Gupta Rajeev, Kaur Manmeet, Islam Shofiqul, Mohan Viswanathan, Mony Prem, Kumar Rajesh, Kutty Vellappillil Raman, Iqbal Romaina, Rahman Omar, Deepa Mohan, Antony Justy, Vijaykumar Krishnapillai, Kazmi Khawar, Yusuf Rita, Mohan Indu, Panwar Raja Babu, Rangarajan Sumathy, Yusuf Salim
Department of Medicine, Eternal Heart Care Centre and Research Institute, Mount Sinai New York Affiliate, Jaipur, India.
School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Am J Hypertens. 2017 Apr 1;30(4):373-381. doi: 10.1093/ajh/hpw169.
Hypertension control rates are low in South Asia. To determine association of measures of socioeconomic status (wealth, education, and social capital) with hypertension awareness, treatment, and control among urban and rural subjects in these countries we performed the present study.
We enrolled 33,423 subjects aged 35-70 years (women 56%, rural 53%, low-education status 51%, low household wealth 25%, low-social capital 33%) in 150 communities in India, Pakistan, and Bangladesh during 2003-2009. Prevalence of hypertension and its awareness, treatment, and control status and their association with wealth, education, and social capital were determined.
Age-, sex-, and location-adjusted prevalence of hypertension in men was 31.5% (23.9-40.2%) and women was 32.6% (24.9-41.5%) with variations in prevalence across study sites (urban 30-56%, rural 11-43%). Prevalence was significantly greater in urban locations, older subjects, and participants with more wealth, greater education, and lower social capital index. Hypertension awareness was in 40.4% (urban 45.9, rural 32.5), treatment in 31.9% (urban 37.6, rural 23.6), and control in 12.9% (urban 15.4, rural 9.3). Control was lower in men and younger subjects. Hypertension awareness, treatment, and control were significantly lower, respectively, in lowest vs. highest wealth index tertile (26.2 vs. 50.6%, 16.9 vs. 44.0%, and 6.9 vs. 17.3%, P < 0.001) and lowest vs. highest educational status tertile (31.2 vs. 48.4%, 21.8 vs. 42.1%, and 7.8 vs. 19.2%, P < 0.001) while insignificant differences were observed in lowest vs. highest social capital index (38.2 vs. 36.1%, 35.1 vs. 27.8%, and 12.5 vs. 9.1%).
This study shows low hypertension awareness, treatment, and control in South Asia. Lower wealth and educational status are important in low hypertension awareness, treatment, and control.
南亚地区高血压控制率较低。为了确定社会经济地位（财富、教育和社会资本）指标与这些国家城乡人群高血压知晓率、治疗率和控制率之间的关联，我们开展了本研究。
2003年至2009年期间，我们在印度、巴基斯坦和孟加拉国的150个社区招募了33423名年龄在35至70岁之间的受试者（女性占56%，农村人口占53%，低教育程度者占51%，低家庭财富者占25%，低社会资本者占33%）。确定了高血压患病率及其知晓率、治疗率和控制率，以及它们与财富、教育和社会资本的关联。
经年龄、性别和地点调整后，男性高血压患病率为31.5%（23.9 - 40.2%），女性为32.6%（24.9 - 41.5%），各研究地点患病率有所不同（城市为30 - 56%，农村为11 - 43%）。城市地区、年龄较大的受试者以及财富更多、教育程度更高和社会资本指数较低的参与者中患病率显著更高。高血压知晓率为40.4%（城市为45.9%，农村为32.5%），治疗率为31.9%（城市为37.6%，农村为23.6%），控制率为12.9%（城市为15.4%，农村为9.3%）。男性和较年轻受试者的控制率较低。最低财富指数三分位数组与最高财富指数三分位数组相比，高血压知晓率、治疗率和控制率分别显著更低（26.2%对50.6%，16.9%对44.0%，6.9%对17.3%，P < 0.001）；最低教育程度三分位数组与最高教育程度三分位数组相比，情况类似（31.2%对48.4%，21.8%对42.1%，7.8%对19.2%，P < 0.001），而最低社会资本指数三分位数组与最高社会资本指数三分位数组相比，差异不显著（38.2%对36.1%，35.1%对27.8%，12.5%对9.1%）。
本研究表明南亚地区高血压知晓率、治疗率和控制率较低。较低的财富和教育程度对高血压知晓率、治疗率和控制率较低具有重要影响。
