Social disparities in prevalence, treatment and control of hypertension in Iran: Second National Surveillance of Risk Factors of Noncommunicable Diseases, 2006

Ebrahimi, Morteza; Mansournia, Mohammad Ali; Haghdoost, Ali Akbar; Abazari, Arash; Alaeddini, Farshid; Mirzazadeh, Ali; Yunesian, Masud

doi:10.1097/hjh.0b013e32833a38f2

Cited by 40 publications

(38 citation statements)

References 35 publications

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“…Studies examining wealth-related inequalities are much fewer in number, however the pro-rich inequalities observed for detection and control observed in our study were consistent with previous findings in China, India and South Africa [5]; as were other study findings regarding hypertension treatment rates in Brazil [30], China [31], Iran [29] and Tanzania [32]. Finally, a recent Canadian study of adults using national data found no evidence for income-related inequality with respect to hypertension detection or control [33], while we observed a small, albeit significant, pro-poor distribution for detection but not control.…”

Section: Discussionsupporting

confidence: 92%

“…While the rates of awareness, treatment and control in Sweden were substantially lower than the other high-income PURE countries, they were similar to those in an earlier study that used data from the WHO MONICA (Multinational MONItoring of trends and determinants in CArdiovascular disease) Project [28]. In Iran, data from the National Surveillance of Risk Factors for NCDs also showed a similarly large attrition in the pathway of hypertensive individuals from detection through treatment to control (33% treated and 12% controlled, respectively, compared with 51 to 18% in our study) [29]. A recent paper combined data from SAGE (WHO Study on global AGEing and adult health) and COURAGE (Collaborative Research on Ageing in Europe), with data on hypertension prevalence by household wealth [5].…”

Section: Discussionsupporting

confidence: 87%

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Wealth and cardiovascular health: a cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries

Palafox

McKee

Balabanova

et al. 2016

Int J Equity Health

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BackgroundEffective policies to control hypertension require an understanding of its distribution in the population and the barriers people face along the pathway from detection through to treatment and control. One key factor is household wealth, which may enable or limit a household’s ability to access health care services and adequately control such a chronic condition. This study aims to describe the scale and patterns of wealth-related inequalities in the awareness, treatment and control of hypertension in 21 countries using baseline data from the Prospective Urban and Rural Epidemiology study.MethodsA cross-section of 163,397 adults aged 35 to 70 years were recruited from 661 urban and rural communities in selected low-, middle- and high-income countries (complete data for this analysis from 151,619 participants). Using blood pressure measurements, self-reported health and household data, concentration indices adjusted for age, sex and urban-rural location, we estimate the magnitude of wealth-related inequalities in the levels of hypertension awareness, treatment, and control in each of the 21 country samples.ResultsOverall, the magnitude of wealth-related inequalities in hypertension awareness, treatment, and control was observed to be higher in poorer than in richer countries. In poorer countries, levels of hypertension awareness and treatment tended to be higher among wealthier households; while a similar pro-rich distribution was observed for hypertension control in countries at all levels of economic development. In some countries, hypertension awareness was greater among the poor (Sweden, Argentina, Poland), as was treatment (Sweden, Poland) and control (Sweden).ConclusionInequality in hypertension management outcomes decreased as countries became richer, but the considerable variation in patterns of wealth-related inequality - even among countries at similar levels of economic development - underscores the importance of health systems in improving hypertension management for all. These findings show that some, but not all, countries, including those with limited resources, have been able to achieve more equitable management of hypertension; and strategies must be tailored to national contexts to achieve optimal impact at population level.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-016-0478-6) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 87%

Wealth and cardiovascular health: a cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries

Palafox

McKee

Balabanova

et al. 2016

Int J Equity Health

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“…2 Most importantly, direct age standardisation to the 35-69 years WHO World Standard Population 17 (26.6%; 25.5% to 27.6%), allows comparison with Egypt (33.8%), 21 Iran (34.1%) 22 or Turkey (34.2%). 23 The low prevalence of hypertension, besides any methodological consideration, might thus be related to the possibility that Yemen is behind in the epidemiological transition currently ongoing in other countries of the Middle East Crescent area.…”

Section: Discussionmentioning

confidence: 99%

Impact of one or two visits strategy on hypertension burden estimation in HYDY, a population-based cross-sectional study: implications for healthcare resource allocation decision making

Modesti¹,

Rapi

Bamoshmoosh

et al. 2012

BMJ Open

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ContextThe prevalence of hypertension in developing countries is coming closer to values found in developed countries. However, surveys usually rely on readings taken at a single visit, the option to implement the diagnosis on readings taken at multiple visits, being limited by costs.ObjectiveTo estimate more accurately the magnitude and extent of the resource that should be allocated to the prevention of hypertension.DesignPopulation-based cross-sectional survey with triplicate blood pressure (BP) readings taken on two separate home-visits.SettingRural and urban locations in three areas of Yemen (capital, inland and coast).ParticipantsA nationally representative sample of the Yemen population aged 15–69 years (5063 men and 5179 women), with an overall response rate of 92% in urban and 94% in rural locations.Main outcome measureHypertension diagnosed as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or self-reported use of antihypertensive drugs.ResultsHypertension prevalence (age-standardised to the WHO world population 2001) based on fulfilling the same criteria on both visits (11.3%; 95% Cl 10.7% to 11.9%), was 35% lower than estimation based on the first visit (17.3%; 16.5% to 18.0%). Advanced age, blood glucose ≥7 mmol/l or proteinuria ≥1+ at dipstick test at visit one were significant predictors of confirmation at visit 2. The 959 participants found to be hypertensive at visit 1 or at visit 2 only and thus excluded from the final diagnosis had a rate of proteinuria (5.0%; 3.8% to 6.5%) comparable to rates of the general population (6.1%; 5.6% to 6.6%), and of subjects normotensive at both visits (5.6%; 5.1% to 6.2%). Only 1.9% of Yemen population classified at high or very high cardiovascular (CV) risk at visit 1 moved to average, low or moderate CV risk categories after two visits.ConclusionsHypertension prevalence based on readings obtained after two visits is 35% lower than estimation based on the first visit, subjects were excluded from final diagnosis belonging to low CV risk classes.

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“…Iran is a country with diverse ethnicities, languages, and priorities (38). Therefore, these differences and priorities, as well as people's needs and beliefs, should be taken into consideration in the design of training programs in HHs.…”

Section: 1mentioning

confidence: 99%

Health Education Performance in Health Houses: A Descriptive study from Iran during April-September 2011

et al. 2018

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Background: One of the many tasks of rural health houses (HHs) is to provide health education for rural clients. Objectives: The purpose of this study was to assess the conditions and responsibilities of HHs regarding health education. Methods: Through systematic random sampling, 1600 HHs were selected during April-September 2011. Besides the characteristics of HHs, type of training, audience groups, time of education, number of participants, and reasons for educational classes were requested in a written format from the selected HHs. Data were analyzed using Excel 2007 and SPSS version 16. Results: In total, 21.9% of HHs had no group education within the first 5 months. Most education was related to the field of reproductive health, followed by intestinal diseases. The largest target group included mothers eligible for family planning. The mean duration of education was 33.6 minutes per week. Based on the findings, 55% of training was conducted due to provincial health priorities. Conclusions: Although cardiovascular diseases, road traffic accidents, and cancers are the major causes of mortality in Iran, most education concentrated on reproductive health, as well as mother and child health. Therefore, modifications in educational methods and planning are necessary.

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Social disparities in prevalence, treatment and control of hypertension in Iran: Second National Surveillance of Risk Factors of Noncommunicable Diseases, 2006

Cited by 40 publications

References 35 publications

Wealth and cardiovascular health: a cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries

Wealth and cardiovascular health: a cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries

Impact of one or two visits strategy on hypertension burden estimation in HYDY, a population-based cross-sectional study: implications for healthcare resource allocation decision making

Health Education Performance in Health Houses: A Descriptive study from Iran during April-September 2011

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