Carrillo-Larco Rodrigo M, Guzman-Vilca Wilmer Cristobal, Xu Xiaolin, Bernabe-Ortiz Antonio
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
EClinicalMedicine. 2023 Jan 30;57:101833. doi: 10.1016/j.eclinm.2023.101833. eCollection 2023 Mar.
The hypertension care cascade has been characterized worldwide, yet it has not been quantified how far above the blood pressure control threshold people with uncontrolled treated hypertension are. We summarized the mean systolic blood pressure (SBP; mmHg) in people treated for hypertension but SBP not <130/80.
We did a cross-sectional analysis of 55 WHO STEPS Surveys (n = 10,658), comprising six world regions (Africa, Americas, Eastern Mediterranean, Europe, Southeast Asia and Western Pacific); we only included the most recent survey by country regardless of when it was conducted. Adults, men and women, aged between 25 and 69 years, with self-reported hypertension receiving antihypertensive medication and whose blood pressure was >130/80 mmHg were included. We quantified the mean SBP overall and by socio-demographic (sex, age, urban/rural location, education) and cardiometabolic (current smoking, self-reported diabetes) risk factors.
The lowest SBP was observed in Kuwait (146.6; 95% CI: 143.8-149.4 mmHg) and the highest in Libya (171.9; 95% CI: 167.8-176.0 mmHg). In 29 countries, the SBP was higher in men, and SBP tended to be higher in older groups except in six countries. In 17 countries, the SBP was higher in rural than in urban sites, for example in Turkmenistan the SBP was 162.3 (95% CI: 158.4-166.2) mmHg in rural versus 151.6 (95% CI: 148.7-154.4) mmHg in urban areas. In 25 countries, the SBP was higher in adults with no education, for example in Benin the SBP in people without formal education was 175.3 (95% CI: 168.8-181.9) mmHg versus 156.4 (95% CI: 148.8-164.0) mmHg in people with higher education.
Stronger interventions to improve and secure access to effective management are needed in most countries and specific groups, to reach hypertension control in people with hypertension already receiving antihypertensive medication.
The Wellcome Trust International Training Fellowship (214185/Z/18/Z).
全球已对高血压治疗级联进行了特征描述，但尚未对未控制的接受治疗的高血压患者高于血压控制阈值的程度进行量化。我们总结了接受高血压治疗但收缩压不低于130/80的人群的平均收缩压（SBP；mmHg）。
我们对55项世界卫生组织（WHO）的全球健康调查（n = 10658）进行了横断面分析，这些调查涵盖六个世界区域（非洲、美洲、东地中海、欧洲、东南亚和西太平洋）；我们仅纳入每个国家最近的一次调查，无论其开展时间。纳入年龄在25至69岁之间、自我报告患有高血压且正在接受抗高血压药物治疗且血压>130/80 mmHg的成年人，包括男性和女性。我们对总体以及按社会人口统计学（性别、年龄、城乡居住地、教育程度）和心血管代谢（当前吸烟、自我报告的糖尿病）风险因素进行了平均收缩压的量化。
科威特的收缩压最低（146.6；95%置信区间：143.8 - 149.4 mmHg），利比亚最高（171.9；95%置信区间：167.8 - 176.0 mmHg）。在29个国家，男性的收缩压更高，除六个国家外，老年组的收缩压往往更高。在17个国家，农村地区的收缩压高于城市地区，例如在土库曼斯坦，农村地区的收缩压为162.3（95%置信区间：158.4 - 166.2）mmHg，而城市地区为151.6（95%置信区间：148.7 - 154.4）mmHg。在25个国家，未受过教育的成年人收缩压更高，例如在贝宁，未受过正规教育的人的收缩压为175.3（95%置信区间：168.8 - 181.9）mmHg，而受过高等教育的人为156.4（95%置信区间：148.8 - 164.0）mmHg。
在大多数国家和特定群体中，需要采取更有力的干预措施来改善并确保获得有效的管理，以使已经接受抗高血压药物治疗的高血压患者实现血压控制。
惠康信托国际培训奖学金（214185/Z/18/Z）
