Kyoto University Health Service, Kyoto, Japan
Global Health Interdisciplinary Unit, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan.
BMJ Open. 2022 Apr 8;12(4):e055668. doi: 10.1136/bmjopen-2021-055668.
To examine the prevalence of hypertension and access to related healthcare services among rural residents of Mumbwa district in Zambia.
Cross-sectional study with probability cluster sampling.
Rural Zambia.
We recruited 690 residents from Mumbwa district aged 25-64 years who had been living in the study area for ≥6 months and had adopted the lifestyle of the study area. Pregnant women and women who had given birth in the past 6 months were excluded. The data collection-questionnaire survey and anthropometric and biological measurements-was conducted between May and July 2016.
In the overall sample, 39.7% and 33.5% of the men and women had hypertension (systolic blood pressure (BP)≥140 or diastolic BP ≥90 mm Hg), respectively. Among the participants without a previous diagnosis of hypertension, 30.3% presented with hypertension at the time of measurement. In the multivariable analysis, alcohol intake and urban residence in men, and older age group, higher education and body mass index ≥25 kg/m in women were significantly associated with hypertension. Among the 21.8% who never had their BP measured, 83.8% were men; among these men, older age (adjusted OR (AOR), 0.43; 95% CI 0.25 to 0.73) and HIV positive status (AOR, 0.37; 95% CI 0.14 to 0.97) were negatively associated, while current smoker status (AOR, 2.09; 95% CI 1.19 to 3.66) was positively associated with the lack of BP measurements.
We found that hypertension is prevalent in the target rural area. However, many were not aware of their hypertension status and many never had their BP measured, indicating a serious gap in cardiovascular disease prevention services in Zambia. There is an urgent need for health promotion and screening for hypertension, especially in the primary health services of rural Zambia. Issues related to healthcare accessibility in men require particular attention.
调查赞比亚姆万扎区农村居民高血压的患病率及相关医疗服务的可及性。
采用概率整群抽样的横断面研究。
赞比亚农村。
我们招募了 690 名年龄在 25-64 岁之间的居民，他们在研究区域居住了≥6 个月，并且采用了研究区域的生活方式。排除孕妇和过去 6 个月内分娩的妇女。数据收集问卷调查和人体测量学及生物学测量于 2016 年 5 月至 7 月进行。
在总体样本中，男性和女性的高血压患病率分别为 39.7%和 33.5%（收缩压≥140mmHg 或舒张压≥90mmHg）。在没有高血压既往诊断的参与者中，30.3%在测量时患有高血压。多变量分析显示，男性中饮酒和城市居住，以及女性中年龄较大、受教育程度较高和体重指数≥25kg/m2 与高血压显著相关。在从未测量过血压的 21.8%的人群中，83.8%为男性；在这些男性中，年龄较大（调整后的比值比（OR），0.43；95%可信区间（CI）0.25 至 0.73）和 HIV 阳性状态（OR，0.37；95%CI 0.14 至 0.97）与缺乏血压测量呈负相关，而目前吸烟状态（OR，2.09；95%CI 1.19 至 3.66）与缺乏血压测量呈正相关。
我们发现目标农村地区高血压患病率较高。然而，许多人不知道自己的高血压状况，许多人从未测量过血压，这表明赞比亚心血管疾病预防服务存在严重差距。迫切需要促进健康和筛查高血压，特别是在赞比亚农村的初级卫生服务中。男性的医疗保健可及性问题需要特别关注。
