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Sociodemographic factors in relation to hypertension prevalence, awareness, treatment and control in a multi-ethnic Asian population: a cross-sectional study.

ABSTRACT: OBJECTIVES:Literature suggested that multi-ethnic Western populations experienced differential hypertension outcomes, but evidence is limited in Asia. This study was aimed to determine sociodemographic correlates of hypertension and its awareness, treatment and control among a multi-ethnic Asian population living in Singapore. SETTING:We used cross-sectional data of participants from the Multi-Ethnic Cohort (MEC) (n=14?530) recruited in Singapore between 2004 and 2010. PARTICIPANTS:Participants who completed questionnaire and attended health examination, without cardiovascular diseases, cancer, stroke, renal failure, asthma and mental illnesses were included in the study. Multivariable logistic regression models were used to determine sociodemographics factors associated with hypertension, unawareness of having hypertension, untreated and uncontrolled hypertension. RESULTS:Among 10?215 participants (47.2% Chinese, 26.0% Malay and 26.8% Indian), hypertension prevalence was estimated to be 31.1%. Older age, Malay ethnicity, male, lower educational level and being homemaker or retired/unemployed were factors significantly associated with hypertension. Stratified analysis suggested that age and education were consistently associated with hypertension across all ethnic groups. The proportions of being unaware, untreated and uncontrolled were 49.0%, 25.2% and 62.4%, respectively. Ethnicity and younger age were associated with unawareness; younger age, male and lower educational level were associated with untreated hypertension and older age was associated with uncontrolled hypertension. CONCLUSIONS:In this study, ethnic differences in relation to hypertension were associated with sociodemographic variability in ethnic groups. Age and educational level were consistent correlates of hypertension in all ethnic groups. Unawareness and uncontrolled hypertension were common in this Asian population and associated with sociodemographic factors. More targeted strategies may be required to overcome the observed disparities.

SUBMITTER: Liew SJ

PROVIDER: S-EPMC6530395 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Sociodemographic factors in relation to hypertension prevalence, awareness, treatment and control in a multi-ethnic Asian population: a cross-sectional study.

Liew Seaw Jia SJ Lee John Tayu JT Tan Chuen Seng CS Koh Choon Huat Gerald CHG Van Dam Rob R Müller-Riemenschneider Falk F

BMJ open 20190519 5

<h4>Objectives</h4>Literature suggested that multi-ethnic Western populations experienced differential hypertension outcomes, but evidence is limited in Asia. This study was aimed to determine sociodemographic correlates of hypertension and its awareness, treatment and control among a multi-ethnic Asian population living in Singapore.<h4>Setting</h4>We used cross-sectional data of participants from the Multi-Ethnic Cohort (MEC) (n=14 530) recruited in Singapore between 2004 and 2010.<h4>Particip ...[more]

PMID: 31110091

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Project description:BackgroundHypertension (HTN) is a major risk factor for cardiovascular diseases, and its prevalence has been rising in low- and middle-income countries. The current study describes HTN prevalence in central Mozambique, association between wealth and blood pressure (BP), and HTN monitoring and diagnosis practice among individuals with elevated BP.MethodsThe study used data from a cross-sectional, representative household survey conducted in Manica and Sofala provinces, Mozambique. There were 4101 respondents, aged ?20?years. We measured average systolic and diastolic BP (SBP and DBP) from three measurements taken in the household setting. Elevated BP was defined as having either SBP ?140 or DBP ?90?mmHg.ResultsThe mean age of the participants was 36.7?years old, 59.9% were women, and 72.5% were from rural areas. Adjusting for complex survey weights, 15.7% (95%CI: 14.0 to 17.4) of women and 16.1% (13.9 to 18.5) of men had elevated BP, and 7.5% (95% CI: 6.4 to 8.7) of the overall population had both SBP ?140 and DBP ?90?mmHg. Among participants with elevated BP, proportions of participants who had previous BP measurement and HTN diagnosis were both low (34.9% (95% CI: 30.0 to 40.1) and 12.2% (9.9 to 15.0) respectively). Prior BP measurement and HTN diagnosis were more commonly reported among hypertensive participants with secondary or higher education, from urban areas, and with highest relative wealth. In adjusted models, wealth was positively associated with higher SBP and DBP.ConclusionsThe current study found evidence of positive association between wealth and BP. The prevalence of elevated BP was lower in Manica and Sofala provinces than the previously estimated national prevalence. Previous BP screening and HTN diagnosis were uncommon in our study population, especially among rural residents, individuals with lower education levels, and those with relatively less wealth. As the epidemiological transition advances in Mozambique, there is a need to develop and implement strategies to increase BP screening and deliver appropriate clinical services, as well as to encourage lifestyle changes among people at risk of developing hypertension in near future.

Project description:ObjectivesTo compare the sociodemography, disease characteristics and hypertension self-care profiles and to determine the factors influencing Hypertension Self-Care Profiles (HTN-SCP) in two populations in primary care settings from Singapore and Malaysia.DesignCross-sectional, cross national.SettingMulti-centre, primary care clinics Malaysia and Singapore.Participants1123 adults with hypertension enrolled and analysed.Primary and secondary outcome measuresComparison between sociodemography, disease characteristics and the mean scores of HTN-SCP domains (behaviour, motivation and self-efficacy) and the factors influencing hypertension self-care.Results1123 adults with hypertension attending primary care clinics in Malaysia and Singapore were involved. The participants' mean age was 63.6 years (SD 9.7) in Singapore and 60.4 (SD 9.1) in Malaysia. Most of the participants in Singapore had tertiary education (22.3%) compared with Malaysia (13.0%), p<0.001. A higher proportion of participants from Singapore had controlled blood pressure (74.6%) compared with Malaysia (33.8%), p<0.001. The mean total score of HTN-SCP was significantly higher among Singapore participants compared with Malaysia participants 190 (SD 28) versus 184 (SD 23) (p<0.001). Similarly, the mean score for motivation domain 67 (SD 10) versus 65 (SD 9), followed by self-efficacy score 65 (SD 11) versus 62 (SD 9) and behaviour score (58 SD 9 vs 56 SD 9) were higher among Singapore participants. In both countries, the factors which influenced higher HTN-SCP mean scores across all domains were being Indian and had tertiary education.ConclusionsThe study population in Singapore had a higher HTN-SCP mean score compared with Malaysia. The common factors influencing higher HTN-SCP mean scores at both study sites were ethnicity and level of education. Future intervention to improve self-care among people with hypertension may need to be tailored to their behaviour, motivation and self-efficacy levels.

Dataset Information

Sociodemographic factors in relation to hypertension prevalence, awareness, treatment and control in a multi-ethnic Asian population: a cross-sectional study.

Publications

Sociodemographic factors in relation to hypertension prevalence, awareness, treatment and control in a multi-ethnic Asian population: a cross-sectional study.

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