Estimated Prevalence Of Hypertension Research Articles

Identification of Hypertension in Electronic Health Records Through Computable Phenotype Development and Validation for Use in Public Health Surveillance: Retrospective Study.

Electronic health record (EHR) systems are widely used in the United States to document care delivery and outcomes. Health information exchange (HIE) networks, which integrate EHR data from the various health care providers treating patients, are increasingly used to analyze population-level data. Existing methods for population health surveillance of essential hypertension by public health authorities may be complemented using EHR data from HIE networks to characterize disease burden at the community level. We aimed to derive and validate computable phenotypes (CPs) to estimate hypertension prevalence for population-based surveillance using an HIE network. Using existing data available from an HIE network, we developed 6 candidate CPs for essential (primary) hypertension in an adult population from a medium-sized Midwestern metropolitan area in the United States. A total of 2 independent clinician reviewers validated the phenotypes through a manual chart review of 150 randomly selected patient records. We assessed the precision of CPs by calculating sensitivity, specificity, positive predictive value (PPV), F1-score, and validity of chart reviews using prevalence-adjusted bias-adjusted κ. We further used the most balanced CP to estimate the prevalence of hypertension in the population. Among a cohort of 548,232 adults, 6 CPs produced PPVs ranging from 71% (95% CI 64.3%-76.9%) to 95.7% (95% CI 84.9%-98.9%). The F1-score ranged from 0.40 to 0.91. The prevalence-adjusted bias-adjusted κ revealed a high percentage agreement of 0.88 for hypertension. Similarly, interrater agreement for individual phenotype determination demonstrated substantial agreement (range 0.70-0.88) for all 6 phenotypes examined. A phenotype based solely on diagnostic codes possessed reasonable performance (F1-score=0.63; PPV=95.1%) but was imbalanced with low sensitivity (47.6%). The most balanced phenotype (F1-score=0.91; PPV=83.5%) included diagnosis, blood pressure measurements, and medications and identified 210,764 (38.4%) individuals with hypertension during the study period (2014-2015). We identified several high-performing phenotypes to identify essential hypertension prevalence for local public health surveillance using EHR data. Given the increasing availability of EHR systems in the United States and other nations, leveraging EHR data has the potential to enhance surveillance of chronic disease in health systems and communities. Yet given variability in performance, public health authorities will need to decide whether to seek optimal balance or declare a preference for algorithms that lean toward sensitivity or specificity to estimate population prevalence of disease.

Prevalence, awareness and management of arterial hypertension: About a Tunisian population-based survey

Hypertension represents a public health problem in Tunisia as in all the world. Estimate prevalence of hypertension in Tunisia, its associated cardiovascular risk factors and evaluate awareness and access of hypertensive patients to health care. Descriptive transversal regional investigation, realized in 2009, which studied by a home survey a representative sample of Tunisian population. The study was conducted among 1340 persons aged 18 and over, residing in the area of Ariana in Tunis. It included an interview and a physical examination with measurement of blood pressure and anthropometric measurements. Prevalence of hypertension was 36%, higher in men (41%) than women (34%). It was inversely related to educational and socioeconomic level. The prevalence of associated cardiovascular risk factors was high: 10% for diabetes, 9% for dyslipidemia, 24% for obesity and 25% for smoking. Half of hypertensive subjects were aware of having hypertension, among them 96% were receiving treatment. The prevalence of hypertension was high in 2009 in this cohort of Tunisian population. As primary prevention, it is important to consider lifestyle modification of the Tunisian people in order to reduce this cardiovascular risk factor. Also, screening for hypertension and improving access to health must be established in order to reduce the burden of this cardiovascular risk factor.

Prevalence of hypertension and associated factors in female prison correctional officers in a national sample in Brazil.

ObjectivesTo estimate hypertension prevalence and associated factors among female correctional officers (FCO) in female Brazilian prisons.MethodsCross‐sectional, analytical study conducted in 15 female prisons in all five Brazilian regions between January 2014 and December 2015. The study population consisted of correctional officers with at least 6 months in the position. The sampling included 40% of FCO present in the prison during data collection, yielding 295 FCOs. Data were collected via Audio Computer‐Assisted Self‐Interview. A physical examination of participants was conducted including blood pressure, weight, and waist and hip circumference. The Odds Ratio and confidence intervals for independent factors were estimated.ResultsHypertension prevalence in correctional officers was 37.9%, (95% CI 32.1‐44.0). Hypertension was associated with obesity (95% CI = 1.884‐9.947), cardiovascular disease (95% CI = 3.348‐16.724), and participation in the specific training course for the relevant position (95% CI = 1.413‐9.564).ConclusionsWhile findings, except for the last factor, are not novel, this is the first such study conducted in Brazil. Hypertension prevalence among this pool of all female correctional officers is higher than in the average population, and FCOs associate this with the prison environment. Current training does not appear to address this problem. Especially since prison populations are growing in Brazil, this problem needs to be addressed for the health of the FCOs and the prisoners in their care.

Prevalence, awareness and management of arterial hypertension: About a Tunisian population-based survey

Hypertension represents a public health problem in Tunisia as well as in the entire world. Estimate prevalence of hypertension in Tunisia, its associated cardiovascular risk factors and evaluate awareness and access of hypertensive patients to health care. Descriptive transversal regional investigation, realized in 2009, which studied by a home survey a representative sample of Tunisian population. The study was conducted among 1340 persons aged 18 and over, residing in the area of Ariana in Tunis. It included an interview and a physical examination with measurement of blood pressure and anthropometric measurements. Prevalence of hypertension was 36%, higher in men (41%) than women (34%). It was inversely related to educational and socio-economic level. The prevalence of associated cardiovascular risk factors was high: 10% for diabetes, 9% for dyslipidemia, 24% for obesity and 25% for smoking. Half of hypertensive subjects were aware of having hypertension; among them 96% were receiving treatment. The prevalence of hypertension was high in 2009 in this cohort of Tunisian population. As primary prevention, it is important to consider lifestyle modification of the Tunisian people in order to reduce this cardiovascular risk factor. Also, screening for hypertension and improving access to health must be established in order to reduce the burden of this cardiovascular risk factor.

Combining population-based administrative health records and electronic medical records for disease surveillance

BackgroundAdministrative health records (AHRs) and electronic medical records (EMRs) are two key sources of population-based data for disease surveillance, but misclassification errors in the data can bias disease estimates. Methods that combine information from error-prone data sources can build on the strengths of AHRs and EMRs. We compared bias and error for four data-combining methods and applied them to estimate hypertension prevalence.MethodsOur study included rule-based OR and AND methods that identify disease cases from either or both data sources, respectively, rule-based sensitivity-specificity adjusted (RSSA) method that corrects for inaccuracies using a deterministic rule, and probabilistic-based sensitivity-specificity adjusted (PSSA) method that corrects for error using a statistical model. Computer simulation was used to estimate relative bias (RB) and mean square error (MSE) under varying conditions of population disease prevalence, correlation amongst data sources, and amount of misclassification error. AHRs and EMRs for Manitoba, Canada were used to estimate hypertension prevalence using validated case definitions and multiple disease markers.ResultsThe OR method had the lowest RB and MSE when population disease prevalence was 10%, and the RSSA method had the lowest RB and MSE when population prevalence increased to 20%. As the correlation between data sources increased, the OR method resulted in the lowest RB and MSE. Estimates of hypertension prevalence for AHRs and EMRs alone were 30.9% (95% CI: 30.6–31.2) and 24.9% (95% CI: 24.6–25.2), respectively. The estimates were 21.4% (95% CI: 21.1–21.7), for the AND method, 34.4% (95% CI: 34.1–34.8) for the OR method, 32.2% (95% CI: 31.8–32.6) for the RSSA method, and ranged from 34.3% (95% CI: 34.1–34.5) to 35.9% (95% CI, 35.7–36.1) for the PSSA method, depending on the statistical model.ConclusionsThe OR and AND methods are influenced by correlation amongst the data sources, while the RSSA method is dependent on the accuracy of prior sensitivity and specificity estimates. The PSSA method performed well when population prevalence was high and average correlations amongst disease markers was low. This study will guide researchers to select a data-combining method that best suits their data characteristics.

The Impact of Coming Demographic Changes in Middle-Income Countries on the Number of Adults in Need of Care for Hypertension: Estimates for Brazil, China, India, Indonesia, Mexico, and South Africa

Background: Over the coming decades, middle-income countries (MICs) are expected to experience substantial population aging. With much of global health research focusing on the economic and mortality burden of aging, the implications of this population growth among older age groups on the future number of individuals in need of healthcare for aging-related diseases often go unappreciated. Using a novel mathematical approach as well as nationally representative blood pressure (BP) data among adults aged 40 years and older from six of the most populous MICs, we estimate - under a range of plausible epidemiological scenarios - the change in the number of individuals in need of hypertension care between 2015 and 2050 that is due to changes in population size, age composition, and disease prevalence. Methods: We used nationally representative household survey data collected between 2012 and 2016 in Brazil, China, India, Indonesia, Mexico, and South Africa to estimate hypertension prevalence for each age group in each country. To reflect unmet need for healthcare, we defined hypertension as systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg regardless of treatment status. Using data on age-specific counts of individuals from the United Nations World Population Prospects, along with a mathematical disease projection equation that we developed, we calculated the change in the number of individuals with hypertension in each country that was due to changes in population size, age composition, and age-specific prevalence under each of four scenarios. These scenarios were that, by 2050, the age-specific hypertension prevalence: i) increases by 10%, ii) remains unchanged, iii) decreases by 10%, and iv) decreases by 25%. Findings: 770,121 adults without a missing BP measurement were included in the analysis. If the current age-specific prevalence schedule of hypertension remains unchanged until 2050, demographic changes alone will increase the number of adults with hypertension by 55% in China, 97% in Brazil, 101% in Indonesia, 105% in South Africa, 108% in India, and 151% in Mexico, corresponding to 319.7 million more individuals across the six countries. If the age-specific prevalence of hypertension is reduced by 25% by 2050 among adults aged ≥40 years, the number of individuals with hypertension will still increase by 145.9 million more individuals, with the relative increase ranging from 16% in China to 88% in Mexico. Interpretation: In MICs, coming demographic changes will vastly overpower potential prevention and health services improvements for hypertension. Large expansions in chronic disease care services will be needed in MICs to meet the inevitable rise of hypertension and other aging-related diseases, such as diabetes and dementia. Funding: Harvard Medical School Center for Global Health Delivery. Declaration of Interest: The authors declare no conflicts of interest.

Prevalence, awareness and management of arterial hypertension: About a Tunisian population-based survey

Background Hypertension represents a public health problem in Tunisia as in all the world. Purposes Estimate prevalence of hypertension in Tunisia, its associated cardiovascular risk factors and evaluate awareness and access of hypertensive patients to health care. Methods Descriptive transversal regional investigation, realized in 2009, which studied by a home survey a representative sample of Tunisian population. The study was conducted among 1340 persons aged 18 and over, residing in the area of Ariana in Tunis. It included an interview and a physical examination with measurement of blood pressure and anthropometric measurements. Results Prevalence of hypertension was 36%, higher in men (41%) than women (34%). It was inversely related to educational and socio-economic level. The prevalence of associated cardiovascular risk factors was high: 10% for diabetes, 9% for dyslipidemia, 24% for obesity and 25% for smoking. Half of hypertensive subjects were aware of having hypertension, among them 96% were receiving treatment. Conclusion the prevalence of hypertension was high in 2009 in this cohort of Tunisian population. As primary prevention, it is important to consider lifestyle modification of the Tunisian people in order to reduce this cardiovascular risk factor. Also, screening for hypertension and improving access to health must be established in order to reduce the burden of this cardiovascular risk factor.

Hypertension prevalence and influence of basal metabolic rate on blood pressure among adult students in Bangladesh

BackgroundHypertension is a global health issue and is currently increasing at rapid pace in South Asian countries including Bangladesh. Although, some studies on hypertension have been conducted in Bangladesh, there is a lack of scientific evidence in the adult student population that was missing from the previous and recent national cross-sectional studies. Moreover, the specific risk factors of hypertension in the Bangladeshi adults still need to be investigated. This study was conducted to estimate hypertension prevalence among adult students in Bangladesh and to test the hypothesis of Luke et al. (Hypertension 43:555–560, 2004) that basal metabolic rate (BMR) and blood pressure are positively associated independent of body size.MethodThe data was collected on 184 adult university students (118 female and 66 male) in Dhaka, Bangladesh. Anthropometric, BMR details and an average of at least two blood pressure measurements were obtained. Hypertension was defined by a systolic blood pressure (SBP) ≥ 140 mmHg and/or, diastolic blood pressure (DBP) ≥ 90 mmHg.ResultsOverall, 6.5% of participants had hypertension with significantly (p < 0.001) higher prevalence in male (12.1%) than in the female (3.4%) students. Age and BMI showed positive and significant correlation with hypertension among the students. When adjusted for body mass index (BMI), as well as other potentially confounding variables such as age, sex, smoking status and degree of urbanization, BMR was positively correlated with SBP and DBP (p < 0.001). Thus, higher BMR is associated with SBP and DBP; this is opposite the well documented inverse relationship between physical activity and blood pressure. If the influence of BMR on blood pressure is confirmed, the systematically elevated BMR might be an important predictor that can explain relatively high blood pressure and hypertension in humans.ConclusionThis study reports the prevalence and associated risk factors of hypertension in the Bangladeshi adult students. The study also showed a positive association between BMR and blood pressure among the participants. A large scale longitudinal study across the country is needed to find out the underlying causes of hypertension in the Bangladeshi adults. In addition, comprehensive and integrated intervention programs focusing on modifiable risk factors are recommended to make awareness and prevent hypertension.

Prevalence, Awareness, Treatment, and Control of Hypertension among Kazakhs with high Salt Intake in Xinjiang, China: A Community-based Cross-sectional Study

Hypertension is a leading cause of death worldwide; data on hypertension among ethnic minorities in China are sparse. This study aimed to estimate hypertension prevalence, awareness, treatment, and control in a Kazakh population, and to assess the association between salt intake and the above measures. A cross-sectional survey was conducted among Kazakh adults (≥30 years old) in the town of Hongdun, Altay, Xinjiang. Survey procedures included a questionnaire, physical measurement, and laboratory tests. Of 1805 eligible individuals, 1668 (92.4%) were included in the analysis. After adjustment for gender, age, and occupation, prevalence of hypertension was 45.5%. The proportions with awareness, treatment, control, or medication-control were 61.0%, 28.8%, 2.9% and 10.1%, respectively. Higher prevalence was seen among nomads and farmers (50.7% and 44.6%, respectively). However, the proportions with treatment or control were lower than seen among urban citizens. Hypertension prevalence was higher in those with higher salt intake (p = 0.0008). In contrast, the proportions with awareness (p = 0.0389), treatment (p = 0.0010), control (p = 0.0503), and medication-control (p = 0.2012) reduced as salt intake increased. In conclusion, hypertension prevalence is high in this population, but the proportions with awareness, treatment, or control are sub-optimal. Public health interventions that improve hypertension prevention and control, particularly among nomads, is needed.

Prevalência de hipertensão arterial sistêmica na cidade de Formiga, MG

To estimate hypertension prevalence and identify associated socioeconomic, demographic, and anthropometric variables. A cross-sectional study with probability sampling. people > or = 18 years of age living in the urban area of Formiga, Minas Gerais state, and registered with the Family Health Program (Programa Saúde da Família-PSF), which covers 94% of the population. Two hundred and eighty-five subjects (131 men and 154 women) were enrolled in the study. Criteria for the diagnosis of hypertension were the following: systolic blood pressure > or = 140 mmHg and/or diastolic blood pressure > or = 90 mmHg, or current use of antihypertensive medication. A standard questionnaire was used to collect socioeconomic and demographic data, as well as information on alcohol consumption, smoking, and physical activity level. Overall prevalence of hypertension in the target population was estimated at 32.7% (95% CI): 28.2-37.2), 31.7% in men and 33.6% in women. Among subjects with prescribed antihypertensive drugs, 66% reported taking their medication regularly. Hypertension prevalence increased steadily with increasing age (OR = 1.07; 95% CI: 1.05-1.10) and was positively associated with waist circumference (OR = 3.05; 95% CI: 1.49-6.22) and negatively associated with the level of physical activity (OR = 0.45; 95% CI: 0.25-0.82). Hypertension prevalence was very high in the adult population registered with the PSF in Formiga, representing a major public health problem. Intervention programs that boost physical activity, promote compliance with drug treatment, and focus on hypertensive subjects unaware of their condition are needed.