Social disparities explain differences in hypertension prevalence, detection and control in Colombia.
Hypertension is the principal risk factor for cardiovascular diseases. The global Prospective Urban Rural Epidemiology study showed that the levels of awareness, treatment and control of this condition are very low worldwide and show large regional variations related to a country's income index. The aim of the present analysis was to identify associations between sociodemographic, geographic, anthropometric, behavioral and clinical factors and the awareness, treatment and control of hypertension within Colombia - a high-middle income country which participated in the global Prospective Urban Rural Epidemiology study.



The sample comprised 7485 individuals aged 35-70 years (mean age 50.8 years, 64% women). Mean SBP and DBP were 129.12 ± 21.23 and 80.39 ± 11.81 mmHg, respectively. The overall prevalence of hypertension was 37.5% and was substantially higher amongst participants with the lowest educational level, who had a 25% higher prevalence (<0.001). Hypertension awareness, treatment amongst those aware, and control amongst those treated were 51.9, 77.5 and 37.1%, respectively. The prevalence of hypertension was higher amongst those with a higher BMI (<0.001) or larger waist-hip ratio (<0.001). Being male, younger, a rural resident and having a low level of education was associated with significantly lower hypertension awareness, treatment and control. The use of combination therapy was very low (27.5%) and was significantly lower in rural areas and amongst those with a low income.



Overall Colombia has a high prevalence of hypertension in combination with very low levels of awareness, treatment and control; however, we found large variations within the country that appear to be associated with sociodemographic disparities.
aFundación Oftalmológica de Santander - FOSCAL, Floridablanca bUniversidad Autónoma de Bucaramanga cUniversidad de Santander (UDES) - Instituto Masira, Bucaramanga dUniversidad de Caldas y Médicos Internistas de Caldas, Manizales eHospital San Juan de Dios y Fundación Cardiomet - Cequin, Universidad del Quindío, Armenia fFundación Cometa, Pasto gHospital Susana Lopez de Valencia, Popayán hFundación RIESCAR, El Espinal iFacultad de Medicina, Universidad Militar Nueva Granada jENDOCARE, Bogotá kUniversidad del Norte y Biolab, Barranquilla lCentro Cardiovascular Santa Lucia, Cartagena mFUNDEMOS, Yopal nUniversidad de Santander, Valledupar, Colombia oPHRI, McMaster University, Hamilton, Ontario, Canada.
Paul A
PA
Camacho
Diego
D
Gomez-Arbelaez
Dora I
DI
Molina
Gregorio
G
Sanchez
Edgar
E
Arcos
Claudia
C
Narvaez
Henry
H
García
Maritza
M
Pérez
Erick A
EA
Hernandez
Myriam
M
Duran
Carlos
C
Cure
Aristides
A
Sotomayor
Alvaro
A
Rico
Tannia M
TM
David
Daniel D
DD
Cohen
Sumathy
S
Rangarajan
Salim
S
Yusuf
Patricio
P
Lopez-Jaramillo
D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D003105:Colombia / Q000453:epidemiology; D004359:Drug Therapy, Combination / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D054624:Health Status Disparities; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D007182:Income; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D014505:Urban Population / Q000706:statistics & numerical data; D049629:Waist-Hip Ratio