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Determinants of Uncontrolled Hypertension in Rural Communities in South Asia—Bangladesh, Pakistan, and Sri Lanka
| Content Provider | Semantic Scholar |
|---|---|
| Author | Jafar, Tazeen Hasan Gandhi, Mihir Jehan, Imtiaz Naheed, Aliya Silva, Hithanadura Asita De Shahab, Hunaina Alam, Dewan S. Luke, Nathasha Vihangi Lim, Ching Wee |
| Copyright Year | 2018 |
| Abstract | BACKGROUND Uncontrolled 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. METHODS We 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). RESULTS Among 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)). CONCLUSIONS The 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. |
| Starting Page | 1205 |
| Ending Page | 1214 |
| Page Count | 10 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://tampub.uta.fi/bitstream/handle/10024/104455/determinants_of_uncontrolled_hypertension_2018.pdf?isAllowed=y&sequence=1 |
| PubMed reference number | 29701801 |
| Alternate Webpage(s) | https://doi.org/10.1093/ajh/hpy071 |
| DOI | 10.1093/ajh/hpy071 |
| Journal | American journal of hypertension |
| Volume Number | 31 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Antihypertensive Agents Cessation of life Community Confidence Intervals Creatinine Diastole Estimated Glomerular Filtration Rate Hypertensive disease Kidney Diseases Microalbumin Simvastatin Treatment - Filtration cassava mosaic virus |
| Content Type | Text |
| Resource Type | Article |
