Cardiovascular risk in Mozambique: who should be treated for hypertension?
Cardiovascular risk in Mozambique: who should be treated for hypertension?
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DOI：
10.1097/hjh.0b013e3283656a0a
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发表时间：
2013-12-01
影响因子：
4.9
通讯作者：
Lunet，Nuno
中科院分区：
文献类型：
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作者：
Damasceno，Albertino;Padrao，Patricia;Lunet，Nuno
目的：估计莫桑比克的比例符合药物治疗高血压，根据单一的危险因素和总的心血管风险approaches.Methods：一个有代表性的样本莫桑比克年龄在40-64岁（n= 1116）进行了评估，根据WHO逐步方法慢性病危险因素监测（STEPS）。我们测量了血压（BP）和12小时空腹血糖水平，并收集了社会人口学特征，吸烟，抗糖尿病和抗高血压药物的使用数据。我们估计了10年内发生致命性或非致命性主要心血管事件的风险（WHO/国际高血压学会风险预测图表），并根据血压值单独计算符合高血压药物治疗条件的未治疗受试者比例，同时考虑总心血管风险（WHO心血管疾病评估和管理指南）。在40-64岁且未服用抗高血压药物的莫桑比克人中，不到4%的人被归类为心血管风险至少20%，而SBP/DBP至少140/90 mmHg的患病率接近40%。共有19.8%的40-64岁的人将有资格进行药物治疗的高血压根据WHO的指南，所有的人都有SBP/DBP至少160/100 mmHg.Conclusion：在莫桑比克40-64岁的人不服用抗高血压药物和SBP/DBP至少140/90 mmHg，只有一半有资格进行药物治疗根据WHO的指南。考虑到后者，在制定战略，以控制高血压在人口水平上，可能会允许更有效地利用稀缺的资源，在发展中国家的设置。
Aim:To estimate the proportion of Mozambicans eligible for pharmacological treatment for hypertension, according to single risk factor and total cardiovascular risk approaches.Methods:A representative sample of Mozambicans aged 40–64 years (n= 1116) was evaluated according to the WHO STEPwise Approach to Chronic Disease Risk Factor Surveillance (STEPS). We measured blood pressure (BP) and 12-h fasting blood glucose levels and collected data on sociodemographic characteristics, smoking, and use of antidiabetic and antihypertensive drugs. We estimated the 10-year risk of a fatal or nonfatal major cardiovascular event (WHO/International Society of Hypertension risk prediction charts), and computed the proportion of untreated participants eligible for pharmacological treatment for hypertension, according to BP values alone and accounting also for the total cardiovascular risk (WHO guidelines for assessment and management of cardiovascular diseases).Results:Among the Mozambicans aged 40–64 years and not taking antihypertensive drugs, less than 4% were classified as having cardiovascular risk at least 20% whereas the prevalence of SBP/DBP at least 140/90 mmHg was nearly 40%. A total of 19.8% of 40–64-year-olds would be eligible for pharmacological treatment of hypertension according to the WHO guidelines, all of whom had SBP/DBP at least 160/100 mmHg.Conclusion:Among the Mozambicans aged 40–64 years not taking antihypertensive drugs and having SBP/DBP at least 140/90 mmHg, only half were eligible for pharmacological treatment according to the WHO guidelines. Taking the latter into account, when defining strategies to control hypertension at a population level, may allow a more efficient use of the scarce resources available in developing settings.