Association between social determinants of health and trends in prevalence of hypertension in patients of the Peruvian Ministry of Health.

Abstract

To evaluate the association between social determinants of health and trends in the prevalence of hypertension among patients of the Peruvian Ministry of Health 2007-2016. We conducted an ecological study with secondary data sources using health care and death records obtained from the Peruvian Ministry of Health, data from the Peruvian National Household Survey and data from the Regional Information System for Decision Making. We determined the standardised prevalence of hypertension at national and region level, conducted a geospatial exploratory analysis at region level, and applied generalised linear mixed models to evaluate the association between social determinants of health and the prevalence of HT, according to the domains suggested by Healthy People 2020. The prevalence of hypertensive patients of the Peruvian Ministry of Health increased from 966.8/100000 in 2007 to 1619.1/100000 in 2016. The prevalence of hypertension rose by 17.7/100000 per 1% increase of insurance coverage and by 2.2/100000 per 1% increase in the number of hospitals. In contrast, it decreased by 12.3/100000 per 1% increase of the poverty rate, by 9.8/100000 per 1% increase of the proportion of people with native language, by 3.6/100000 per 1% increase of GDP per capita and by 3/100000 per 1% increase in the number of local health centres. The growing trend of HT prevalence in Peru is directly associated with insurance coverage and number of hospitals, and inversely associated with poverty rate, proportion of people with native language, GDP per capita and number of local health centres.