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Analysis of 17 Factors Potentially Related to Hypertension Control in the Siberian Urban Sample
A N Ryabikov1, E V Mazdorova1, E S Mazurenko1
1Research Institute of Therapy and Preventive Medicine, Branch of the Federal Research Center Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk.
Insights
Inadequate blood pressure control in Siberian adults is linked to male gender, long-term hypertension, and alcohol use. Moderate physical activity and smoking in women were associated with better blood pressure management.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Arterial hypertension (AH) affects a significant portion of the adult population, with many individuals failing to achieve target blood pressure (BP) goals despite antihypertensive therapy (AHT).
- Non-pharmacological factors, encompassing lifestyle and socioeconomic elements, play a crucial role in BP regulation.
- Understanding these determinants is essential for developing comprehensive strategies to improve hypertension management.
Purpose of the Study:
- To investigate non-pharmacological factors associated with ineffective BP control in a Siberian urban population sample of individuals with AH undergoing AHT.
- To identify specific demographic, behavioral, and socioeconomic correlates of inadequate BP control (IABPC).
Main Methods:
- The study analyzed data from the HAPIEE project in Novosibirsk, including 2,449 individuals aged 55-84 with AH receiving AHT.
- Participants were categorized into groups with adequate BP control (ABPC) and inadequate BP control (IABPC).
- Multivariate logistic regression was employed to assess associations between IABPC and various factors, including gender, age, AH duration, comorbidities (Type 2 Diabetes Mellitus, CVD), anthropometric/biochemical parameters, behavioral factors (smoking, alcohol consumption, physical activity), and socioeconomic status.
Main Results:
- Approximately 30.7% of the studied population achieved adequate BP control.
- IABPC was significantly associated with male gender (OR 1.72), AH duration exceeding 10 years (OR 2.55), and regular alcohol consumption (1-3 times/month: OR 1.36; 1-4 times/week: OR 1.91).
- Moderate physical activity showed an inverse association with IABPC (OR 0.78). Sex-specific associations included inverse links with CVD history in men (OR 0.62) and smoking in women (OR 0.51), while economically inactive status was linked to IABPC in women (OR 1.39).
Conclusions:
- Inadequate BP control is prevalent among older adults with AH in Siberia, even with AHT.
- Key non-pharmacological factors contributing to IABPC include male gender, prolonged AH duration, and frequent alcohol consumption.
- Strategies to optimize BP control should consider lifestyle modifications such as increasing physical activity and smoking cessation (in women), alongside addressing socioeconomic factors like economic inactivity in women.
Abstract:
Aim To identify non-pharmacological factors associated with ineffective blood pressure (BP) control among individuals with arterial hypertension (AH) in a Siberian urban population sample.Material and methods A considerable proportion of individuals with AH does not achieve BP goals. BP control is influenced by a number of non-drug determinants, including non-modifiable and multiple modifiable factors. In a population sample (men/women, 55-84 years old, n=3,898, 2015-2018, HAPIEE project, Novosibirsk), a category of individuals with AH receiving antihypertensive therapy (AHT) (n=2,449) was selected and two groups with adequate and inadequate BP control (ABPC and IABPC, respectively) were identified. We evaluated associations of IABPC and a series of potentially related factors, including gender, age, AH duration, type 2 diabetes mellitus, cardiovascular diseases (CVD), anthropometric and biochemical parameters, behavioral (smoking, alcohol consumption, physical activity (PA)) and socioeconomic factors (education, marital status, economic activity, material deprivation).Results In a sample of 55-84-year-old individuals with AH taking AHT, ABPC was 30.7%. In the multivariate logistic model, IABPC was directly associated with male gender (odds ratio (OR) 1.72; 95% confidence interval (CI) 1.28-2.31), AH duration longer than 10 years (OR 2.55; 95% CI 2.07-3.14), alcohol consumption 1-3 times a month (OR 1.36; 95% CI 1.02-1.81) and 1-4 times a week (OR 1.91; 95% CI 1.26-2.89) and was inversely associated with moderate PA (OR 0.78; 95% CI 0.62-0.98). In men, IABPC was additionally inversely associated with history of CVD (OR 0.62; 95% CI 0.42-0.92). In women, IABPC was additionally associated with economically inactive status (OR 1.39; 95% CI 1.03-1.86) and inversely associated with smoking (OR 0.51; 95% CI 0.29-0.87).Conclusion In a Siberian population sample of 55-84-year-olds, one third of individuals with AH receiving AHT adequately controlled their BP. Inadequate BP control was directly associated with male gender, long history of AH, frequent alcohol consumption, and economically inactive status (in women), and was inversely associated with moderate PA, CVD (in men), and smoking (in women). Attention to non-pharmacological determinants may help optimize BP control.
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