Evaluating the Hypertension Cascade of Care in Adults in Urban Lao PDR: Evidence From the VITERBI Cohort Study.

IF 2.6 Q2 PERIPHERAL VASCULAR DISEASE

Vascular Health and Risk Management Pub Date : 2025-03-15 eCollection Date: 2025-01-01 DOI:10.2147/VHRM.S506857

Georg Loss, Jordyn T Wallenborn, Miley Sinantha-Hu, Vattahanaphone Ouipoulikoune, Nicole Probst-Hensch, Sengchanh Kounnavong, Somphou Sayasone, Peter Odermatt, Günther Fink

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引用次数: 0

Abstract

Background: Hypertension (HT) is a major risk factor for adult morbidity and mortality in low- and middle-income countries and little is known regarding the distribution of HT risk and treatment access within urban areas.

Patients and methods: We used data from the Vientiane Multi-Generational Birth Cohort in urban Lao PDR to assess the prevalence of loss and retention across five stages of HT care for 40+ year old adults: i) prevalence of hypertension, ii) hypertensives who ever had their BP measured by a health care professional, iii) hypertensives ever diagnosed with HT by a professional, iv) patients currently treated with HT medication, and v) patients with currently controlled BP. We estimated associations between sociodemographic and lifestyle predictors and the proportion of participants who reached each care cascade step using mutually adjusted Poisson regression modeling.

Results: Among the 3196 participants aged 40 to 99 years, the overall prevalence of HT was 16.3%, with higher rates for women, people over 60 years, peripheral district residents, low educated, widowed, and obese. Among people with HT, 90.2% ever had their BP measured by a health care professional, 69.3% ever received a HT diagnosis, 60.9% HT were currently on (drug) treatment, and 39.5% had currently controlled BP. The largest cascade of care losses occurred at the diagnosis and control stages with better outcomes for women. While central districts showed higher rates of diagnosis, control levels were lower than in peripheral districts, but there these differences appeared to be explained by adjusting for sociodemographic and lifestyle factors.

Conclusion: While HT prevalence in Lao PDR is lower than reported for other LMICs, more than 16% over the age of 40 years suffer from HT, and 60% of these cases are currently not controlled. Major policy efforts are needed to support this population and to prevent HT-driven excess mortality.

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评估老挝城市居民高血压级联治疗：来自VITERBI队列研究的证据。

背景：高血压（HT）是低收入和中等收入国家成人发病和死亡的一个主要危险因素，人们对城市地区高血压风险分布和治疗可及性知之甚少。患者和方法：我们使用老挝人民民主共和国城市万象多代出生队列的数据来评估40岁以上成年人在HT护理的五个阶段的损失和保留的流行情况：i)高血压的流行情况，ii)曾经由医疗保健专业人员测量血压的高血压患者，iii)曾经被专业人员诊断为HT的高血压患者，iv)目前接受HT药物治疗的患者，v)目前血压得到控制的患者。我们使用相互调整的泊松回归模型估计了社会人口学和生活方式预测因子与达到每个护理级联步骤的参与者比例之间的关联。结果：在3196名年龄在40 ~ 99岁之间的参与者中，HT的总体患病率为16.3%，其中女性、60岁以上人群、周边地区居民、低教育程度人群、丧偶人群和肥胖人群的患病率较高。在HT患者中，90.2%的人曾由卫生保健专业人员测量血压，69.3%的人曾接受过HT诊断，60.9%的HT目前正在接受（药物）治疗，39.5%的人目前血压得到控制。最大的护理损失级联发生在诊断和控制阶段，妇女的预后较好。虽然中心地区的诊断率较高，但控制水平低于周边地区，但这些差异似乎可以通过调整社会人口和生活方式因素来解释。结论：虽然老挝人民民主共和国的HT患病率低于其他中低收入国家的报告，但40岁以上人群中有16%以上患有HT，其中60%的病例目前未得到控制。需要作出重大政策努力来支持这一人群，并防止高温导致的过高死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vascular Health and Risk Management PERIPHERAL VASCULAR DISEASE-

CiteScore

4.20

自引率

3.40%

发文量

109

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed journal of therapeutics and risk management, focusing on concise rapid reporting of clinical studies on the processes involved in the maintenance of vascular health; the monitoring, prevention, and treatment of vascular disease and its sequelae; and the involvement of metabolic disorders, particularly diabetes. In addition, the journal will also seek to define drug usage in terms of ultimate uptake and acceptance by the patient and healthcare professional.