Awareness, treatment, and control of hypertension in adults aged 45 years and over and their spouses in India: A nationally representative cross-sectional study.

<h4>Background</h4>Lack of nationwide evidence on awareness, treatment, and control (ATC) of hypertension among older adults in India impeded targeted management of this condition. We aimed to estimate rates of hypertension ATC in the older population and to assess differences in these r...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Sanjay K Mohanty, Sarang P Pedgaonkar, Ashish Kumar Upadhyay, Fabrice Kämpfen, Prashant Shekhar, Radhe Shyam Mishra, Jürgen Maurer, Owen O'Donnell
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/05e35362438449ecbeece7b71cd730b1
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:05e35362438449ecbeece7b71cd730b1
record_format	dspace
spelling	oai:doaj.org-article:05e35362438449ecbeece7b71cd730b12021-12-02T19:55:38ZAwareness, treatment, and control of hypertension in adults aged 45 years and over and their spouses in India: A nationally representative cross-sectional study.1549-12771549-167610.1371/journal.pmed.1003740https://doaj.org/article/05e35362438449ecbeece7b71cd730b12021-08-01T00:00:00Zhttps://doi.org/10.1371/journal.pmed.1003740https://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>Lack of nationwide evidence on awareness, treatment, and control (ATC) of hypertension among older adults in India impeded targeted management of this condition. We aimed to estimate rates of hypertension ATC in the older population and to assess differences in these rates across sociodemographic groups and states in India.<h4>Methods and findings</h4>We used a nationally representative survey of individuals aged 45 years and over and their spouses in all Indian states (except one) in 2017 to 2018. We identified hypertension by blood pressure (BP) measurement ≥140/90 mm Hg or self-reported diagnosis if also taking medication or observing salt/diet restriction to control BP. We distinguished those who (i) reported diagnosis ("aware"); (ii) reported taking medication or being under salt/diet restriction to control BP ("treated"); and (iii) had measured systolic BP <140 and diastolic BP <90 ("controlled"). We estimated age-sex adjusted hypertension prevalence and rates of ATC by consumption quintile, education, age, sex, urban-rural, caste, religion, marital status, living arrangement, employment status, health insurance, and state. We used concentration indices to measure socioeconomic inequalities and multivariable logistic regression to estimate fully adjusted differences in these outcomes. Study limitations included reliance on BP measurement on a single occasion, missing measurements of BP for some participants, and lack of data on nonadherence to medication. The 64,427 participants in the analysis sample had a median age of 57 years: 58% were female, and 70% were rural dwellers. We estimated hypertension prevalence to be 41.9% (95% CI 41.0 to 42.9). Among those with hypertension, we estimated that 54.4% (95% CI 53.1 to 55.7), 50.8% (95% CI 49.5 to 52.0), and 28.8% (95% CI 27.4 to 30.1) were aware, treated, and controlled, respectively. Across states, adjusted rates of ATC ranged from 27.5% (95% CI 22.2 to 32.8) to 75.9% (95% CI 70.8 to 81.1), from 23.8% (95% CI 17.6 to 30.1) to 74.9% (95% CI 69.8 to 79.9), and from 4.6% (95% CI 1.1 to 8.1) to 41.9% (95% CI 36.8 to 46.9), respectively. Age-sex adjusted rates were lower (p < 0.001) in poorer, less educated, and socially disadvantaged groups, as well as for males, rural residents, and the employed. Among individuals with hypertension, the richest fifth were 8.5 percentage points (pp) (95% CI 5.3 to 11.7; p < 0.001), 8.9 pp (95% CI 5.7 to 12.0; p < 0.001), and 7.1 pp (95% CI 4.2 to 10.1; p < 0.001) more likely to be aware, treated, and controlled, respectively, than the poorest fifth.<h4>Conclusions</h4>Hypertension prevalence was high, and ATC of the condition were low among older adults in India. Inequalities in these indicators pointed to opportunities to target hypertension management more effectively and equitably on socially disadvantaged groups.Sanjay K MohantySarang P PedgaonkarAshish Kumar UpadhyayFabrice KämpfenPrashant ShekharRadhe Shyam MishraJürgen MaurerOwen O'DonnellPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 18, Iss 8, p e1003740 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Sanjay K Mohanty Sarang P Pedgaonkar Ashish Kumar Upadhyay Fabrice Kämpfen Prashant Shekhar Radhe Shyam Mishra Jürgen Maurer Owen O'Donnell Awareness, treatment, and control of hypertension in adults aged 45 years and over and their spouses in India: A nationally representative cross-sectional study.
description	<h4>Background</h4>Lack of nationwide evidence on awareness, treatment, and control (ATC) of hypertension among older adults in India impeded targeted management of this condition. We aimed to estimate rates of hypertension ATC in the older population and to assess differences in these rates across sociodemographic groups and states in India.<h4>Methods and findings</h4>We used a nationally representative survey of individuals aged 45 years and over and their spouses in all Indian states (except one) in 2017 to 2018. We identified hypertension by blood pressure (BP) measurement ≥140/90 mm Hg or self-reported diagnosis if also taking medication or observing salt/diet restriction to control BP. We distinguished those who (i) reported diagnosis ("aware"); (ii) reported taking medication or being under salt/diet restriction to control BP ("treated"); and (iii) had measured systolic BP <140 and diastolic BP <90 ("controlled"). We estimated age-sex adjusted hypertension prevalence and rates of ATC by consumption quintile, education, age, sex, urban-rural, caste, religion, marital status, living arrangement, employment status, health insurance, and state. We used concentration indices to measure socioeconomic inequalities and multivariable logistic regression to estimate fully adjusted differences in these outcomes. Study limitations included reliance on BP measurement on a single occasion, missing measurements of BP for some participants, and lack of data on nonadherence to medication. The 64,427 participants in the analysis sample had a median age of 57 years: 58% were female, and 70% were rural dwellers. We estimated hypertension prevalence to be 41.9% (95% CI 41.0 to 42.9). Among those with hypertension, we estimated that 54.4% (95% CI 53.1 to 55.7), 50.8% (95% CI 49.5 to 52.0), and 28.8% (95% CI 27.4 to 30.1) were aware, treated, and controlled, respectively. Across states, adjusted rates of ATC ranged from 27.5% (95% CI 22.2 to 32.8) to 75.9% (95% CI 70.8 to 81.1), from 23.8% (95% CI 17.6 to 30.1) to 74.9% (95% CI 69.8 to 79.9), and from 4.6% (95% CI 1.1 to 8.1) to 41.9% (95% CI 36.8 to 46.9), respectively. Age-sex adjusted rates were lower (p < 0.001) in poorer, less educated, and socially disadvantaged groups, as well as for males, rural residents, and the employed. Among individuals with hypertension, the richest fifth were 8.5 percentage points (pp) (95% CI 5.3 to 11.7; p < 0.001), 8.9 pp (95% CI 5.7 to 12.0; p < 0.001), and 7.1 pp (95% CI 4.2 to 10.1; p < 0.001) more likely to be aware, treated, and controlled, respectively, than the poorest fifth.<h4>Conclusions</h4>Hypertension prevalence was high, and ATC of the condition were low among older adults in India. Inequalities in these indicators pointed to opportunities to target hypertension management more effectively and equitably on socially disadvantaged groups.
format	article
author	Sanjay K Mohanty Sarang P Pedgaonkar Ashish Kumar Upadhyay Fabrice Kämpfen Prashant Shekhar Radhe Shyam Mishra Jürgen Maurer Owen O'Donnell
author_facet	Sanjay K Mohanty Sarang P Pedgaonkar Ashish Kumar Upadhyay Fabrice Kämpfen Prashant Shekhar Radhe Shyam Mishra Jürgen Maurer Owen O'Donnell
author_sort	Sanjay K Mohanty
title	Awareness, treatment, and control of hypertension in adults aged 45 years and over and their spouses in India: A nationally representative cross-sectional study.
title_short	Awareness, treatment, and control of hypertension in adults aged 45 years and over and their spouses in India: A nationally representative cross-sectional study.
title_full	Awareness, treatment, and control of hypertension in adults aged 45 years and over and their spouses in India: A nationally representative cross-sectional study.
title_fullStr	Awareness, treatment, and control of hypertension in adults aged 45 years and over and their spouses in India: A nationally representative cross-sectional study.
title_full_unstemmed	Awareness, treatment, and control of hypertension in adults aged 45 years and over and their spouses in India: A nationally representative cross-sectional study.
title_sort	awareness, treatment, and control of hypertension in adults aged 45 years and over and their spouses in india: a nationally representative cross-sectional study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/05e35362438449ecbeece7b71cd730b1
work_keys_str_mv	AT sanjaykmohanty awarenesstreatmentandcontrolofhypertensioninadultsaged45yearsandoverandtheirspousesinindiaanationallyrepresentativecrosssectionalstudy AT sarangppedgaonkar awarenesstreatmentandcontrolofhypertensioninadultsaged45yearsandoverandtheirspousesinindiaanationallyrepresentativecrosssectionalstudy AT ashishkumarupadhyay awarenesstreatmentandcontrolofhypertensioninadultsaged45yearsandoverandtheirspousesinindiaanationallyrepresentativecrosssectionalstudy AT fabricekampfen awarenesstreatmentandcontrolofhypertensioninadultsaged45yearsandoverandtheirspousesinindiaanationallyrepresentativecrosssectionalstudy AT prashantshekhar awarenesstreatmentandcontrolofhypertensioninadultsaged45yearsandoverandtheirspousesinindiaanationallyrepresentativecrosssectionalstudy AT radheshyammishra awarenesstreatmentandcontrolofhypertensioninadultsaged45yearsandoverandtheirspousesinindiaanationallyrepresentativecrosssectionalstudy AT jurgenmaurer awarenesstreatmentandcontrolofhypertensioninadultsaged45yearsandoverandtheirspousesinindiaanationallyrepresentativecrosssectionalstudy AT owenodonnell awarenesstreatmentandcontrolofhypertensioninadultsaged45yearsandoverandtheirspousesinindiaanationallyrepresentativecrosssectionalstudy
_version_	1718375821429702656

Awareness, treatment, and control of hypertension in adults aged 45 years and over and their spouses in India: A nationally representative cross-sectional study.

Ejemplares similares