Prevalence, Awareness, Treatment and Control of Hypertension in Rural and Urban Communities in High-, Middle-, and Low-Income Countries

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dc.contributor.authorChow, Clara K.
dc.contributor.authorKoon, Teo K.
dc.contributor.authorPuoane, Thandi
dc.contributor.authorRangarajan, Sumathy
dc.contributor.authorIslam, Shofiqul
dc.contributor.authorGupta, Rajeev
dc.contributor.authorAvezum, Alvaro
dc.contributor.authorBahonar, Ahmad
dc.contributor.authorChifamba, Jephat
dc.contributor.authorDagenais, Gilles
dc.contributor.authorDiaz, Rafael
dc.contributor.authorKazmi, Khawar
dc.contributor.authorLanas, Fernando
dc.contributor.authorWei, Li
dc.contributor.authorLopez-Jaramillo, Patricio
dc.contributor.authorFanghong, Lu
dc.contributor.authorIsmail, Noor Hassim
dc.contributor.authorRosengren, Annika
dc.contributor.authorSzuba, Andrzej
dc.contributor.authorTemizhan, Ahmet
dc.contributor.authorWielgosz, Andy
dc.contributor.authorYusuf, Rita
dc.contributor.authorYusufali, Afzalhussein
dc.contributor.authorMcKee, Martin
dc.contributor.authorLiu, Lisheng
dc.contributor.authorMony, Prem
dc.contributor.authorYusuf, Salim
dc.date.accessioned2017-07-03T10:23:07Z
dc.date.available2017-07-03T10:23:07Z
dc.date.issued2013
dc.description.abstractIMPORTANCE: Hypertension is the most important preventable cause of morbidity and mortality globally, yet there are relatively few data collected using standardized methods. OBJECTIVE: To examine hypertension prevalence, awareness, treatment, and control in participants at baseline in the Prospective Urban Rural Epidemiology (PURE) study. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional study of 153,996 adults (complete data for this analysis on 142,042) aged 35 to 70 years, recruited between January 2003 and December 2009. Participants were from 628 communities in 3 high-income countries (HIC), 10 upper-middle-income and low-middle-income countries (UMIC and LMIC), and 4 low-income countries (LIC). MAIN OUTCOMES AND MEASURES: Hypertension was defined as individuals with self-reported treated hypertension or with an average of 2 blood pressure measurements of at least 140/90 mm Hg using an automated digital device. Awareness was based on self-reports, treatment was based on the regular use of blood pressure-lowering medications, and control was defined as individuals with blood pressure lower than 140/90 mm Hg. RESULTS: Among the 142,042 participants, 57,840 (40.8%; 95% CI, 40.5%-41.0%) had hypertension and 26,877 (46.5%; 95% CI, 46.1%-46.9%) were aware of the diagnosis. Of those who were aware of the diagnosis, the majority (23,510 [87.5%; 95% CI, 87.1%-87.9%] of those who were aware) were receiving pharmacological treatments, but only a minority of those receiving treatment were controlled (7634 [32.5%; 95% CI, 31.9%-33.1%]). Overall, 30.8%, 95% CI, 30.2%-31.4% of treated patients were taking 2 or more types of blood pressure-lowering medications. The percentages aware (49.0% [95% CI, 47.8%-50.3%] in HICs, 52.5% [95% CI, 51.8%-53.2%] in UMICs, 43.6% [95% CI, 42.9%-44.2%] in LMICs, and 40.8% [95% CI, 39.9%-41.8%] in LICs) and treated (46.7% [95% CI, 45.5%-47.9%] in HICs, 48.3%, [95% CI, 47.6%-49.1%] in UMICs, 36.9%, [95% CI, 36.3%-37.6%] in LMICs, and 31.7% [95% CI, 30.8%-32.6%] in LICs) were lower in LICs compared with all other countries for awareness (P <.001) and treatment (P <.001). Awareness, treatment, and control of hypertension were higher in urban communities compared with rural ones in LICs (urban vs rural, P <.001) and LMICs (urban vs rural, P <.001), but similar for other countries. Low education was associated with lower rates of awareness, treatment, and control in LICs, but not in other countries. CONCLUSIONS AND RELEVANCE: Among a multinational study population, 46.5% of participants with hypertension were aware of the diagnosis, with blood pressure control among 32.5% of those being treated. These findings suggest substantial room for improvement in hypertension diagnosis and treatment.en_US
dc.description.accreditationDepartment of HE and Training approved list
dc.identifier.citationChow, C. K. et al. (2013). Prevalence, Awareness, Treatment and Control of Hypertension in Rural and Urban Communities in High-, Middle-, and Low-Income Countries. Journal of the American Medical Association (JAMA), 310 (9): 959-968en_US
dc.identifier.issn0098-7484
dc.identifier.urihttp://hdl.handle.net/10566/3027
dc.language.isoenen_US
dc.publisherAmerican Medical Associationen_US
dc.rightsPublisher retains copyright. Authors may archive the published version in their institutional repository.
dc.source.urihttp://dx.doi.org/10.1001/jama.2013.184182
dc.subjectPrevalenceen_US
dc.subjectAwarenessen_US
dc.subjectTreatmenten_US
dc.subjectControl of hypertensionen_US
dc.subjectLow-income countriesen_US
dc.subjectRural and urban communitiesen_US
dc.titlePrevalence, Awareness, Treatment and Control of Hypertension in Rural and Urban Communities in High-, Middle-, and Low-Income Countriesen_US
dc.typeArticleen_US

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