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Measuring Hypertension Progression With Transition Probabilities: Estimates From the WHO SAGE Longitudinal Study
This paper assessed the transition probabilities between the stages of hypertension severity and the length of time an individual might spend at a particular disease state using the new American College of Cardiology/American Heart Association hypertension blood pressure guidelines. Data for this st...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058215/ https://www.ncbi.nlm.nih.gov/pubmed/33898368 http://dx.doi.org/10.3389/fpubh.2021.571110 |
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author | Boateng, Godfred O. Lartey, Stella T. Baiden, Philip Si, Lei Biritwum, Richard Berko Kowal, Paul Magnussen, Costan G. Ben Taleb, Ziyad Palmer, Andrew J. Luginaah, Isaac |
author_facet | Boateng, Godfred O. Lartey, Stella T. Baiden, Philip Si, Lei Biritwum, Richard Berko Kowal, Paul Magnussen, Costan G. Ben Taleb, Ziyad Palmer, Andrew J. Luginaah, Isaac |
author_sort | Boateng, Godfred O. |
collection | PubMed |
description | This paper assessed the transition probabilities between the stages of hypertension severity and the length of time an individual might spend at a particular disease state using the new American College of Cardiology/American Heart Association hypertension blood pressure guidelines. Data for this study were drawn from the Ghana WHO SAGE longitudinal study, with an analytical sample of 1884 across two waves. Using a multistate Markov model, we estimated a seven-year transition probability between normal/elevated blood pressure (systolic ≤ 129 mm Hg & diastolic <80 mm Hg), stage 1 (systolic 130-139 mm Hg & diastolic 80-89 mm Hg), and stage 2 (systolic ≥140mm Hg & diastolic≥90 mm Hg) hypertension and adjusted for the individual effects of anthropometric, lifestyle, and socio-demographic factors. At baseline, 22.5% had stage 1 hypertension and 52.2% had stage 2 hypertension. The estimated seven-year transition probability for the general population was 19.0% (95% CI: 16.4, 21.8) from normal/elevated blood pressure to stage 1 hypertension, 31.6% (95% CI: 27.6, 35.4%) from stage 1 hypertension to stage 2 hypertension, and 48.5% (45.6, 52.1%) for remaining at stage 2. Other factors such as being overweight, obese, female, aged 60+ years, urban residence, low education and high income were associated with an increased probability of remaining at stage 2 hypertension. However, consumption of recommended servings of fruits and vegetables per day was associated with a delay in the onset of stage 1 hypertension and a recovery to normal/elevated blood pressure. This is the first study to show estimated transition probabilities between the stages of hypertension severity across the lifespan in sub-Saharan Africa. The results are important for understanding progression through hypertension severity and can be used in simulating cost-effective models to evaluate policies and the burden of future healthcare. |
format | Online Article Text |
id | pubmed-8058215 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-80582152021-04-22 Measuring Hypertension Progression With Transition Probabilities: Estimates From the WHO SAGE Longitudinal Study Boateng, Godfred O. Lartey, Stella T. Baiden, Philip Si, Lei Biritwum, Richard Berko Kowal, Paul Magnussen, Costan G. Ben Taleb, Ziyad Palmer, Andrew J. Luginaah, Isaac Front Public Health Public Health This paper assessed the transition probabilities between the stages of hypertension severity and the length of time an individual might spend at a particular disease state using the new American College of Cardiology/American Heart Association hypertension blood pressure guidelines. Data for this study were drawn from the Ghana WHO SAGE longitudinal study, with an analytical sample of 1884 across two waves. Using a multistate Markov model, we estimated a seven-year transition probability between normal/elevated blood pressure (systolic ≤ 129 mm Hg & diastolic <80 mm Hg), stage 1 (systolic 130-139 mm Hg & diastolic 80-89 mm Hg), and stage 2 (systolic ≥140mm Hg & diastolic≥90 mm Hg) hypertension and adjusted for the individual effects of anthropometric, lifestyle, and socio-demographic factors. At baseline, 22.5% had stage 1 hypertension and 52.2% had stage 2 hypertension. The estimated seven-year transition probability for the general population was 19.0% (95% CI: 16.4, 21.8) from normal/elevated blood pressure to stage 1 hypertension, 31.6% (95% CI: 27.6, 35.4%) from stage 1 hypertension to stage 2 hypertension, and 48.5% (45.6, 52.1%) for remaining at stage 2. Other factors such as being overweight, obese, female, aged 60+ years, urban residence, low education and high income were associated with an increased probability of remaining at stage 2 hypertension. However, consumption of recommended servings of fruits and vegetables per day was associated with a delay in the onset of stage 1 hypertension and a recovery to normal/elevated blood pressure. This is the first study to show estimated transition probabilities between the stages of hypertension severity across the lifespan in sub-Saharan Africa. The results are important for understanding progression through hypertension severity and can be used in simulating cost-effective models to evaluate policies and the burden of future healthcare. Frontiers Media S.A. 2021-04-07 /pmc/articles/PMC8058215/ /pubmed/33898368 http://dx.doi.org/10.3389/fpubh.2021.571110 Text en Copyright © 2021 Boateng, Lartey, Baiden, Si, Biritwum, Kowal, Magnussen, Ben Taleb, Palmer and Luginaah. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Public Health Boateng, Godfred O. Lartey, Stella T. Baiden, Philip Si, Lei Biritwum, Richard Berko Kowal, Paul Magnussen, Costan G. Ben Taleb, Ziyad Palmer, Andrew J. Luginaah, Isaac Measuring Hypertension Progression With Transition Probabilities: Estimates From the WHO SAGE Longitudinal Study |
title | Measuring Hypertension Progression With Transition Probabilities: Estimates From the WHO SAGE Longitudinal Study |
title_full | Measuring Hypertension Progression With Transition Probabilities: Estimates From the WHO SAGE Longitudinal Study |
title_fullStr | Measuring Hypertension Progression With Transition Probabilities: Estimates From the WHO SAGE Longitudinal Study |
title_full_unstemmed | Measuring Hypertension Progression With Transition Probabilities: Estimates From the WHO SAGE Longitudinal Study |
title_short | Measuring Hypertension Progression With Transition Probabilities: Estimates From the WHO SAGE Longitudinal Study |
title_sort | measuring hypertension progression with transition probabilities: estimates from the who sage longitudinal study |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058215/ https://www.ncbi.nlm.nih.gov/pubmed/33898368 http://dx.doi.org/10.3389/fpubh.2021.571110 |
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