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Gaps in hypertension care and control: a population‐based study in low‐income urban Medellin, Colombia

OBJECTIVES: To assess hypertension prevalence and the extent and associated factors of hypertension diagnosis, follow‐up, treatment and control gaps in low‐income urban Medellin, Colombia. METHODS: We randomly sampled 1873 adults aged 35 or older. Unaware hypertensive individuals were defined as tho...

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Autores principales: Londoño Agudelo, Esteban, Pérez Ospina, Viviana, Battaglioli, Tullia, Taborda Pérez, Cecilia, Gómez‐Arias, Rubén, Van der Stuyft, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453502/
https://www.ncbi.nlm.nih.gov/pubmed/33938098
http://dx.doi.org/10.1111/tmi.13599
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author Londoño Agudelo, Esteban
Pérez Ospina, Viviana
Battaglioli, Tullia
Taborda Pérez, Cecilia
Gómez‐Arias, Rubén
Van der Stuyft, Patrick
author_facet Londoño Agudelo, Esteban
Pérez Ospina, Viviana
Battaglioli, Tullia
Taborda Pérez, Cecilia
Gómez‐Arias, Rubén
Van der Stuyft, Patrick
author_sort Londoño Agudelo, Esteban
collection PubMed
description OBJECTIVES: To assess hypertension prevalence and the extent and associated factors of hypertension diagnosis, follow‐up, treatment and control gaps in low‐income urban Medellin, Colombia. METHODS: We randomly sampled 1873 adults aged 35 or older. Unaware hypertensive individuals were defined as those without previous diagnosis whose average blood pressure was equal to or above 140/90 mmHg. For aware hypertensive patients, control was delimited as average blood pressure below 140/90 if under 59 years old or diabetic, and as less than 150/90 otherwise. We used logistic regression to identify care gap‐associated factors. RESULTS: Hypertension prevalence was 43.5% (95% CI 41.2–45.7). We found 28.2% aware and 15.3% unaware hypertensive individuals, which corresponds to a 35.1% (95% CI 31.9–38.5) underdiagnosis. This gap was determined by age, sex, education and lifestyle factors. 14.4% (95% CI 11.6–17.6) of aware hypertensive patients presented a follow‐up gap, 93.4% (95% CI 90.9–95.2) were prescribed antihypertensive drugs, but 38.9% (95% CI 34.7–43.3) were not compliant. The latter was strongly associated with follow‐up. The hypertension control gap in aware hypertensive patients, 39.0% (95% CI: 34.9–43.2), was associated with being older, having diabetes, weakly adhering to pharmacological treatment and receiving poor non‐pharmacological advice. Overall, 60.4% (95% CI 57.0–63.8) of aware and unaware hypertensive participants had either diagnosed but uncontrolled or undiagnosed hypertension. CONCLUSIONS: We found high hypertension prevalence coupled with, from an international perspective, encouraging awareness and control figures. Still, there remains ample room for improvement. Our findings can assist in designing integrated primary healthcare measures that further strengthen equitable and effective access to hypertension care and control.
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spelling pubmed-84535022021-09-27 Gaps in hypertension care and control: a population‐based study in low‐income urban Medellin, Colombia Londoño Agudelo, Esteban Pérez Ospina, Viviana Battaglioli, Tullia Taborda Pérez, Cecilia Gómez‐Arias, Rubén Van der Stuyft, Patrick Trop Med Int Health Original Research Papers OBJECTIVES: To assess hypertension prevalence and the extent and associated factors of hypertension diagnosis, follow‐up, treatment and control gaps in low‐income urban Medellin, Colombia. METHODS: We randomly sampled 1873 adults aged 35 or older. Unaware hypertensive individuals were defined as those without previous diagnosis whose average blood pressure was equal to or above 140/90 mmHg. For aware hypertensive patients, control was delimited as average blood pressure below 140/90 if under 59 years old or diabetic, and as less than 150/90 otherwise. We used logistic regression to identify care gap‐associated factors. RESULTS: Hypertension prevalence was 43.5% (95% CI 41.2–45.7). We found 28.2% aware and 15.3% unaware hypertensive individuals, which corresponds to a 35.1% (95% CI 31.9–38.5) underdiagnosis. This gap was determined by age, sex, education and lifestyle factors. 14.4% (95% CI 11.6–17.6) of aware hypertensive patients presented a follow‐up gap, 93.4% (95% CI 90.9–95.2) were prescribed antihypertensive drugs, but 38.9% (95% CI 34.7–43.3) were not compliant. The latter was strongly associated with follow‐up. The hypertension control gap in aware hypertensive patients, 39.0% (95% CI: 34.9–43.2), was associated with being older, having diabetes, weakly adhering to pharmacological treatment and receiving poor non‐pharmacological advice. Overall, 60.4% (95% CI 57.0–63.8) of aware and unaware hypertensive participants had either diagnosed but uncontrolled or undiagnosed hypertension. CONCLUSIONS: We found high hypertension prevalence coupled with, from an international perspective, encouraging awareness and control figures. Still, there remains ample room for improvement. Our findings can assist in designing integrated primary healthcare measures that further strengthen equitable and effective access to hypertension care and control. John Wiley and Sons Inc. 2021-05-22 2021-08 /pmc/articles/PMC8453502/ /pubmed/33938098 http://dx.doi.org/10.1111/tmi.13599 Text en © 2021 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research Papers
Londoño Agudelo, Esteban
Pérez Ospina, Viviana
Battaglioli, Tullia
Taborda Pérez, Cecilia
Gómez‐Arias, Rubén
Van der Stuyft, Patrick
Gaps in hypertension care and control: a population‐based study in low‐income urban Medellin, Colombia
title Gaps in hypertension care and control: a population‐based study in low‐income urban Medellin, Colombia
title_full Gaps in hypertension care and control: a population‐based study in low‐income urban Medellin, Colombia
title_fullStr Gaps in hypertension care and control: a population‐based study in low‐income urban Medellin, Colombia
title_full_unstemmed Gaps in hypertension care and control: a population‐based study in low‐income urban Medellin, Colombia
title_short Gaps in hypertension care and control: a population‐based study in low‐income urban Medellin, Colombia
title_sort gaps in hypertension care and control: a population‐based study in low‐income urban medellin, colombia
topic Original Research Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453502/
https://www.ncbi.nlm.nih.gov/pubmed/33938098
http://dx.doi.org/10.1111/tmi.13599
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