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Lamloum D, Fassio F, Osetinsky B, Tediosi F. Care Cascades for Hypertension in Low-Income Settings: A Systematic Review and Meta-Analysis. Int J Public Health 2023; 68:1606428. [PMID: 37901590 PMCID: PMC10600349 DOI: 10.3389/ijph.2023.1606428] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Objective: High blood pressure is the leading risk factor for cardiovascular disease. The hypertension care cascade (HCC) is increasingly being used to evaluate the effectiveness of interventions. This systematic review aims to examine HCC in low-income settings. Methods: The search strategy included articles published between January 2010 and April 2023. We excluded studies with incomplete HCC, on fragile patients or aged <18 years, reviews. We used the MOOSE guideline. Five researchers retrieved data on the survey year, country, population, HCC and diagnostic methods for hypertension. We used JBI Critical Appraisal Tools for quality assessment. Results: Ninety-five articles were analyzed. Average hypertension prevalence was 33% (95% CI: 31%-34%), lower in LICs than in LMICs (25% vs. 34%). The overall mean awareness of hypertension was 48% (95% CI: 45%-51%), its treatment was 35% (95% IC: 32%-38%) and its control 16% (95% CI: 14%-18%). In almost all steps, percentages were lower in LICs and in Sub-Saharan Africa. Conclusion: Trends in HCC vary between countries, with poorer performance in LICs. This review highlights the need for interventions tailored to low-income settings in order to improve hypertension care.
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Affiliation(s)
- Demetrio Lamloum
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Bern, Switzerland
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Federico Fassio
- Department of Public Health, Experimental and Forensic Medicine, Section of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, Italy
| | - Brianna Osetinsky
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Fabrizio Tediosi
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Elnaem MH, Mosaad M, Abdelaziz DH, Mansour NO, Usman A, Elrggal ME, Cheema E. Disparities in Prevalence and Barriers to Hypertension Control: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114571. [PMID: 36361453 PMCID: PMC9655663 DOI: 10.3390/ijerph192114571] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/16/2022] [Accepted: 10/31/2022] [Indexed: 05/29/2023]
Abstract
Controlling hypertension (HTN) remains a challenge, as it is affected by various factors in different settings. This study aimed to describe the disparities in the prevalence and barriers to hypertension control across countries of various income categories. Three scholarly databases-ScienceDirect, PubMed, and Google Scholar-were systematically examined using predefined search terms to identify potentially relevant studies. Original research articles published in English between 2011 and 2022 that reported the prevalence and barriers to HTN control were included. A total of 33 studies were included in this systematic review. Twenty-three studies were conducted in low and middle-income countries (LMIC), and ten studies were from high-income countries (HIC). The prevalence of hypertension control in the LMIC and HIC studies ranged from (3.8% to 50.4%) to (36.3% to 69.6%), respectively. Concerning barriers to hypertension control, patient-related barriers were the most frequently reported (n = 20), followed by medication adherence barriers (n = 10), lifestyle-related barriers (n = 8), barriers related to the affordability and accessibility of care (n = 8), awareness-related barriers (n = 7), and, finally, barriers related to prescribed pharmacotherapy (n = 6). A combination of more than one category of barriers was frequently encountered, with 59 barriers reported overall across the 33 studies. This work reported disparities in hypertension control and barriers across studies conducted in LMIC and HIC. Recognizing the multifactorial nature of the barriers to hypertension control, particularly in LMIC, is crucial in designing and implementing customized interventions.
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Affiliation(s)
- Mohamed Hassan Elnaem
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia
- Quality Use of Medicines Research Group, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia
| | - Manar Mosaad
- Department of Internal Medicine, Ministry of Health, Alexandria Governorate 5517176, Egypt
| | - Doaa H Abdelaziz
- Pharmacy Practice & Clinical Pharmacy Department, Faculty of Pharmacy, Future University in Egypt, Cairo 4740011, Egypt
| | - Noha O. Mansour
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Mansoura University, Mansoura 7650030, Egypt
| | - Abubakar Usman
- Discipline of Clinical Pharmacy, Universiti Sains Malaysia, Penang 11800, Malaysia
| | | | - Ejaz Cheema
- School of Pharmacy, University of Management and Technology, Lahore 54770, Pakistan
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Turé R, Damasceno A, Djicó M, Lunet N. Prevalence, awareness, treatment, and control of hypertension in Bissau, Western Africa. J Clin Hypertens (Greenwich) 2022; 24:358-361. [PMID: 35172025 PMCID: PMC8925014 DOI: 10.1111/jch.14443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/10/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022]
Abstract
Hypertension is the leading preventable risk factor for cardiovascular diseases. In Guinea–Bissau there are no previous population‐based hypertension surveys. Therefore, the authors aimed to estimate the prevalence, awareness, treatment, and control of high blood pressure among adults living in Bissau. A sample (n = 973) of dwellers in Bissau, aged 18–69 years, was assembled through stratified and cluster sampling. Patients underwent face‐to‐face interviews and blood pressure measurements following the World Health Organization Stepwise Approach to Chronic Disease Risk Factor Surveillance. The prevalence of hypertension was 26.9%, and 51.4% of hypertensive individuals were aware of their condition, of whom 51.8% reported having received pharmacological treatment in the previous 2 weeks. Among the latter, 49.9% had blood pressure values below 140/90 mm Hg. These findings show that hypertension has become a major public health problem in Guinea‐Bissau, emphasizing the urgent need to develop and implement national strategies for the prevention and management of hypertension.
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Affiliation(s)
- Ruben Turé
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, Porto, 4050-600, Portugal.,Instituto de Saúde Pública da Universidade do Porto, Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas 135, Porto, 4050-600, Portugal
| | - Albertino Damasceno
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, Porto, 4050-600, Portugal.,Instituto de Saúde Pública da Universidade do Porto, Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas 135, Porto, 4050-600, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, 4200-319, Portugal.,Faculdade de Medicina, Universidade Eduardo Mondlane, 3453 Avenida Julius Nyerere, Maputo, Moçambique
| | - Mouhammed Djicó
- CCM - Comissão de Coordenação Multissetorial de luta contra a TB, Rua Marien N'Gouabi, Rua Marien N'Gouabi, S/N, atrás do CMI de Bissau, Bissau, Guinea-Bissau.,CNEPS - Comité Nacional de Ética em Pesquisa na Saúde, Avenida Combatente da Liberdade da Pátria, Avenida Combatente da Liberdade de Pátria, Hospital "3 de Agosto", Bissau, Guinea-Bissau
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, Porto, 4050-600, Portugal.,Instituto de Saúde Pública da Universidade do Porto, Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas 135, Porto, 4050-600, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Prof. Hernâni Monteiro, Porto, 4200-319, Portugal
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Sarfo FS, Mobula LM, Burnham G, Ansong D, Plange-Rhule J, Sarfo-Kantanka O, Ofori-Adjei D. Factors associated with uncontrolled blood pressure among Ghanaians: Evidence from a multicenter hospital-based study. PLoS One 2018; 13:e0193494. [PMID: 29554106 PMCID: PMC5858765 DOI: 10.1371/journal.pone.0193494] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 02/12/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The burden of uncontrolled hypertension in Low-and-Middle Income Countries (LMICs) is high, with an increased risk of cardiovascular diseases and chronic renal failure in these settings. OBJECTIVE To assess the factors associated with uncontrolled blood pressure control in a cross-section of Ghanaian hypertensive subjects involved in an on-going multicenter epidemiological study aimed at improving access to hypertension treatment. METHODS A cross-sectional study involving 2,870 participants with hypertension with or without diabetes who were enrolled at 5 hospitals in Ghana (2 tertiary, 2 district and 1 rural hospital). Data on demographics, medical history, lifestyle factors, anti-hypertensive medications and treatment adherence were collected. The 14-item version of the Hill-Bone compliance to high blood pressure therapy scale was used to assess adherence to treatment in 3 domains namely adherence to medications, salt intake and clinic appointments. Questionnaires on knowledge, attitudes and practices on hypertension, sources of antihypertensive medications and challenges with accessing these medications were also administered. Blood pressure, weight and height were measured for each subject at enrollment. Factors associated with uncontrolled blood pressure (>140/90mmHg) were assessed using a multivariate logistic regression model. RESULTS The mean ± SD age of study participants was 58.9 ± 16.6 years, with a female preponderance (76.8%). Among study participants, 1,213 (42.3%) study participants had blood pressure measurements under control. Factors that remained significantly associated with uncontrolled blood pressure with adjusted OR (95% CI) included receiving therapy at a tertiary level of care: 2.47 (1.57-3.87), longer duration of hypertension diagnosis: 1.01 (1.00-1.03), poor adherence to therapy: 1.21 (1.09-1.35) for each 5 points higher score on the Hill-Bone scale, reported difficulties in obtaining antihypertensive medications: 1.24 (1.02-1.49) and number of antihypertensive medications prescribed: 1.32 (1.21-1.44). CONCLUSION We have found high rates of uncontrolled blood pressure among Ghanaian patients with hypertension accessing healthcare in public institutions. The system-level and individual-level factors associated with poor blood pressure control should be addressed to improve hypertension management among Ghanaians.
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Affiliation(s)
- Fred Stephen Sarfo
- Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- * E-mail:
| | - Linda M. Mobula
- Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Gilbert Burnham
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Daniel Ansong
- Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Osei Sarfo-Kantanka
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - David Ofori-Adjei
- Department of Medicine & Therapeutics, University of Ghana School of Medicine and Dentistry, Accra, Ghana
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Accessing clinical services and retention in care following screening for hypertension and diabetes among Malawian adults: an urban/rural comparison. J Hypertens 2017; 34:2172-9. [PMID: 27552644 DOI: 10.1097/hjh.0000000000001070] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Interventions to impact on the burden of chronic noncommunicable diseases, such as hypertension and diabetes, include screening of asymptomatic adults, but little is known about the subsequent course of clinical care. We report on the uptake of referral for clinical assessment and retention in care, following a large urban/rural population screening program in Malawi. METHODS Adult residents were screened for raised blood pressure and raised fasting blood glucose at a demographic surveillance site in rural Karonga District and in urban Area 25, Lilongwe with well supported chronic care clinics. Successful uptake was defined as presenting for clinical assessment within 6 weeks of referral, and nonattenders were followed at home. Logistic regression was used to examine association of uptake with demographic and clinical factors. Retention was assessed using survival analysis techniques. RESULTS A total of 27 305 participants were screened for hypertension and diabetes between May 2013 and September 2015. Of these, 4075 (14.9%) were referred for suspected hypertension (3640), diabetes (172), or both (263). Among those referred, 2480 (60.9%), reported for clinical assessment. Factors associated with uptake of care included being female, rural residency, older age, unemployment, prior medication, and diabetes. Retention, for those enrolled in care following a formal clinical assessment, was associated with the final diagnosis following clinical assessment, rural residency, and older age. CONCLUSION Screening for hypertension and diabetes identifies large numbers of individuals who need further clinical assessment, but strategies are needed to ensure better linkage and retention into care.
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Duboz P, Boëtsch G, Gueye L, Macia E. Hypertension in the Ferlo (Northern Senegal): prevalence, awareness, treatment and control. Pan Afr Med J 2017; 25:177. [PMID: 28292139 PMCID: PMC5326029 DOI: 10.11604/pamj.2016.25.177.10105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 07/25/2016] [Indexed: 11/27/2022] Open
Abstract
Introduction The aim of this article is to assess prevalence, awareness, treatment and control of hypertension in rural Senegal (Sahelian Ferlo region). Methods This study was carried out in 2015 on a population sample of 500 individuals living in the municipality of Tessekere, constructed using the quota method. Sociodemographic characteristics, hypertension, hypertension awareness, treatment and control, and body mass index of individuals were collected during face-to-face interviews. Statistical analyses used were Chi-square tests and binary logistic regressions. Results Prevalence of hypertension was 31.40%. Prevalence of awareness, treatment and control among hypertensives, were 43.31%, 24.84% and 11.46% respectively. Logistic regression showed that the prevalence and awareness of hypertension increased with age. Overweight and obese subjects were more often hypertensive, but did not differ from others in awareness and treatment. Conclusion Given the very high prevalence of hypertension in the region, a strategic approach to prevent and control hypertension is critically needed.
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Affiliation(s)
- Priscilla Duboz
- UMR 7268 ADèS, Téssékéré international Human-Environment Observatory, Aix-Marseille Université/EFS/CNRS, Faculté de Médecine Secteur Nord Boulevard Pierre Dramard, 13955 Marseille cedex 15, France
| | - Gilles Boëtsch
- UMI 3189 Environnement, Santé, Sociétés CNRS/Université Cheikh Anta Diop/Université de Bamako/CNRST, Laboratoire de Physiologie Exploratoire et Fonctionnelle, Faculté de Médecine de Dakar, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Lamine Gueye
- UMI 3189 Environnement, Santé, Sociétés CNRS/Université Cheikh Anta Diop/Université de Bamako/CNRST, Laboratoire de Physiologie Exploratoire et Fonctionnelle, Faculté de Médecine de Dakar, Université Cheikh Anta Diop, Dakar, Sénégal
| | - Enguerran Macia
- UMI 3189 Environnement, Santé, Sociétés CNRS/Université Cheikh Anta Diop/Université de Bamako/CNRST, Laboratoire de Physiologie Exploratoire et Fonctionnelle, Faculté de Médecine de Dakar, Université Cheikh Anta Diop, Dakar, Sénégal
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Haplotype-based, case–control study of the receptor (calcitonin) activity-modifying protein (RAMP) 1 gene in essential hypertension. J Hum Hypertens 2017; 31:361-365. [DOI: 10.1038/jhh.2016.96] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 08/13/2016] [Accepted: 09/19/2016] [Indexed: 12/16/2022]
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Macia E, Gueye L, Duboz P. Hypertension and Obesity in Dakar, Senegal. PLoS One 2016; 11:e0161544. [PMID: 27622534 PMCID: PMC5021383 DOI: 10.1371/journal.pone.0161544] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 08/08/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Cardiovascular disease is a major public health problem in many sub-Saharan African countries, but data on the main cardiovascular risk factors-hypertension and obesity-are almost nonexistent in Senegal. The aims of this study were therefore (i) to report the prevalence, awareness, treatment and control of hypertension among adults in Dakar, (ii) to assess the prevalence of general and central obesity, and (iii) to analyze the association between hypertension and general and central obesity. METHODS A cross-sectional survey was carried out in 2015 on a representative sample of 1000 dwellers of the Senegalese capital aged 20-90. RESULTS The overall prevalence of hypertension was 24.7%. Among hypertensive respondents, 28.4% were aware of their condition; 16.0% were on antihypertensive medication; 4.9% had controlled blood pressure. The frequency of doctor visits was a significant predictor of awareness (OR = 2.16; p<0.05) and treatment (OR = 2.57; p<0.05) of hypertension. The prevalence of underweight, overweight and general obesity were 12.6%, 19.2% and 9.7% respectively. The prevalence of central obesity was 26% by WC and 39.8% by WHtR. General obesity and central obesity by WHtR significantly predicted HTN among men and women, but not central obesity by WC. CONCLUSIONS This study has demonstrated a high prevalence of hypertension in Dakar and a high prevalence of obesity among women-particularly among older women. The awareness, treatment, and effective control of hypertension are unacceptably low. The blood pressure of women with general obesity, and men with central obesity, in the community should be monitored regularly to limit the burden of cardiovascular disease in Senegal.
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Affiliation(s)
- Enguerran Macia
- UMI 3189 Environnement, santé, sociétés (CNRS / Université Cheikh Anta Diop / Université de Bamako / CNRST Burkina-Faso), Faculté de Médecine, de Pharmacie et d’Odontostomatologie, Dakar, Senegal
| | - Lamine Gueye
- UMI 3189 Environnement, santé, sociétés (CNRS / Université Cheikh Anta Diop / Université de Bamako / CNRST Burkina-Faso), Faculté de Médecine, de Pharmacie et d’Odontostomatologie, Dakar, Senegal
| | - Priscilla Duboz
- UMR 7268 Anthropologie, Droit, Ethique et Santé (CNRS / Aix-Marseille Université / EFS), Faculté de Médecine, Secteur Nord, CS 80011, Marseille Cedex 15, France
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Baldo MP, Zaniqueli DA, Magalhães P, Capingana DP, Silva AB, Mill JG. Gender-specific determinants of blood pressure elevation in Angolan adults. Blood Press 2016; 26:9-17. [PMID: 27177194 DOI: 10.1080/08037051.2016.1179500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Hypertension affects African-American adults more than any other ethnic group in the US. However, some of the black populations living outside Africa are well adapted to food and lifestyle. We aimed to describe the clinical characteristics underlying the gender-specific determinants of BP and the risk of hypertension in public-sector workers living in Angola. MATERIALS AND METHODS 609 volunteers (48% men) were included in this cross-sectional and descriptive study. Demographic, socioeconomic and life style data were collected during an interview. Systolic BP (SBP) and diastolic BP (DBP) were measured, along with some anthropometric and clinical variables. RESULTS The prevalence of hypertension is 45.2% without difference between genders. Obesity was more prevalent in women (29.2% vs. 8.9%, p < 0.05). The age-related increment in SBP is higher in women (14.2 ± 1.1 vs 9.5 ± 1.3 mmHg/decade, p < 0.05). In men, age, BMI, cholesterol and LDLc/HDLc explained 21, 4, 2.5 and 2.9% of SBP variability, respectively. In women, age, BMI and HC explain 27, 2 and 1% of SBP variability, respectively. The risk for hypertension is 5 × high among men aged ≥45 years, and 3.5× in those having BMI ≥25. Women aged 45 years or older have 8 × risk of hypertension and 2× the risk by having BMI ≥25. CONCLUSIONS We found that advanced age (≥45) and overweight/obesity (BMI ≥25) are the main risk factors for hypertension in adults from Angola. However, our data suggest that age and BMI may have different influence on increasing BP in men and women.
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Affiliation(s)
- Marcelo P Baldo
- a Department of Physiological Sciences , Federal University of Espírito Santo , Vitória , ES , Brazil.,b Department of Pathophysiology , Montes Claros State University - UNIMONTES , Montes Claros , MG , Brazil
| | - Divanei A Zaniqueli
- a Department of Physiological Sciences , Federal University of Espírito Santo , Vitória , ES , Brazil
| | - Pedro Magalhães
- a Department of Physiological Sciences , Federal University of Espírito Santo , Vitória , ES , Brazil.,c Department of Physiology, Faculty of Medicine , University Agostinho Neto , Luanda , Angola
| | - Daniel P Capingana
- a Department of Physiological Sciences , Federal University of Espírito Santo , Vitória , ES , Brazil.,c Department of Physiology, Faculty of Medicine , University Agostinho Neto , Luanda , Angola
| | - Amilcar B Silva
- a Department of Physiological Sciences , Federal University of Espírito Santo , Vitória , ES , Brazil.,c Department of Physiology, Faculty of Medicine , University Agostinho Neto , Luanda , Angola
| | - José Geraldo Mill
- a Department of Physiological Sciences , Federal University of Espírito Santo , Vitória , ES , Brazil
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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: 4.9] [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.
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Sarki AM, Nduka CU, Stranges S, Kandala NB, Uthman OA. Prevalence of Hypertension in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Medicine (Baltimore) 2015; 94:e1959. [PMID: 26683910 PMCID: PMC5058882 DOI: 10.1097/md.0000000000001959] [Citation(s) in RCA: 206] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/09/2015] [Accepted: 10/13/2015] [Indexed: 11/26/2022] Open
Abstract
We aimed to obtain overall and regional estimates of hypertension prevalence, and to examine the pattern of this disease condition across different socio-demographic characteristics in low-and middle-income countries. We searched electronic databases from inception to August 2015. We included population-based studies that reported hypertension prevalence using the current definition of blood pressure ≥140/90 mm Hg or self-reported use of antihypertensive medication. We used random-effects meta-analyses to pool prevalence estimates of hypertension, overall, by World Bank region and country income group. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. A total of 242 studies, comprising data on 1,494,609 adults from 45 countries, met our inclusion criteria. The overall prevalence of hypertension was 32.3% (95% confidence interval [CI] 29.4-35.3), with the Latin America and Caribbean region reporting the highest estimates (39.1%, 95% CI 33.1-45.2). Pooled prevalence estimate was also highest across upper middle income countries (37.8%, 95% CI 35.0-40.6) and lowest across low-income countries (23.1%, 95% CI 20.1-26.2). Prevalence estimates were significantly higher in the elderly (≥65 years) compared with younger adults (<65 years) overall and across the geographical regions; however, there was no significant sex-difference in hypertension prevalence (31.9% vs 30.8%, P = 0.6). Persons without formal education (49.0% vs 24.9%, P < 0.00001), overweight/obese (46.4% vs 26.3%, P < 0.00001), and urban settlers (32.7% vs 25.2%, P = 0.0005) were also more likely to be hypertensive, compared with those who were educated, normal weight, and rural settlers respectively. This study provides contemporary and up-to-date estimates that reflect the significant burden of hypertension in low- and middle-income countries, as well as evidence that hypertension remains a major public health issue across the various socio-demographic subgroups. On average, about 1 in 3 adults in the developing world is hypertensive. The findings of this study will be useful for the design of hypertension screening and treatment programmes in low- and middle-income countries.
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Affiliation(s)
- Ahmed M Sarki
- From the Division of Health Sciences, University of Warwick Medical School, Coventry, UK (AMS, CUN); Family and Youth Health Initiative (FAYOHI), Nigeria (AMS); Department of Population Health, Luxembourg Institute of Health, Luxembourg (SS, N-BK); Warwick-Centre for Applied Health Research and Delivery (WCAHRD), Division of health Sciences, University of Warwick Medical School, Coventry, UK (OAU); and Centre for Applied Health Research and Delivery (CAHRD), Liverpool School of Tropical Medicine, International Health Group, Liverpool, UK (OAU); Department of Mathematics and Information sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, UK (N-BK)
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An overview of the nutrition transition in West Africa: implications for non-communicable diseases. Proc Nutr Soc 2014; 74:466-77. [PMID: 25529539 DOI: 10.1017/s0029665114001669] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The nutrition landscape in West Africa has been dominated by the programmes to address undernutrition. However, with increasing urbanisation, technological developments and associated change in dietary patterns and physical activity, childhood and adult overweight, and obesity are becoming more prevalent. There is an evidence of increasing intake of dietary energy, fat, sugars and protein. There is low consumption of fruit and vegetables universally in West Africa. Overall, the foods consumed are predominantly traditional with the component major food groups within recommended levels. Most of the West African countries are at the early stages of nutrition transition but countries such as Cape Verde, Ghana and Senegal are at the latter stages. In the major cities of the region, children consume energy-dense foods such as candies, ice cream and sweetened beverages up to seven times as frequently as fruit and vegetables. Adult obesity rates have increased by 115 % in 15 years since 2004. In Ghana, the prevalence of overweight/obesity in women has increased from 12·8 % in 1993 to 29·9 % in 2008. In Accra, overweight/obesity in women has increased from 62·2 % in 2003 to 64·9 % in 2009. The age-standardised proportion of adults who engage in adequate levels of physical activity ranges from 46·8 % in Mali to 94·7 % in Benin. The lingering stunting in children and the rising overweight in adults have resulted to a dual burden of malnutrition affecting 16·2 % of mother-child pairs in Cotonou. The prevalence of hypertension has been increased and ranges from 17·6 % in Burkina Faso to 38·7 % in Cape Verde. The prevalence is higher in the cities: 40·2 % in Ougadougou, 46·0 % in St Louis and 54·6 % in Accra. The prevalence of diabetes ranges from 2·5 to 7·9 % but could be as high as 17·9 % in Dakar, Senegal. The consequences of nutrition transition are not only being felt by the persons in the high socioeconomic class, but also in cities such as Accra and Ouagadougou, where at least 19 % of adults from the poorest households are overweight and 19-28 % have hypertension. Concerted national action involving governments, partners, private sector and civil society is needed to re-orient health systems and build capacity to address the dual burden of malnutrition, to regulate the food and beverage industry and to encourage healthy eating throughout the life course.
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Duboz P, Touré M, Hane F, Macia E, Coumé M, Bâ A, Boëtsch G, Guèye L, Chapuis-Lucciani N. [Ageing and chronic diseases in Senegal. A comparison between rural (Ferlo) and urban (Dakar) populations]. ACTA ACUST UNITED AC 2014; 108:25-31. [PMID: 25256252 DOI: 10.1007/s13149-014-0397-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 07/22/2014] [Indexed: 11/25/2022]
Abstract
The objectives of this study were: to compare the prevalence of hypertension, overweight and obesity in rural (Ferlo) and urban (Dakar) Senegalese populations aged 50 and over. The survey was conducted on individuals aged 50 and older living in the rural area (N=478) and in the urban area (N=220). We have collected data about age, gender, marital status, education level, and knowledge, treatment of hypertension, height, weight and blood pressure. We have observed that overweight and obesity were more prevalent in the urban area (Dakar) than in the rural one (Ferlo). The risk of overweight or obesity decreased when age increased, and women had weight problems more often than men. The prevalence of arterial hypertension was lower in rural area (55.86%) than in Dakar (66.36%), but increased at an older age. However, the logistic regression showed that these increased proportion of hypertension in Dakar is linked to the more important proportion of overweight and obese people in this area. Moreover, rates of knowledge, treatment and control of hypertension are particularly low in the rural area of Senegal. In conclusion, age-associated diseases should be better managed in Senegal, particularly in rural areas.
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Affiliation(s)
- P Duboz
- Faculté de médecine secteur Nord, UMR 7268 ADES, CNRS/Aix-Marseille Université/EFS, Boulevard Pierre Dramard, Marseille, France.
- Observatoire hommes-milieux international Téssékéré, Dakar, Sénégal.
| | - M Touré
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
| | - F Hane
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
| | - E Macia
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
| | - M Coumé
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
| | - A Bâ
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
| | - G Boëtsch
- Observatoire hommes-milieux international Téssékéré, Dakar, Sénégal
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
| | - L Guèye
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
| | - N Chapuis-Lucciani
- Unité mixe internationale 3189, environnement, santé, sociétés, CNRS-CNRST-USTTB-UCAD-UGB, Université Cheikh Anta Diop, Faculté de médecine, BP 5005, Dakar, Sénégal
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JIANG B, LIU H, RU X, ZHANG H, WU S, WANG W. Hypertension detection, management, control and associated factors among residents accessing community health services in Beijing. Sci Rep 2014; 4:4845. [PMID: 24784167 PMCID: PMC4007080 DOI: 10.1038/srep04845] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 04/11/2014] [Indexed: 01/13/2023] Open
Abstract
The aim of this study was to analyse high blood pressure detection, management, control and associated factors among residents accessing community health services (CHSs) in Beijing. We screened for HBP in 9524 individuals aged 50 years or older who accessed care in four Beijing CHSs. Among the 9397 residents with questionnaire responses that qualified them for inclusion in the study, 5029 patients with HBP were identified, 1510 (i.e., 30% of the HBP patient group) of whom were newly identified cases. The rate of hypertension detection was 53.5%. Among the 5029 HBP patients, the rates of awareness, treatment and control of hypertension were 70.0%, 62.1% and 29.6%, respectively. In general, the rate of hypertension control was higher when the rates of hypertension awareness and treatment were higher in subgroups stratified by different sociodemographic and risk factors, except for the overweight and obesity subgroups. In conclusion, suboptimal HBP awareness, treatment, and control are still major problems confronting CHSs in Beijing. Control of hypertension in the population may be improved by increasing awareness and improving the treatment of hypertension in CHSs.
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Affiliation(s)
- Bin JIANG
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Hongmei LIU
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xiaojuan RU
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Hui ZHANG
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Shengping WU
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Wenzhi WANG
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
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