title: Hypertension prevalence, awareness, treatment, and control in mozambique: urban/rural gap during epidemiological transition.
abstract: The prediction of cardiovascular risk profile trends in low-income countries and timely action to modulate their transitions are among the greatest global health challenges. In 2005 we evaluated a nationally representative sample of the Mozambican population (n=3323; 25 to 64 years old) following the Stepwise Approach to Chronic Disease Risk Factor Surveillance. Prevalence of hypertension (systolic blood pressure > or =140 mm Hg and/or diastolic blood pressure > or =90 mm Hg and/or antihypertensive drug therapy), awareness (having been informed of the hypertensive status by a health professional in the previous year), treatment among the aware (use of antihypertensive medication in the previous fortnight), and control among those treated (blood pressure <140/90 mm Hg) were 33.1% (women: 31.2%; men: 35.7%), 14.8% (women: 18.4%; men: 10.6%), 51.9% (women: 61.1%; men: 33.3%), and 39.9% (women: 42.9%; men: 28.7%), respectively. Urban/rural comparisons are presented as age- and education-adjusted odds ratios (ORs) and 95% CIs. Among women, hypertension (OR: 2.0; 95% CI: 1.2 to 3.0) and awareness (OR: 4.3; 95% CI: 1.9 to 9.5) were more frequent in urban areas. No urban/rural differences were observed in men (hypertension: OR: 1.3, 95% CI: 0.9 to 2.0; awareness: OR: 1.5, 95% CI: 0.5 to 4.7). Treatment prevalence was not significantly different across urban/rural settings (women: OR: 1.4, 95% CI: 0.5 to 4.4; men: OR: 0.3, 95% CI: 0.1 to 1.4). Control was less frequent in urban women (OR: 0.2; 95% CI: 0.0 to 1.0) and more frequent in urban men (OR: 78.1; 95% CI: 2.2 to 2716.6). Our results illustrate the changing paradigms of "diseases of affluence" and the dynamic character of epidemiological transition. The urban/rural differences across sexes support a trend toward smaller differences, emphasizing the need for strategies to improve prevention, correct diagnosis, and access to effective treatment.
authors.affiliation: Eduardo Mondlane University, Maputo, Mozambique. tino_7117@hotmail.com
authors.forename: Albertino
authors.initials: A
authors.lastname: Damasceno
authors.forename: Ana
authors.initials: A
authors.lastname: Azevedo
authors.forename: Carla
authors.initials: C
authors.lastname: Silva-Matos
authors.forename: António
authors.initials: A
authors.lastname: Prista
authors.forename: Domingos
authors.initials: D
authors.lastname: Diogo
authors.forename: Nuno
authors.initials: N
authors.lastname: Lunet
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D015992:Body Mass Index; D004032:Diet; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009073:Mozambique / Q000453:epidemiology; D015995:Prevalence; D012423:Rural Health / Q000706:statistics & numerical data; D016540:Smoking Cessation; D014504:Urban Health / Q000706:statistics & numerical data; D049629:Waist-Hip Ratio; D015431:Weight Loss
chemical_list: D000959:Antihypertensive Agents