Hypertension: its prevalence and population-attributable fraction for mortality from cardiovascular disease in the Asia-Pacific region.
OBJECTIVE
About half of the world's burden of cardiovascular disease is carried by countries in the Asia-Pacific region. This study aimed to quantify the contribution of hypertension to cardiovascular diseases (CVD) at the country level, by calculating the sex-specific, population-attributable fractions (PAFs) for fatal ischaemic heart disease (IHD) and stroke (haemorrhagic and ischaemic) for the World Health Organization Western Pacific and South-east Asian regions.


METHODS
The most recent sex-specific prevalence data on hypertension were sought. Age-adjusted hazard ratio (HR) estimates for fatal IHD and stroke associated with hypertension were obtained using Cox analyses of individual participant cohort data from 600,000 adult participants in the Asia-Pacific Cohort Studies Collaboration. HR estimates and prevalence were then used to calculate sex-specific PAFs for fatal IHD and stroke, by country.


RESULTS
In 15 countries with available data, the prevalence of hypertension ranged from 5-47% in men and from 7-38% in women. Overall, the fraction of IHD attributable to hypertension ranged from 4-28% in men and from 8-39% in women. Corresponding ranges for haemorrhagic stroke were 18-66% and 15-49%, and for ischaemic stroke were 8-44% and 12-45%.


CONCLUSIONS
In the Asia-Pacific region, up to 66% of some subtypes of CVD can be attributed to hypertension, underscoring the immense impact that blood pressure- lowering strategies could have in this populous region.
Martiniuk
Alexandra L C
AL
The George Institute for International Health at the University of Sydney, Australia. amartiniuk@george.org.au
Lee
Crystal M Y
CM
Lawes
Carlene M M
CM
Ueshima
Hirotsugu
H
Suh
Il
I
Lam
Tai Hing
TH
Gu
Dongfeng
D
Feigin
Valery
V
Jamrozik
Konrad
K
Ohkubo
Takayoshi
T
Woodward
Mark
M
D000328:Adult; D000368:Aged; D001210:Asia, Southeastern / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D017202:Myocardial Ischemia / Q000453:epidemiology; D010139:Pacific Islands / Q000453:epidemiology; D044382:Population Groups / Q000706:statistics & numerical data*; D015995:Prevalence; D016016:Proportional Hazards Models; D012107:Research Design; D012307:Risk Factors; D012727:Sex Characteristics; D017678:Sex Distribution; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000401:mortality