Impact of 2017 ACC/AHA guideline on prevalence, awareness, treatment, control, and determinants of hypertension: a population-based cross-sectional study in southwest of Iran.

IF 3.2 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Population Health Metrics Pub Date : 2021-05-25 DOI:10.1186/s12963-021-00260-5

Fatemeh Sadeghi, Bahman Cheraghian, Zahra Mohammadi, Sadaf G Sepanlou, Sahar Masoudi, Zahra Rahimi, Leila Danehchin, Yousef Paridar, Farhad Abolnezhadian, Mohammad Noori, Seyed Ali Mard, Ali Akbar Shayesteh, Hossein Poustchi

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引用次数: 3

Abstract

Background: In 2017, the American College of Cardiology/American Heart Association (ACC/AHA) provided a new guideline for hypertension prevention and management. We aimed to update the prevalence, awareness, control, and determinants of hypertension based on this guideline in Khuzestan province, southwest of Iran, and to estimate the number of people who are eligible for non-pharmacologic and pharmacologic intervention.

Methods: This population-based cross-sectional study was conducted in Khuzestan, a large province in the southwest of Iran. Comprehensive information about the potential relating factors of hypertension was collected, blood pressure was measured, and anthropometric measurements were obtained. Moreover, the dietary pattern was evaluated in 2830 individuals, using a qualitative food frequency questionnaire.

Results: Among 30,506 participants, 30,424 individuals aged 20-65 years were eligible for the study. In comparison with the previous guideline released by the Joint National Committee (JNC8), the prevalence of hypertension in Khuzestan dramatically increased from 15.81 to 42.85% after implementation of the ACC/AHA guideline, which was more dominant in the male population and the 45-54 age group. The sex and age adjustment of the hypertension prevalence was estimated to be 39.40%. The percentage of hypertension awareness, treatment, and control were 45.85%, 35.42%, and 59.63%, which dropped to 22.72%, 26.37%, and 28.94% after implementation of new guideline, respectively.

Conclusions: In the ACC/AHA guideline, a higher number of individuals with the pre-hypertension condition were shifted into the hypertension category and the level of awareness, treatment, and control were dramatically decreased, which highlight a great need to expand the public health infrastructure for further managing the substantial increased burden on healthcare system. However, further studies with population over 65 years are required to estimate the eligibility for antihypertensive treatment in this province after implementation of new guideline.

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2017年ACC/AHA指南对高血压患病率、意识、治疗、控制和决定因素的影响:伊朗西南部一项基于人群的横断面研究

背景:2017年，美国心脏病学会/美国心脏协会(ACC/AHA)为高血压预防和管理提供了新的指南。我们的目的是根据该指南更新伊朗西南部胡齐斯坦省高血压的患病率、意识、控制和决定因素，并估计有资格接受非药物和药物干预的人数。方法:这项基于人群的横断面研究是在伊朗西南部的一个大省胡齐斯坦进行的。收集高血压潜在相关因素的综合信息，测量血压，并进行人体测量。此外，采用定性食物频率问卷对2830人的饮食模式进行了评估。结果:在30,506名参与者中，30,424名年龄在20-65岁之间的人符合研究条件。与之前全国联合委员会(JNC8)发布的指南相比，ACC/AHA指南实施后，胡齐斯坦高血压患病率从15.81%急剧上升至42.85%，且在男性人群和45-54岁年龄组中更为明显。高血压患病率的性别和年龄调整估计为39.40%。高血压知晓率为45.85%、治疗率为35.42%、控制率为59.63%，新指南实施后分别降至22.72%、26.37%、28.94%。结论:在ACC/AHA指南中，有更多的高血压前期患者被转移到高血压类别，意识、治疗和控制水平急剧下降，这突出了扩大公共卫生基础设施以进一步管理医疗系统负担的必要性。然而，需要对65岁以上人群进行进一步研究，以评估新指南实施后该省抗高血压治疗的适格性。

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来源期刊

Population Health Metrics PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.50

自引率

0.00%

发文量

审稿时长

29 weeks

期刊介绍： Population Health Metrics aims to advance the science of population health assessment, and welcomes papers relating to concepts, methods, ethics, applications, and summary measures of population health. The journal provides a unique platform for population health researchers to share their findings with the global community. We seek research that addresses the communication of population health measures and policy implications to stakeholders; this includes papers related to burden estimation and risk assessment, and research addressing population health across the full range of development. Population Health Metrics covers a broad range of topics encompassing health state measurement and valuation, summary measures of population health, descriptive epidemiology at the population level, burden of disease and injury analysis, disease and risk factor modeling for populations, and comparative assessment of risks to health at the population level. The journal is also interested in how to use and communicate indicators of population health to reduce disease burden, and the approaches for translating from indicators of population health to health-advancing actions. As a cross-cutting topic of importance, we are particularly interested in inequalities in population health and their measurement.