271475 Prevalence and determinants of hypertension awareness, treatment, and control in Latin America

Wednesday, October 31, 2012 : 9:35 AM - 9:50 AM

Lina Vera-Cala, MD, MSc, PhD candidate , Department of Population Health Sciences - Department of Public Health, University of Wisconsin at Madison - Universidad Industrial de Santander at Colombia, Madison, WI
Leonelo Bautista, MD, MPH, Dr PH , Department of Population Health Sciences, University of Wisconsin, Madison, WI
Juan Pablo Casas, MD, PhD , Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
Jaime Miranda, MD, MSc, PhD , Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
Laso Investigators, MD , Department of Population Health, University of Wisconsin, Madison, WI
     
Hypertension is a major contributor to the global burden of cardiovascular diseases (CVD). Worldwide, 13% of deaths and 6% of disability-adjusted life years are attributed to hypertension. About 80% of the attributable health burden occurs in low- and middle-income countries. Although hypertension is relatively easy to diagnose and treat, hypertension awareness, treatment, and control (ATC) rates are low in most populations. To determine the prevalence of and identify factors associated to hypertension ATC in Latin America (LA), we used cross-sectional data from 10,228 hypertensives from the LA Studies on Obesity (LASO), which includes random samples from eight LA countries. We estimated the prevalence of hypertension ATC post-stratifying by the age and gender distribution of the population. We used continuation ratio models with the complementary log-log link to identify determinants of progressing from one stage to the next. Hypertension and ATC prevalence were 20.3%, 59.2%, 44.6%, and 48.1%, respectively. The likelihood of transitioning from unaware to aware was increased by age (hazard ratio-HR:1.23; 95%CI:1.17,1.29), women (HR:1.58; 95%CI:1.31,1.90), education (HR:1.47; 95%CI:1.07,2.03), diabetes (HR:1.29; 95%CI:1.08,1.53), and CVD history (HR:2.13; 95%CI:1.51,3.00). The likelihood of transitioning from aware to treated was increased by age (HR:1.23; 95%CI:1.17,1.29), women (HR:1.41; 95%CI:1.17,1.71) and CVD history (HR:2.13; 95%CI:1.51,3.00). Finally, the likelihood of transitioning from treated to controlled was increased by women (HR:1.41; 95%CI:1.17,1.71) and decreased by age (HR:0.89; 95%CI:0.73,1.10), diabetes (HR:0.23; 95%CI:0.06,0.85), and obesity (HR:0.66; 95%CI:0.46,0.96). This study identifies factors associated with the pathway to poor hypertension control. Such information is vital for the design and implementation of successful cardiovascular prevention programs in LA.

Learning Areas:
Biostatistics, economics
Chronic disease management and prevention
Clinical medicine applied in public health
Epidemiology
Public health or related research

Learning Objectives:
To describe the prevalence of hypertension awareness, treatment, and control in Latin America. To identify sociodemographic and clinical factors associated with the probability of transitioning from unaware to aware, from aware to treated, and from treated to controlled among hypertensive in Latin America.

Keywords: Hypertension, Latin American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal investigator of multiple studies on hypertension in Latin America. I am the principal invetigator of this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5051.0: Cardiovascular Disease