Jardim Thiago Veiga, Reiger Sheridan, Abrahams-Gessel Shafika, Gomez-Olive F Xavier, Wagner Ryan G, Wade Alisha, Bärnighausen Till W, Salomon Joshua, Tollman Stephen, Gaziano Thomas A
aDepartment of Cardiovascular Medicine, Brigham and Women's HospitalbCenter for Health Decision Science, Harvard T.H. Chan School of Public Health, BostoncHarvard Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts, USAdMedical Research Council/Wits Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South AfricaeINDEPTH Network, Accra, GhanafAfrica Wits-INDEPTH Genomic Studies of Cardiovascular Disease, University of the Witwatersrand; Division of Epidemiology and Global Health, Department of Public Health and Clinical MedicinegUmea Centre for Global Health Research, Umea University, Umea, SwedenhSchool of Public Health, University of the Witwatersrand, Johannesburg, South AfricaiDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USAjAfrica Health Research Institute (AHRI), Mtubatuba, South AfricakInstitute of Public Health, University of Heidelberg, Heidelberg, Germany.
J Hypertens. 2017 Jun;35(6):1283-1289. doi: 10.1097/HJH.0000000000001312.
Assess awareness, treatment, and control of hypertension, as an indication of its management, in rural South Africa, especially regarding modifiers of these variables.
A population-representative sample of adults aged at least 40 years residing in the rural Agincourt subdistrict (Mpumalanga Province) covered by a long-term health and sociodemographic surveillance system was recruited. In-person interviews, physical exams, and dried blood spots were collected. Hypertension awareness, treatment, and control rates were assessed. A regression model was built to identify predictors of those outcomes.
The mean age of the 2884 hypertensive participants was 64.1 ± 12.7 years. Hypertension awareness rate was 64.4%, treatment among those aware was 89.3 and 45.8% of those treated were controlled. Considering aware and unaware hypertensives, treatment rate was 49.7% and control 22.8%. In the multivariable regression model, awareness was predicted by female sex, age at least 60 years, higher social economic status, prior cardiovascular disease (CVD), nonimmigrant status, literacy, and physical limitation. Improved control among those treated was predicted by age at least 60 years. Blood pressure control among all hypertensive study participants was predicted by female sex, being HIV-negative, age at least 60 years, nonimmigrant status, and prior CVD.
High rates of awareness and treatment of hypertension as well as good levels of control were found in this population, probably explained by the long-term surveillance program conducted in the area. Considering the predictors of hypertension management, particular attention should be given to men, residents younger than 60 years, immigrants, and study participants without CVD as these characteristics were predictors of poor outcome.
评估南非农村地区高血压的知晓率、治疗率和控制率，以此作为其管理情况的指标，尤其关注这些变量的影响因素。
招募了居住在阿金库尔农村分区（姆普马兰加省）、年龄至少40岁的具有人群代表性的成年人样本，该地区由一个长期的健康和社会人口监测系统覆盖。进行了面对面访谈、体格检查并采集了干血斑样本。评估了高血压的知晓率、治疗率和控制率。建立了回归模型以确定这些结果的预测因素。
2884名高血压参与者的平均年龄为64.1±12.7岁。高血压知晓率为64.4%，知晓者中的治疗率为89.3%，接受治疗者中有45.8%得到控制。综合考虑知晓和不知晓的高血压患者，治疗率为49.7%，控制率为22.8%。在多变量回归模型中，女性、年龄至少60岁、较高的社会经济地位、既往心血管疾病（CVD）、非移民身份、识字能力和身体受限是知晓率的预测因素。年龄至少60岁是接受治疗者中控制情况改善的预测因素。女性、HIV阴性、年龄至少60岁、非移民身份和既往CVD是所有高血压研究参与者血压控制情况的预测因素。
该人群中高血压的知晓率和治疗率较高，控制水平也较好，这可能是由于该地区实施的长期监测项目。考虑到高血压管理的预测因素，应特别关注男性、60岁以下居民、移民以及没有心血管疾病的研究参与者，因为这些特征是不良结局的预测因素。
