2023-09-28 14:46:10 +00:00
|
|
|
abstract: 'Objective Assess capacity of health-care facilities in a low-resource
|
|
|
|
|
|
|
|
|
|
setting to implement the absolute risk approach for assessment of
|
|
|
|
|
|
|
|
|
|
cardiovascular risk in hypertensive patients and effective management of
|
|
|
|
|
|
|
|
|
|
hypertension
|
|
|
|
|
|
|
|
|
|
Design and setting A descriptive cross-sectional study in Egbeda and
|
|
|
|
|
|
|
|
|
|
Oluyole local government areas of Oyo State in Nigeria in 56 randomly
|
|
|
|
|
|
|
|
|
|
selected primary- (n = 42) and secondary-level (n = 2) health-care and
|
|
|
|
|
|
|
|
|
|
private health-care (n = 12) facilities.
|
|
|
|
|
|
|
|
|
|
Participants One thousand consecutive, known hypertensives attending the
|
|
|
|
|
|
|
|
|
|
selected facilities for follow-up, and health-care providers working in
|
|
|
|
|
|
|
|
|
|
the above randomly selected facilities, were interviewed.
|
|
|
|
|
|
|
|
|
|
Results About two-thirds of hypertensives utilized primary-care centers
|
|
|
|
|
|
|
|
|
|
both for diagnosis and for follow-up. Laboratory and other
|
|
|
|
|
|
|
|
|
|
investigations to exclude secondary hypertension or to assess target
|
|
|
|
|
|
|
|
|
|
organ damage were not available in the majority of facilities,
|
|
|
|
|
|
|
|
|
|
particularly in primary care. A considerable knowledge and awareness gap
|
|
|
|
|
|
|
|
|
|
related to hypertension and its complications was found, both among
|
|
|
|
|
|
|
|
|
|
patients and health-care providers. Blood pressure control rates were
|
|
|
|
|
|
|
|
|
|
poor {[}28\% with systolic blood pressure (SBP) < 140 mmHg and diastolic
|
|
|
|
|
|
|
|
|
|
blood pressure (DBP) < 90 mmHg] and drug prescription patterns were not
|
|
|
|
|
|
|
|
|
|
evidence based and cost effective. The majority of patients (73\%) in
|
|
|
|
|
|
|
|
|
|
this low socio-economic group (mean monthly income US\$73) had to pay
|
|
|
|
|
|
|
|
|
|
fully, out of their own pocket, for consultations and medications.
|
|
|
|
|
|
|
|
|
|
Conclusions If the absolute risk approach for assessment of risk and
|
|
|
|
|
|
|
|
|
|
effective management of hypertension is to be implemented in
|
|
|
|
|
|
|
|
|
|
low-resource settings, appropriate policy measures need to be taken to
|
|
|
|
|
|
|
|
|
|
improve the competency of health-care providers, to provide basic
|
|
|
|
|
|
|
|
|
|
laboratory facilities and to develop affordable financing mechanisms.
|
|
|
|
|
|
|
|
|
|
(C) 2004 Lippincott Williams Wilkins.'
|
|
|
|
|
affiliation: 'Mendis, S (Corresponding Author), WHO, Bur 4034, 20 Ave Appia, CH-1211
|
|
|
|
|
Geneva, Switzerland.
|
|
|
|
|
|
|
|
|
|
WHO, Bur 4034, CH-1211 Geneva, Switzerland.'
|
|
|
|
|
author: Mendis, S and Abegunde, D and Oladapo, O and Celletti, F and Nordet, P
|
|
|
|
|
author-email: mendiss@who.int
|
|
|
|
|
author_list:
|
|
|
|
|
- family: Mendis
|
|
|
|
|
given: S
|
|
|
|
|
- family: Abegunde
|
|
|
|
|
given: D
|
|
|
|
|
- family: Oladapo
|
|
|
|
|
given: O
|
|
|
|
|
- family: Celletti
|
|
|
|
|
given: F
|
|
|
|
|
- family: Nordet
|
|
|
|
|
given: P
|
|
|
|
|
da: '2023-09-28'
|
|
|
|
|
doi: 10.1097/00004872-200401000-00013
|
|
|
|
|
eissn: 1473-5598
|
|
|
|
|
files: []
|
|
|
|
|
issn: 0263-6352
|
|
|
|
|
journal: JOURNAL OF HYPERTENSION
|
|
|
|
|
keywords: hypertension; cardiovascular risk; absolute risk; low-resource settings
|
|
|
|
|
keywords-plus: 'GENERAL-PRACTICE; BLOOD-PRESSURE; NATIONAL-SURVEY; HEALTH; POPULATION;
|
|
|
|
|
|
|
|
|
|
CARE'
|
|
|
|
|
language: English
|
|
|
|
|
month: JAN
|
|
|
|
|
number: '1'
|
|
|
|
|
number-of-cited-references: '23'
|
|
|
|
|
orcid-numbers: mendis, shanthi/0000-0002-8959-5738
|
|
|
|
|
pages: 59-64
|
|
|
|
|
papis_id: 41f7e6ac92213a09ff69a62fecab4d65
|
|
|
|
|
ref: Mendis2004barriersmanagement
|
|
|
|
|
researcherid-numbers: 'Mendis, Shanthi/GLT-0465-2022
|
|
|
|
|
|
|
|
|
|
'
|
|
|
|
|
times-cited: '56'
|
|
|
|
|
title: Barriers to management of cardiovascular risk in a low-resource setting using
|
|
|
|
|
hypertension as an entry point
|
2023-10-01 08:15:07 +00:00
|
|
|
type: article
|
2023-09-28 14:46:10 +00:00
|
|
|
unique-id: WOS:000222672400012
|
|
|
|
|
usage-count-last-180-days: '0'
|
|
|
|
|
usage-count-since-2013: '3'
|
|
|
|
|
volume: '22'
|
|
|
|
|
web-of-science-categories: Peripheral Vascular Disease
|
|
|
|
|
year: '2004'
|
