Abstract
ObjectiveHypertension is the major driver of the cardiovascular epidemic facing Indonesia in the 21st century. Understanding the socioeconomic inequalities associated with hypertension is essential for designing effective intervention strategies. The aim of the current study was to use sub-nationally representative survey data to examine socio-demographic inequalities in the prevalence, diagnosis and management of hypertension in Indonesian adults.MethodsWe investigated factors associated with hypertension prevalence, diagnosis, treatment and control using data on self-reported diagnosis and treatment, and blood pressure measurements, collected from 9755 respondents aged 40 years and up in the 2007 Indonesian Family Life Survey (IFLS 4).ResultsAge-standardized prevalence of hypertension among the study participants was 47.8% (95% CI: 46.8, 48.9), of which almost 70% were undiagnosed. Hypertension was significantly higher in women than men (52.3% versus 43.1%, p-value<0.001). Prevalence of hypertension increased significantly with ageing (Pfor trend <0.001). Over 91% (men: 92.1%, women: 90.0%) of hypertension cases were uncontrolled. Gender, education and socioeconomic status had differential impact on the diagnosis of hypertension and in receiving treatment.ConclusionsOverall, less than a third were aware of their hypertension and a quarter of those on medication had their blood pressure effectively controlled. Men and those of younger age were more vulnerable to have undiagnosed and untreated hypertension. Substantial effort should be given to improve awareness about the condition and making provision for early diagnosis and treatment.
Highlights
Elevated blood pressure is the leading risk factor in terms of its contribution to the burden of cardiovascular disease (CVD) [1,2] with two-thirds of all stroke and half of all coronary heart disease (CHD) attributable to sub-optimal blood pressure levels.[3]
Less than a third were aware of their hypertension and a quarter of those on medication had their blood pressure effectively controlled
Treatment of hypertension is predicated on an individual being aware of their hypertensive status which given the often asymptomatic nature of elevated blood pressure remains a major obstacle– in lower- and middle-income countries (LMIC), where routine CVD surveillance is limited and access to medical care remains prohibitively expensive for large parts of the population.[9,10,11,12]
Summary
Hypertension is the major driver of the cardiovascular epidemic facing Indonesia in the 21st century. Understanding the socioeconomic inequalities associated with hypertension is essential for designing effective intervention strategies. The aim of the current study was to use sub-nationally representative survey data to examine socio-demographic inequalities in the prevalence, diagnosis and management of hypertension in Indonesian adults. Editor: Yan Li, Shanghai Institute of Hypertension, CHINA Received: March 19, 2016 Accepted: July 27, 2016 Published: August 24, 2016
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