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.2021.100016.
While we have good evidence about the hypertension care cascade, we do not know the mean blood pressure (BP) in these groups. We described the mean BP in four groups based on the hypertension care cascade at the national and sub-national levels in Peru.
Descriptive analysis of six national health surveys. Blood pressure was measured twice and the second record herein analysed. We defined four groups: i) people with self-reported hypertension diagnosis receiving antihypertensive medication; ii) people with self-reported hypertension diagnosis not receiving antihypertensive medication; iii) people unaware they have hypertension with blood pressure ≥140 or 90 mmHg; and iv) otherwise healthy people.
There were 125,066 people; mean age was 49.8 years and there were more women (51.7%). At the national level, in men and women and throughout the study period, we observed that the mean systolic BP (SBP) was the highest in people unaware they have hypertension; the mean SBP was similar between those with and without antihypertension medication, yet slightly higher in the former group. At the sub-national level, even though the mean SBP in the unaware group was usually the highest, there were some regions and years in which the mean SBP was the highest in the untreated and treated groups.
These results complement the hypertension care cascade with a clinically relevant parameter: mean BP. The results point where policies may be needed to secure effective interventions to control hypertension in Peru, suggesting that improving early diagnosis and treatment coverage could be priorities.
Wellcome Trust (214185/Z/18/Z).
虽然我们有关于高血压护理流程的充分证据，但我们不清楚这些人群的平均血压（BP）情况。我们描述了秘鲁全国和国家以下层面基于高血压护理流程的四组人群的平均血压。
对六项全国健康调查进行描述性分析。血压测量两次，此处分析第二次记录。我们定义了四组：i）自我报告高血压诊断并接受降压药物治疗的人群；ii）自我报告高血压诊断但未接受降压药物治疗的人群；iii）未意识到自己患有高血压但血压≥140或90 mmHg的人群；iv）其他健康人群。
共有125,066人；平均年龄为49.8岁，女性更多（51.7%）。在全国层面，在男性和女性以及整个研究期间，我们观察到未意识到自己患有高血压的人群平均收缩压（SBP）最高；接受和未接受抗高血压药物治疗的人群平均SBP相似，但前一组略高。在国家以下层面，尽管未意识到高血压的人群平均SBP通常最高，但在某些地区和年份，未治疗和治疗人群的平均SBP最高。
这些结果用一个临床相关参数——平均血压，对高血压护理流程进行了补充。结果指出了在秘鲁可能需要政策来确保有效干预以控制高血压的方向，表明改善早期诊断和治疗覆盖率可能是优先事项。
惠康信托基金会（214185/Z/18/Z）。
