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Factors associated with hypertension awareness, treatment and control in Thai Nguyen, Vietnam

Factors associated with hypertension awareness, treatment and control in Thai Nguyen, Vietnam. Duc Anh Ha MD., DrPH Hoa Lan Nguyen MD., PhD Hanoi, April 12, 2012. Outline. Introduction Objectives Data and methodology Results Conclusion. Introduction.

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Factors associated with hypertension awareness, treatment and control in Thai Nguyen, Vietnam

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  1. Factors associated with hypertension awareness, treatment and control in Thai Nguyen, Vietnam Duc Anh Ha MD., DrPH Hoa Lan Nguyen MD., PhD Hanoi, April 12, 2012

  2. Outline Introduction Objectives Data and methodology Results Conclusion

  3. Introduction Over the last two decades and the NCDs have become a major societal problem. In 2010 showed that morbidity from NCDs was around 3 times higher than that of infectious diseases. Increased life expectancy invariably prolongs the life-course exposure to CVD risk factors. CVD is now the leading cause of death in Vietnam, accounting for 25% of all deaths annually (172,322 deaths), and nearly one-fifth of the total burden of disease in Vietnam in 2006 Major risks are either on the rise or at alarming levels: prevalence of hypertension 25% among adults.

  4. Introduction Hypertension is considered to be one of the most important causes of premature mortality worldwide. One of the most readily preventable risk factors for CVD as it can be easily detected and it can be effectively treated with low-cost drugs. Establishing factors associated with awareness and management is an essential starting point in preventing increasing burden of morbidity and mortality from hypertension- related CVD. In Viet Nam, despite increasing prevalence of hypertension, information on factors associated with awareness, treatment, and control of hypertension is very scarce.

  5. Objectives To describe prevalence of hypertension To examine factors associated with hypertension awareness, treatment, and control among the adult population in Thai Nguyen. To provide policy implications for improving the hypertension management program.

  6. Data and methodology • Study participants • Survey conducted in 2011 in Thai Nguyen; • First stage: 60 communes were selected from 180 communes in Thai Nguyen using probability proportional to size procedure; • Second stage: 2 villages were randomly selected from chosen communes; • Final stage: 24 adults were randomly selected from each chosen village. • Total sample of 2,880 people aged 18 years old and above, of whom 2,351 people aged 25 and above were eligible for the study.

  7. Data and methodology • Survey methods • All adult participants completed a questionnaire in person interview, dietary assessment and physical examination. • Physical examination included measurement of weigh, height and blood pressure. • Two consecutive readings of BP were taken on both hands with the participant in a seated position for at least 5 minutes of rest. • The means of two measures was used for analysis.

  8. Data and methodology • Survey methods (cont) • Hypertension was defined as Systolic BP>=140 or distolic >=90 mmHg, or systolic BP>=130 or distolic BP>=80 mmHg if having history of diabetes or chronic kidney diseases; or self reporting of hypertensive, or taking hypertensive medications . • Awareness of hypertension was defined as self-report of any previous diagnosis of hypertension by a healthcare professional. • Treatment of hypertension was defined as self-reported use of a prescription medication for management of hypertension during the previous 2 weeks. • BP controlled if BP<90/140 for individuals without history of diabetes and chronic kidney diseases, BP<130/80 for inviduals with history of one of these conditions

  9. Data and methodology • Statistical analysis • Socio-demographic, clinical, and behavioral characteristics using simple descriptive statistics. • Differences in these characteristics were compared between men and women using the chi-square test for categorical variables and Wilcoxon sum rank test for continuous variables. • Prevalence of hypertension calculated for our overall study population, and according to selected participant’s socio-demographic, clinical characteristics, and smoking, eating behaviors was calculated using svy procedures in STATA to solve multiple stage survey design. • Logistic regression models using svy procedure were utilized examepotential factors. All analyses were performed using STATA 11.0 (StataCorp. TX).

  10. Study Population Characteristics

  11. Distribution of Systolic Blood Pressure according to Participant’s Age and Sex

  12. Distribution of Diastolic Blood Pressure according to Participant’s Age and Sex

  13. Prevalence of Hypertension, Awareness, Treated, and Controlled

  14. Multivariate logistic regression results

  15. Conclusion A further one in five adults in Thai Nguyen is hypertensive. Far fewer are aware of this and even fewer have adequately controlled blood pressure. The “rule of halves” was far from being achieved. Improving awareness of hypertension in the wider community as well as improving treatment and control of it in order is necessary to reduce the rate of hypertension-related mortality and morbidity.

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