Standards for the Uniform Reporting of Hypertension in Adults Using Population Survey Data: Recommendations From the World Hypertension League Expert Committee

Gee, Marianne E.; Campbell, Norm R.C.; Sarrafzadegan, Nizal; Jafar, Tazeen H.; Khalsa, Tej K.; Mangat, Birinder; Poulter, Neil; Prabhakaran, Dorairaj; Sonkodi, S.; Whelton, Paul K.; Woodward, Mark; Zhang, Xin Hua

doi:10.1111/jch.12387

Cited by 69 publications

(77 citation statements)

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“…In the main analyses, control was the proportion of participants with hypertension who had an average systolic and diastolic blood pressure of less than 140/90 mm Hg, also as recommended by the WHO STEPS protocol [13] and in many current guidelines [14]. We report three standard definitions of hypertension (Table 1) to enable comparisons with other research [15], but use the standard ‘lower threshold’ definition to define the denominator in the main analyses.…”

Section: Methodsmentioning

confidence: 99%

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: Methodsmentioning

confidence: 99%

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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“…17 Hypertension prevalence was estimated across racial/ethnic subgroups based on socio-demographic characteris- (Figure 1). Among Hispanic subgroups, Dominicans were found to have the highest hypertension prevalence (32.2%), followed by Puerto Ricans (27.7%), while Mexicans had the lowest prevalence (8.1%).…”

Section: Methodsmentioning

confidence: 99%

Hypertension Prevalence in New York City Adults: Unmasking Undetected Racial/Ethnic Variation, NYC HANES 2004

et al. 2016

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Main Outcome Measures: Logistic regression was performed to identify differences in HTN prevalence between ethnic subgroups controlling for age, sex, education and BMI. Results Conclusion:When analyzing racial/ethnic subgroups, NH Black and Hispanic adults from Dominican Republic had the highest HTN prevalence followed by South Asian and Puerto Rican adults. Mexican adults had the lowest prevalence of all groups. These findings highlight that ethnic subgroup differences go undetected when stratified by broader racial/ ethnic categories. To our knowledge, this is the first population-based study using objective measures to highlight these differences. Ethn

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“…In Iran, the prevalence of hypertension is high, with an increasing trend in recent years (24). Unfortunately, its control level among treated patients remains low (25)(26)(27). This may be one explanation of the high prevalences of IHD and stroke, and their occurrences among younger patients in Iran.…”

Section: Discussionmentioning

confidence: 99%

Do cardiometabolic risk factors relative risks differ for the occurrence of ischemic heart disease and stroke?

et al. 2016

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Background:The effects of the risk factors of ischemic heart disease (IHD) and stroke on the occurrence of these diseases differ between different populations. Objectives: To study the difference in the effects of different cardiovascular (CVD) risk factors on the incidence of IHD and stroke in an Iranian adult population. Patients and Methods:The Isfahan Cohort Study (ICS) is a longitudinal study that followed up 6323 subjects older than 35 years with no history of CVD since 2001. Of the original sample, only 5431 participants were contacted and followed up until 2011. The end points were the occurrence of IHD (defined as fatal and non-fatal myocardial infarction, unstable angina, and sudden cardiac death) and stroke. After 10 years of follow-up, 564 new cases of IHD and 141 new cases of stroke were detected. The relative risks (RRs) of cardiometabolic risk factors such as hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, high low-density lipoprotein cholesterol (LDL-C) level, low high-density lipoprotein cholesterol (HDL-C) level, current smoking, obesity, high waist-to-hip ratio, family history of CVD, and metabolic syndrome were compared between IHD and stroke patients. The ratio of relative risks (RRR) was calculated for comparing two RRs and estimated adjusted RRR was calculated by using generalized linear regression with a log link and binomial distribution. Results: The RRs of the occurrence of IHD and stroke in diabetic patients were 1.94 and 3.26, respectively, and the difference was statistically different (P = 0.016). The RR of high LDL-C was significantly higher for IHD than for stroke (P = 0.045), while all the other risk factors showed similar RRs for IHD and stroke, with no significant difference in their RRR, including hypertension. Diabetes and hypertension had the highest RRs for IHD, followed by diabetes, metabolic syndrome, and hypertension for stroke. Conclusions:The effect of diabetes mellitus on stroke was more significant than on IHD, and the effect of high LDL-C level was more significant on IHD than on stroke, other risk factors, including hypertension, have similar RRs for IHD and stroke. Health care professionals need more training regarding the RRs of these risk factors in the Iranian society, and health decision makers should consider it in their future policies.

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Standards for the Uniform Reporting of Hypertension in Adults Using Population Survey Data: Recommendations From the World Hypertension League Expert Committee

Cited by 69 publications

References 36 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

Hypertension Prevalence in New York City Adults: Unmasking Undetected Racial/Ethnic Variation, NYC HANES 2004

Do cardiometabolic risk factors relative risks differ for the occurrence of ischemic heart disease and stroke?

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