Repositorio
Institucional

Yusuf, Salim

Chow, Clara K.

Teo, Koon K.

Rangarajan, Sumathy

Islam, Shofiqul

Gupta, Rajeev

Avezum, Alvaro

Bahonar, Ahmad

Chifamba, Jephat

Dagenais, Gilles

Diaz, Rafael

Kazmi, Khawar

Lanas, Fernando

Wei, Li

Lopez-Jaramillo, Patricio

Lu Fanghong

Ismail, Noor Hassim

Puoane, Thandi

Rosengren, Annika

Szuba, Andrzej

Temizhan, Ahmet

Wielgosz, Andy

Yusuf, Rita

Yusufali, Afzalhussein

Mckee, Martin

Liu, Lisheng

Mony, Prem

Prevalence, Awareness, Treatment, and Control of Hypertension in Rural and Urban Communities in High-, Middle-, and Low-Income Countries

AMER MEDICAL ASSOC

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION

en

IMPORTANCE Hypertension is the most important preventable cause of morbidity and mortality globally, yet there are relatively few data collected using standardized methods. OBJECTIVE To examine hypertension prevalence, awareness, treatment, and control in participants at baseline in the Prospective Urban Rural Epidemiology (PURE) study. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study of 153 996 adults (complete data for this analysis on 142 042) aged 35 to 70 years, recruited between January 2003 and December 2009. Participants were from 628 communities in 3 high-income countries (HIC), 10 upper-middle-income and low-middle-income countries (UMIC and LMIC), and 4 low-income countries (LIC). MAIN OUTCOMES AND MEASURES Hypertension was defined as individuals with self-reported treated hypertension or with an average of 2 blood pressure measurements of at least 140/90 mm Hg using an automated digital device. Awareness was based on self-reports, treatment was based on the regular use of blood pressure-lowering medications, and control was defined as individuals with blood pressure lower than 140/90 mm Hg. RESULTS Among the 142 042 participants, 57 840 (40.8%; 95% CI, 40.5%-41.0%) had hypertension and 26 877 (46.5%; 95% CI, 46.1%-46.9%) were aware of the diagnosis. Of those who were aware of the diagnosis, the majority (23 510 [87.5%; 95% CI, 87.1%-87.9%] of those who were aware) were receiving pharmacological treatments, but only a minority of those receiving treatment were controlled (7634 [32.5%; 95% CI, 31.9%-33.1%]). Overall, 30.8%, 95% CI, 30.2%-31.4% of treated patients were taking 2 or more types of blood pressure-lowering medications. The percentages aware (49.0% [95% CI, 47.8%-50.3%] in HICs, 52.5%[95% CI, 51.8%-53.2%] in UMICs, 43.6%[95% CI, 42.9%-44.2%] in LMICs, and 40.8%[95% CI, 39.9%-41.8%] in LICs) and treated (46.7%[95% CI, 45.5%-47.9%] in HICs, 48.3%, [95% CI, 47.6%-49.1%] in UMICs, 36.9%, [95% CI, 36.3%-37.6%] in LMICs, and 31.7% [95% CI, 30.8%-32.6%] in LICs) were lower in LICs compared with all other countries for awareness (P < .001) and treatment (P < .001). Awareness, treatment, and control of hypertension were higher in urban communities compared with rural ones in LICs (urban vs rural, P < .001) and LMICs (urban vs rural, P < .001), but similar for other countries. Low education was associated with lower rates of awareness, treatment, and control in LICs, but not in other countries. CONCLUSIONS AND RELEVANCE Among a multinational study population, 46.5% of participants with hypertension were aware of the diagnosis, with blood pressure control among 32.5% of those being treated. These findings suggest substantial room for improvement in hypertension diagnosis and treatment.

Artículo original

The PURE study is an investigator-initiated study that is funded through a variety of sources including the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, grants from several pharmaceutical companies, and grants from various governmental bodies in different countries. Dr S Yusuf is supported by the Mary W Burke endowed chair of the Heart and Stroke Foundation of Ontario. The PURE study is an investigator-initiated study that is funded by the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario and through unrestricted grants from several pharmaceutical companies (with major contributions from AstraZeneca [Sweden and Canada], Novartis, Sanofi [France and Canada], Boehringer Ingelheim [Germany and Canada], Servier, King Pharma, GlaxoSmithKline), and additionally by various national bodies in different countries: Bangladesh: Independent University, Bangladesh, Mitra and Associates

Brazil: Unilever Health Institute, Brazil Canada: Public Health Agency of Canada and Champlain Cardiovascular Disease Prevention Network

Chile: Universidad de la Frontera

China: National Center for Cardiovascular Diseases

Colombia: Colciencias, Grant number: 6566-04-18062

India: Indian Council of Medical Research

Malaysia: Ministry of Science, Technology and Innovation of Malaysia: Grant Number 07-05-IFN-MEB010, Universiti Teknologi MARA, Universiti Kebangsaan Malaysia (UKM-Hejim-Komuniti-15-2010)

Poland: Polish Ministry of Science and Higher Education grant Nr 290/W-PURE/2008/0, Wroclaw Medical University

South Africa: The North-West University, SANPAD (SA and Netherlands Programme for Alternative Development), National Research Foundation, Medical Research Council of SA, The SA Sugar Association (SASA), Faculty of Community and Health Sciences (UWC)

Sweden: Swedish Council for Working Life and Social Research, Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning, Swedish Heart and Lung Foundation, Swedish Research Council, Grant from the Swedish State under LUA Agreement, Grant from the Vastra Gotaland Region (FOUU)

Turkey: Metabolic Syndrome Society, AstraZeneca, Turkey, Sanofi, Turkey

United Arab Emirates: Sheikh Hamdan Bin Rashid Al Maktoum Award For Medical Sciences, Dubai Health Authority, Dubai UAE.

El estudio PURE es un estudio iniciado por el investigador que se financia a través de diversas fuentes, incluidos los Institutos Canadienses de Investigación en Salud, la Fundación del Corazón y el Ictus de Ontario, subvenciones de varias compañías farmacéuticas y subvenciones de varios organismos gubernamentales en diferentes países. El Dr. S. Yusuf cuenta con el apoyo de la cátedra Mary W. Burke de la Fundación del Corazón y el Ictus de Ontario. El estudio PURE es un estudio iniciado por el investigador que se financia mediante subvenciones sin restricciones de varias compañías farmacéuticas (con importantes contribuciones de AstraZeneca [Suecia y Canadá], Novartis, Sanofi [Francia y Canadá], Boehringer Ingelheim [Alemania y Canadá], Servier, King Pharma, GlaxoSmithKline), y adicionalmente mediante diversos organismos nacionales en diferentes países: Bangladesh: Independent University, Bangladesh, Mitra and Associates

Brasil: Unilever Health Institute, Brasil Canadá: Public Health Agency of Canada y Champlain Cardiovascular Disease Prevention Network

Chile: Universidad de la Frontera

China: Centro Nacional de Enfermedades Cardiovasculares

Colombia: Colciencias, número de subvención: 6566-04-18062

India: Consejo Indio de Investigación Médica

Malasia: Ministerio de Ciencia, Tecnología e Innovación de Malasia: número de subvención 07-05-IFN-MEB010, Universiti Teknologi MARA, Universiti Kebangsaan Malaysia (UKM-Hejim-Komuniti-15-2010)

Polonia: Ministerio de Ciencia y Educación Superior de Polonia, subvención n.° 290/W-PURE/2008/0, Universidad Médica de Breslavia

Sudáfrica: Universidad del Noroeste, SANPAD (Programa de Sudáfrica y Países Bajos para el Desarrollo Alternativo), Fundación Nacional de Investigación, Consejo de Investigación Médica de Sudáfrica, Asociación Azucarera de Sudáfrica (SASA), Facultad de Ciencias Comunitarias y de la Salud (UWC)

Suecia: Consejo Sueco para la Vida Laboral y la Investigación Social, Consejo Sueco de Investigación para el Medio Ambiente, las Ciencias Agrícolas y la Planificación Espacial, Fundación Sueca del Corazón y los Pulmones, Consejo Sueco de Investigación, Subvención del Estado Sueco en virtud del Acuerdo LUA, Subvención de la Región de Vastra Gotaland (FOUU)

Turquía: Sociedad del Síndrome Metabólico, AstraZeneca, Turquía, Sanofi, Turquía

Emiratos Árabes Unidos: Premio Sheikh Hamdan Bin Rashid Al Maktoum para las Ciencias Médicas, Autoridad Sanitaria de Dubái, Dubái, Emiratos Árabes Unidos.

10.1001/jama.2013.184182

pdf

PRESSURE-RELATED DISEASE

NONPHYSICIAN CLINICIAN

CARDIOVASCULAR RISK

EPIDEMIOLOGY PURE

GLOBAL BURDEN

HEALTH

NUTRITION

AGREEMENT

ADULTS

ENFERMEDAD RELACIONADA CON LA PRESIÓN

CLÍNICO NO MÉDICO

RIESGO CARDIOVASCULAR

EPIDEMIOLOGÍA PURA

CARGA GLOBAL

SALUD

NUTRICIÓN

ACUERDO

ADULTOS

PRESSURE-RELATED DISEASE

NONPHYSICIAN CLINICIAN

CARDIOVASCULAR RISK

EPIDEMIOLOGY PURE

GLOBAL BURDEN

HEALTH

NUTRITION

AGREEMENT

ADULTS

ENFERMEDAD RELACIONADA CON LA PRESIÓN

CLÍNICO NO MÉDICO

RIESGO CARDIOVASCULAR

EPIDEMIOLOGÍA PURA

CARGA GLOBAL

SALUD

NUTRICIÓN

ACUERDO

ADULTOS

Epidemiología

Sistema Cardiovascular y Cardiaco

Prevalence, Awareness, Treatment, and Control of Hypertension in Rural and Urban Communities in High-, Middle-, and Low-Income Countries

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION

hibrida

verde

acceso abierto

acceso abierto

PMID 24002282

en

Artículo original

versión publicada

Canadian Institutes of Health Research#Heart and Stroke Foundation of Ontario#Mary W Burke endowed chair of the Heart and Stroke Foundation of Ontario#AstraZeneca Sweden#AstraZeneca Canada#Novartis#Sanofi France#Sanofi Canada#Boehringer Ingelheim Germany#Boehringer Ingelheim Canada#Servier#King Pharma#GlaxoSmithKline#Independent University, Bangladesh#Mitra and Associates#Unilever Health Institute, Brazil#Public Health Agency of Canada#Champlain Cardiovascular Disease Prevention Network#Universidad de la Frontera#National Center for Cardiovascular Diseases#Colciencias 6566-04-18062#Indian Council of Medical Research#Ministry of Science, Technology and Innovation of Malaysia 07-05-IFN-MEB010#Universiti Teknologi MARA#Universiti Kebangsaan Malaysia UKM-Hejim-Komuniti-15-2010#Polish Ministry of Science and Higher Education 290/W-PURE/2008/0#Wroclaw Medical University#North-West University#SANPAD (SA and Netherlands Programme for Alternative Development)#National Research Foundation#Medical Research Council of SA#SA Sugar Association (SASA)#Faculty of Community and Health Sciences (UWC)#Swedish Council for Working Life and Social Research#Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning#Swedish Heart and Lung Foundation#Swedish Research Council#Swedish State under LUA Agreement#Vastra Gotaland Region (FOUU)#Metabolic Syndrome Society#AstraZeneca, Turkey#Sanofi, Turkey#Sheikh Hamdan Bin Rashid Al Maktoum Award For Medical Sciences#Dubai Health Authority, Dubai UAE

Canadian Institutes of Health Research

Heart and Stroke Foundation of Ontario

Mary W Burke endowed chair of the Heart and Stroke Foundation of Ontario

AstraZeneca Sweden

AstraZeneca Canada

Novartis

Sanofi France

Sanofi Canada

Boehringer Ingelheim Germany

Boehringer Ingelheim Canada

Servier

King Pharma

GlaxoSmithKline

Independent University, Bangladesh

Mitra and Associates

Unilever Health Institute, Brazil

Public Health Agency of Canada

Champlain Cardiovascular Disease Prevention Network

Universidad de la Frontera

National Center for Cardiovascular Diseases

Colciencias 6566-04-18062

Indian Council of Medical Research

Ministry of Science, Technology and Innovation of Malaysia 07-05-IFN-MEB010

Universiti Teknologi MARA

Universiti Kebangsaan Malaysia UKM-Hejim-Komuniti-15-2010

Polish Ministry of Science and Higher Education 290/W-PURE/2008/0

Wroclaw Medical University

North-West University

SANPAD (SA and Netherlands Programme for Alternative Development)

National Research Foundation

Medical Research Council of SA

SA Sugar Association (SASA)

Faculty of Community and Health Sciences (UWC)

Swedish Council for Working Life and Social Research

Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning

Swedish Heart and Lung Foundation

Swedish Research Council

Swedish State under LUA Agreement

Vastra Gotaland Region (FOUU)

Metabolic Syndrome Society

AstraZeneca, Turkey

Sanofi, Turkey

Sheikh Hamdan Bin Rashid Al Maktoum Award For Medical Sciences

Dubai Health Authority, Dubai UAE

AMER MEDICAL ASSOC

0098-7484

959

968

Medicina general e interna

Medicine, General & Internal

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