Treatment of hypertension in Germany: is there a social gradient?

Laaser, Ulrich; Breckenkamp, Jürgen; Bjegovic, Vesna

doi:10.1007/s00038-011-0274-4

Cited by 5 publications

(7 citation statements)

References 29 publications

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“… 26 Our findings highlight that the need of comprehensive pro-poor public health programs for hypertension management in rural South Asia. 27 , 28 …”

Section: Discussionmentioning

confidence: 99%

Determinants of Uncontrolled Hypertension in Rural Communities in South Asia—Bangladesh, Pakistan, and Sri Lanka

Jafar

Gandhi

Jehan

et al. 2018

American Journal of Hypertension

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BACKGROUNDUncontrolled blood pressure (BP) is a leading risk factor for death and disability in South Asia. We aimed to determine the cross-country variation, and the factors associated with uncontrolled BP among adults treated for hypertension in rural South Asia.METHODSWe enrolled 1,718 individuals aged ≥40 years treated for hypertension in a cross-sectional study from rural communities in Bangladesh, Pakistan, and Sri Lanka. Multivariable logistic regression model was used to determine the factors associated with uncontrolled BP (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg).RESULTSAmong hypertensive individuals, 58.0% (95% confidence interval (CI) 55.7, 60.4) had uncontrolled BP: 52.8% (49.0, 56.6) in Bangladesh, 70.6% (65.7, 75.1) in Pakistan, and 56.5% (52.7, 60.1) in Sri Lanka. The odds (odds ratio (95% CI)) of uncontrolled BP were significantly higher in individuals with lower wealth index (1.17 (1.02, 1.35)); single vs. married (1.46 (1.10, 1.93)); higher log urine albumin-to-creatinine ratio (1.41 (1.24, 1.60)); lower estimated glomerular filtration rate (1.23 (1.01, 1.49)); low vs. high adherence to antihypertensive medication (1.50 (1.16, 1.94)); and Pakistan (2.91 (1.60, 5.28)) vs. Sri Lanka. However, the odds were lower in those with vs. without self-reported kidney disease (0.51 (0.28, 0.91)); and receiving vs. not receiving statins (0.62 (0.44, 0.87)).CONCLUSIONSThe majority of individuals with treated hypertension have uncontrolled BP in rural Bangladesh, Pakistan, and Sri Lanka with significant disparities among and within countries. Urgent public health efforts are needed to improve access and adherence to antihypertensive medications in disadvantaged populations in rural South Asia.

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“… 26 Our findings highlight that the need of comprehensive pro-poor public health programs for hypertension management in rural South Asia. 27 , 28 …”

Section: Discussionmentioning

confidence: 99%

Determinants of Uncontrolled Hypertension in Rural Communities in South Asia—Bangladesh, Pakistan, and Sri Lanka

Jafar

Gandhi

Jehan

et al. 2018

American Journal of Hypertension

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“…Globally, approximately two-thirds of CVD and one-half of IHD were attributable to non-optimal blood pressure, with little variation by sex 1,39 . It is surprising that the controlled fraction of this key risk factor is usually smaller than a quarter of those with hypertension 40 .…”

Section: Discussionmentioning

confidence: 99%

The burden of disease preventable by risk factor reduction in Serbia

Šipetić¹,

Bjegović-Mikanović²,

Vlajinac³

et al. 2013

VOJNOSANIT PREGL

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This study shows that a high percentage of disease and injury burden in Serbia is attributable to avoidable risk factors, which emphasizes the need for improvement of relevant preventive strategies and programs at both individual and population levels. Social preferences should be determined for a comprehensive set of conditions and cost effectiveness analyses of potential interventions should be carried out. Furthermore, positive measures, derived from health, disability and quality of life surveys, should be included.

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“…Given the low rates of control in Germany, the aim of this study is to test the hypothesis of statistically significant differences between socio-economic groups for the treatment parameters of cholesterol. In an earlier similar analysis of awareness, treatment and treatment effectiveness of hypertension, no statistically significant differences were found between socio-economic groups [5].…”

Section: T Reat Ment O F Elevate D Cholesterol In G Erman Ymentioning

confidence: 81%

“…The most recent data available on hypercholesterolemia for Germany comes from the Federal Health Survey (FHS) [5,6] with data from 1998. The study population was defined as all persons aged between 18 and 79 years living in private households in Germany.…”

Section: Methodsmentioning

confidence: 99%

Treatment of elevated cholesterol in a representative cross-sectional sample of 4 892 Germans: is there a social gradient?

Laaser

Breckenkamp

Sauzet

et al. 2022

ebph

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Background: effective control of cardiovascular risk factors remains low in most countries and also in Germany. We investigate whether socio-economic status has an impact on the level of medical treatment and control (normalized values) of total cholesterol. Methods: data on blood lipids from 4 892 participants in the last German Health Survey of 1998 are analysed, adjusting for key determinants in logistic regression analyses. Socio-economic status is not determined by educational achievement alone but also including occupation and household income. Results: the actual prevalence of total cholesterol of ≥240 mg/dl was 53.4%. Only 3.6% of prevalent cases are under effective treatment. Less favourable values of total cholesterol and HDL are displayed by males and in lower social groups, while the middle groups are in an intermediate position. Chances to be treated for hypercholesterolemia are significantly less favourable for females (odds ratio (OR) estimate: 0.70) and better for the age bands ≥50 (OR 2.37) and ≥60 (OR 3.57), if a general practitioner is visited (OR 1.77), and if living in Eastern Germany (OR 1.89). However, chances are not significantly different according to social status. Conclusions: statistically significant social group differences cannot be detected at the present low level of effective treatment. This may be different if higher levels of control are achieved.

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Treatment of hypertension in Germany: is there a social gradient?

Abstract: German survey data for antihypertensive treatment do not show any significant disadvantage for the lowest social class.

Cited by 5 publications

References 29 publications

Determinants of Uncontrolled Hypertension in Rural Communities in South Asia—Bangladesh, Pakistan, and Sri Lanka

Determinants of Uncontrolled Hypertension in Rural Communities in South Asia—Bangladesh, Pakistan, and Sri Lanka

The burden of disease preventable by risk factor reduction in Serbia

Treatment of elevated cholesterol in a representative cross-sectional sample of 4 892 Germans: is there a social gradient?

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