https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(05)17741-1.pdf

Global burden of hypertension: analysis of worldwide data

Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial

Importance Hypertension is the most important preventable cause of morbidity and mortality globally, yet there are relatively few data collected using standardized methods. Objective To examine hypertension prevalence, awareness, treatment, and control in participants at baseline in the Prospective Urban Rural Epidemiology (PURE) study. Design, Setting, and Participants A cross-sectional study of 153 996 adults (complete data for this analysis on 142 042) aged 35 to 70 years, recruited between January 2003 and December 2009. Participants were from 628 communities in 3 high-income countries (HIC), 10 upper–middle-income and low–middle-income countries (UMIC and LMIC), and 4 low-income countries (LIC). Main Outcomes and Measures Hypertension was defined as individuals with self-reported treated hypertension or with an average of 2 blood pressure measurements of at least 140/90 mm Hg using an automated digital device. Awareness was based on self-reports, treatment was based on the regular use of blood pressure–lowering medications, and control was defined as individuals with blood pressure lower than 140/90 mm Hg. Results Among the 142 042 participants, 57 840 (40.8%; 95% CI, 40.5%-41.0%) had hypertension and 26 877 (46.5%; 95% CI, 46.1%-46.9%) were aware of the diagnosis. Of those who were aware of the diagnosis, the majority (23 510 [87.5%; 95% CI, 87.1%-87.9%] of those who were aware) were receiving pharmacological treatments, but only a minority of those receiving treatment were controlled (7634 [32.5%; 95% CI, 31.9%-33.1%]). Overall, 30.8%, 95% CI, 30.2%-31.4% of treated patients were taking 2 or more types of blood pressure–lowering medications. The percentages aware (49.0% [95% CI, 47.8%-50.3%] in HICs, 52.5% [95% CI, 51.8%-53.2%] in UMICs, 43.6% [95% CI, 42.9%-44.2%] in LMICs, and 40.8% [95% CI, 39.9%-41.8%] in LICs) and treated (46.7% [95% CI, 45.5%-47.9%] in HICs, 48.3%, [95% CI, 47.6%-49.1%] in UMICs, 36.9%, [95% CI, 36.3%-37.6%] in LMICs, and 31.7% [95% CI, 30.8%-32.6%] in LICs) were lower in LICs compared with all other countries for awareness (P Conclusions and Relevance Among a multinational study population, 46.5% of participants with hypertension were aware of the diagnosis, with blood pressure control among 32.5% of those being treated. These findings suggest substantial room for improvement in hypertension diagnosis and treatment.

https://jamanetwork.com/journals/jama/articlepdf/1734702/joi130042.pdf

Prevalence, Awareness, Treatment, and Control of Hypertension in Rural and Urban Communities in High-, Middle-, and Low-Income Countries

http://repositorio.inger.gob.mx/jspui/bitstream/20.500.12100/17171/1/PIIS0140673614613477.pdf

The burden of disease in older people and implications for health policy and practice

PurposeTo examine the prevalence and the level of awareness, treatment and control of hypertension in different world regions.Study selectionA literature search of the MEDLINE database, using the Medical Subject Headings prevalence, hypertension, blood pressure and cross-sectional studies, was condu

Worldwide prevalence of hypertension: a systematic review.

The objective of this study was to estimate the prevalence and distribution of hypertension and to determine the status of hypertension awareness, treatment, and control in the general adult population in China. The International Collaborative Study of Cardiovascular Disease in ASIA (InterASIA), conducted in 2000-2001, used a multistage cluster sampling method to select a nationally representative sample. A total of 15 540 adults, age 35 to 74 years, were examined. Three blood pressure measurements were obtained by trained observers by use of a standardized mercury sphygmomanometer after a 5-minute sitting rest. Information on history of hypertension and use of antihypertensive medications was obtained by use of a standard questionnaire. Hypertension was defined as a mean systolic blood pressure > or =140 mm Hg, diastolic blood pressure > or =90 mm Hg, and/or use of antihypertensive medications. Overall, 27.2% of the Chinese adult population age 35 to 74 years, representing 129 824 000 persons, had hypertension. The age-specific prevalence of hypertension was 17.4%, 28.2%, 40.7%, and 47.3% in men and 10.7%, 26.8%, 38.9%, and 50.2% in women age 35 to 44 years, 45 to 54 years, 55 to 64 years, and 65 to 74 years, respectively. Among hypertensive patients, only 44.7% were aware of their high blood pressure, 28.2% were taking antihypertensive medication, and 8.1% achieved blood pressure control (<140/90 mm Hg). Our results indicate that hypertension is highly prevalent in China. The percentages of those with hypertension who are aware, treated, and controlled are unacceptably low. These results underscore the urgent need to develop national strategies to improve prevention, detection, and treatment of hypertension in China.

Prevalence, awareness, treatment, and control of hypertension in china.

OBJECTIVE To compare the prevalence, awareness, treatment and control of hypertension in north and south, and urban and rural residents of China. DESIGN A cross-sectional survey conducted in 2000-2001. SETTING AND PARTICIPANTS A multistage cluster sampling method was used to select a nationally representative sample of 15 540 men and women aged 35-74 years from the general Chinese population. MAIN OUTCOME MEASURES Three blood pressure measurements were obtained by trained observers using a standardized mercury sphygmomanometer. Information on history of hypertension and use of antihypertensive medications was obtained by use of a standard questionnaire. Hypertension was defined as a mean systolic blood pressure >or= 140 mmHg and/or diastolic blood pressure >or= 90 mmHg and/or use of antihypertensive medications. RESULTS The age-standardized prevalence of hypertension was significantly higher among residents living in north than in south China (33.8 versus 23.3%, P < 0.001), but similar in those living in urban and rural areas (29.0 versus 28.1%, P = 0.3). Average systolic and diastolic blood pressure levels were consistently higher in north than in south residents. Residents in north China had higher percentages of awareness but lower percentages of control compared with their counterparts in south China. Percentages of awareness, treatment and control of hypertension were significantly higher in urban than in rural residents. CONCLUSIONS Our study documents a marked north-south gradient in the prevalence of hypertension in China. The previously reported urban-rural difference in the prevalence of hypertension was not noted, perhaps due to a rapid increase in the prevalence of hypertension in rural China.

Geographic variations in the prevalence, awareness, treatment and control of hypertension in China.

Objective To determine whether a community-based cardiovascular disease (CVD) intervention program, undertaken over six years, was cost-effective Methods Based on Beijing Fangshan Cardiovascular Disease Comprehensive Prevention Program, the cost for intervention and expenditure saved from caring for CVD in the communities with intervention from 1992 to 1997 were calculated, and cost-effectiveness analysis was performed using disability-adjusted life years (DALYs) gained as an indicator of effectiveness Results The cost for one DALY gained reduced gradually from 1992 to 1997, with an average ratio of cost to effectiveness of four to one (4:1) It cost annually 1,58600, 1,38020, -2,35080, -90530, -1,49560 and -1,76670 RMB yuan for one life-year saved, from 1992 to 1997 respectively, in a gradually decreasing trend with the increase in length of intervention After intervention for two years, ratio of cost to effectiveness has become negative since 1994, which meant a positive benefit from intervention Sensitivity analysis showed that ratio of cost to effectiveness was little sensitive to the changes in discount rate, weight of age and increase in cost of hospitalization for stroke and coronary heart disease, which reflected its reliability Conclusion Community-based comprehensive intervention for CVD in rural population is cost-effective

Guanyong Huang

Papers

Prevalence, awareness, treatment, and control of hypertension in china.

Geographic variations in the prevalence, awareness, treatment and control of hypertension in China.

[Cost-effectiveness analysis of Beijing Fangshan cardiovascular prevention program in 1992 - 1997].