Gorgas Memorial Institute for Health Studies, Panama City, Panama.
Ministry of Health, Panama City, Panama.
PLoS One. 2022 Nov 28;17(11):e0276222. doi: 10.1371/journal.pone.0276222. eCollection 2022.
BACKGROUND: Recent estimates of hypertension in Panama remain unknown. We aim to describe the variation in prevalence and unawareness of hypertension in two Panamanian provinces using two different cross-sectional population-based studies and to investigate risk factors associated with hypertension unawareness. METHODS: Data were derived from a sub-national study conducted in the provinces of Panama and Colon (PREFREC-2010 [2,733 participants]) and from a nationally representative study (ENSPA-2019), in which we restricted our analyses to the same provinces (4,653 participants). Individuals aged 30-75 years who had (a) self-reported history of hypertension or (b) blood pressure (BP) ≥140/90mmHg or (c) a combination or both were classified as hypertensive. Participants with BP≥140/90mmHg who denied a history of hypertension were considered unaware of the condition. Multivariable logistic regression models were used to estimate the association between risk factors and unawareness, expressed as odds ratios (OR) and 95% confidence interval (CI). FINDINGS: In 2010, the prevalence and unawareness of hypertension in men were 51.6% (95% CI: 45.7-57.5) and 32.3% (25.4-40.1), respectively, and in women 46.0% (42.1-49.9) and 16.1% (12.6-20.4), respectively. In 2019, the prevalence and unawareness of hypertension in men were 46.5% (42.1-51.0) and 52.3% (45.9-58.6), and in women 42.1% (39.6-44.7) and 33.3% (29.8-37.0). Men (2010 and 2019), age <50 years (2010 and 2019), having no/primary education (2010), and living in a non-urban region (2019) were positively associated with hypertension unawareness, whereas obesity (2010), physical inactivity (2010), family history of hypertension (2019), and BP assessment in the year before study enrollment (2010 and 2019) were inversely associated with hypertension unawareness. INTERPRETATION: Benefits of a decrease in the prevalence of hypertension are being undermined by an increase in hypertension unawareness. Actions should be encouraged to strengthen the implementation of the existing healthcare program for cardiovascular risk factor control.
背景：关于巴拿马的高血压患病率，目前仍未有确切的估计数据。本研究旨在使用两项不同的基于人群的横断面研究，描述巴拿马两个省份高血压的患病率和知晓率的变化，并探讨与高血压知晓率相关的危险因素。
方法：数据来自于在巴拿马省和科隆省进行的一项次国家级研究（PREFREC-2010[2,733 名参与者]）和一项全国代表性研究（ENSPA-2019），我们将分析仅限于这两个省份（4,653 名参与者）。将（a）有高血压病史或（b）血压（BP）≥140/90mmHg 或（c）两者结合的 30-75 岁个体归为高血压患者。BP≥140/90mmHg 但否认有高血压病史的患者被认为是高血压未被知晓者。使用多变量逻辑回归模型来估计风险因素与未被知晓之间的关联，以比值比（OR）和 95%置信区间（CI）表示。
结果：2010 年，男性高血压的患病率和未被知晓率分别为 51.6%（95%CI：45.7-57.5）和 32.3%（25.4-40.1），女性分别为 46.0%（42.1-49.9）和 16.1%（12.6-20.4）。2019 年，男性高血压的患病率和未被知晓率分别为 46.5%（42.1-51.0）和 52.3%（45.9-58.6），女性分别为 42.1%（39.6-44.7）和 33.3%（29.8-37.0）。男性（2010 年和 2019 年）、年龄<50 岁（2010 年和 2019 年）、未接受/接受小学教育（2010 年）和居住在非城市地区（2019 年）与高血压未被知晓率呈正相关，而肥胖（2010 年）、缺乏体力活动（2010 年）、高血压家族史（2019 年）和研究前一年的血压评估（2010 年和 2019 年）与高血压未被知晓率呈负相关。
结论：高血压患病率的下降所带来的益处正被高血压未被知晓率的上升所抵消。应鼓励采取行动，加强现有心血管危险因素控制的医疗保健计划的实施。
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