Multiple cardiovascular risk factor care in 55 low- and middle-income countries: A cross-sectional analysis of nationally-representative, individual-level data from 280,783 adults

被引：0

作者：

Diallo, Alpha Oumar ^{[1
]}

Marcus, Maja E. ^{[2
,3
]}

Flood, David ^{[4
]}

Theilmann, Michaela ^{[5
,6
]}

Rahim, Nicholas E. ^{[7
]}

Kinlaw, Alan ^{[8
,9
]}

Franceschini, Nora ^{[1
]}

Sturmer, Til ^{[1
]}

Tien, Dessie, V ^{[7
]}

Abbasi-Kangevari, Mohsen ^{[10
]}

Agoudavi, Kokou ^{[11
]}

Andall-Brereton, Glennis ^{[12
]}

Aryal, Krishna ^{[13
]}

Bahendeka, Silver ^{[14
]}

Bicaba, Brice ^{[15
]}

Bovet, Pascal ^{[16
,17
]}

Dorobantu, Maria ^{[18
]}

Farzadfar, Farshad ^{[10
]}

Ghamari, Seyyed-Hadi ^{[10
]}

Gathecha, Gladwell ^{[19
]}

Guwatudde, David ^{[20
]}

Gurung, Mongal ^{[21
]}

Houehanou, Corine ^{[22
]}

Houinato, Dismand ^{[22
]}

Hwalla, Nahla ^{[23
]}

Jorgensen, Jutta ^{[24
]}

Kagaruki, Gibson ^{[25
]}

Karki, Khem ^{[26
]}

Martins, Joao ^{[27
]}

Mayige, Mary ^{[25
]}

Mcclure, Roy Wong ^{[28
]}

Moghaddam, Sahar Saeedi ^{[29
]}

Mwalim, Omar ^{[30
]}

Mwangi, Kibachio Joseph ^{[19
]}

Norov, Bolormaa ^{[31
]}

Quesnel-Crooks, Sarah ^{[12
]}

Sibai, Abla ^{[32
]}

Sturua, Lela ^{[33
]}

Tsabedze, Lindiwe ^{[34
]}

Wesseh, Chea ^{[35
]}

Geldsetzer, Pascal ^{[5
,6
,36
]}

Atun, Rifat ^{[37
,38
]}

Vollmer, Sebastian ^{[2
,3
]}

Baernighausen, Till ^{[5
,6
,39
]}

Davies, Justine ^{[40
,41
,42
]}

Ali, Mohammed K. ^{[43
]}

Seiglie, Jacqueline A. ^{[44
]}

Gower, Emily W. ^{[1
,45
]}

Manne-Goehler, Jennifer ^{[2
,3
,46
]}

机构：

[1] Univ North Carolina Chapel Hill, Gillings Sch Global Publ Hlth, Dept Epidemiol, Chapel Hill, NC 27599 USA

[2] Univ Goettingen, Dept Econ, Gottingen, Germany

[3] Univ Goettingen, Ctr Modern Indian Studies, Gottingen, Germany

[4] Univ Michigan, Ann Arbor, MI USA

[5] Heidelberg Univ, Heidelberg Inst Global Hlth, Fac Med, Heidelberg, Germany

[6] Heidelberg Univ, Univ Hosp, Heidelberg Inst Global Hlth, Heidelberg, Germany

[7] Harvard Med Sch, Massachusetts Gen Hosp, Med Practice Evaluat Ctr, Boston, MA 02114 USA

[8] Univ North Carolina, Eshelman Sch Pharm, Div Pharmaceut Outcomes & Policy, Sch Pharm Chapel Hill, Chapel Hill, NC USA

[9] Univ North Carolina Chapel Hill, Cecil G Sheps Ctr Hlth Serv Res, Chapel Hill, NC USA

[10] Univ Tehran Med Sci, Endocrinol & Metab Populat Sci Inst, Noncommunicable Dis Res Ctr, Tehran, Iran

[11] Togo Minist Hlth, Lome, Togo

[12] Caribbean Publ Hlth Agcy, Port Of Spain, Trinidad Tobago

[13] Abt Associates Inc, Nepal Hlth Sect Programme 3, Monitoring Evaluat & Operat Res Project, Kathmandu, Nepal

[14] St Francis Hosp Nsambya, Kampala, Uganda

[15] Inst African Sante Publ, Ouagadougou, Burkina Faso

[16] Minist Hlth, Victoria, Seychelles

[17] Univ Ctr Primary Care & Publ Hlth Unisante, Lausanne, Switzerland

[18] Emergency Hosp Bucharest, Dept Cardiol, Bucharest, Romania

[19] Minist Hlth, Div Noncommunicable Dis, Nairobi, Kenya

[20] Makerere Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Kampala, Uganda

[21] Minist Hlth, Hlth Res & Epidemiol Unit, Thimphu, Bhutan

[22] Univ Abomey Calavi, Fac Hlth Sci, Lab Epidemiol Chron & Neurol Dis, Cotonou, Benin

[23] Amer Univ Beirut, Fac Agr & Food Sci, Beirut, Lebanon

[24] Univ Copenhagen, Inst Global Hlth, Dept Publ Hlth & Epidemiol, Copenhagen, Denmark

[25] Natl Inst Med Res, Dar Es Salaam, Tanzania

[26] Tribhuvan Univ, Inst Med, Dept Community Med & Publ Hlth, Kathmandu, Nepal

[27] Univ Nacl Timor Lorosae, Fac Med & Hlth Sci, Dili, Timor-Leste

[28] Costa Rican Social Secur Fund, Off Epidemiol & Surveillance, San Jose, Costa Rica

[29] Univ Tehran Med Sci, Endocrinol & Metab Clin Sci Inst, Endocrinol & Metab Res Ctr, Tehran, Iran

[30] Minist Hlth, Zanzibar City, Tanzania

[31] Natl Ctr Publ Hlth, Nutr Dept, Ulaanbaatar, Mongolia

[32] Amer Univ Beirut, Fac Hlth Sci, Dept Epidemiol & Populat Hlth, Beirut, Lebanon

[33] Natl Ctr Dis Control & Publ Hlth, Noncommunicable Dis Dept, Tbilisi, Georgia

[34] NERCHA, Mbabane, Eswatini

[35] Minist Hlth, Monrovia, Liberia

[36] Stanford Univ, Div Primary Care & Populat Hlth, Stanford, CA USA

[37] Harvard Univ, Harvard TH Chan Sch Publ Hlth, Dept Global Hlth & Populat, Boston, MA USA

[38] Harvard Univ, Harvard Med Sch, Dept Global Hlth & Social Med, Boston, MA USA

[39] Africa Hlth Res Inst, Somkhele, South Africa

[40] Univ Witwatersrand, Sch Publ Hlth, MRC Wits Rural Publ Hlth & Hlth Transit Res Unit, Johannesburg, South Africa

[41] Univ Birmingham, Inst Appl Hlth Res, Birmingham, England

[42] Stellenbosch Univ, Ctr Global Surg, Dept Global Hlth, Cape Town, South Africa

[43] Emory Univ, Rollins Sch Publ Hlth, Hubert Dept Global Hlth, Atlanta, GA USA

[44] Massachusetts Gen Hosp, Diabet Unit, Boston, MA USA

[45] Univ North Carolina Chapel Hill, Sch Med, Dept Ophthalmol, Chapel Hill, NC 27599 USA

[46] Harvard Med Sch, Brigham & Womens Hosp, Div Infect Dis, Boston, MA USA

来源：

PLOS GLOBAL PUBLIC HEALTH | 2024年 / 4卷 / 03期

关键词：

MEDICATION USE; MULTIMORBIDITY; DISEASE; HYPERTENSION; PREVENTION; CASCADE; AFRICA; BURDEN; OLDER;

D O I：

10.1371/journal.pgph.0003019

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

The prevalence of multiple age-related cardiovascular disease (CVD) risk factors is high among individuals living in low- and middle-income countries. We described receipt of healthcare services for and management of hypertension and diabetes among individuals living with these conditions using individual-level data from 55 nationally representative population-based surveys (2009-2019) with measured blood pressure (BP) and diabetes biomarker. We restricted our analysis to non-pregnant individuals aged 40-69 years and defined three mutually exclusive groups (i.e., hypertension only, diabetes only, and both hypertension-diabetes) to compare individuals living with concurrent hypertension and diabetes to individuals with each condition separately. We included 90,086 individuals who lived with hypertension only, 11,975 with diabetes only, and 16,228 with hypertension-diabetes. We estimated the percentage of individuals who were aware of their diagnosis, used pharmacological therapy, or achieved appropriate hypertension and diabetes management. A greater percentage of individuals with hypertension-diabetes were fully diagnosed (64.1% [95% CI: 61.8-66.4]) than those with hypertension only (47.4% [45.3-49.6]) or diabetes only (46.7% [44.1-49.2]). Among the hypertension-diabetes group, pharmacological treatment was higher for individual conditions (38.3% [95% CI: 34.8-41.8] using antihypertensive and 42.3% [95% CI: 39.4-45.2] using glucose-lowering medications) than for both conditions jointly (24.6% [95% CI: 22.1-27.2]).The percentage of individuals achieving appropriate management was highest in the hypertension group (17.6% [16.4-18.8]), followed by diabetes (13.3% [10.7-15.8]) and hypertension-diabetes (6.6% [5.4-7.8]) groups. Although health systems in LMICs are reaching a larger share of individuals living with both hypertension and diabetes than those living with just one of these conditions, only seven percent achieved both BP and blood glucose treatment targets. Implementation of cost-effective population-level interventions that shift clinical care paradigm from disease-specific to comprehensive CVD care are urgently needed for all three groups, especially for those with multiple CVD risk factors.

引用

页数：17

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