title: Institutional hypertension control in Malaysia: a multicenter study focusing on gender and cardiovascular risk factor profile difference.
abstract: The prevalence of hypertension in Malaysia is alarmingly high. The National Survey in 2006 showed 43% of people aged ≥30 had hypertension and among treated patients, only 26% reached the target blood pressure (BP) of <140/90 mmHg. We evaluated BP control in tertiary institutions in Malaysia and the difference in hypertension control between genders and within specific cardiovascular risk factor groups. This cross-sectional study aimed at determining BP control among hypertensive patients attending three specialist institutions in Malaysia, located in Kuala Lumpur, Kuantan and Kota Bharu. A total of 950 patients with known hypertension for at least 6 months were recruited between January 2007 and July 2008. There were more males (n=548, 57.7%) with a mean age of 60.3±10.5 (±s.d.) years. The mean systolic BP (SBP) and diastolic BP were 138.8±20.3 mmHg and 79.6±11.3 mmHg, respectively. In total, 48.5% of all the patients had good BP control (<140/90 mmHg). Males had better SBP control compared with female (SBP: 135.9±18.7 vs. 142.8±21.7 mmHg, P<0.001). Overall, 54.6% of the patients had ischemic heart disease (IHD), 24.2% had undergone coronary revascularization, 50.1% were diabetic, 68.6% hyperlipidemic, 17.3% smokers and 27.5% had renal impairment. Males and small numbers of antihypertensives used were independently associated with better treatment outcome. In summary, our data reveal a poorer BP control, secondary to higher SBP levels in women. Moreover, the gender difference is more pronounced in patients with concomitant diabetes mellitus, renal impairment and IHD.
authors.affiliation: UKM Medical Center Kuala Lumpur, Kota Bharu, Malaysia.
authors.forename: Maskon
authors.initials: M
authors.lastname: Oteh
authors.forename: Shah Mohd Shah
authors.initials: SM
authors.lastname: Azarisman
authors.forename: Syazril Adnan
authors.initials: SA
authors.lastname: Azreen
authors.forename: Ab Rahman
authors.initials: AR
authors.lastname: Jamaluddin
authors.forename: Abdullah
authors.initials: A
authors.lastname: Aszrin
authors.forename: Chih Kuan
authors.initials: CK
authors.lastname: Ting
authors.forename: Ismail
authors.initials: I
authors.lastname: Shaiful Bahri
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology*; D007674:Kidney Diseases / Q000453:epidemiology; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology; D009204:Myocardial Revascularization / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents