Hypertension among older adults in low- and middle-income countries

Prevalence, awareness and control

Bibliographic Data

ID23376159
AuthorsPeter Lloyd-Sherlock (0000-0002-1367-0703, University of London, corresponding author), Jennifer Beard (0000-0002-8557-0242, University of London), Nadia Minicuci (0000-0002-0970-6531, University of London), S Ebrahim (0000-0003-3901-7160, University of London), Somnath Chatterji (0000-0002-3085-6550, University of London)
Year2014
Volume43
Issue1
Pages116-128
Publication date2014-02-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueInternational Journal of Epidemiology (JOURNAL)
Journal identifiersISSN: 0300-5771 • E-ISSN: 1464-3685
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1093/ije/dyt215
PMID24505082
PMCIDPMC3937973
OpenAlexW2128639343
LanguageEN
Citations received72
References cited31

BACKGROUND: This study uses data from the World Health Organization's Study on Global Ageing and Adult Health (SAGE) to examine patterns of hypertension prevalence, awareness, treatment and control for people aged 50 years and over in China, Ghana, India, Mexico, the Russian Federation and South Africa. METHODS: The SAGE sample comprises of 35 125 people aged 50 years and older, selected randomly. Hypertension was defined as ≥140 mmHg (systolic blood pressure) or ≥90 mmHg (diastolic blood pressure) or by currently taking antihypertensives. Control of hypertension was defined as blood pressure below 140/90 mmHg on treatment. A person was defined as aware if he/she was hypertensive and self-reported the condition. RESULTS: Prevalence rates in all countries are broadly comparable to those of developed countries (52.9%; range 32.3% in India to 77.9% in South Africa). Hypertension was associated with overweight/obesity and was more common in women, those in the lowest wealth quintile and in heavy alcohol consumers. Awareness was found to be low for all countries, albeit with substantial national variations (48.3%; range 23.3% in Ghana to 72.1% in the Russian Federation). This was also the case for control (10.2%; range 4.1% in Ghana to 14.1% India) and treatment efficacy (26.3%; range 17.4% in the Russian Federation to 55.2% in India). Awareness was associated with increasing age, being female and being overweight or obese. Effective control of hypertension was more likely in older people, women and in the richest quintile. Obesity was associated with poorer control. CONCLUSIONS: The high rates of hypertension in low- and middle-income countries are striking. Levels of treatment and control are inadequate despite half those sampled being aware of their condition. Since cardiovascular disease is by far the largest cause of years of life lost in these settings, these findings emphasize the need for new approaches towards control of this major risk factor.

Blood pressure · Environmental health · Obesity · Overweight · Public health · Blood Pressure and Hypertension Studies · Demography · Diabetes, Cardiovascular Risks, and Lipoproteins · Internal Medicine · Medicine · Sodium Intake and Health · Gerontology