Determinants of prevalence, awareness, treatment and control of high blood pressure

Öz

Objective: The aim of the study was to evaluate prevalence, awareness, treatment and control rates of hypertension (HT) and associated factors among individuals over 30 years old living in Balcova District of Izmir.Methods: Data from 12,742 individuals who participated the baseline study of Heart of Balcova Project during 2007-2009 was evaluated. HT was defined as mean blood pressure ≥140/90mmHg or being on antihypertensive medication. Multivariate logistic regression analysis was applied to assess the determinants of prevalence, awareness, treatment and control of high blood pressure. Results: The overall prevalence of HT was 39,5% in male, 41.6% in female and 40,9% in total. Among participants with HT, 73.3% were aware of it. Among participants aware of HT 90.9% were treated, 49.6% of those treated were controlled (BP <140/90 mmHg). HT presence was associated with increasing age, female gender, poor self assessed health, physical inactivity, high waist circumference, diagnosis of coronary heart disease(CHD), diabetes or hyperlipidemia, family history of CHD. Awareness of HT was positively associated with increasing age, male gender, CHD, stroke, DM, hyperlipidemia, and history of CHD. Awareness was lower among individuals who added salt without tasting the meal. HT control was significantly higher among men while it decreased with increasing age.Conclusion: In this study awareness, treatment and control rates for HT were higher compared to other studies. While female gender, presence of chronic diseases and family history of CHD increased awareness and control, male gender and obesity had negative impact on control rates. The reasons behind low control rates despite high awareness should be explored in further studies

Anahtar Kelimeler

• Hypertension
• prevalence
• awareness
• treatment
• control

Hipertansiyon sıklığı, farkındalığı, tedavi alma ve kan basıncı kontrolünü etkileyen etmenler

Öz

Amaç: Bu çalışmada İzmir ili Balçova İlçesi’nde yaşayan 30 yaş ve üzeri bireylerde hipertansiyon (HT) sıklığı ve HT farkındalık, tedavi ve kontrol düzeylerini etkileyen etmenlerin değerlendirilmesi amaçlanmıştır.

Yöntemler: Balçova’nın Kalbi Projesi kapsamında 2007-2009 yılları arasında durum saptama aşamasına katılan 12,742 kişinin verisi değerlendirilmiştir. Ortalama kan basıncı ≥140/90 mmHg üzerinde olan ya da antihipertansif ilaç kullanan bireyler “hipertansiyonu var” olarak kabul edilmişlerdir. HT varlığı, farkındalık, tedavi ve kontrol düzeylerini etkileyen etmenler çok değişkenli lojistik regresyon analizi ile değerlendirilmiştir.

Bulgular: Hipertansiyon sıklığı erkeklerde %39,5, kadınlarda %41,6 ve toplamda %40,9 olarak bulunmuştur. Hipertansif olan bireylerin % 73,3’ü sağlık durumlarının farkındadır. HT varlığının farkında olan bireylerin ise %90,9’u ilaç tedavisi almakta ve %49,6’sının kan basıncı kontrol altında bulunmaktadır. Artan yaş, kadın cinsiyet, sağlık algısının kötü olması, fiziksel inaktivite, bel çevresinin sınır değerin üstünde olması koroner kalp hastalığı (KKH), Diyabet (DM) veya hiperlipidemi tanısı ve ailede KKH öyküsü HT görülme olasılığını artırmıştır. HT farkındalığını ise artan yaş, erkek cinsiyet, KKH, inme, DM, hiperlipidemi varlığı ve ailede KKH öyküsü olması olumlu etkiler iken tadına bakmadan tuz kullanan bireylerde farkındalık düzeyi anlamlı olarak düşük bulunmuştur. HT kontrolü artan yaş ile birlikte azalırken, erkeklerde daha yüksek bulunmuştur.

Sonuç: Bu çalışmada HT farkındalık, tedavi ve kontrol oranları diğer çalışmalara göre daha yüksektir. Kadın cinsiyet, kronik hastalık ve ailede KKH hikayesi varlığı farkındalık ve kontrolü artırırken erkek cinsiyet ve obezite varlığı kontrol düzeylerini olumsuz etkilemektedir. Farkındalığın yüksek olmasına rağmen kontrol oranlarının düşük olmasının nedenleri ileri çalışmalarla incelenmesi gerekmektedir.

Anahtar Kelimeler

• hipertansiyon
• prevalans
• farkındalık
• tedavi
• kontrol

Kaynakça

1. Ezzati M, Lopez AD, Rodgers A, et al. Selected major risk factors and global and regional burden of disease. Lancet 2002,
2. :1347-1360.
3. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 2006;3:e442.
4. Danaei G, Finucane MM, Lin JK et al. National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5.4 million participants. Lancet 2011;377:568-577.
5. Gaziano TA, Bitton A, Anand S, et al. The global cost of nonoptimal blood pressure. J Hypertens 2009;27:1472-1477.
6. Smith WC, Lee AJ, Crombie IK, et al. Control of blood pressure in Scotland: the rule of halves. BMJ 1990;300:981-983.
7. Chow CK, Teo KK, Rangarajan S, et al. Prevalence, wareness,
8. treatment, and control of hypertension in rural and urban

9. communities in high-, middle-, and low-income countries.
10. JAMA 2013;310:959-968.
11. Altun B, Suleymanlar G, Utas C, et al. Prevalence, awareness,
12. treatment and control of hypertension in adults with chronic
13. kidney disease in Turkey: results from the CREDIT study.
14. Kidney Blood Press Res 2012;36:36-46.
15. Ünal B, Ergör G: Türkiye Kronik Hastalıklar ve Risk Faktörleri
16. Sıklığı Çalışması. In. Ankara: Sağlık Bakanlığı; 2013.
17. Sengul S, Erdem Y, Akpolat T, et al. Controlling hypertension
18. in Turkey: not a hopeless dream. Kidney Int Suppl (2011)
19. ;3:326-331.
20. Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007;25:1105-1187.
21. Sozmen K, Baydur H, Simsek H, et al. Decomposing socioeconomic inequalities in self assessed health in Turkey. IntJ
22. Equity Health 2012;11:73.
23. Craig CL, Marshall AL, Sjostrom M, et al. International physical activity questionnaire: 12-country reliability and validity.
24. Med Sci Sports Exerc 2003;35:1381-1395.
25. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and
26. management of the metabolic syndrome: an American Heart
27. Association/National Heart, Lung, and Blood Institute scientific statement: Executive Summary. Crit Pathw Cardiol
28. ;4:198-203.
29. Graham I, Atar D, Borch-Johnsen K, et al. European guidelines on cardiovascular disease prevention in clinical practice: full text. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur J Cardiovasc Prev Rehabil 2007;14 Suppl 2:S1-113.
30. National Cholesterol Education Program Expert Panel on
31. Detection E, Treatment of High Blood Cholesterol in A.
32. Third Report of the National Cholesterol Education Program
33. (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002, 106:3143-3421.
34. Ergor G, Soysal A, Sozmen K, et al. Balcova heart study: rationale and methodology of the Turkish cohort. Int J Public
35. Health 2012;57:535-542.
36. Satman I, Yilmaz T, Sengul A, et al. Population-based study
37. of diabetes and risk characteristics in Turkey: results of the
38. Turkish Diabetes Epidemiology Study (TURDEP). Diabetes
39. Care 2002;25:1551-1556.
40. Satman I, Omer B, Tutuncu Y, et al. Twelve-year trends in
41. the prevalence and risk factors of diabetes and prediabetes in
42. Turkish adults. Eur J Epidemiol 2013;28:169-180.
43. Altun B, Arici M, Nergizoglu G, et al. Prevalence, awareness,
44. treatment and control of hypertension in Turkey (the PatenT
45. study) in 2003. J Hypertens 2005;23:1817-1823.
46. Asilar RH, Inandi T, Yimdirim A, et al. Frequency, Awareness,
47. Treatment and Control of Hypertension in the over 40 Population of Erzincan. TAF Prev Med Bull 2014;13:357-366.
48. Ha DA, Goldberg RJ, Allison JJ, et al. Prevalence, Awareness, Treatment, and Control of High Blood Pressure: A Pop ulation-Based Survey in Thai Nguyen, Vietnam. PLoS One
49. ;8:e66792.
50. Saeed AA, Al-Hamdan NA, Bahnassy AA, et al. Prevalence,
51. Awareness, Treatment, and Control of Hypertension among
52. Saudi Adult Population: A National Survey. Int J Hypertens 2011;2011:174135.
53. Gee ME, Campbell NR, Bancej CM, et al. Perception of uncontrolled blood pressure and behaviours to improve blood
54. pressure: findings from the 2009 Survey on Living with
55. Chronic Diseases in Canada. J Hum Hypertens 2012;26:188-
56. -
57. Jaddou HY, Batieha AM, Khader YS, et al. Hypertension
58. prevalence, awareness, treatment and control, and associated
59. factors: results from a national survey, Jordan. Int J Hypertens
60. ;2011:828797.
61. Dogan N, Toprak D, Demir S. Hypertension prevalence and
62. risk factors among adult population in Afyonkarahisar region: a cross-sectional research. Anadolu Kardiyol Derg
63. ;12:47-52.
64. Danon-Hersch N, Marques-Vidal P, Bovet P, et al. revalence,
65. awareness, treatment and control of high blood pressure in a
66. Swiss city general population: the CoLaus study. Eur J Cardiovasc Prev Rehabil 2009;16:66-72.
67. Douketis JD, Sharma AM. The management of hypertension
68. in the overweight and obese patient: is weight reduction sufficient? Drugs 2004;64:795-803.
69. Mason H, Shoaibi A, Ghandour R, et al. A cost effectiveness
70. analysis of salt reduction policies to reduce coronary heart
71. disease in four Eastern Mediterranean countries. PLoS One
72. ;9:e84445.
73. Erdem Y, Arici M, Altun B, et al. The relationship between hy pertension and salt intake in Turkish population: SALTURK
74. study. Blood Press 2010;19:313-318.
75. Tunstall-Pedoe H, Connaghan J, Woodward M, et al. Pattern of declining blood pressure across replicate population
76. surveys of the WHO MONICA project, mid-1980s to mid-1990s, and the role of medication. BMJ 2006;332:629-635.
77. Nissinen A, Berrios X, Puska P. Community-based noncommunicable disease interventions: lessons from developed countries for developing ones. Bull World Health Organ 2001;79:963-970.