Association of Household Wealth Index, Educational Status, and Social Capital with Hypertension Awareness, Treatment, and Control in South Asia
Association of Household Wealth Index, Educational Status, and Social Capital with Hypertension Awareness, Treatment, and Control in South Asia
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DOI：
10.1093/ajh/hpw169
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发表时间：
2017-04-01
影响因子：
3.2
通讯作者：
Yusuf, Salim
中科院分区：
文献类型：
--
作者：
Gupta, Rajeev;Kaur, Manmeet;Yusuf, Salim
目的：南亚地区的高血压控制率很低。为了确定衡量社会经济地位的指标(财富、教育和社会资本)与城市和农村受试者对高血压的认识、治疗和控制之间的关联，我们进行了这项研究。方法2003-2009年，我们在印度、巴基斯坦和孟加拉国的150个社区招募了33,423名年龄在35-70岁之间的受试者(女性56%，农村53%，低教育水平51%，低家庭财富25%，低社会资本33%)。高血压患病率及其知晓、治疗和控制状况及其与财富、教育和社会资本的关系。结果经性别和地点校正的高血压患病率在男性为31.5%(23.9-40.2%)，女性为32.6%(24.9-41.5%)，不同研究地点的患病率存在差异(城市为30-56%，农村为11-43%)。患病率在城市地区、年龄较大的受试者以及财富更多、受教育程度更高、社会资本指数较低的参与者中显著更高。高血压知晓率40.4%(城市45.9%，农村32.5%)，治疗31.9%(城市37.6%，农村23.6%)，控制率12.9%(城市15.4%，农村9.3%)。男性和年轻受试者的控制力较低。高血压知晓率、治疗率和控制率分别显著低于财富指数最低者(26.2vs.50.6%、16.9vs.44.0%和6.9vs.17.3%，P<；0.001)和教育程度最低者(31.2vs.48.4%、21.8%vs.42.1%和7.8vs.19.2%，P<；0.001)，而最低和最高的社会资本指数差异不显著(38.2vs.36.1%，35.1 vs.27.8%，12.5vs.9.1%)。结论本研究显示南亚地区的高血压知晓率、治疗和控制率较低。较低的财富和教育程度是高血压知晓率、治疗率和控制率低的重要因素。
OBJECTIVEHypertension control rates are low in South Asia. To determine association of measures of socioeconomic status (wealth, education, and social capital) with hypertension awareness, treatment, and control among urban and rural subjects in these countries we performed the present study.METHODSWe enrolled 33,423 subjects aged 35-70 years (women 56%, rural 53%, low-education status 51%, low household wealth 25%, low-social capital 33%) in 150 communities in India, Pakistan, and Bangladesh during 2003-2009. Prevalence of hypertension and its awareness, treatment, and control status and their association with wealth, education, and social capital were determined.RESULTSAge-, sex-, and location-adjusted prevalence of hypertension in men was 31.5% (23.9-40.2%) and women was 32.6% (24.9-41.5%) with variations in prevalence across study sites (urban 30-56%, rural 11-43%). Prevalence was significantly greater in urban locations, older subjects, and participants with more wealth, greater education, and lower social capital index. Hypertension awareness was in 40.4% (urban 45.9, rural 32.5), treatment in 31.9% (urban 37.6, rural 23.6), and control in 12.9% (urban 15.4, rural 9.3). Control was lower in men and younger subjects. Hypertension awareness, treatment, and control were significantly lower, respectively, in lowest vs. highest wealth index tertile (26.2 vs. 50.6%, 16.9 vs. 44.0%, and 6.9 vs. 17.3%, P < 0.001) and lowest vs. highest educational status tertile (31.2 vs. 48.4%, 21.8 vs. 42.1%, and 7.8 vs. 19.2%, P < 0.001) while insignificant differences were observed in lowest vs. highest social capital index (38.2 vs. 36.1%, 35.1 vs. 27.8%, and 12.5 vs. 9.1%).CONCLUSIONSThis study shows low hypertension awareness, treatment, and control in South Asia. Lower wealth and educational status are important in low hypertension awareness, treatment, and control.