It s well-known that hypertension is a strong risk factor for stroke and other cardiovascular ills, but it is a silent condition in most and may not be diagnosed and treated appropriately. The extensive lack of effective treatment was demonstrated by a recent large-scale, multinational study reported in the journal JAMA.
Researchers led by Dr. Clara K. Chow of McMaster University in Ontario, Canada examined data from over 140,000 participants from 17 countries of varying income levels. The data came from the Prospective Urban Rural Epidemiology (PURE) study. Blood pressure was measured in adults between the ages of 35 and 70 years. The study began in 2003 and ran for 6 years.
Awareness of hypertension was based on self-report, and hypertension was defined as those with self-reported treated conditions, or with an average of two blood pressure measurements of at least 140/90 mg Hg.
Among the participants, 41 percent had hypertension, and fewer than half of those individuals were aware of that diagnosis. Of the approximately 27,000 people who were aware, 86 percent were receiving pharmaceutical treatment, but only about 33 percent of their conditions were being controlled by that treatment, even though about 31 percent of the treated patients were taking 2 or more medications.
As might be expected based on the distribution of medical care, the researchers found that awareness, treatment and control of high blood pressure were significantly higher in urban as compared to rural areas in low income countries, but were similar in higher income countries. Furthermore, low education level was also associated with lower rates of awareness, treatment and control in low income countries as compared to other countries.
The authors concluded These findings suggest substantial room for improvement in hypertension diagnosis and treatment. And ACSH s Dr. Ruth Kava added Although this was a cross-sectional study, i.e. one that measured blood pressure only at one point in time, the large number of individuals and areas examined points to which areas and people should be targeted to diminish the dangerous sequelae of hypertension.
