Carrillo-Larco Rodrigo M, Guzman-Vilca Wilmer Cristobal, Bernabe-Ortiz Antonio
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
Lancet Reg Health Am. 2021 Sep;1:None. doi: 10.1016/j.lana.2021.100022.
While there is a growing interest in antihypertensive medication rates among people with hypertension in low- and middle-income countries, little has been described about antihypertensive medication rates among eligible people based on the absolute cardiovascular risk approach. Following the risk-based approach, we described the proportion of eligible people receiving antihypertensive medication in Peru.
Analysis of six (2015-2020) national health surveys. Absolute cardiovascular risk was computed with the 2019 WHO cardiovascular risk charts and based on local guidelines. Antihypertensive treatment allocation based on the absolute cardiovascular risk was defined using the Package of essential noncommunicable (PEN) disease interventions for primary health care in low-resource settings and the HEARTS guidelines by the WHO; we also followed the recommendations by local guidelines.
There were 120,059 people. Overall, according to the local guidelines the 17.9% of the population would be eligible for antihypertensive medication while this estimate was 8.1% based on the WHO guidelines. At the national level, depending on the guidelines, we observed a steady trend of eligible people receiving antihypertension medication (e.g., men, local guidelines), a decreasing trend (e.g., men, <60, local guidelines) or an increasing trend (e.g., men, ≥60, local guidelines). At the sub-national level, seventeen regions showed an increasing antihypertensive treatment rate based on the local guidelines; when based on the WHO guidelines, eleven regions showed a decreasing rate.
Peru needs to define a tool for surveillance of absolute cardiovascular risk and to monitor antihypertensive treatment allocation among high-risk people.
Wellcome Trust (214185/Z/18/Z).
虽然中低收入国家高血压患者的降压药物使用率越来越受到关注，但基于绝对心血管风险方法，关于符合条件人群的降压药物使用率描述甚少。遵循基于风险的方法，我们描述了秘鲁接受降压药物治疗的符合条件人群的比例。
对六项（2015 - 2020年）全国健康调查进行分析。使用2019年世界卫生组织心血管风险图表并根据当地指南计算绝对心血管风险。基于绝对心血管风险的降压治疗分配是根据低资源环境下初级卫生保健的基本非传染性疾病干预包（PEN）和世界卫生组织的HEARTS指南定义的；我们也遵循了当地指南的建议。
共有120,059人。总体而言，根据当地指南，17.9%的人口符合使用降压药物的条件，而根据世界卫生组织指南，这一比例为8.1%。在国家层面，根据不同指南，我们观察到符合条件人群接受抗高血压药物治疗呈现出稳定趋势（如男性，当地指南）、下降趋势（如男性，<60岁，当地指南）或上升趋势（如男性，≥60岁，当地指南）。在国家以下层面，17个地区根据当地指南显示抗高血压治疗率上升；而根据世界卫生组织指南，11个地区显示下降。
秘鲁需要定义一种工具来监测绝对心血管风险，并监测高危人群的降压治疗分配情况。
惠康信托基金会（214185/Z/18/Z）。
