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Risk factors associated with hypertension awareness, treatment, and control in a multi-ethnic Asian population
Yi Wu1, E Shyong Tai, Derrick Heng
1Centre for Molecular Epidemiology, National University of Singapore, Mt Elizabeth Medical Centre, Singapore.
Insights
Hypertension awareness and control are low in Singapore despite high treatment rates. Targeted education and screening are needed for younger, educated adults and Malays to improve hypertension management.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Hypertension is a major cardiovascular disease risk factor.
- Effective management requires awareness, treatment, and control.
- Multi-ethnic Asian populations present unique challenges in hypertension care.
Purpose of the Study:
- To investigate demographic and cardiovascular disease risk factors associated with hypertension awareness, treatment, and control.
- To identify disparities in hypertension management within a multi-ethnic Asian population.
Main Methods:
- Analysis of data from 5022 participants across four cross-sectional studies (2004-2007).
- Data collection via questionnaires, physical examinations, and blood tests.
- Statistical analysis using multiple logistic regression to calculate odds ratios and 95% confidence intervals.
Main Results:
- Hypertension awareness (51.8%) and control (27.1%) were low, despite high treatment rates (84.4% of aware individuals).
- Younger, never-married, highly educated working adults showed reduced awareness and treatment.
- Low socioeconomic status individuals had higher treatment rates but poorer control.
- Coexisting cardiovascular disease risk factors did not improve treatment or control.
- Diuretic use, a guideline-recommended treatment, was uncommon (15.0%).
Conclusions:
- Significant improvements in hypertension awareness, treatment, and control are needed in Singapore.
- Enhanced education and targeted screening/treatment are recommended for younger, educated, higher socioeconomic status individuals, and Malays.
- Specific interventions are required to improve control among older and diabetic hypertensive patients.
Objectives:
To investigate demographic and cardiovascular disease risk factors associated with awareness, treatment and control of hypertension in a multi-ethnic Asian population.
Methods:
Participants from four previous cross-sectional studies were invited for a repeat examination (2004--2007). Information of demographic details and cardiovascular disease risk factors was obtained using questionnaire, physical examination and blood tests. Odds ratios and 95% confidence intervals were calculated using multiple logistic regression models.
Results:
The final number of respondents was 5022 (response rate 49.7%). Although hypertension treatment (84.4% of those aware of hypertension) was high, awareness (51.8% of those having hypertension) and control (27.1% of hypertension on treatment) were low. Reduced awareness and treatment were associated with being younger, never married, and working adults with a higher education level. Low socioeconomic status individuals were more likely to be treated but had poorer control. A similar relationship was found for treatment and control for individuals with coexisting cardiovascular disease risk factors. The use of multiple drug classes was not associated with better control. Diuretic use for treatment of hypertension, as recommended by local and international guidelines, was not common (15.0% of all hypertension medications used).
Conclusions:
The awareness, treatment, and control of hypertension in Singapore can be improved. There is a need to improve awareness through education and target screening and treatment in younger, working adults with higher levels of education and higher economic status, as well as Malays. Control of hypertension could be improved among older or diabetic hypertensive individuals.
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