Am J Epidemiol. 2015 Feb 1;181(3):180-4. doi: 10.1093/aje/kwu339. Epub 2014 Dec 29.
Hypertension is a leading risk factor in the global disease burden. Limited hypertension awareness is a major determinant of widespread gaps in hypertension treatment and control, especially in developing countries. We analyzed data on persons aged 50 years or older from 6 low- and middle-income countries participating in the first wave (2007-2010) of the World Health Organization's Survey of Global Ageing and Adult Health (SAGE). Our estimates suggest that just 1 year of routine opportunistic hypertension screening during formal visits to medical-care providers could yield significant increases in hypertension awareness among seniors in the developing world. We also show that eliminating missed opportunities for hypertension screening in medical settings would not necessarily exacerbate existing socioeconomic differences in hypertension awareness, despite requiring at least occasional contact with a formal health-care provider for obtaining a hypertension diagnosis. Thus, routine opportunistic screening for hypertension in formal medical settings may provide a simple but reliable way to increase hypertension awareness. Moreover, the proposed approach has the added advantage of leveraging existing resources and infrastructures, as well as facilitating a direct transition from the point of diagnosis to subsequent expert counseling and clinical care for newly identified hypertension patients.
高血压是全球疾病负担的主要危险因素之一。高血压知晓率有限是造成高血压治疗和控制广泛差距的主要决定因素,尤其是在发展中国家。我们分析了来自参与世界卫生组织全球老龄化和成人健康调查(SAGE)第一波(2007-2010 年)的 6 个中低收入国家 50 岁及以上人群的数据。我们的估计表明,在医疗保健提供者的正式访问期间仅进行一年常规机会性高血压筛查,就可以显著提高发展中国家老年人的高血压知晓率。我们还表明,尽管至少需要偶尔接触正式的医疗保健提供者才能获得高血压诊断,但在医疗环境中消除高血压筛查的错失机会不一定会加剧现有的社会经济差异在高血压知晓率方面,尽管至少需要偶尔接触正式的医疗保健提供者才能获得高血压诊断。因此,在正式医疗环境中进行常规机会性高血压筛查可能是提高高血压知晓率的一种简单但可靠的方法。此外,拟议的方法具有利用现有资源和基础设施的额外优势,并为从诊断点直接过渡到随后为新确定的高血压患者提供专家咨询和临床护理提供了便利。