Hussain Mohammad Akhtar, Mamun Abdullah Al, Reid Christopher, Huxley Rachel R
Division of Epidemiology and Biostatistics, School of Public Health, The University of Queensland, Brisbane, Australia.
School of Public Health, Curtin University, Perth, Australia.
PLoS One. 2016 Aug 24;11(8):e0160922. doi: 10.1371/journal.pone.0160922. eCollection 2016.
Hypertension is the major driver of the cardiovascular epidemic facing Indonesia in the 21st century. Understanding the socioeconomic inequalities associated with hypertension is essential for designing effective intervention strategies. The aim of the current study was to use sub-nationally representative survey data to examine socio-demographic inequalities in the prevalence, diagnosis and management of hypertension in Indonesian adults.
We investigated factors associated with hypertension prevalence, diagnosis, treatment and control using data on self-reported diagnosis and treatment, and blood pressure measurements, collected from 9755 respondents aged 40 years and up in the 2007 Indonesian Family Life Survey (IFLS 4).
Age-standardized prevalence of hypertension among the study participants was 47.8% (95% CI: 46.8, 48.9), of which almost 70% were undiagnosed. Hypertension was significantly higher in women than men (52.3% versus 43.1%, p-value<0.001). Prevalence of hypertension increased significantly with ageing (Pfor trend <0.001). Over 91% (men: 92.1%, women: 90.0%) of hypertension cases were uncontrolled. Gender, education and socioeconomic status had differential impact on the diagnosis of hypertension and in receiving treatment.
Overall, less than a third were aware of their hypertension and a quarter of those on medication had their blood pressure effectively controlled. Men and those of younger age were more vulnerable to have undiagnosed and untreated hypertension. Substantial effort should be given to improve awareness about the condition and making provision for early diagnosis and treatment.
高血压是21世纪印度尼西亚面临的心血管疾病流行的主要驱动因素。了解与高血压相关的社会经济不平等对于设计有效的干预策略至关重要。本研究的目的是利用具有次国家级代表性的调查数据，研究印度尼西亚成年人高血压患病率、诊断和管理方面的社会人口不平等情况。
我们使用2007年印度尼西亚家庭生活调查（IFLS 4）中9755名40岁及以上受访者的自我报告诊断和治疗数据以及血压测量数据，调查与高血压患病率、诊断、治疗和控制相关的因素。
研究参与者中年龄标准化高血压患病率为47.8%（95%置信区间：46.8, 48.9），其中近70%未被诊断。女性高血压患病率显著高于男性（52.3%对43.1%，p值<0.001）。高血压患病率随年龄增长显著增加（趋势p值<0.001）。超过91%（男性：92.1%，女性：90.0%）的高血压病例未得到控制。性别、教育程度和社会经济地位对高血压的诊断和接受治疗有不同影响。
总体而言，不到三分之一的人意识到自己患有高血压，而服药者中四分之一的人的血压得到了有效控制。男性和年轻人更容易出现未被诊断和未得到治疗的高血压。应付出巨大努力提高对该病的认识，并提供早期诊断和治疗。
