title: Hypertension among older adults in low- and middle-income countries: prevalence, awareness and control.
abstract: BACKGROUND
  This study uses data from the World Health Organization's Study on Global Ageing and Adult Health (SAGE) to examine patterns of hypertension prevalence, awareness, treatment and control for people aged 50 years and over in China, Ghana, India, Mexico, the Russian Federation and South Africa.
  
  
  METHODS
  The SAGE sample comprises of 35 125 people aged 50 years and older, selected randomly. Hypertension was defined as ≥140 mmHg (systolic blood pressure) or ≥90 mmHg (diastolic blood pressure) or by currently taking antihypertensives. Control of hypertension was defined as blood pressure below 140/90 mmHg on treatment. A person was defined as aware if he/she was hypertensive and self-reported the condition.
  
  
  RESULTS
  Prevalence rates in all countries are broadly comparable to those of developed countries (52.9%; range 32.3% in India to 77.9% in South Africa). Hypertension was associated with overweight/obesity and was more common in women, those in the lowest wealth quintile and in heavy alcohol consumers. Awareness was found to be low for all countries, albeit with substantial national variations (48.3%; range 23.3% in Ghana to 72.1% in the Russian Federation). This was also the case for control (10.2%; range 4.1% in Ghana to 14.1% India) and treatment efficacy (26.3%; range 17.4% in the Russian Federation to 55.2% in India). Awareness was associated with increasing age, being female and being overweight or obese. Effective control of hypertension was more likely in older people, women and in the richest quintile. Obesity was associated with poorer control.
  
  
  CONCLUSIONS
  The high rates of hypertension in low- and middle-income countries are striking. Levels of treatment and control are inadequate despite half those sampled being aware of their condition. Since cardiovascular disease is by far the largest cause of years of life lost in these settings, these findings emphasize the need for new approaches towards control of this major risk factor.
authors: School of International Development, University of East Anglia, Norwich, UK, Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland National Research Council, Institute of Neuroscience, Padova, Italy, London School of Hygiene and Tropical Medicine, London, UK and Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland.
authors: Peter
authors: P
authors: Lloyd-Sherlock
authors: John
authors: J
authors: Beard
authors: Nadia
authors: N
authors: Minicuci
authors: Shah
authors: S
authors: Ebrahim
authors: Somnath
authors: S
authors: Chatterji
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D003430:Cross-Sectional Studies; D019049:Developed Countries; D003906:Developing Countries; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D015995:Prevalence; D012307:Risk Factors; D057566:Self Report; D017678:Sex Distribution; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D000959:Antihypertensive Agents
keywords: Hypertension; developing countries; older people; risk factors