Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its ...detection, treatment, and control from 1990 to 2019 for 200 countries and territories.
We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age.
The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran.
Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings.
WHO.
A Primary Care-Driven eConsult Service Murray, Kelsey R., MD, MHA, Grant Family Medicine, OhioHealth; Johansen, Michael E., MD MS, Associate Editor
Annals of family medicine,
03/2018, Letnik:
16, Številka:
2
Journal Article
Purpose: The aims of this study was to determine the perspective of family physicians working in primary care on the seasonal influenza vaccine and to investigate the relationship between ...administering the vaccine to themselves and recommending of the vaccine to their patients. Materials and Methods: The sample of our questionnaire study, which is a cross-sectional study, consists of family physicians working in the Family Health Centers in Erzurum city center between March and May 2019. A questionnaire with 17 questions was applied to the participants. Results: The 137 family physicians were included in the study. Family physicians were asked whether they had a seasonal flu vaccine before, and it was determined that 66 (48.2%) of 137 physicians had been vaccinated with the seasonal flu vaccine before, but 71 (51.8%) of them did not have the seasonal flu vaccine before. It was learned that 9 of the participants (6.6%) did not recommend the seasonal flu vaccine to any of their patients, whereas 12 (8.8%) of them recommended it to all their patients. The remaining 116 (84.7%) physicians recommended it to their risky patients. It was observed that there was a statistically significant difference in the frequency of recommending seasonal influenza vaccine to the patients between general practitioners and family medicine specialists (p<0.005). Conclusion: Although most of the physicians think that they have sufficient knowledge about the flu vaccine, the rates of recommendation and vaccination are very low.
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