Busingye D, Arabshahi S, Evans R G, Srikanth V K, Kartik K, Kalyanram K, Riddell M A, Zhu X, Suresh O, Thrift A G
Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
Department of Physiology, Cardiovascular Disease Program, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.
J Hum Hypertens. 2017 May;31(5):347-353. doi: 10.1038/jhh.2016.85. Epub 2017 Jan 5.
The aim of this study was to identify factors associated with awareness, treatment and control of hypertension in a rural setting in India. Following screening of the population, all individuals with hypertension (blood pressure (BP) ⩾140/90 mm Hg or taking antihypertensive medications) were invited to participate in this study. We measured BP, height, weight, skinfolds, waist and hip circumference, and administered a questionnaire to obtain information regarding socioeconomic and behavioural characteristics. Multivariable logistic regression was used to determine factors associated with awareness, treatment and control of hypertension. We recruited 277 individuals with hypertension. Awareness (43%), treatment (33%) and control (27%) of hypertension were poor. Greater distance to health services (odds ratio (OR) 0.56 (95% confidence interval (CI)) 0.32-0.98) was associated with poor awareness of hypertension while having had BP measured within the previous year (OR 4.72, 95% CI 2.71-8.22), older age and greater per cent body fat were associated with better awareness. Factors associated with treatment of hypertension were having had BP measured within the previous year (OR 6.18, 95% CI 3.23-11.82), age ⩾65 years, physical inactivity and greater per cent body fat. The only factor associated with control of hypertension was greater per cent body fat (OR 1.05, 95% CI 1.01-1.11). Improving geographic access and utilisation of health services should improve awareness and treatment of hypertension in this rural population. Further research is necessary to determine drivers of control.
本研究旨在确定印度农村地区与高血压知晓、治疗和控制相关的因素。在对人群进行筛查后,所有高血压患者(血压(BP)⩾140/90 mmHg或正在服用抗高血压药物)均被邀请参与本研究。我们测量了血压、身高、体重、皮褶厚度、腰围和臀围,并发放问卷以获取有关社会经济和行为特征的信息。采用多变量逻辑回归来确定与高血压知晓、治疗和控制相关的因素。我们招募了277名高血压患者。高血压的知晓率(43%)、治疗率(33%)和控制率(27%)较低。距离医疗服务机构较远(比值比(OR)0.56(95%置信区间(CI))0.32 - 0.98)与高血压知晓率低相关,而在前一年测量过血压(OR 4.72,95% CI 2.71 - 8.22)、年龄较大和体脂百分比更高则与更好的知晓率相关。与高血压治疗相关的因素包括在前一年测量过血压(OR 6.18,95% CI 3.23 - 11.82)、年龄⩾65岁、身体活动不足和体脂百分比更高。与高血压控制相关的唯一因素是体脂百分比更高(OR 1.05,95% CI 1.01 - 1.11)。改善地理可达性和医疗服务利用情况应能提高该农村人群对高血压的知晓率和治疗率。有必要进一步开展研究以确定控制的驱动因素。