Abstract P317: Prevalence, Awareness, Treatment, and Control of Hypertension in the Southern Cone of Latin America

Abstract

Objective: Hypertension is the major preventable risk factor for cardiovascular disease (CVD) and premature deaths worldwide. We conducted a population-based cross-sectional study in a multistage-probabilistic sample of around 8,000 subjects aged 35-74 years old from 4 cities of the Southern Cone of Latin America (SCLA): Bariloche and Marcos Paz in Argentina, Temuco in Chile and Canelones in Uruguay, to estimate the prevalence and distribution of hypertension, and to determine hypertension awareness, treatment, and control in this population. Methods: Three blood pressure (BP) measurements were obtained by trained observers. Data on history of hypertension and use of BP medications was obtained from a standard questionnaire. Hypertension was defined as a mean systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or use of antihypertensive drugs. Prevalence of hypertension was calculated by weighting sampling factors derived from population census data from 2010 for each city. Results: Of the adult population aged 35-74 yrs, 43.3 % (44.7% in men and 41.5% in women) had hypertension. The age-specific prevalence was 24.9%, 39.8%, 59%, and 71.8% for ages 35-44, 45-54, 55-64 and 65-74 yrs, respectively. In addition, the prevalence of hypertension decreased with the levels of education (52.2%, 40.7% and 33.6% for primary, secondary and tertiary/university education, respectively). Overall, 62.2% of hypertensives were aware of their diagnosis, 47.7 % were under drug treatment, and 21.5 % achieved BP control (<140/90 mm Hg). The percentage of patients, who were aware, treated, and controlled was 53.3 %, 37.7 %, and 13.6 %, respectively in men, and 73.9 %, 60.9 %, and 31.7 % in women. The age-specific rate of awareness was 38.6%, 55.8%, 70.9%, and 78.4% for ages 35-44, 45-54, 55-64, 65-74 yrs. The hypertension control rates were 13.5%, 16.6%, 24.3% and 30.0% for patients aged 35-44, 45-54, 55-65, and 65-74 yrs. The control rates were 62.4%, 44.6%, 41.7%, and 41.9% among those who were under drug treatment for the above age-groups. Conclusion: In the SCLA, hypertension remains a significant public health problem. The prevalence of hypertension is high while the awareness, treatment and control are unacceptably low in the general population and vary by age, gender, and education levels. There is a clear gradient by age regarding hypertension control, which is better in the oldest stratum. This finding seems to be related to better awareness rates and hence more chances to be treated for aged subjects. However, when considering only those who are receiving drug treatment, the youngest are better controlled than the oldest, mainly due to higher levels of BP in the latter. These data provide a basis for targeting public health policies to reduce BP levels and the prevalence of hypertension in the region.