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Sani RN, Connelly PJ, Toft M, Rowa-Dewar N, Delles C, Gasevic D, Karaye KM. Rural-urban difference in the prevalence of hypertension in West Africa: a systematic review and meta-analysis. J Hum Hypertens 2024; 38:352-364. [PMID: 35430612 PMCID: PMC11001577 DOI: 10.1038/s41371-022-00688-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/16/2022] [Accepted: 03/30/2022] [Indexed: 12/16/2022]
Abstract
Urbanisation is considered a major contributor to the rising prevalence of hypertension in West Africa, yet the evidence regarding rural-urban differences in the prevalence of hypertension in the region has been mixed. A systematic literature search of four electronic databases: PubMed, Embase, African Journals Online, and WHO's African Index Medicus; and reference lists of eligible studies was carried out. Original quantitative studies describing the rural-urban difference in the prevalence of hypertension in one or more countries in West Africa, and published in English language from the year 2000 to 2021 were included. A random effects meta-analysis model was used to estimate the odds ratio of hypertension in rural compared to urban locations. A limited sex-based random effects meta-analysis was conducted with 16 studies that provided sex-disaggregated data. Of the 377 studies screened, 22 met the inclusion criteria (n = 62,907). The prevalence of hypertension was high in both rural, and urban areas, ranging from 9.7% to 60% in the rural areas with a pooled prevalence of 27.4%; and 15.5% to 59.2% in the urban areas with a pooled prevalence of 33.9%. The odd of hypertension were lower in rural compared to urban dwellers [OR 0.74, 95% CI: 0.66-0.83; p < 0.001]. The pooled prevalence of hypertension was 32.6% in males, and 30.0% in females, with no significant difference in the odds of hypertension between the sexes [OR 0.91, 95% CI: 0.8-1.05, p = 0.196]. Comprehensive hypertension control policies are needed for both rural, and urban areas in West Africa, and for both sexes.
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Affiliation(s)
- Ruqayya Nasir Sani
- Department of Medicine, Aminu kano Teaching Hospital, Kano, Nigeria.
- Center for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK.
| | - Paul J Connelly
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Mette Toft
- Center for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Neneh Rowa-Dewar
- Center for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Christian Delles
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Danijela Gasevic
- Center for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kamilu Musa Karaye
- Department of Medicine, Aminu kano Teaching Hospital, Kano, Nigeria
- Bayero University Kano, Kano, Nigeria
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Ibrahim UM, Jibo AM, Muazu S, Zubairu Z, Ringim SU, Namadi FA, Ringim SH, Buba LF, Jalo RI, Tsiga-Ahmed FI, Abdulsalam K, Karkarna MZ. Factors associated with hypertension among adults in high burden kidney disease areas of Jigawa State, Nigeria: A cross-sectional survey. Niger Postgrad Med J 2023; 30:275-284. [PMID: 38037783 DOI: 10.4103/npmj.npmj_214_23] [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] [Indexed: 12/02/2023]
Abstract
Background Hypertension is the leading risk factor for preventable cardiovascular-related complications and mortalities worldwide. Materials and Methods A cross-sectional survey was conducted to assess the prevalence and factors associated with hypertension among 361 adults from four local government areas (LGAs) of Jigawa state identified to have high burden of kidney diseases. The Modified WHO STEPS questionnaire and multi-stage sampling technique were employed and data were analysed using IBM SPSS version 22.0. Results The age of the respondents ranged from 18 to 102 years with a median of 45 (interquartile range = 30-80) years. More than a quarter (34.9%) of the respondents were unemployed. Few reported history of alcohol ingestion (0.8%) and cigarette smoking (1.1%). The prevalence of systolic hypertension was 116 (32.1%), while that of diastolic hypertension was 133 (36.8%). Jahun LGA had higher cases (36.7%) of systolic hypertension, whereas Dutse LGA had higher cases (47.8%) of diastolic hypertension. Systolic hypertension was significantly higher (P < 0.001) among those >35 years of age. The odds of developing systolic hypertension were significantly lower among those between the ages of 18 and 35 years, and those between the ages of 18 and 35 years were less likely to have systolic hypertension than those above the age of 35 years (adjusted odds ratio = 9.0; 95% confidence interval = 4.6-17.6). Similarly, those who reported family history of diabetes and hypertension (P < 0.001) had a significantly higher proportion of systolic hypertension. Conclusions The prevalence of hypertension was alarming in the high burden kidney disease areas. The government should develop a sustainable model for the mass community screening of risk factors and community-based health insurance for the effective management of all identified cases.
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Affiliation(s)
| | - Abubakar Mohammed Jibo
- Department of Community Medicine, Bayero University and Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Salisu Muazu
- Department of Internal Medicine, Federal University Dutse, Dutse, Jigawa, Nigeria
| | - Zahrau Zubairu
- Department of Nursing Science, Hemodialysis Unit, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Saadatu Uba Ringim
- Department of Public Health, Texila American University, Georgetown, Guyana, Niger
| | | | - Sadiq Hassan Ringim
- Department of Internal Medicine, Rasheed Shekoni Teaching Hospital, Dutse, Jigawa, Nigeria
| | - Luka Fitto Buba
- Department of Environmental Management, Bayero University Kano, Kano, Nigeria
| | - Rabiu Ibrahim Jalo
- Department of Community Medicine, Bayero University and Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | - Kabiru Abdulsalam
- Department of Chemical Pathology and Immunology, Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
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Kilama D, Ayella DO, Asiimwe I, Nakibuuka B, Laker F, Bongomin F. Undiagnosed Hypertension Among Market Salespersons in Kitgum Central Market, Northern Uganda. Integr Blood Press Control 2023; 16:37-46. [PMID: 37484203 PMCID: PMC10362878 DOI: 10.2147/ibpc.s402988] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/15/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Hypertension may be common among market salespersons who are mostly physically inactive throughout the day. However, the burden of hypertension in this population remains unknown. In this study, we determined the prevalence of undiagnosed hypertension and associated factors among market salesperson in Kitgum central market, Kitgum district, Northern Uganda. Methods A cross-sectional study, recruiting market salespersons aged 18 years or older without a prior diagnosis of hypertension or currently on anti-hypertensive therapy was conducted. A standardized questionnaire was administered, and body mass index (BMI) estimated. Hypertension was defined as two consistent measurements of systolic blood pressure ≥140mmHg and/or diastolic blood pressure ≥90mmHg measured 4 hours apart. Multivariable logistic regression analysis was performed to determine factors independently associated with undiagnosed hypertension. P<0.05 was considered statistically significant. Results We enrolled 240 participants. The mean age was 39.4 ± 12.8 years. Most (83.3%, n=199) participants were female and urban dwellers (88.3%, n=212). The prevalence of undiagnosed hypertension was 16.7% (n=40). Of the 40 participants with hypertension, 16 (40%) were younger than 40 years. Factors associated with undiagnosed hypertension were, age >50 years (adjusted odds ratio (aOR): 7.0, 95% confidence interval (CI): 1.9-25.6, p=0.003), male gender (aOR: 4.2, 95CI: 1.5-11.1, p=0.005), alcohol consumption (aOR: 2.6, 95CI: 1.1-6.0, p=0.021), and being overweight (aOR: 3.6, 95CI: 1.5-8.8, p=0.005). Conclusion About one in six of market salespersons had undiagnosed hypertension, with a disproportionately high burden among those younger than 40 years. A larger multi-centric study is recommended to confirm our findings.
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Affiliation(s)
- Denish Kilama
- Department of Public Health, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Daniel Okumu Ayella
- Department of Public Health, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Isaac Asiimwe
- Department of Public Health, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Betty Nakibuuka
- Department of Public Health, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Florence Laker
- Department of Public Health, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
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Elias S, Dadi TK. Prevalence of Undiagnosed Hypertension and Associated Factors among Adults in Mizan-Aman Town, Bench Sheko Zone, Southwest Ethiopia: A Community-Based Cross-Sectional Study. Adv Med 2023; 2023:2746284. [PMID: 37469806 PMCID: PMC10352527 DOI: 10.1155/2023/2746284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/27/2023] [Accepted: 06/30/2023] [Indexed: 07/21/2023] Open
Abstract
Objectives This study aimed to assess the prevalence of undiagnosed hypertension and associated factors among people aged 18 years and above in Mizan-Aman town of Bench Sheko Zone in Southwest Ethiopia. Study Design. A community-based cross-sectional study design was carried out among people aged 18 years old and above from April 1 to 30, 2021, in Mizan Aman town. Methods A community-based cross-sectional study design was carried out among people aged 18 years old and above from April 1 to 30, 2021, in Mizan Aman town. Seven hundred fifty-nine subjects were selected by the multistage sampling technique. A structured pretested STEPwise questionnaire was used to interview the participants. Data entry and analysis were done using EpiData 3.1 and SPSS version 25 statistical software, respectively. Descriptive analysis was undertaken, and the results were presented using frequency tables, graphs, and statistical summaries. The dependent variable has a dichotomized response of yes and no, and hence binary logistic regression was used to predict a dependent variable based on independent variables, and predictors having p ≤ 0.25 on the bivariable analysis were considered as candidates for the multivariable analysis. Odds ratios with their 95% confidence intervals were calculated to measure the strength of association, and finally a p value <0.05 was considered statistically significant. Result The prevalence of undiagnosed hypertension was 14.8% with 95% CI [12.3-15.6]. Older age (AOR = 3.1, 95% CI [1.5-6.5]), male (AOR = 2.2, 95% CI [1.3-3.9]), low physical activity (AOR = 3.9, 95% CI [1.8-8.3]), low consumption of fruit and vegetable (AOR = 4.5, 95% CI [2.4-8.8]), and higher BMI (AOR = 2.7, 95% CI [1.6-4.6]) were significantly associated with undiagnosed hypertension. Conclusion The current study outlined that the prevalence of undiagnosed hypertension was high in the study area. In addition, most of the risk factors identified were modifiable, and hence community-based preventive approaches like lifestyle modification, increasing awareness, and strengthening routine screening at primary health service facilities resulted in a substantial change in tackling the burden effectively.
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Affiliation(s)
- Sebsibe Elias
- Public Health Department, College of Health Sciences, Mizan-Aman College of Health Science, Mizan-Aman, Ethiopia
| | - Teshome Kabeta Dadi
- Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Ambaw Kassie G, Alemu A, Yosef Gebrekidan A, Asmare Adella G, Eshetu K, Wolie Asres A, Sisay Asgedom Y. Undiagnosed hypertension and associated factors among adults in ethiopia: a systematic review and meta-analysis. BMC Cardiovasc Disord 2023; 23:278. [PMID: 37244992 PMCID: PMC10225092 DOI: 10.1186/s12872-023-03300-0] [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: 03/17/2023] [Accepted: 05/13/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Hypertension is a major public health problem, resulting in 10 million deaths annually. Undiagnosed hypertension affects more people than ever before. It is more likely to be linked to severe hypertension, which can lead to stroke, cardiovascular disease, and ischemic heart disease. Thus, this systematic review and meta-analysis aimed to synthesize the prevalence of undiagnosed hypertension and its associated factors in Ethiopia. METHODS Databases, such as Medline/PubMed, Google Scholar, Science Direct, AJOL, and the Cochrane Library, were systematically searched to find potential studies published until December 2022. A Microsoft Excel spreadsheet was used to enter the extracted data. The pooled prevalence of undiagnosed hypertension and its associated factors was estimated using a random effect model. I2 statistics and the Cochrane Q-test were used to assess statistical heterogeneity across the studies. Begg's and Egger's tests were performed to identify possible publication bias. RESULTS A total of ten articles with 5,782 study participants were included in this meta-analysis. In the random effects model, the pooled prevalence of undiagnosed hypertension was 18.26% (95% CI = 14.94-21.58). Being older (OR = 3.8, 95% CI = 2.56, 5.66), having a body mass index > 25 kg/m2 (OR = 2.71, 95% CI = 2.1, 3.53), having a family history of hypertension (OR = 2.22, 95% CI = 1.47, 3.36), and having DM comorbidity (OR = 2.44, 95% CI = 1.38, 4.32) were significantly associated with undiagnosed hypertension. CONCLUSION In this meta-analysis, the pooled prevalence of undiagnosed hypertension was found to be high in Ethiopia. Being older, having a BMI > 25 kg/m2, having a family history of hypertension, and having DM comorbidity were found to be risk factors for undiagnosed hypertension.
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Affiliation(s)
- Gizachew Ambaw Kassie
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
| | - Afework Alemu
- School of Medicine, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amanuel Yosef Gebrekidan
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Getachew Asmare Adella
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kirubel Eshetu
- School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Abiyot Wolie Asres
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Yordanos Sisay Asgedom
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Alhawari H, AlShelleh S, Alhawari H, AlRyalat SA, Khanfar AN, Alzoubi O. Prevalence of Undiagnosed Hypertension and Its Predictors in Jordan: A Cross-Sectional Study. Int J Gen Med 2022; 15:7919-7928. [PMID: 36317098 PMCID: PMC9617551 DOI: 10.2147/ijgm.s388121] [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: 08/30/2022] [Accepted: 10/18/2022] [Indexed: 11/04/2022] Open
Abstract
Introduction Hypertension is an important cause of morbidity and mortality worldwide. Undiagnosed hypertension is a serious issue that leads to increased morbidity and mortality. In this study, we aim to identify the prevalence of undiagnosed hypertension in the healthy Jordanian population, as well as identify predictors of high blood pressure readings in presumably healthy Jordanians. Materials and Methods We recruited healthy visitors accompanying patients at our Jordan University Hospital Clinics ranging from 18 to 80 years of age. We measured each participant's systolic and diastolic blood pressure at our outpatient clinics on two different days, one week apart. We also obtained demographic data, weight, height, smoking status, and family history of hypertension and cardiovascular diseases. Results A total of 896 participants were included in this study with a mean age of 48 years. The median of systolic blood pressure readings was 125 mmHg, and the median of diastolic blood pressure readings was 83 mmHg. 38.5% had undiagnosed stage 1 hypertension and 30.5% had undiagnosed stage 2 hypertension according to the American College of Cardiology/American Heart Association guidelines. On the other hand, 25.4% had undiagnosed grade 1 hypertension and 5.1% had undiagnosed grade 2 hypertension according to the European Society of Hypertension guidelines. Conclusion According to the ACC/AHA guidelines, 68.5% of previously healthy Jordanians met the criteria to be diagnosed with hypertension. Predictors of high systolic blood pressure were age, BMI and family history of CAD, while female gender is associated with a lower systolic blood pressure. For diastolic blood pressure, only BMI and family history of CAD were associated with significantly higher diastolic blood pressure, while female gender and exercise were significantly associated with lower diastolic blood pressure.
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Affiliation(s)
- Hussein Alhawari
- Department of Internal Medicine, School of Medicine, the University of Jordan, Amman, Jordan,Correspondence: Hussein Alhawari, Division of Nephrology, Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, 11942, Jordan, Email
| | - Sameeha AlShelleh
- Department of Internal Medicine, School of Medicine, the University of Jordan, Amman, Jordan
| | - Hussam Alhawari
- Department of Internal Medicine, School of Medicine, the University of Jordan, Amman, Jordan
| | - Saif Aldeen AlRyalat
- Department of Special Surgery, School of Medicine, the University of Jordan, Amman, Jordan
| | - Asim N Khanfar
- Department of Internal Medicine, School of Medicine, the University of Jordan, Amman, Jordan
| | - Osama Alzoubi
- Department of Internal Medicine, School of Medicine, the University of Jordan, Amman, Jordan
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Olawepo JO, Ezeanolue EE, Ekenna A, Ogunsola OO, Itanyi IU, Jedy-Agba E, Egbo E, Onwuchekwa C, Ezeonu A, Ajibola A, Olakunde BO, Majekodunmi O, Ogidi AG, Chukwuorji J, Lasebikan N, Dakum P, Okonkwo P, Oyeledun B, Oko J, Khamofu H, Ikpeazu A, Nwokwu UE, Aliyu G, Shittu O, Rositch AF, Powell BJ, Conserve DF, Aarons GA, Olutola A. Building a national framework for multicentre research and clinical trials: experience from the Nigeria Implementation Science Alliance. BMJ Glob Health 2022; 7:bmjgh-2021-008241. [PMID: 35450861 PMCID: PMC9024272 DOI: 10.1136/bmjgh-2021-008241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/25/2022] [Indexed: 01/21/2023] Open
Abstract
There is limited capacity and infrastructure in sub-Saharan Africa to conduct clinical trials for the identification of efficient and effective new prevention, diagnostic and treatment modalities to address the disproportionate burden of disease. This paper reports on the process to establish locally driven infrastructure for multicentre research and trials in Nigeria known as the Nigeria Implementation Science Alliance Model Innovation and Research Centres (NISA-MIRCs). We used a participatory approach to establish a research network of 21 high-volume health facilities selected from all 6 geopolitical zones in Nigeria capable of conducting clinical trials, implementation research using effectiveness-implementation hybrid designs and health system research. The NISA-MIRCs have a cumulative potential to recruit 60 000 women living with HIV and an age-matched cohort of HIV-uninfected women. We conducted a needs assessment, convened several stakeholder outreaches and engagement sessions, and established a governance structure. Additionally, we selected and trained a core research team, developed criteria for site selection, assessed site readiness for research and obtained ethical approval from a single national institutional review board. We used the Exploration, Preparation, Implementation, Sustainment framework to guide our reporting of the process in the development of this network. The NISA-MIRCs will provide a nationally representative infrastructure to initiate new studies, support collaborative research, inform policy decisions and thereby fill a significant research infrastructure gap in Africa’s most populous country.
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Affiliation(s)
- John Olajide Olawepo
- Department of Health Sciences, Northeastern University, Boston, Massachusetts, USA.,Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria
| | - Echezona Edozie Ezeanolue
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria .,Healthy Sunrise Foundation, Las Vegas, Nevada, USA
| | - Adanma Ekenna
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria.,Department of Community Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | | | - Ijeoma Uchenna Itanyi
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria.,Department of Community Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
| | | | - Emmanuel Egbo
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria
| | | | - Alexandra Ezeonu
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria
| | - Abiola Ajibola
- Center for Integrated Health Programs (CIHP), Abuja, FCT, Nigeria
| | - Babayemi O Olakunde
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria.,Department of Community Prevention and Care Services, National Agency for Control of AIDS (NACA), Abuja, FCT, Nigeria
| | | | - Amaka G Ogidi
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria
| | - JohnBosco Chukwuorji
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria.,Department of Psychology, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Nwamaka Lasebikan
- Center for Translation and Implementation Research (CTAIR), University of Nigeria, Nsukka, Enugu, Nigeria.,Oncology Center, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu, Nigeria
| | - Patrick Dakum
- Institute of Human Virology Nigeria, Abuja, FCT, Nigeria
| | | | - Bolanle Oyeledun
- Center for Integrated Health Programs (CIHP), Abuja, FCT, Nigeria
| | - John Oko
- Caritas Nigeria, Abuja, FCT, Nigeria
| | | | - Akudo Ikpeazu
- National AIDS, Viral Hepatitis and Sexually Transmitted Infections Control Programme, Federal Ministry of Health, Abuja, FCT, Nigeria
| | | | - Gambo Aliyu
- National Agency for the Control of AIDS (NACA), Abuja, FCT, Nigeria
| | - Oladapo Shittu
- Federal University of Health Sciences Otukpo, Otukpo, Benue State, Nigeria
| | - Anne F Rositch
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Byron J Powell
- Center for Mental Health Services Research, Brown School at Washington University in St Louis, St Louis, Missouri, USA
| | - Donaldson F Conserve
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Gregory A Aarons
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Ayodotun Olutola
- Center for Clinical Care and Clinical Research, Abuja, FCT, Nigeria
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Guerrero-Díaz DV, Hernández-Vásquez A, Montoya-Rivera WC, Rojas-Roque C, Chacón Díaz MA, Bendezu-Quispe G. Undiagnosed hypertension in Peru: analysis of associated factors and socioeconomic inequalities, 2019. Heliyon 2021; 7:e07516. [PMID: 34296015 PMCID: PMC8282964 DOI: 10.1016/j.heliyon.2021.e07516] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/13/2021] [Accepted: 07/05/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To determine the factors associated and measure the socioeconomic inequalities in people with undiagnosed hypertension in Peru. MATERIALS AND METHODS An observational, cross-sectional, analytical study was performed using data from the 2019 Demographic and Family Health Survey (ENDES, acronym in Spanish) database. The dependent variable was the presence of undiagnosed hypertension (mean systolic blood pressure ≥140 mmHg and/or mean diastolic blood pressure ≥90 mmHg in the two blood pressure measurements and with no prior diagnosis of hypertension by a health care professional). Adjusted prevalence ratios were estimated to determine the factors associated with undiagnosed hypertension. The socioeconomic inequality in undiagnosed hypertension was estimated using concentration curves and the Erreygers concentration index. RESULTS 67.2% of 3697 persons with hypertension had not been diagnosed. Non-diagnosis of hypertension was more prevalent in men who were residents of the Coast and in inhabitants residing at more than 3000 m above sea level. Being 50 years of age or older, having health insurance, being obese and having diabetes mellitus were associated with a lower prevalence of undiagnosed hypertension. Inequality of the non-diagnosis of hypertension was found to be concentrated in the poorest population. CONCLUSIONS At least one out of every two adult Peruvians with hypertension have not been diagnosed with this condition. Socioeconomic inequality was found, as well as socio-demographic and health-related factors associated with undiagnosed hypertension. Our findings identify some population subgroups in which interventions for screening and treatment of hypertension should be prioritized in order to reduce both inequalities and complications of hypertension among the most vulnerable.
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Affiliation(s)
| | - Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | | | | | | | - Guido Bendezu-Quispe
- Universidad Privada Norbert Wiener, Centro de Investigación Epidemiológica en Salud Global, Lima, Peru
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