health Science Center, Beijing, China;
| |
Collapse
|
|
46
|
Lao XQ, Ma WJ, Sobko T, Zhang YH, Xu YJ, Xu XJ, Yu DM, Nie SP, Cai QM, Wei XL, Xia L, Wong MCS. Dramatic escalation in metabolic syndrome and cardiovascular risk in a Chinese population experiencing rapid economic development. BMC Public Health 2014; 14:983. [PMID: 25240739 PMCID: PMC4247017 DOI: 10.1186/1471-2458-14-983] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 09/16/2014] [Indexed: 12/27/2022] Open
Abstract
Background Metabolic syndrome (MetSyn) increases the incidence of cardiovascular disease. Information on changes in prevalence of MetSyn in developing countries is limited. This study aims to compare MetSyn prevalence and its associated vascular risk over the period between 2002 and 2010 in a population which has had the world’s fastest economic development over the past three decades. Methods Two health surveys were conducted by using the multistage cluster random sampling method in a Chinese population of 85 million in southern China. The participants received a full medical check-up, including measurement of blood pressure (BP), obesity indices, fasting lipids and glucose levels. Data describing socio-economic status and lifestyle factors were also collected through interview. Metabolic syndrome was defined in accordance with the International Diabetes Federation criteria. Results A total of 3,561 participants from Survey 2010 were included in the data analysis. Women had a significantly higher prevalence of MetSyn than men. Comparison between the two surveys shows that age-standardized prevalence of MetSyn increased fourfold (from 5.4% in 2002 to 21.3% in 2010) in those ≧ 20 years. Among the MetSyn components, prevalence of hyperglycaemia has increased most (from 9.1% to 53.1%). The age-standardized prevalence of central obesity, hypertension, hypertriglyceridaemia and low HDL-cholesterol increased from 13.5% to 25.4%, from 23.6% to 40.8%, from 12.1% to 17.4% and from 32.1% to 71.1%, respectively. Differences between rural and urban residents in the prevalence in MetSyn and its components narrowed in 2010. Conclusions Cardiovascular risk escalated dramatically in this population between 2002 and 2010. The escalation may relate to the rapid economic development, which led to accelerating changes in nutrition, lifestyle, and socio-economic status. Our findings suggest that health transition in rapidly developing second- and third-world countries may be much faster than what has been observed in Western countries.
Collapse
Affiliation(s)
| | | | | | - Yong Hui Zhang
- Center for Disease Control and Prevention of Guangdong Province, 160, Qun Xian Road Pan Yu District Guangzhou, China.
| | | | | | | | | | | | | | | | | |
Collapse
|
|
47
|
Overall obesity is leveling-off while abdominal obesity continues to rise in a Chinese population experiencing rapid economic development: analysis of serial cross-sectional health survey data 2002-2010. Int J Obes (Lond) 2014; 39:288-94. [PMID: 24858655 DOI: 10.1038/ijo.2014.95] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 04/14/2014] [Accepted: 05/15/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Obesity epidemic is related to industrialization and urbanization that have lead to changes in nutrition, lifestyle and socio-economic status. However, information on the trajectory of the obesity epidemic in populations experiencing rapid economic development is limited. We therefore investigate trends in obesity from 2002 to 2010 in a southern Chinese population experiencing world's fastest economic development. METHODS Between 2002 and 2010 four standardized surveys were conducted in a population of 85 million residents in Guangdong, China. Multistage cluster sampling was adopted to recruit representative samples. Weight, height and waist circumference of the participants were measured in a standardized way. The analysis included residents aged between 18 and 69 years. The number of participants included in the present analysis for Surveys conducted in 2002, 2004, 2007 and 2010 were 13058, 7646, 6441 and 8575, respectively. RESULTS From year 2002 to 2010, the age-standardized Body mass index (BMI) insignificantly changed from 21.7 kg m(-2) to 22.3 kg m(-2), and the prevalence of overweight and overall obesity from 15.8 to 16.6% (both P>0.05). The age-standardized waist circumference increased from 73.7 to 78.4 cm, and prevalence of abdominal obesity increased from 12.9 to 23.7% (both P<0.001). In urban areas, BMI and overall obesity changed little during the 8-year period (BMI increased from 22.6 to 22.7 kg m(-2) and overall obesity changed from 23.7 to 21.4%), whereas there were slight increases of the same in rural areas (BMI increased from 20.8 to 22.1 kg m(-2)and overall obesity increased from 8.2 to 13.3%). Waist circumference and abdominal obesity increased significantly in both areas, but the increase was more pronounced in rural areas (in urban area, waist circumference increased from 75.1 to 78.5 cm and abdominal obesity from 16.8 to 26.5%; in rural area, waist circumference from 72.2 to 78.3 and abdominal obesity from 8.8 to 22.0%). CONCLUSIONS BMI and overall obesity in this population, which has experienced the world's fastest economic development over the past three decades, has been leveling-off, while waist circumference and abdominal obesity, independent predictors of cardiovascular risk, have continued to rise. Our findings suggest that obesity epidemic transition in rapidly developing populations may be much faster than what has been observed in Western countries.
Collapse
|
|
48
|
Feng XL, Pang M, Beard J. Health system strengthening and hypertension awareness, treatment and control: data from the China Health and Retirement Longitudinal Study. Bull World Health Organ 2014; 92:29-41. [PMID: 24391298 PMCID: PMC3865551 DOI: 10.2471/blt.13.124495] [Citation(s) in RCA: 143] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 08/13/2013] [Accepted: 08/17/2013] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To monitor hypertension prevalence, awareness, treatment and control in China two to three years after major reform of the health system. METHODS Data from a national survey conducted in 2011-2012 among Chinese people aged 45 years or older - which included detailed anthropometric measurements - were used to estimate the prevalence of hypertension and the percentages of hypertensive individuals who were unaware of, receiving no treatment for, and/or not controlling their hypertension well. Modified Poisson regressions were used to estimate relative risks (RRs). FINDINGS At the time of the survey, nearly 40% of Chinese people aged 45 years or older had a hypertensive disorder. Of the individuals with hypertension, more than 40% were unaware of their condition, about 50% were receiving no medication for it and about 80% were not controlling it well. Compared with the other hypertensive individuals, those who were members of insurance schemes that covered the costs of outpatient care were more likely to be aware of their hypertension (adjusted RR, aRR: 0.737; 95% confidence interval, CI: 0.619-0.878) to be receiving treatment for it (aRR: 0.795; 95% CI: 0.680-0.929) and to be controlling it effectively (aRR: 0.903; 95% CI: 0.817-0.996). CONCLUSION In China many cases of hypertension are going undetected and untreated, even though the health system appears to deliver effective care to individuals who are aware of their hypertension. A reduction in the costs of outpatient care to patients would probably improve the management of hypertension in China.
Collapse
Affiliation(s)
- Xing Lin Feng
- Department of Health Policy and Administration, School of Public Health, Peking University, Beijing, 100191, China
| | - Mingfan Pang
- Department of Health Policy and Administration, School of Public Health, Peking University, Beijing, 100191, China
| | - John Beard
- Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland
| |
Collapse
|
|
49
|
Jin CN, Yu CM, Sun JP, Fang F, Wen YN, Liu M, Lee APW. The healthcare burden of hypertension in Asia. HEART ASIA 2013; 5:238-43. [PMID: 27326143 DOI: 10.1136/heartasia-2013-010408] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 10/05/2013] [Accepted: 10/29/2013] [Indexed: 01/11/2023]
Abstract
As the leading global risk for mortality, hypertension (HT) is a common healthcare problem in the world. The total number of patients with HT is likely to grow in the next few decades as the population age and the prevalence of obesity and diabetes increase. HT, as a major modifiable risk factor for cardiovascular disease, results in more deaths than any other risk factors, including diabetes and cigarette smoking. High prevalence, inadequate awareness, suboptimal treatment and low rate of achieving guideline-recommended target blood pressure control are key factors leading to severe cardiovascular complications that impose a heavy socioeconomic burden, especially in developing countries. Asia is the world's largest and most populous continent with approximately 4.3 billion people, hosting 60% of the world's current human population, and has a high growth rate. Asia differs very widely from the West with regard to ethnic groups, cultures, environments, economics, historical ties and government systems. Therefore, the purpose of this review is to comprehensively summarise the epidemiology, treatment practice and the status of control of HT in different Asian countries in order to guide the future prevention and management in this part of the world.
Collapse
Affiliation(s)
- Chun-Na Jin
- Division of Cardiology, Department of Medicine and Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, NT , Hong Kong
| | - Cheuk-Man Yu
- Division of Cardiology, Department of Medicine and Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, NT , Hong Kong
| | - Jing-Ping Sun
- Division of Cardiology, Department of Medicine and Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, NT , Hong Kong
| | - Fang Fang
- Division of Cardiology, Department of Medicine and Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, NT , Hong Kong
| | - Yong-Na Wen
- Division of Cardiology, Department of Medicine and Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, NT , Hong Kong
| | - Ming Liu
- Division of Cardiology, Department of Medicine and Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, NT , Hong Kong
| | - Alex Pui-Wai Lee
- Division of Cardiology, Department of Medicine and Therapeutics , Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, NT , Hong Kong
| |
Collapse
|
|
50
|
Lao XQ, Xu YJ, Wong MCS, Zhang YH, Ma WJ, Xu XJ, Cai QM, Xu HF, Wei XL, Tang JL, Griffiths SM. Hypertension prevalence, awareness, treatment, control and associated factors in a developing southern Chinese population: analysis of serial cross-sectional health survey data 2002-2010. Am J Hypertens 2013; 26:1335-45. [PMID: 23846723 DOI: 10.1093/ajh/hpt111] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate trends in the distribution, prevalence, awareness, treatment, and control of hypertension in a Chinese population that has had the fastest growing gross domestic product in the world over the past 3 decades. METHODS Four standardized cross-sectional health surveys were conducted between 2002 and 2010 in a population consisting of 85 million residents in Guangdong Province. Multistage cluster sampling was adopted to recruit representative samples. The data were obtained through on-site health examinations and face-to-face interviews. RESULTS The aging trend in this population was not significant (P = 0.17) during the survey period, whereas body mass index/waist circumference increased significantly (P = 0.047 for body mass index and P < 0.001 for waist circumference). The age-standardized prevalence of hypertension increased from 10.5% to 13.3%, averaging a 0.35% increase per year. A higher risk was observed in younger residents over the survey period. Awareness and treatment increased by 22.0% and 19.0%, respectively, in the rural areas, whereas there was no significant change in the urban area (the corresponding figures were 1.8% and -3.1%, respectively). There was no improvement in hypertension control (the age-standardized control prevalence in 2002 was 50.3%, whereas it was 43.2% in 2010). CONCLUSIONS The prevalence of hypertension increased slightly in this population with the fastest economic development. This increase mirrored the trend of increasing obesity. Awareness and treatment of hypertension have improved in the rural areas, although there were no significant changes in the urban areas. The prevalence of awareness and treatment remains at unacceptably low levels, suggesting that urgent and aggressive strategies are necessary to improve hypertension control and intervention.
Collapse
Affiliation(s)
- Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong; Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
| | - Yan Jun Xu
- Guangdong Institute of Public Health, Guangzhou, China
| | - Martin Chi Sang Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong
| | - Yong Hui Zhang
- Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China
| | - Wen Jun Ma
- Guangdong Institute of Public Health, Guangzhou, China; Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China.
| | - Xiao Jun Xu
- Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China
| | - Qiu Mao Cai
- Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China
| | - Hao Feng Xu
- Center for Disease Control and Prevention of Guangdong Province, Guangzhou, China
| | - Xiao Lin Wei
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong
| | - Jin Ling Tang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong
| | - Sian Meryl Griffiths
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong
| |
Collapse
|