Factors associated with hypertension prevalence, unawareness and treatment among Costa Rican elderly

Abstract

BackgroundReliable information on the prevalence of hypertension is crucial in the development of health policies for prevention, control, and early diagnosis of this condition. This study describes the prevalence of hypertension among Costa Rican elderly, and identifies co-factors associated with its prevalence, unawareness and treatment.MethodsThe prevalence of hypertension is estimated for the Costa Rican elderly. Measurement error is assessed, and factors associated with high blood pressure are explored. Data for this study came from a nationally representative sample of about 2,800 individuals from CRELES (Costa Rica: Longevity and Healthy Aging Study). Two blood pressure measures were collected using digital monitors. Self reports of previous diagnosis, and medications taken were also recorded as part of the study.ResultsNo evidence of information bias was found among interviewers, or over time. Hypertension prevalence in elderly Costa Ricans was found to be 65% (Males = 60%, Females = 69%). Twenty-five percent of the studied population did not report previous diagnoses of hypertension, but according to our measurement they had high blood pressure. The proportion of unaware men is higher than the proportion of unaware women (32% vs. 20%). The main factors associated with hypertension are: age, being overweight or obese, and family history of hypertension. For men, current smokers are 3 times more likely to be unaware of their condition than non smokers. Both men and women are less likely to be unaware of their condition if they have a family history of hypertension. Those women who are obese, diabetic, have suffered heart disease or stroke, or have been home visited by community health workers are less likely to be unaware of their hypertension. The odds of being treated are higher in educated individuals, those with a family history of hypertension, elderly with diabetes or those who have had heart disease.ConclusionSex differences in terms of hypertension prevalence, unawareness, and treatment in elderly people have been found. Despite national programs for hypertension detection and education, unawareness of hypertension remains high, particularly among elderly men. Modifiable factors identified to be associated with prevalence such as obesity and alcohol intake could be used in educational programs aimed at the detection and treatment of those individuals who have the condition.

Prevalence, awareness, treatment and control of hypertension in the elderly population of Singapore

“…Another Singaporean study using the same definition of hypertension as we did, although not limited to the elderly, did report a prevalence of hypertension among those aged X65 years that was comparable with our findings. 6 Similar to previous studies, 14,[16][17][18]20,22,23,25,26 we observed hypertension to be associated with age, higher BMI and diabetes. We also observed elderly men to be at a higher risk of hypertension, whereas previous studies have reported either no association with gender, 17,20 or a higher risk for women.…”

“…36 The prevalence of hypertension and its awareness, treatment and control in studies conducted exclusively among the elderly and using our criteria for defining hypertension is given in Table 5. 14,15,17,[19][20][21][22][23][24][25][26][27] Although most of these studies reported a lower prevalence of hypertension 17,20,[22][23][24][25]27 than what we observed (73.9%), some Hypertension among elderly Singaporeans R Malhotra et al reported a similar prevalence 14,19,21,23,26 or, in one study, 15 an even higher prevalence. Other than differences in the BP measurement instrument (manual or electronic) and number of readings (two or three) used for defining SBP and DBP, the variation could also reflect differences in demographic (for example, age, gender, ethnicity) and lifestyle (for example, diet, physical activity) profiles and in economic development across countries (prevalence is usually higher in more developed economies 38 ).…”

“…A variety of socio-demographic and health variables, evaluated as potential correlates with hypertension and/or awareness, treatment and control of hypertension in previous studies, 6,[14][15][16][17][18][19][20][21][22][23][24][25][26][27]32 were evaluated as correlates in the present analysis.…”

“…1,14,15,17,[19][20][21][22][23][24][25][26][27] Among hypertensives, those who responded in the negative to 'Have you ever been diagnosed with high blood pressure by a medical professional?' were considered to be unaware and those who responded in the negative to 'Are you presently taking any medicine prescribed by a physician for high blood pressure?'…”

“…4,6 Recognizing the elderly as an at-risk population, studies in various countries have documented the prevalence and correlates of hypertension and of awareness, treatment and control of hypertension among the elderly. [14][15][16][17][18][19][20][21][22][23][24][25][26][27] These studies suggest considerable heterogeneity for the prevalence of these conditions across elderly subgroups, defined by socio-demographic or health characteristics. Furthermore, neither the prevalence nor the identified correlates are uniform across countries.…”