Spatial distribution and control status of hypertension in urban field practice area of a tertiary medical care institution of South India: A cross-sectional analytical study

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL
Namrata Kharat, P. Sivanantham, G. Kumar, James T. Devasia, S. Kar
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Abstract

Background: Hypertension is a global public health issue. Geographic information systems (GIS) are increasingly being used by health-care systems as an emerging tool to address the public health burden of hypertension. Objective: The objective of the study is to describe the geographic distribution of adults with known hypertension residing in the urban field practice area of a tertiary care institution and to assess the factors associated with its control status. Materials and Methods: We conducted a cross-sectional analytical study in an urban health center (UHC) with adults with hypertension (n = 343) seeking care from the NCD clinic of UHC and private clinics were included. Geo-coding was done (n = 343) using digital GPS device by house-to-house visit and average of the three blood pressure recordings using digital sphygmomanometer taken for assessing control status (n = 277) of hypertension. A structured questionnaire was used to collect sociodemographic, risk factors distribution, and medication adherence. Geospatial analysis was done using QGIS 3.0, ArcGIS 10.2 and SPSS version 22 (IBM Corp. Armonk, NY, USA) was used for statistical analysis. Results: The geographic distribution showed clusters and hotspots in the study area. Of the 277 study participants, 57.4% (51.6–63.5) had blood pressure under control and 41% were male. Patients with age ≥60 years (prevalence ratios [PR]: 1.2, 95% CI: 1–1.6), with no comorbidity (PR: 1.3, 95% CI: 1–1.7), high medicine adherence (PR: 7.6, 95% CI: 3.9–14.6) were independent factors associated with control status. Conclusion: The study identified the clustering and hotspot areas of known patients with hypertension. Around three-fifth of known hypertensives had their blood pressure under control.
南印度一家三级医疗机构城市野战区高血压的空间分布和控制状况:横断面分析研究
背景:高血压是一个全球性的公共卫生问题。地理信息系统越来越多地被卫生保健系统用作解决高血压公共卫生负担的新兴工具。目的:本研究的目的是描述居住在城市三级医疗机构现场实践区的已知高血压成年人的地理分布,并评估与其控制状况相关的因素。材料和方法:我们在城市卫生中心(UHC)对从UHC的NCD诊所寻求护理的高血压成年人(n=343)进行了横断面分析研究,其中包括私人诊所。通过挨家挨户的访问,使用数字GPS设备进行地理编码(n=343),并使用数字血压计对三次血压记录进行平均,以评估高血压的控制状态(n=277)。使用结构化问卷收集社会人口统计学、危险因素分布和药物依从性。使用QGIS 3.0、ArcGIS 10.2进行地理空间分析,并使用SPSS版本22(IBM Corp.Armonk,NY,USA)进行统计分析。结果:研究区的地理分布呈现出聚集性和热点性。在277名研究参与者中,57.4%(51.6–63.5)的血压得到控制,41%为男性。年龄≥60岁(患病率[PR]:1.2,95%CI:1-1.6)、无合并症(PR:1.3,95%CI:1~1.7)、高药物依从性(PR:7.6,95%CI:3.9-14.6)的患者是与控制状态相关的独立因素。结论:本研究确定了已知高血压患者的聚集性和热点区域。大约五分之三的已知高血压患者的血压得到了控制。
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