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Boateng EB, Ampofo AG. A glimpse into the future: modelling global prevalence of hypertension. BMC Public Health 2023; 23:1906. [PMID: 37789258 PMCID: PMC10546636 DOI: 10.1186/s12889-023-16662-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 08/30/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Hypertension is a major risk factor for cardiovascular diseases. Insights and foresights on trends of hypertension prevalence are crucial to informing health policymaking. We examined and projected the patterns of hypertension prevalence among sexes. METHODS Using annual hypertension prevalence (18 + years) data sourced from WHO Global Health Observatory data repository from 1975 to 2015, Prophet models were developed to forecast the 2040 prevalence of hypertension in males, females, and both sexes. We used k-means clustering and self-organising maps to determine the clusters of hypertension prevalence concerning both sexes among 176 countries. RESULTS Worldwide, Croatia is estimated to have the highest prevalence of hypertension in males by 2040, while that of females is in Niger. Among the world's most populated countries, Pakistan and India are likely to increase by 7.7% and 4.0% respectively in both sexes. South-East Asia is projected to experience the largest hypertension prevalence in males, whereas Africa is estimated to have the highest prevalence of hypertension in females. Low-income countries are projected to have the highest prevalence of hypertension in both sexes. By 2040, the prevalence of hypertension worldwide is expected to be higher in the male population than in female. Globally, the prevalence of hypertension is projected to decrease from 22.1% in 2015 to 20.3% (20.2 - 20.4%) in 2040. We also identified three patterns of hypertension prevalence in 2040, cluster one countries are estimated to have the highest prevalence of hypertension in males (29.6%, 22.2 - 41.1%) and females (29.6%, 19.4 - 38.7%). CONCLUSION These findings emphasise the need for new and effective approaches toward the prevention and control of hypertension in Africa, South-East Asia, and Low-income countries.
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Affiliation(s)
- Emmanuel B Boateng
- School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia.
| | - Ama G Ampofo
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
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Cho KI, Jeon DW, Ahn HS, Jin DK, Lee HS, Lee JY, Lim HS, Manolis AJ, Rha SW, Park SW. Efficacy and safety of nebivolol in Korean patients with hypertension by age and sex: a subanalysis from the BENEFIT-KOREA study. Clin Hypertens 2021; 27:9. [PMID: 33722290 PMCID: PMC7958700 DOI: 10.1186/s40885-021-00165-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 02/26/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND BENEFIT-KOREA (BEnefits after 24 weeks of NEbivolol administration For essential hypertensIon patients wiTh various comorbidities and treatment environments in Korea) study, an observational study in South Korea, demonstrated the efficacy and safety of nebivolol in Asian patients with essential hypertension with and without comorbidities in real-world settings. We present a subanalysis of the efficacy and safety of nebivolol across age and sex in the BENEFIT-KOREA cohort. METHODS Adult South Korean patients with essential hypertension participated in the prospective, single-arm, open, observational BENEFIT-KOREA study; 3011 patients received nebivolol as monotherapy or add-on therapy. Changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP), and pulse rate at 12 and 24 weeks were evaluated. Participants were divided into three age groups-young males and females: < 50 years; middle-aged males and females: ≥50 years to < 70 years; and older males and females: ≥70 years. RESULTS The mean age of study participants was 63.5 ± 12.9 years; majority were between 50 and 69 years of age and 40.4% were females. A significant decrease was observed in mean SBP, DBP, and pulse rate from baseline at 12 and 24 weeks in males and females across all age groups analyzed (all P < 0.001 vs. baseline), with no significant difference in mean reduction in SBP and DBP from baseline between sex within the age groups. Majority of reported adverse events were mild. The incidence of adverse events was lower in young participants versus middle-aged and older participants. CONCLUSIONS Our subanalysis from the real-world BENEFIT-KOREA study in Asian patients with essential hypertension demonstrated the efficacy and safety of once-daily nebivolol across age groups with no between-sex differences. TRIAL REGISTRATION Name of the registry: clinicaltrials.gov. TRIAL REGISTRATION NUMBER NCT03847350 . Date of registration: February 20, 2019 retrospectively registered.
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Affiliation(s)
- Kyoung Im Cho
- Division of Cardiology, Kosin University Gospel Hospital, Busan, Republic of Korea
| | - Dong Woon Jeon
- Division of Cardiology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
| | - Hyo Seung Ahn
- Division of Cardiology, Department of Internal Medicine, Sahmyook Medical Center, Seoul, Republic of Korea
| | - Dong Kyu Jin
- Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Hyun Sang Lee
- Department of Cardiology, CHA Gumi Medical Center, Gumi, Republic of Korea
| | - Jong-Young Lee
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Hong-Seok Lim
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | | | - Seung-Woon Rha
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea
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Gorbani F, Mahmoodi H, Sarbakhsh P, Shaghaghi A. Predictive Performance of Pender's Health Promotion Model for Hypertension Control in Iranian Patients. Vasc Health Risk Manag 2020; 16:299-305. [PMID: 32764950 PMCID: PMC7381821 DOI: 10.2147/vhrm.s258458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/05/2020] [Indexed: 11/26/2022] Open
Abstract
Objective The main aim of this study was to investigate predictive factors of adherence to the hypertension control therapeutic and lifestyle recommendations in a sample of Iranian patients based on the constructs of Pender’s health promotion model. Patients and Methods The cross-sectional study was performed on the 380 hypertensive patients who were referred to the health centers, the emergency and internal diseases departments of the Bagheralolom Hospital, and the cardiologists’ offices in the city of Ahar, North West of Iran. Data were collected using a researcher designed questionnaire based on the Pender’s health promotion model. The Pearson correlation test, multivariate linear regression, and independent t-test were used for data analysis. Results Mean age of the recruited patients was 52.94 (SD=12.8). Perceived benefits, perceived barriers, situational influences, and interpersonal influences (adjusted R2= 0.525) explained 52.5% of the observed variation in adherence to hypertension control recommendations. Conclusion Successful hypertension control in patients with chronic morbidity need to be based on sound data about major determinants of the relevant health/illness behaviors. The study findings revealed that the Pender’s health promotion model could be applicable as a theoretical framework to identify major determinants of adherence to hypertension control recommendations. Future cross-cultural validation of the study findings in more representative and larger sample sizes could add to the legitimacy of the evidence surrounding self-care practices in hypertensive patients.
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Affiliation(s)
- Fatemeh Gorbani
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hassan Mahmoodi
- Social Determinant of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Parvin Sarbakhsh
- Department of Biostatistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abdolreza Shaghaghi
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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Qu Z, Parry M, Liu F, Wen X, Li J, Zhang Y, Wang D, Li X. Self-management and blood pressure control in China: a community-based multicentre cross-sectional study. BMJ Open 2019; 9:e025819. [PMID: 30898823 PMCID: PMC6528047 DOI: 10.1136/bmjopen-2018-025819] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 02/01/2019] [Accepted: 02/01/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES This study explored the relationship between self-management and blood pressure (BP) control in China. DESIGN A cross-sectional study. SETTING Eight community health centres from four cities in the Northeast (Shenyang), Northwest (Xi'an), Southwest (Chengdu) and South (Changsha) of China. PARTICIPANTS A total of 873 adults with hypertension, including 360 men and 513 women. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg. OUTCOME MEASUREMENTS BP control was the primary outcome variable. This was categorised as good control if individuals with hypertension reduced their BP to <140/90 mm Hg, otherwise, it was categorised as poor control. Secondary outcomes included self-management, defined as: (1) context or condition-specific factors or physical/social environments (eg, age, sex, marital status, education, personal income and health insurance) and (2) process or knowledge/beliefs, self-regulation skills/abilities and social facilitation (eg, treatment, diet, exercise and risk factor management). Data were analysed using logistic regression models using SPSS V.20. RESULTS A total of 67.1% (n=586) participants had poor BP control. Limited outpatient care benefits in mainly rural residents (OR 2.26, 95% CI 1.06 to 4.81) and longer disease duration (OR 1.03, 95% CI 1.01 to 1.04) were associated with poor BP control. Self-management practices reduced the odds of having poor BP control (OR 0.98, 95% CI 0.97 to 0.99). CONCLUSIONS The individual and family self-management theory can serve as an effective theory for understanding the key contexts, processes and outcomes essential for BP control in China. Future research should evaluate the effect of a self-management intervention (eg, self-monitoring, medication adherence, regular and routine doctor visits, and social supports) for BP control in China using a multisite cluster randomised controlled trial. Sex and gender difference, cost and patient-reported outcomes should also be examined.
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Affiliation(s)
- Zhan Qu
- School of Nursing, Xi'an Jiaotong University, Health Science Center, Xi'an, Shaanxi, China
| | - Monica Parry
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Fang Liu
- School of Nursing, Xi'an Jiaotong University, Health Science Center, Xi'an, Shaanxi, China
| | - Xiulin Wen
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jieqiong Li
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yanan Zhang
- School of Public Health, Xi'an Jiaotong University, Health Science Center, Xi'an, Shaanxi, China
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Xiaomei Li
- School of Nursing, Xi'an Jiaotong University, Health Science Center, Xi'an, Shaanxi, China
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Sousa ALL, Batista SR, Sousa AC, Pacheco JAS, Vitorino PVDO, Pagotto V. Hypertension Prevalence, Treatment and Control in Older Adults in a Brazilian Capital City. Arq Bras Cardiol 2019; 112:271-278. [PMID: 30916203 PMCID: PMC6424046 DOI: 10.5935/abc.20180274] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/18/2018] [Accepted: 08/02/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The diagnosis, treatment and control of arterial hypertension are fundamental for a reduction in cardiovascular outcomes, especially in the elderly. In Brazil, there are few studies that specifically identified these rates in the elderly population. OBJECTIVE To verify rates of prevalence, treatment and control of hypertension in elderly people living in the urban area of a Brazilian capital city. METHODS A cross-sectional, population-based, randomized, cluster-based study with 912 non-institutionalized elderly individuals (≥ 60 years), living in urban areas in the city of Goiania, Midwest Brazil. Predictor variables were: age, gender, socioeconomic and lifestyle aspects. Blood pressure measurements were performed at home; patients were considered as having arterial hypertension when SBP and/or DBP ≥ 140/90 mmHg or when using antihypertensive drugs (dependent variable). Rates of hypertension treatment and control were evaluated. Variable association analyses were performed by multivariate logistic regression and level of significance was set at 5%. RESULTS The prevalence of arterial hypertension was 74.9%, being higher (78.6%) in men (OR 1.4, 95% CI: 1.04-1.92); the treatment rate was 72.6%, with higher rates being observed in smokers (OR 2.06, 95% CI: 1.28-3.33). The rate of hypertension control was 50.8%,being higher in women (OR 1.57, 95% CI: 1.19-2.08). CONCLUSION The prevalence rates were high. Treatment and control rates were low and associated with gender, age and lifestyle, indicating the need for early and individual interventions.
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Affiliation(s)
- Ana Luiza Lima Sousa
- Faculdade de Enfermagem, Universidade Federal de Goiás
(UFG), Goiânia, GO - Brazil
| | | | | | | | | | - Valéria Pagotto
- Faculdade de Enfermagem, Universidade Federal de Goiás
(UFG), Goiânia, GO - Brazil
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Giena VP, Thongpat S, Nitirat P. Predictors of health-promoting behaviour among older adults with hypertension in Indonesia. Int J Nurs Sci 2018; 5:201-205. [PMID: 31406825 PMCID: PMC6626242 DOI: 10.1016/j.ijnss.2018.04.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 03/07/2018] [Accepted: 04/02/2018] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES This study aimed to determine the predictors of health-promoting behaviour among older adults with hypertension in Bengkulu City, Bengkulu, Indonesia. METHODS A cross-sectional study was conducted in 333 older adults with hypertension, who were selected using multistage sampling method. Data were obtained by face-to-face interview with structured questionnaires. The questionnaires used in this study included the Health-Promoting Lifestyle Profile II (HPLP II), Hypertension Knowledge-Level Scale (HK-LS), Self-Rated Abilities for Health Practices Scale (SRAHP), Barriers to Health-promoting Behaviour Scales (BAS), Benefits to Health-Promoting Behaviour Scales (BES), Multidimensional Scale of Perceived Social Support (MSPSS) and Situational Influences Questionnaire (SIQ). Data were analysed by using multiple linear regressions. RESULTS The mean and standard deviation (Mean ± SD) of each questionnaire were as follows: HPLP II, 2.55 ± 0.19; HK-LS, 11.83 ± 3.00; SRAHP, 2.00 ± 5.87; BAS, 27.89 ± 2.70; BES, 34.29 ± 2.29; MSPSS, 60.35 ± 8.12; and SIQ, 47.71 ± 6.66. According to the multiple linear regression model, 36.9% of the variation in health-promoting behaviour among older adults with hypertension can be explained by six variables, namely, education, knowledge, self-efficacy, perceived barriers, social support and situational influences (adjusted R 2 = 0.369). CONCLUSIONS High and good-quality education will increase the level of health-promoting behaviour, whereas barriers, such as expense and time requirement, can decrease it. Situational influences and support from family and friends can also influence the older adult's attempts to change their health behaviour. Increased self-efficacy will clearly result in improved health-promoting behaviour of older adults with hypertension.
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Kim WJ, Joo WT, Baek J, Sohn SY, Namkoong K, Youm Y, Kim HC, Park YR, Chu SH, Lee E. Factors Associated with Insomnia among the Elderly in a Korean Rural Community. Psychiatry Investig 2017; 14:400-406. [PMID: 28845165 PMCID: PMC5561396 DOI: 10.4306/pi.2017.14.4.400] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 06/12/2016] [Accepted: 06/18/2016] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Sleep disturbance is common in the elderly, which is result from multi-factorial causes encompassing socio-demographic, behavioral, and clinical factors. We aimed to identify factors associated with insomnia among the elderly in a rural community in South Korea, a country with a rapidly growing aged population. METHODS This cross-sectional study used the data from the second wave of the Korean Social life, Health and Ageing Project, which is a cohort study of individuals living in a typical rural community in South Korea. Socio-demographic, behavioral, and clinical characteristics were obtained through face-to-face interviews. Various factors suspected to be associated with insomnia were compared between elderly participants with and without insomnia, and multiple logistic regression analyses were conducted to identify independent risk factors for insomnia. RESULTS We found that 32.4% of 509 participants (72.8±7.7 years old) had insomnia. Female sex [odds ratio (OR)=2.19], low education level (OR=2.44), current smoking (OR=2.26), number of chronic diseases (OR=2.21 for 2-3 chronic diseases; OR=2.06 for 4 or more chronic diseases), and depression (OR=2.53) were independently associated with insomnia. CONCLUSION We found that sex, education, chronic disease, and depression independently increase the risk of insomnia of the elderly in a Korean rural community. To overcome the elderly's insomnia, interventions should target modifiable factors such as depression. To promote active aging, longitudinal studies of factors associated with insomnia among the elderly should be performed in different regions and communities.
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Affiliation(s)
- Woo Jung Kim
- Department of Psychiatry, Seonam University College of Medicine, Myongji Hospital, Goyang, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Won-tak Joo
- Department of Sociology, Yonsei University, Seoul, Republic of Korea
| | - Jiwon Baek
- Department of Sociology, Yonsei University, Seoul, Republic of Korea
| | - Sung Yun Sohn
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry,Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kee Namkoong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry,Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University, Seoul, Republic of Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yeong-Ran Park
- Division of Silver Industry, Kangnam University, Yongin, Republic of Korea
| | - Sang Hui Chu
- Department of Clinical Nursing Science, Yonsei University, Seoul, Republic of Korea
| | - Eun Lee
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry,Yonsei University College of Medicine, Seoul, Republic of Korea
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Choi HM, Kim HC, Kang DR. Sex differences in hypertension prevalence and control: Analysis of the 2010-2014 Korea National Health and Nutrition Examination Survey. PLoS One 2017; 12:e0178334. [PMID: 28542557 PMCID: PMC5444798 DOI: 10.1371/journal.pone.0178334] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 05/11/2017] [Indexed: 12/26/2022] Open
Abstract
Although not fully understood, sex may affect both the prevalence and control rate of hypertension. The present study was designed to investigate factors associated with hypertension prevalence and control among Korean adults. We analyzed 27,887 individuals (12,089 males and 15,798 females) aged 30 years or older who participated in the fifth (2010-2012) and sixth (2013-2014) Korea National Health and Nutrition Examination Survey. Multiple logistic regression models were applied to delineate factors associated with the prevalence and control of hypertension separately for men and women. Overall, the prevalence of hypertension was higher in men (34.6%) than in women (30.8%). However, after the age of 60 years, hypertension was more prevalent in females than in males. Regardless of sex, the older the participants were, the more likely they were to have hypertension. Factors positively associated with hypertension prevalence were old age, low education, and high BMI in women (p<0.001) and increasing age, low income, alcohol intake, and high BMI in men (p<0.001). The overall control rate of hypertension was higher in women (51.3%) than in men (44.8%). However, after the age of 60 years, hypertension control rates were higher in men than in women. Factors decreasing hypertension control were white-collared women and young age, alcohol consumption in men. Sex differences in hypertension prevalence and control were discovered among Korean adults. After the age of 60, females were more likely to have hypertension and less likely to maintain hypertension control than males of the same age range. Accordingly, sex-specific approaches are recommended for effective blood pressure management.
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Affiliation(s)
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dae Ryong Kang
- Center of Biomedical Data Science / Institute of Genomic Cohort, Wonju College of Medicine, Yonsei University, Wonju, Korea
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Lee HY. Socioeconomic Disparities in the Prevalence, Diagnosis, and Control of Hypertension in the Context of a Universal Health Insurance System. J Korean Med Sci 2017; 32:561-567. [PMID: 28244279 PMCID: PMC5334151 DOI: 10.3346/jkms.2017.32.4.561] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 01/01/2017] [Indexed: 11/20/2022] Open
Abstract
A lower use of preventive intervention in low socioeconomic populations has been described in countries with universal coverage health care systems, but little is known about the possible socioeconomic inequalities in secondary prevention in a universal health insurance system. Data from the 2010-2013 Korea National Health and Nutrition Examination Survey, a nationwide survey, were analyzed. A total of 20,044 subjects older than 30 years of age were included after excluding subjects with missing data. Prevalence ratios were calculated using Poisson regression models with robust variance to explore factors associated with the prevalence, unawareness, and inappropriate control of hypertension. Hypertension prevalence decreased with increasing education and income level. We observed an inverse association between education level and undiagnosed hypertension among women, but not men. Socioeconomic level was not associated with inadequate control of hypertension among men or women. Future interventions should include primary prevention efforts targeted at lower socioeconomic populations to reduce disparities. There is substantial room for improvement in secondary prevention efforts. Monitoring strategies may highlight gaps in the preventive and care services offered to the most vulnerable individuals and encourage governments and practitioners to address these gaps.
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Affiliation(s)
- Hoo Yeon Lee
- Department of Social Medicine, Dankook University College of Medicine, Cheonan, Korea.
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Sex-specific effects of social networks on the prevalence, awareness, and control of hypertension among older Korean adults. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2016; 13:580-6. [PMID: 27605938 PMCID: PMC4996832 DOI: 10.11909/j.issn.1671-5411.2016.07.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Hypertension is a common chronic disease among older adults, and is associated with medical complications and mortality. This study aimed to examine the effects of social network characteristics on the prevalence, awareness, and control of hypertension among older adults. Methods The Korean Social Life, Health, and Aging Project (KSHAP) interviewed 814 ≥ 60-year-old residents and their spouses from a rural township between December 2011 and March 2012 (response rate: 95%). We evaluated the data from 595 participants. Multivariate logistic regression models were used to assess the effects of network characteristics on hypertension. Results We observed strong sex-specific network effects on the prevalence, awareness, and control of hypertension. Among older women, network density was associated with hypertension awareness [odds ratio (OR): 2.63, 95% confidence interval (CI): 1.03–5.37] and control (OR: 1.72; 95% CI: 0.94–3.13). Among older men, large networks were associated with a lower prevalence of hypertension (OR: 0.75; 95% CI: 0.58–0.96). Compared to older women, older men with coarse networks exhibited better hypertension awareness (OR: 0.37; 95% CI: 0.14–0.95) and control (OR: 0.42; 95% CI: 0.19–0.91). Network size interacted with density for hypertension control (P = 0.051), with controlled hypertension being associated with large and course networks. Conclusions A large network was associated with a lower risk for hypertension, and a coarse network was associated with hypertension awareness and control among older men. Older women with dense networks were most likely to exhibit hypertension awareness and control.
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The persisting gender gap in hypertension management and control in Germany: 1998 and 2008-2011. Hypertens Res 2016; 39:457-66. [PMID: 26818655 DOI: 10.1038/hr.2016.5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 12/11/2015] [Accepted: 12/17/2015] [Indexed: 01/13/2023]
Abstract
Hypertension is a major risk factor for cardiovascular morbidity; therefore, its control is very important. International Guidelines recommend the same hypertension management in men and women; however, studies suggest that management of hypertension differs. This study explores gender-age disparities in the management and control of hypertension in Germany in 1998 and 2008-2011. Data from the German Health Examination Surveys (GNHIES98 1998, n=7124 and DEGS1 2008-2011, n=7988, age 18-79 years), including standardized blood pressure measurements and Anatomical Therapeutic Chemical medication codes, were analyzed by gender and two age groups. For 1998 and 2008-2011 in Germany, the gender gap in hypertension management persisted without significant changes. Hypertensive men in 2008-2011 had lower awareness of their condition (78.3 vs. 86.8%), less treatment for hypertension (65.3 vs. 79.2%), less control of hypertension (45.4 vs. 57.5%) and less treatment among those aware of their condition (83.9 vs. 91.5%) than did women. These gender differences were greater in younger compared with older adults (18-54 years vs. 55-79 years). No gender differences were observed in control of hypertension among those treated in 1998; however, subsequent improvement was less in younger men compared with the other age-gender groups, leading to a new gender gap in 18-54-year olds (women 84.8%, men 63.9%). Younger women used more β-blockers and less angiotensin-converting enzyme inhibitors (ACEI) than younger men. Factors positively associated with control among those treated for hypertension in the younger group were being a woman, using β-blockers or using ACEI, or angiotensin-receptor blockers. In the older group, diabetes was negatively associated with control of hypertension, whereas having cardiovascular comorbidities was positively associated. Gender disparities in hypertension management and control still exist in Germany but may be masked because they are age-dependent.
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