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Islam SMS, Daryabeygi-Khotbehsara R, Ghaffari MP, Uddin R, Gao L, Xu X, Siddiqui MU, Livingstone KM, Siopis G, Sarrafzadegan N, Schlaich M, Maddison R, Huxley R, Schutte AE. Burden of Hypertensive Heart Disease and High Systolic Blood Pressure in Australia from 1990 to 2019: Results From the Global Burden of Diseases Study. Heart Lung Circ 2023; 32:1178-1188. [PMID: 37743220 DOI: 10.1016/j.hlc.2023.06.853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/23/2023] [Accepted: 06/28/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND There is a dearth of comprehensive studies examining the burden and trends of hypertensive heart disease (HHD) and high systolic blood pressure (SBP) among the Australian population. We aimed to explore the burden of HHD and high SBP, and how they changed over time from 1990 to 2019 in Australia. METHODS We analysed data from the Global Burden of Disease study in Australia. We assessed the prevalence, mortality, disability-adjusted life-years (DALY), years lived with disability (YLD) and years of life lost (YLL) attributable to HHD and high SBP. Data were presented as point estimates with 95% uncertainty intervals (UI). We compared the burden of HHD and high SBP in Australia with World Bank defined high-income countries and six other comparator countries with similar sociodemographic characteristics and economies. RESULTS From 1990 to 2019, the burden of HHD and high SBP in Australia reduced. Age standardised prevalence rate of HHD was 119.3 cases per 100,000 people (95% UI 86.6-161.0) in 1990, compared to 80.1 cases (95% UI 57.4-108.1) in 2019. Deaths due to HDD were 3.4 cases per 100,000 population (95% UI 2.6-3.8) in 1990, compared to 2.5 (95% UI 1.9-3.0) in 2019. HHD contributed to 57.2 (95% UI 46.6-64.7) DALYs per 100,000 population in 1990 compared to 38.4 (95% UI 32.0-45.2) in 2019. Death rates per 100,000 population attributable to high SBP declined significantly over time for both sexes from 1990 (155.6 cases; 95% UI 131.2-177.0) to approximately one third in 2019 (53.8 cases; 95% UI 43.4-64.4). Compared to six other countries in 2019, the prevalence of HHD was highest in the USA (274.3%) and lowest in the UK (52.6%), with Australia displaying the third highest prevalence. Australia ranked second in term of lowest rates of deaths and third for lowest DALYs respectively due to high SBP. From 1990-2019, Australia ranked third best for reductions in deaths and DALYs due to HHD and first for reductions in deaths and DALYs due to high SBP. CONCLUSION Over the past three decades, the burden of HHD in Australia has reduced, but its prevalence remains relatively high. The contribution of high SBP to deaths, DALYs and YLLs also reduced over the three decades.
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Affiliation(s)
| | | | | | - Riaz Uddin
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Vic, Australia
| | - Lan Gao
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Vic, Australia
| | - Xiaoyue Xu
- School of Population Health, University of New South Wales, Sydney, NSW, Australia; The George Institute for Global Health, Sydney, NSW, Australia
| | - Muhammad Umer Siddiqui
- Department of Internal Medicine, Thomas Jefferson University Hospital Philadelphia, PA, USA
| | | | - George Siopis
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Vic, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Markus Schlaich
- Dobney Hypertension Centre, Medical School-Royal Perth Hospital Unit, The University of Western Australia, Perth, WA, Australia
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Vic, Australia
| | - Rachel Huxley
- Faculty of Health, Deakin University, Geelong, Vic, Australia
| | - Aletta E Schutte
- School of Population Health, University of New South Wales, Sydney, NSW, Australia; The George Institute for Global Health, Sydney, NSW, Australia
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Carnagarin R, Nolde JM, Yang J, Marques FZ, Picone DS, Lambert GW, Beaney T, Poulter NR, Schutte AE, Reid CM, Brockman D, Schlaich MP. Stagnating rates of blood pressure control in Australia: insights from opportunistic screening of 10 046 participants of the May Measurement Month campaigns. J Hypertens 2023; 41:632-637. [PMID: 36723455 DOI: 10.1097/hjh.0000000000003379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Raised blood pressure (BP) remains the single most important modifiable risk factor contributing to cardiovascular and all-cause mortality in Australia and worldwide. May Measurement Month , a global BP measurement and screening campaign initiated by the International Society of Hypertension and carried out in Australia since its inception in 2017, aimed at obtaining standardized BP measurements from members of the community to increase awareness of high BP and its associated risks. METHOD Adults participants (≥18 years) were recruited through opportunistic sampling across Australia during the month of May in 2017, 2018 and 2019. Trained volunteers recorded BP readings in a standardized manner and collected data on demographic, lifestyle factors and comorbidities. Hypertension was defined as SBP of at least 140 mmHg, or DBP of at least 90 mmHg, or taking antihypertensive medication. Data were collated centrally and analysis was carried out using regression models to evaluate the associations between BP and participant characteristics. RESULTS A total of 10 046 participants were screened, of whom 3097 (31.0%) had hypertension, only 48.5% were aware of their condition and 44.4% were taking antihypertensive medication. Of those taking antihypertensive medication, 53.2% were controlled to less than 140/90 mmHg, whereas the remaining 46.8% of participants had BP of at least 140/90 mmHg suggestive of inadequately treated hypertension. CONCLUSION Consecutive data obtained over a 3-year period in Australia demonstrated stagnating awareness, treatment and control rates with the latter two being substantially lower than global rates and those in other high-income countries. Concerted efforts from all stakeholders will be required to help overcome the unacceptably poor rates of BP treatment and control in Australia.
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Affiliation(s)
- Revathy Carnagarin
- Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit/Royal Perth Hospital Research Foundation, University of Western Australia, Perth, Western Australia
| | - Janis M Nolde
- Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit/Royal Perth Hospital Research Foundation, University of Western Australia, Perth, Western Australia
| | - Jun Yang
- Department of Medicine, Endocrine Hypertension Group, Hudson Institute of Medical Research
| | - Francine Z Marques
- Hypertension Research Laboratory, School of Biological Sciences, Monash University
- Heart Failure Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria
| | - Dean S Picone
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania
| | - Gavin W Lambert
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Thomas Beaney
- Department of Primary Care and Public Health
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Aletta E Schutte
- School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, New South Wales
| | - Christopher M Reid
- School of Population Health, Centre of Clinical Research and Education, Curtin University, Bentley
| | - Derrin Brockman
- Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit/Royal Perth Hospital Research Foundation, University of Western Australia, Perth, Western Australia
| | - Markus P Schlaich
- Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit/Royal Perth Hospital Research Foundation, University of Western Australia, Perth, Western Australia
- Departments of Cardiology and Nephrology, Royal Perth Hospital, Perth, Western Australia, Australia
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Carnagarin R, Yang J, Critchley S, Picone D, Tan I, Marques FZ, Cowley D, Fernando M, Beaney T, Trengrove N, Omelczuk S, Poulter NR, Brockman D, Schlaich MP. May Measurement Month 2019: an analysis of blood pressure screening results from Australia. Eur Heart J Suppl 2021; 23:B18-B20. [PMID: 34629990 PMCID: PMC8494053 DOI: 10.1093/eurheartj/suab016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
May Measurement Month (MMM) is an annual global blood pressure (BP) screening
campaign aimed at obtaining standardized BP measurements and other relevant
health information from members of the community to increase awareness of
elevated BP and the associated risks. Adults (≥18 years) were
recruited through opportunistic sampling across the various Australian states
during May 2019. Three BP readings were recorded in a standardized manner for
each participant, and data on lifestyle factors and comorbidities were
collected. Hypertension was defined as a systolic BP ≥140 mmHg,
or a diastolic BP ≥90 mmHg (according to the MMM protocol) or
taking antihypertensive medication. Multiple imputation was used to estimate
participants’ mean BP where three readings were not available. Of the
2877 participants, 901 (31.3%) had hypertension of whom 455
(50.5%) were aware of their condition, and 366 (40.6%) were on
antihypertensive medication. Of those taking antihypertensive medication,
54.3% were controlled to <140/90 mmHg with the remaining
45.7% of participants inadequately treated. Approximately 74% of
treated patients were on a single antihypertensive medication. The MMM campaign
provides an important platform for standardized compilation of BP data and
creation of BP awareness in Australia and other nations worldwide. Data from the
2019 MMM campaign highlight that BP control rates in Australia remain
unacceptably low.
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Affiliation(s)
- Revathy Carnagarin
- Dobney Hypertension Centre, Department of Medicine, Royal Perth Hospital/University of Western Australia, Level 3, MRF Building, Rear 50 Murray St, Perth, Western Australia 6000, Australia
| | - Jun Yang
- Department of Medicine, Monash University, Clayton Victoria 3168, Australia
| | - Sue Critchley
- School of Public Health, Centre of Clinical Research and Education, Curtin University, Bentley WA 6102, Australia
| | - Dean Picone
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania 7000, Australia
| | - Isabella Tan
- Department of Biomedical Sciences, Faculty of Medicine, Macquarie University, Sydney, NSW 2109, Australia
| | - Francine Z Marques
- Hypertension Research Laboratory, School of Biological Sciences, Monash University, Clayton, VIC 3168, Australia.,Heart Failure Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
| | - Diane Cowley
- Endocrine Hypertension Research Centre, University of Queensland Diamantina Institute, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia
| | - Mario Fernando
- Flora Hill Medical Centre, Flora Hill, VIC 3550, Australia
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, London, W12 7RH, UK.,Department of Primary Care and Public Health, Imperial College London, London, W6 8RP, UK
| | - Naomi Trengrove
- School of Health Sciences, University of Notre Dame Australia, Fremantle, WA 6160, Australia
| | - Salima Omelczuk
- School of Health Sciences, University of Notre Dame Australia, Fremantle, WA 6160, Australia
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, London, W12 7RH, UK
| | - Derrin Brockman
- Dobney Hypertension Centre, Department of Medicine, Royal Perth Hospital/University of Western Australia, Level 3, MRF Building, Rear 50 Murray St, Perth, Western Australia 6000, Australia
| | - Markus P Schlaich
- Dobney Hypertension Centre, Department of Medicine, Royal Perth Hospital/University of Western Australia, Level 3, MRF Building, Rear 50 Murray St, Perth, Western Australia 6000, Australia.,Departments of Cardiology and Nephrology, Royal Perth Hospital, Perth WA 6000, Australia
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Blood pressure control in Australian general practice: analysis using general practice records of 1.2 million patients from the MedicineInsight database. J Hypertens 2021; 39:1134-1142. [PMID: 33967217 DOI: 10.1097/hjh.0000000000002785] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Hypertension is mostly managed in primary care. This study investigated the prevalence of diagnosed hypertension in Australian general practice and whether hypertension control is influenced by sociodemographic characteristics, duration since diagnosis or prescription of antihypertensive medications. METHODS Cross-sectional study using a large national database of electronic medical records of patients attending general practice in 2017 (MedicineInsight). RESULTS Of 1.2 million 'regular' patients (one or more consultations per year in every year from 2015 to 2017), 39.8% had a diagnosis of hypertension (95% confidence interval 38.7-40.9). Of these, 85.3% had their blood pressure (BP) recorded in 2017, and 54.9% (95% confidence interval 54.2-55.5) had controlled hypertension (<140/90 mmHg). BP control was lower in females (54.1%) compared with males (55.7%) and in the oldest age group (52.0%), with no differences by socioeconomic status. Hypertension control was lower among 'regular' patients recently diagnosed (6-12 months = 48.6% controlled) relative to those more than 12 months since diagnosis (1-2 years = 53.6%; 3-5 years 55.5%; >5 years = 55.0%). Among recently diagnosed 'regular' patients, 59.2% had no record of being prescribed antihypertensive therapy in the last 6 months of the study, of which 44.3% had controlled hypertension. For those diagnosed more than 5 years ago, 37.4% had no record of being prescribed antihypertensive patients, and 56% had normal BP levels. CONCLUSION Although the prevalence of hypertension varied by socidemographics, there were no differences in BP assessment or control by socioeconomic status. Hypertension control remains a challenge in primary care, and electronic medical records provide an opportunity to assess hypertension management.
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Carnagarin R, Fonseca R, Brockman D, Critchley S, Tan I, Trengove N, Tan K, Lambert GW, Cowley D, Burrell LM, Poulter NR, Beaney T, Ster AC, Xia X, Schlaich MP. May Measurement Month 2018: an analysis of blood pressure screening results from Australia. Eur Heart J Suppl 2020; 22:H17-H19. [PMID: 32884459 PMCID: PMC7455264 DOI: 10.1093/eurheartj/suaa018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
May Measurement Month (MMM), originally initiated as a temporary solution to address the lack of blood pressure (BP) screening programs worldwide, emerged as an effective annual campaign to increase the awareness of hypertension. MMM18, a cross-sectional survey of volunteers aged ≥18 years was carried out during May 2018 predominantly in capital cities across Australia following the standard MMM protocol. Blood pressure screening along with additional information including anthropometric data and responses to questionnaires on demographic, lifestyle, and environmental factors were collected from 3 352 individuals across Australia. After multiple imputation, 1 026 (30.6%) adult Australians had hypertension. Of the 2 936 individuals not on antihypertensive treatment, 610 (20.8%) were hypertensive, and 237 (57.1%) of the 416 individuals receiving antihypertensive treatment had uncontrolled BP. In line with MMM17 results and other previous surveys, MMM18 revealed that close to one-third of the screened population (30.6%) had hypertension, 57.1% of individuals treated with BP-lowering medication remained uncontrolled indicating suboptimal management of the condition in the majority of patients. Most importantly, only 49.0% of those with hypertension were aware of their elevated BP, highlighting lack of awareness of elevated BP in nearly half of the affected population. Elevated BP was directly associated with alcohol consumption, overweight, and obesity. Our findings demonstrate the need for (i) continued efforts to increase BP awareness in the population, (ii) optimization of BP management strategies, and (iii) tackling some of the major contributors to BP elevation, including alcohol consumption and obesity.
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Affiliation(s)
- Revathy Carnagarin
- Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit, University of Western Australia, Level 3, MRF Building, Rear 50 Murray St, Perth, WA, 6000, Australia
| | - Ricardo Fonseca
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Derrin Brockman
- Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit, University of Western Australia, Level 3, MRF Building, Rear 50 Murray St, Perth, WA, 6000, Australia
| | | | | | | | - Kearney Tan
- Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit, University of Western Australia, Level 3, MRF Building, Rear 50 Murray St, Perth, WA, 6000, Australia
| | | | - Diane Cowley
- Princess Alexandra Hospital (Queensland Health), Brisbane, Australia
| | - Louise M Burrell
- Department of Medicine, University of Melbourne, Austin Health, Melbourne, Australia
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, UK
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, UK.,Department of Primary Care and Public Health, Imperial College London
| | - Anca Chis Ster
- Imperial Clinical Trials Unit, Imperial College London, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, UK
| | - Markus P Schlaich
- Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit, University of Western Australia, Level 3, MRF Building, Rear 50 Murray St, Perth, WA, 6000, Australia.,Neurovascular Hypertension & Kidney Disease Laboratory, Alfred & Baker Hypertension Network, Baker Heart and Diabetes Institute, Melbourne, Australia.,Department of Cardiology, Royal Perth Hospital, Perth, Australia.,Department of Nephrology, Royal Perth Hospital, Perth, Australia
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