The epidemiology of blood pressure in East Asia

Abstract

Although the majority of publications on the epidemiology of hypertension are on North American and European populations, high blood pressure and its health consequences are worldwide phenomena. For several reasons, good epidemiological data on blood pressure in the population are essential to understanding high blood pressure.Firstly, epidemiological studies inform our understanding of the extent of the problem. What are mean blood pressures in a population? How many individuals are likely to require treatment for hypertension? An understanding of the extent of the problem is essential if we are to plan and develop health services to deal with the clinical needs that are associated with high blood pressure. This includes the management of hypertension, the treatment of stroke and the treatment of cardiovascular disease.Secondly, epidemiological monitoring can tell us whether blood pressures in a given population are increasing or decreasing. Alongside demographic data this information gives us a picture of where we are going in terms of health service needs. Rising average blood pressures in a population mean that greater numbers of persons will need treatment for hypertension. It also means that there are likely to be more cardiovascular diseases to treat in the future. This is particularly true if other risk factors are changing in the population, for example if the population is ageing, smoking is on the increase or average cholesterol levels are rising.Thirdly, such data are important if we are to understand what factors cause high blood pressure. This includes both the proximal factors -such as obesity or salt intake -and the distal factors -such as socio-economic or cultural conditions that influence diet and lifestyle -which underlie the proximal factors. In the long term, insight into the causes of high blood pressure offers the best chance of informing policies that will reduce average blood pressures in the population as a whole.There are many potential sources of bias in population surveys of blood pressure. Efforts must be made to ensure the sample is representative of the population as a whole. The measurement technique must be highly standardised: even small differences in measurement technique can make important differences in the mean blood pressures in a population survey. Minh et al.'s 1 paper on the prevalence and socio-economic determinants of hypertension in a rural population in Vietnam goes some way towards minimising these sources of bias. As a result of this it is an important contribution to our understanding of blood pressure in South East Asian populations. Vietnam is a country of some 80 million people (about the same population as Germany), yet there are few epidemiological studies of its people's blood pressure. Their study found lower mean blood pressures than in Western Europe and a lower prevalence of hypertension in farmers than other workers. Few of those that were hypertensive were on treatment. The findings of the study are valuable both as a description of the epidemiology...

Hypertension in the Asia-Pacific region

“…2 Similarly, in the Asia-Pacific region, hypertension is particularly important as this region contains at least 65% of the world's population. 3,4 In the western pacific and south-eastern Asia regions, the prevalence of hypertension ranges from 5 to 47% in men and from 7 to 38% in women, which is comparable with that in western/developed countries. 3 Although the age-standardized rate of hypertension in Korea, Thailand and Taiwan is the lowest among the seven world regions defined by the World Bank, 2 the incidence of hypertension is actually high, 5 due to increasing obesity and metabolic syndrome.…”

Prevalence of hypertension among the elderly Malays living in rural Malaysia

“…The risk of hypertension has even been associated with BMI as low as 23 to 25kg/m2. 9,26,27 In a study in Taiwan, a logistic regression model showed a higher probability of hypertension among elderly Taiwanese with greater BMI. 28 However, because the study design is cross-sectional it is unclear if the malnutrition is a cause of hypertension or secondary to it.…”

Prevalence of hypertension, pre-hypertension and undetected hypertension in Mashhad, Iran

“…Studies from low and high-income countries have shown that women are usually more aware of their HTN. A plausible reason for this is a greater degree of surveillance of women because of maternal and child health programs (Harrison and Marshall, 2006).…”

“…Adiposity is an established risk factor for HTN, appearing to have an impact on HTN for a BMI as low as 23-25 kg/m 2 (Harrison and Marshall, 2006). In a study based in Taiwan, using logistic regression model, HTN was reported to be related to aging and BMI (Tsai et al, 2007).…”