wow-inequalities/02-data/intermediate/wos_sample/e4f54395b718604109769a28dbb98aa1-mohanty-sanjay-k.-a/info.yaml

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2023-09-28 14:46:10 +00:00
abstract: 'Author summary Why was this study done? We found only one study that
reported estimated rates of awareness, treatment, and control (ATC) of
hypertension in India using a nationally representative sample covering
all states, but that study was restricted to adults aged 15 to 49 years.
Another study estimated rates of hypertension ATC among older adults,
but that study covered only 6 states. This study aimed to provide
nationally representative estimates of hypertension ATC in the older
population of India and to describe differences in these indicators of
hypertension management across sociodemographic groups and states. What
did the researchers do and find? We used a nationally representative
sample of adults aged 45 years and over and their spouses covering all
states (except one) of India in 2017 to 2018. We used measured blood
pressure (BP) and self-reported diagnosis and treatment for high BP to
estimate hypertension prevalence and the percentages of those with
hypertension who were aware of their condition, treated for it, and had
achieved BP control. We found that a slight majority of those with
hypertension were aware of their condition, around half were being
treated, and less than a third had controlled their BP. While these
rates indicated substantial gaps in hypertension management among the
older population of India, they were higher than estimates previously
obtained from samples restricted to, or including, younger people. We
found substantial variation in the indicators of hypertension management
across states. Older Indians who were poorer, less educated, socially
disadvantaged, male, rural, and working were less likely to be aware,
treated, and to have achieved BP control. What do these findings mean?
Hypertension prevalence is high in India, particularly in the older
population. In this critical population group, low rates of ATC point to
deficiencies in diagnosis and management of the condition and in the
prevention of cardiovascular diseases (CVDs). Effectively addressing
these deficiencies requires subtle targeting of interventions that
balances attention to prevalence, which is higher in the high-income
states and socioeconomically advantaged groups, with attention to gaps
in ATC, which are greater in the low- or middle-income states and
disadvantaged groups.
Background Lack of nationwide evidence on awareness, treatment, and
control (ATC) of hypertension among older adults in India impeded
targeted management of this condition. We aimed to estimate rates of
hypertension ATC in the older population and to assess differences in
these rates across sociodemographic groups and states in India. Methods
and findings We used a nationally representative survey of individuals
aged 45 years and over and their spouses in all Indian states (except
one) in 2017 to 2018. We identified hypertension by blood pressure (BP)
measurement >= 140/90 mm Hg or self-reported diagnosis if also taking
medication or observing salt/diet restriction to control BP. We
distinguished those who (i) reported diagnosis ({''''}aware{''''}); (ii)
reported taking medication or being under salt/diet restriction to
control BP ({''''}treated{''''}); and (iii) had measured systolic BP <140
and diastolic BP <90 ({''''}controlled{''''}). We estimated age-sex adjusted
hypertension prevalence and rates of ATC by consumption quintile,
education, age, sex, urban-rural, caste, religion, marital status,
living arrangement, employment status, health insurance, and state. We
used concentration indices to measure socioeconomic inequalities and
multivariable logistic regression to estimate fully adjusted differences
in these outcomes. Study limitations included reliance on BP measurement
on a single occasion, missing measurements of BP for some participants,
and lack of data on nonadherence to medication. The 64,427 participants
in the analysis sample had a median age of 57 years: 58\% were female,
and 70\% were rural dwellers. We estimated hypertension prevalence to be
41.9\% (95\% CI 41.0 to 42.9). Among those with hypertension, we
estimated that 54.4\% (95\% CI 53.1 to 55.7), 50.8\% (95\% CI 49.5 to
52.0), and 28.8\% (95\% CI 27.4 to 30.1) were aware, treated, and
controlled, respectively. Across states, adjusted rates of ATC ranged
from 27.5\% (95\% CI 22.2 to 32.8) to 75.9\% (95\% CI 70.8 to 81.1),
from 23.8\% (95\% CI 17.6 to 30.1) to 74.9\% (95\% CI 69.8 to 79.9), and
from 4.6\% (95\% CI 1.1 to 8.1) to 41.9\% (95\% CI 36.8 to 46.9),
respectively. Age-sex adjusted rates were lower (p < 0.001) in poorer,
less educated, and socially disadvantaged groups, as well as for males,
rural residents, and the employed. Among individuals with hypertension,
the richest fifth were 8.5 percentage points (pp) (95\% CI 5.3 to 11.7;
p < 0.001), 8.9 pp (95\% CI 5.7 to 12.0; p < 0.001), and 7.1 pp (95\% CI
4.2 to 10.1; p < 0.001) more likely to be aware, treated, and
controlled, respectively, than the poorest fifth. Conclusions
Hypertension prevalence was high, and ATC of the condition were low
among older adults in India. Inequalities in these indicators pointed to
opportunities to target hypertension management more effectively and
equitably on socially disadvantaged groups.'
affiliation: 'Mohanty, SK (Corresponding Author), Int Inst Populat Sci, Dept Fertil
Studies, Mumbai, Maharashtra, India.
Mohanty, Sanjay K., Int Inst Populat Sci, Dept Fertil Studies, Mumbai, Maharashtra,
India.
Pedgaonkar, Sarang P., Int Inst Populat Sci, Dept Populat Policies \& Programmes,
Mumbai, Maharashtra, India.
Upadhyay, Ashish Kumar; Shekhar, Prashant; Mishra, Radhe Shyam, Int Inst Populat
Sci, Mumbai, Maharashtra, India.
Kampfen, Fabrice, Univ Penn, Populat Studies Ctr, Philadelphia, PA 19104 USA.
Maurer, Jurgen, Univ Lausanne, Inst Hlth Econ \& Management, Dept Econ, Lausanne,
Switzerland.
O''Donnell, Owen, Erasmus Univ, Erasmus Sch Econ, Rotterdam, Netherlands.
O''Donnell, Owen, Erasmus Univ, Erasmus Sch Hlth Policy \& Management, Rotterdam,
Netherlands.'
article-number: e1003740
author: Mohanty, Sanjay K. and Pedgaonkar, Sarang P. and Upadhyay, Ashish Kumar and
Kampfen, Fabrice and Shekhar, Prashant and Mishra, Radhe Shyam and Maurer, Jurgen
and O'Donnell, Owen
author-email: sanjayiips@yahoo.co.in
author_list:
- family: Mohanty
given: Sanjay K.
- family: Pedgaonkar
given: Sarang P.
- family: Upadhyay
given: Ashish Kumar
- family: Kampfen
given: Fabrice
- family: Shekhar
given: Prashant
- family: Mishra
given: Radhe Shyam
- family: Maurer
given: Jurgen
- family: O'Donnell
given: Owen
da: '2023-09-28'
doi: 10.1371/journal.pmed.1003740
eissn: 1549-1676
files: []
issn: 1549-1277
journal: PLOS MEDICINE
keywords-plus: BLOOD-PRESSURE; PREVALENCE; MIDDLE; DISEASE
language: English
month: AUG
number: '8'
number-of-cited-references: '32'
orcid-numbers: 'Mohanty, Sanjay K/0000-0001-9041-5952
O''Donnell, Owen/0000-0002-6289-1924
Kampfen, Fabrice/0000-0001-7304-7473
Upadhyay, Ashish/0000-0003-2518-4603
/0000-0002-3923-677X
PEDGAONKAR, SARANG/0000-0002-7570-2037'
papis_id: a3f4b2bdf1f4b2dc5c5a09ffec8b4eb2
ref: Mohanty2021awarenesstreatment
researcherid-numbers: 'Mohanty, Sanjay K/AAR-7658-2020
pedgaonkar, sarang/HCH-0304-2022
O''Donnell, Owen/C-1732-2015
'
times-cited: '23'
title: 'Awareness, treatment, and control of hypertension in adults aged 45 years
and over and their spouses in India: A nationally representative cross-sectional
study'
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000687920900001
usage-count-last-180-days: '1'
usage-count-since-2013: '1'
volume: '18'
web-of-science-categories: Medicine, General \& Internal
year: '2021'