Hypertension Prevalence, Awareness, Treatment, and Control in Selected LMIC Communities: Results From the NHLBI/UHG Network of Centers of Excellence for Chronic Diseases.
BACKGROUND
Hypertension is the leading cause of cardiovascular disease and premature death worldwide. The prevalence of this public health problem is increasing in low- and middle-income countries (LMICs) in both urban and rural communities.


OBJECTIVE
The aim of this study was to examine hypertension prevalence, awareness, treatment, and control in adults 35 to 74 years of age from urban and rural communities in LMICs in Africa, Asia, and South America.


METHODS
The authors analyzed data from 7 population-based cross-sectional studies in selected communities in 9 LMICs that were conducted between 2008 and 2013. Age- and sex-standardized prevalence rates of pre-hypertension and hypertension were calculated. The prevalence rates of awareness, treatment, and control of hypertension were estimated overall and by subgroups of age, sex, and educational level.


RESULTS
In selected communities, age- and sex-standardized prevalence rates of hypertension among men and women 35 to 74 years of age were 49.9% (95% confidence interval [CI]: 42.3% to 57.4%) in Kenya, 54.9% (95% CI: 51.3% to 58.4%) in South Africa, 52.5% (95% CI: 50.1% to 54.8%) in China, 32.5% (95% CI: 31.7% to 33.3%) in India, 42.3% (95% CI: 40.4% to 44.2%) in Pakistan, 45.4% (95% CI: 43.6% to 47.2%) in Argentina, 39.9% (95% CI: 37.8% to 42.1%) in Chile, 19.2% (95% CI: 17.8% to 20.5%) in Peru, and 44.1% (95% CI: 41.6% to 46.6%) in Uruguay. The proportion of awareness varied from 33.5% in India to 69.0% in Peru, the proportion of treatment among those who were aware of their hypertension varied from 70.8% in South Africa to 93.3% in Pakistan, and the proportion of blood pressure control varied from 5.3% in China to 45.9% in Peru.


CONCLUSIONS
The prevalence of hypertension varies widely in different communities. The rates of awareness, treatment, and control also differ in different settings. There is a clear need to focus on increasing hypertension awareness and control in LMICs.
Centro de Excelencia en Salud Cardiovascular para el Cono Sur, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina. Electronic address: virazola@iecs.org.ar.
Vilma E
VE
Irazola
Centro de Excelencia en Salud Cardiovascular para el Cono Sur, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
Laura
L
Gutierrez
Duke Clinical Research Institute, Durham, NC, USA.
Gerald
G
Bloomfield
CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
Rodrigo M
RM
Carrillo-Larco
Public Health Foundation of India, Gurgaon, India; Centre for Chronic Disease Control, Gurgaon, India.
Prabhakaran
P
Dorairaj
Division of Cardiovascular Medicine, Brigham & Women's Hospital, Boston, MA, USA; Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Thomas
T
Gaziano
Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Division of Diabetic Medicine and Endocrinology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Naomi S
NS
Levitt
CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
J Jaime
JJ
Miranda
CRONICAS Center of Excellence for Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
Antonio Bernabe
AB
Ortiz
Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Krisela
K
Steyn
The George Institute for Global Health at Peking University Health Science Center, Beijing, China; Peking University Clinical Research Institute, Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China.
Yangfeng
Y
Wu
St. John's Medical College and Research Institute, St. John's National Academy of Health Sciences, Bangalore, India.
Denis
D
Xavier
The George Institute for Global Health at Peking University Health Science Center, Beijing, China; Duke Global Health Institute and Global Health Research Center, Duke Kunshan University, Kunshan, China.
Lijing L
LL
Yan
Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
Jiang
J
He
Centro de Excelencia en Salud Cardiovascular para el Cono Sur, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
Adolfo
A
Rubinstein
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001118:Argentina / Q000453:epidemiology; D002677:Chile / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D007194:India / Q000453:epidemiology; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D054555:National Heart, Lung, and Blood Institute (U.S.); D010154:Pakistan / Q000453:epidemiology; D010568:Peru / Q000453:epidemiology; D058246:Prehypertension / Q000453:epidemiology*; D015995:Prevalence; D055818:Public-Private Sector Partnerships; D013019:South Africa / Q000453:epidemiology; D014481:United States; D014583:Uruguay / Q000453:epidemiology
D000959:Antihypertensive Agents