학술논문
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.
Document Type
Academic Journal
Author
Diallo AO; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.; Marcus ME; Department of Economics and Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany.; Flood D; University of Michigan, Ann Arbor, Michigan, United States of America.; Theilmann M; Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.; Rahim NE; Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America.; Kinlaw A; Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina School of Pharmacy at Chapel Hill, Chapel Hill, North Carolina, United States of America.; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.; Franceschini N; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.; Stürmer T; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.; Tien DV; Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America.; Abbasi-Kangevari M; Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.; Agoudavi K; Togo Ministry of Health, Lome, Togo.; Andall-Brereton G; Caribbean Public Health Agency, Port of Spain, Trinidad and Tobago.; Aryal K; Nepal Health Sector Programme 3, Monitoring Evaluation and Operational Research Project, Abt Associates, Kathmandu, Nepal.; Bahendeka S; Saint Francis Hospital Nsambya, Kampala, Uganda.; Bicaba B; Institut Africain de Santé Publique, Ouagadougou, Burkina Faso.; Bovet P; Ministry of Health, Victoria, Seychelles.; University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland.; Dorobantu M; Department of Cardiology, Emergency Hospital of Bucharest, Bucharest, Romania.; Farzadfar F; Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.; Ghamari SH; Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.; Gathecha G; Division of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya.; Guwatudde D; Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda.; Gurung M; Health Research and Epidemiology Unit, Ministry of Health, Thimphu, Bhutan.; Houehanou C; Laboratory of Epidemiology of Chronic and Neurological Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin.; Houinato D; Laboratory of Epidemiology of Chronic and Neurological Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin.; Hwalla N; Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon.; Jorgensen J; Dept of Public Health and Epidemiology, Institute of Global Health, Copenhagen University, Copenhagen, Denmark.; Kagaruki G; National Institute for Medical Research, Dar es Salaam, Tanzania.; Karki K; Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.; Martins J; Faculty of Medicine and Health Sciences, Universidade Nacional Timor Lorosa'e, Dili, Timor-Leste.; Mayige M; National Institute for Medical Research, Dar es Salaam, Tanzania.; McClure RW; Office of Epidemiology and Surveillance, Costa Rican Social Security Fund, San José, Costa Rica.; Moghaddam SS; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.; Mwalim O; Ministry of Health, Zanzibar City, Tanzania.; Mwangi KJ; Division of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya.; Norov B; Nutrition Department, National Center for Public Health, Ulaanbaatar, Mongolia.; Quesnel-Crooks S; Caribbean Public Health Agency, Port of Spain, Trinidad and Tobago.; Sibai A; Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.; Sturua L; Non-Communicable Disease Department, National Center for Disease Control and Public Health, Tbilisi, Georgia.; Tsabedze L; Ministry of Health, Mbabane, Eswatini.; Wesseh C; Ministry of Health, Monrovia, Liberia.; Geldsetzer P; Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.; Division of Primary Care and Population Health, Stanford University, Stanford, California, United States of America.; Atun R; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.; Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, Massachusetts, United States of America.; Vollmer S; Department of Economics and Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany.; Bärnighausen T; Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.; Africa Health Research Institute, Somkhele, South Africa.; Davies J; MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of Witwatersrand, Johannesburg, South Africa.; Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.; Centre for Global Surgery, Department of Global Health, Stellenbosch University, Cape Town, South Africa.; Ali MK; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.; Seiglie JA; Diabetes Unit, Massachusetts General Hospital, Boston, MA, United States of America.; Gower EW; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.; Department of Ophthalmology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.; Manne-Goehler J; Department of Economics and Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany.; Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.
Source
Publisher: Public Library of Science Country of Publication: United States NLM ID: 9918283779606676 Publication Model: eCollection Cited Medium: Internet ISSN: 2767-3375 (Electronic) Linking ISSN: 27673375 NLM ISO Abbreviation: PLOS Glob Public Health Subsets: PubMed not MEDLINE
Subject
Language
English
Abstract
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.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Diallo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Diallo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)