The impact of a 6-year comprehensive community trial on the awareness, treatment and control rates of hypertension in Iran: experiences from the Isfahan healthy heart program

Abstract

ObjectivesWe aimed to evaluate the changes over time in the prevalence, awareness, treatment, and control rate of hypertension in intervention and reference areas of a comprehensive community trial with reference area.MethodsData from independent sample surveys before and after implementation of the program (2001 vs.2007) were used to compare differences in the intervention and references areas over time. Hypertension was defined as blood pressure ≥140/90 mmHg in non-diabetic patients and ≥130/80 mmHg in diabetic individuals and or taking antihypertensive medications. Interventional activities included educational strategies at population level as well as for hypertensive patients, their families and health professionals.ResultsThe study population of the baseline survey included 6175 (48.7% males) in the interventional area and 6339 (51.3% male) in the reference area. The corresponding figures in the post-intervention phase was 4717 (49.3% male) in the interventional area and 4853 (50.7% male) individuals in the reference area. The prevalence of hypertension had a non-significant decrease from 20.5%to 19.6%, in the interventional area whereas in the reference area, it increased from 17.4% to 19.6% (P = 0.003). If we consider Bp ≥ 140/90 in diabetic and non-diabetic patients as hypertension definition, the prevalence of hypertension in the interventional areas had a non-significant decrease from 18.9% in 2001 to 17.8% in 2007, whereas in the reference area, it had a significant rise from 15.7% to 17.9% (P = 0.002) respectively. Awareness, treatment and control rates of hypertension had better improvement in urban and rural part of the interventional area compared to reference area. The awareness, treatment, and control rates of hypertension increased significantly in the age groups of more than 40 years, as well as in all groups of body mass index in interventional areas without significant change in the reference area. Mean systolic blood pressure of study population in the interventional area decreased from 116.13 ±19.37 to 112.92 ± 18.27 mmHg (P < 0.001) without significant change in reference area.ConclusionsThis comprehensive and integrated program of interventions was effective in tackling with the prevalence of hypertension, and may improve the awareness, treatment and control rates of this disorder in a developing country setting.

Effectiveness of community-based comprehensive healthy lifestyle promotion on cardiovascular disease risk factors in a rural Vietnamese population: a quasi-experimental study

“…Similarly to limited experience from community interventions in developing countries [23-26], our study showed the short-term effect on some CVDRFs especially on BP, suggesting that lifestyle intervention can be successfully implemented in similar rural settings where the burden of hypertension is high but the awareness of them is quite low.…”

Hypertension Knowledge, Awareness, and Self-Management Behaviors Affect Hypertension Control: A Community-Based Study in Xuhui District, Shanghai, China

“…Among patients with type 2 DM, high BP is common at the time of diagnosis of diabetes [8]. A reduction in SBP leads to significant declines in heart failure, myocardial infarction, stroke, and other atherosclerotic events [9]. Patients in the present study who visited clinics because of fear of complications were more likely to fail in controlling hypertension as well.…”

The Influence of Health Systems on Hypertension Awareness, Treatment, and Control: A Systematic Literature Review

“…51 of the included studies were quantitative and two were qualitative [22],[23]. Of the 51 quantitative studies, one was a RCT [24]; 12 were cohort studies [25]–[34], two of which were retrospective [30],[34]; three were case-control studies [35]–[37]; 32 were cross-sectional studies; and three were ecological studies [38]–[40]. 42 of the 53 studies (79%) were carried out in countries classified by the World Bank as high-income countries, 36 of which were in the US.…”