Prevalence, awareness, treatment and control of high blood pressure in a cohort in Northern Andean Peru

Glob Health Action. 2023 Dec 31;16(1):2285100. doi: 10.1080/16549716.2023.2285100. Epub 2023 Dec 1.

Abstract

Background: Gaps exist along the high blood pressure (HBP) diagnosis-treatment-control pathway in high, low and middle-income countries.

Objective: To determine the prevalence of HBP and to describe the levels of awareness, control and treatment of HBP in the rural Peruvian Andes.

Methods: This cross-sectional study is embedded into a multigenerational cohort. We analysed data of all adult participants aged ≥ 30 years (n = 2752) who answered a baseline health and lifestyle questionnaire and underwent a physical examination, which included three blood pressure readings. HBP was defined as measured systolic or diastolic blood pressure (BP) ≥140 and/or 90 mm Hg and/or self-reported physician-diagnosed hypertension and/or self-reported antihypertensive intake. The determinants of the prevalence of HBP, unawareness of HBP and uncontrolled HBP were assessed using mixed-effect logistic regressions.

Results: HBP was present in 18.9% of the participants. Of those with measured HBP, 72.2% were unaware of their HBP. Among those with a diagnosed or medically treated hypertension, 58.4% had uncontrolled HBP. The prevalence of HBP was higher in women (OR: 1.12, CI: 1.02-1.24), increased with age (OR: 1.01, CI: 1.01-1.01) and the presence of family history of hypertension (OR: 1.15, CI: 1.08-1.24), and decreased with healthier lifestyle score (OR: 0.93, CI: 0.91-0.95). Unawareness of HBP was lower among women (OR: 0.56, CI: 0.38-0.83), higher among participants living over 3000 m Above Sea Level (OR: 1.15, CI: 1.03-1.27) and decreased with age (OR: 0.99, CI: 0.98-0.99).

Conclusions: Unawareness of HBP was high, few HTN patients received treatment and BP remained high in the presence of antihypertensive treatment.

Keywords: Andes; Hypertension; awareness; control; high-altitude.

MeSH terms

  • Adult
  • Antihypertensive Agents* / therapeutic use
  • Blood Pressure
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension* / drug therapy
  • Hypertension* / epidemiology
  • Peru / epidemiology
  • Prevalence

Substances

  • Antihypertensive Agents

Grants and funding

The establishment of the ALTO cohort was supported by the Eckenstein-Geigy Foundation. GS was supported by Consejo Nacional de Ciencia, Tecnología e Innovación Tecnológica (CONCYTEC)-Peru and the Swiss School of Public Health Global P3HS. The funders had no role in the study design, the collection, analysis or interpretation of the data, the writing of the report or any decision related to the publication.