Prevalence, awareness, treatment and control of high blood pressure in a cohort in Northern Andean Peru

ABSTRACT

Background

Gaps exist along the high blood pressure (HBP) diagnosis-treatment-control pathway in high, low and middle-income countries.

Objective

To determine the prevalence of HBP and to describe the levels of awareness, control and treatment of HBP in the rural Peruvian Andes.

Methods

This cross-sectional study is embedded into a multigenerational cohort. We analysed data of all adult participants aged ≥ 30 years (n = 2752) who answered a baseline health and lifestyle questionnaire and underwent a physical examination, which included three blood pressure readings. HBP was defined as measured systolic or diastolic blood pressure (BP) ≥140 and/or 90 mm Hg and/or self-reported physician-diagnosed hypertension and/or self-reported antihypertensive intake. The determinants of the prevalence of HBP, unawareness of HBP and uncontrolled HBP were assessed using mixed-effect logistic regressions.

Results

HBP was present in 18.9% of the participants. Of those with measured HBP, 72.2% were unaware of their HBP. Among those with a diagnosed or medically treated hypertension, 58.4% had uncontrolled HBP. The prevalence of HBP was higher in women (OR: 1.12, CI: 1.02–1.24), increased with age (OR: 1.01, CI: 1.01–1.01) and the presence of family history of hypertension (OR: 1.15, CI: 1.08–1.24), and decreased with healthier lifestyle score (OR: 0.93, CI: 0.91–0.95). Unawareness of HBP was lower among women (OR: 0.56, CI: 0.38–0.83), higher among participants living over 3000 m Above Sea Level (OR: 1.15, CI: 1.03–1.27) and decreased with age (OR: 0.99, CI: 0.98–0.99).

Conclusions

Unawareness of HBP was high, few HTN patients received treatment and BP remained high in the presence of antihypertensive treatment.

KEYWORDS:

• Hypertension
• awareness
• control
• high-altitude
• Andes

Responsible Editor Jennifer Stewart Williams

Responsible Editor Jennifer Stewart Williams

Acknowledgments

We thank the study participants for their valuable time and kind participation. We appreciate and thank the local authorities of the RED IV San Marcos and the health centres’ pregnancy surveillance system team for their continuous support. We also express gratitude to our field staff, especially to Angelica Fernandez who coordinated the fieldwork activities of the ALTO cohort. The authors gratefully acknowledge the work of our data manager Hector Verastegui.

Author contributions

GSS, DM, SH and NPH conceived and designed the study. GSS and SH conducted the data collection. GSS performed the analysis and wrote the first draft of the manuscript. JH supervised the statistical analysis. GSS, DM, SH, GF, JH and NPH interpreted the data and results. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical approval

The study was approved by the Universidad Peruana Cayetano Heredia (UPCH) Ethical Review Board (N° 192-08-16) and the Swiss ethics commission, Ethikkommission Nordwest und Zentralschweiz (EKNZ) (Req-2020–00088). The Cajamarca Regional Health Authority was informed of the study and an institutional agreement was signed between UPCH, the Swiss Tropical and Public Health Institute and the regional authority. All participants signed a written informed consent form.

Paper context

Peru shows significant heterogeneity in the prevalence and prevention of high blood pressure across its regions. Understanding the local trends in awareness, treatment, and control of high blood pressure is essential for tailoring disease management to the local context. We found a strong sex-age association with prevalence and unawareness of high blood pressure in the Peruvian Andes. Implementing age and sex-specific interventions is crucial for the effective management of high blood pressure.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon request.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/16549716.2023.2285100.

Additional information

Funding

The establishment of the ALTO cohort was supported by the Eckenstein-Geigy Foundation. GS was supported by Consejo Nacional de Ciencia, Tecnología e Innovación Tecnológica (CONCYTEC)-Peru and the Swiss School of Public Health Global P3HS. The funders had no role in the study design, the collection, analysis or interpretation of the data, the writing of the report or any decision related to the publication.