본문 바로가기
KERD
논문KCI 등재후보

Challenges of managing hypertension in Pakistan - a review

Elahi Adil|Ali Arzina Aziz|Khan Aamir Hameed|Samad Zainab|Shahab Hunaina|Aziz Namra|Almas Aysha
대한고혈압학회 (The Korean Society of Hypertension)|2023.01|Clinical Hypertension|제29권 |pp. 17-17|DOI 10.1186/s40885-023-00245-6

1

조회

0

다운로드

1

인용

0

참고문헌

키워드

HypertensionPrevalenceReviewRisk factorsPakistanBlood pressure

초록

Background This review aims to describe existing evidence on the state of hypertension in Pakistan, including the prevalence, associated risk factors, preventive strategies, and challenges in the management of hypertension. Methods A comprehensive literature search was conducted electronically using PubMed and Google Scholar. Using specific screening methodology, 55 articles were selected to be included. Results We found from this extensive review that several small studies report high prevalence of hypertension but there is a lack of population based prevalence of hypertension in Pakistan. Lifestyle risk factors such as obesity, unhealthy diet, decreased physical activity, low socioeconomic status, and lack of access to care were the main associated factors with hypertension. Lack of blood pressure monitoring practices and medication non-adherence were also linked to uncontrolled hypertension in Pakistan and were more evident in primary care setups. The evidence presented is essential for delineating the burden of the disease, hence allowing for better management of this underserved population. Conclusion There is a need for updated surveys to depict the true prevalence and management of hypertension in Pakistan. Cost-effective implementation strategies and policies at the national level are needed for both prevention and control of hypertension.

Abstract

Background This review aims to describe existing evidence on the state of hypertension in Pakistan, including the prevalence, associated risk factors, preventive strategies, and challenges in the management of hypertension. Methods A comprehensive literature search was conducted electronically using PubMed and Google Scholar. Using specific screening methodology, 55 articles were selected to be included. Results We found from this extensive review that several small studies report high prevalence of hypertension but there is a lack of population based prevalence of hypertension in Pakistan. Lifestyle risk factors such as obesity, unhealthy diet, decreased physical activity, low socioeconomic status, and lack of access to care were the main associated factors with hypertension. Lack of blood pressure monitoring practices and medication non-adherence were also linked to uncontrolled hypertension in Pakistan and were more evident in primary care setups. The evidence presented is essential for delineating the burden of the disease, hence allowing for better management of this underserved population. Conclusion There is a need for updated surveys to depict the true prevalence and management of hypertension in Pakistan. Cost-effective implementation strategies and policies at the national level are needed for both prevention and control of hypertension.

참고문헌 (79)

  1. Yao Q, "Health-related quality of life of people with self-reported hypertension : a national cross-sectional survey in China", Int J Environ Res Public Health, 16(10), pp.1721~ (2019)
  2. Kearney PM, "Global burden of hypertension : analysis of worldwide data", Lancet(London, England), 365(9455), pp.217~223 (2005)
  3. Mohsen IM, "Hypertension in developing countries : a major challenge for the future", Curr Hypertens Rep, 20(5), pp.38~ (2018)
  4. Prabhakaran D, "Prevalence and incidence of hypertension : results from a representative cohort of over 16, 000 adults in three cities of South Asia", Indian Heart J, 69(4), pp.434~441 (2017)
  5. Basit A, "Prevalence and contributing risk factors for hypertension in urban and rural areas of Pakistan; a study from second National Diabetes Survey of Pakistan(NDSP)2016–2017", Clin Exp Hypertens, 42(3), pp.218~224 (2020)
  6. Shafi ST, "A survey of hypertension prevalence, awareness, treatment, and control in health screening camps of rural central Punjab, Pakistan", J Epidemiol Glob Health, 7(2), pp.135~140 (2017)
  7. "Cardiovascular diseases"[URL]
  8. "Pakistan"[URL]
  9. Hassan A, "Healthcare system of Pakistan", Int J Adv Res Publ, 1(4), pp.170~173 (2017)
  10. "WHO EMRO | Health service delivery | Programmes | Pakistan"[URL]
  11. Barolia R, "Risk factors of cardiovascular disease and its recommendations in Pakistani context", J Pak Med Assoc, 67(11), pp.1723~1729 (2017)
  12. Rafique I, "Prevalence of risk factors for noncommunicable diseases in adults : key findings from the Pakistan STEPS survey", East Mediterr Health J, 24(1), pp.33~41 (2018)
  13. Siddiqui H, "Risk factors assessment for hypertnesion in a squatter settlement of Karachi", J Pak Med Assoc, 5(9), pp.390~392 (2005)
  14. Ishtiaq S, "Assessment of the risk factors of hypertension among adult & elderly group in twin cities of Pakistan", J Pak Med Assoc, 67(11), pp.1664~1669 (2017)
  15. Almas A, "Hypertensive crisis, burden, management, and outcome at a tertiary care center in Karachi", Int J Chronic Dis, 2014, pp.1~7 (2014)
  16. Fowokan A, "Multifactorial correlates of blood pressure in South Asian children in Canada : a cross-sectional study", BMJ Open, 9(4), pp.e027844~ (2019)
  17. Jafar TH, "A community-based intervention for managing hypertension in rural South Asia", N Engl J Med, 382(8), pp.717~726 (2020)
  18. Jafar TH, "Children, obesity, and high blood pressure : Asian populations at high risk", Am J Hypertens, 22(1), pp.6~7 (2009)
  19. Jafar TH, "Community based lifestyle intervention for blood pressure reduction in children and young adults in developing country: cluster randomised controlled trial", BMJ, 340, pp.c2641~ (2010)
  20. Jafar TH, "Children in south Asia have higher body mass-adjusted blood pressure levels than white children in the United States", Circulation, 111(10), pp.1291~1297 (2005)
  21. Bilal M, "Prevalence and risk factors of hypertension among children attending out patient department of a tertiary care hospital in Karachi", Cureus, 12(5), pp.e7957~ (2020)
  22. Bloch MJ, "Worldwide prevalence of hypertension exceeds 13 billion", J Am Soc Hypertens, 10(10), pp.753~754 (2016)
  23. Abariga SA, "Prevalence and determinants of hypertension in India based on the 2017 ACC", AHA guideline : evidence from the India National Family Health Survey, 2020, pp.33(3), 252~260
  24. Islam JY, "Epidemiology of hypertension among Bangladeshi adults using the 2017 ACC", AHA hypertension clinical practice guidelines and joint National Committee 7guidelines, 2018, pp.32(10), 668~680
  25. Goma FM, "May measurement month 2017 : blood pressure screening results from Zambia-Sub-Saharan Africa", Eur Heart J Suppl, 21(Suppl D), pp.D130~D132 (2019)
  26. Zhou B, "Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension", Nat Rev Cardiol, 18(11), pp.785~802 (2021)
  27. Riaz M, "Factors associated with hypertension in Pakistan : a systematic review and metaanalysis", PLoS One, 16(1), pp.e0246085~ (2021)
  28. Jafar TH, "Prevalence of overweight and obesity and their association with hypertension and diabetes mellitus in an Indo-Asian population", Can Med Assoc J, 175(9), pp.1071~1077 (2006)
  29. Akram J, "Hypertension and obesity : a cross-sectional study", Eur J Med Heal Sci, 3(4), pp.90~94 (2021)
  30. Ali Khan Khuwaja, "Preventable Lifestyle Risk Factors for Non-Communicable Diseases in the Pakistan Adolescents Schools Study 1 (PASS-1)", 예방의학회지, 44(5), pp.210~217 (2011), 대한예방의학회
  31. Mansoori S, "Added sugar intake is associated with blood pressure in older females", Nutrients, 11(9), pp.2060~ (2019)
  32. Safdar N, "Dietary patterns and their association with hypertnesion among Pakistani urban adults", Asia Pac J Clin Nutr, 24(4), pp.710~719 (2015)
  33. "Country factsheet insufficient physical activity" (2015)[URL]
  34. Jabeen I, "Physical activity levels and their correlates among secondary school adolescents in a township of Karachi, Pakistan", J Pak Med Assoc, 68(5), pp.737~743 (2018)
  35. Ajani K, "Levels and predictors of selfcare among patients with hypertension in Pakistan", Int J Gen Med, 14, pp.1023~ (2021)
  36. Lim SS, "A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010 : a systematic analysis for the Global Burden of Disease Study 2010", Lancet, 380(9859), pp.2224~2260 (2012)
  37. Zibara V, "Epidemiology and management of hypertension among refugees in the Middle East : a review of the literature", J Hum Hypertens, 35(8), pp.657~666 (2021)
  38. Bentham J, "Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016 : a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults", Lancet(London, England), 390(10113), pp.2627~2642 (2017)
  39. Ezzati M, "Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: a pooled analysis of 1018 population-based measurement studies with 88.6 million participants", Int J Epidemiol, 47(3), pp.872~883 (2018)
  40. Micha R, "Global, regional and national consumption of major food groups in 1990 and 2010 : a systematic analysis including 266 country-specific nutrition surveys worldwide on behalf of the Global Burden of Diseases Nutrition and Chronic Diseases Expert Group", Nutri Open, 5, pp.1~23 (2015)
  41. Lewington S, "Seasonal variation in blood pressure and its relationship with outdoor temperature in 10 diverse regions of China : the China Kadoorie Biobank", J Hypertens, 30(7), pp.1383~ (2012)
  42. "A century of trends in adult human height" (2016)[URL]
  43. Peters SAE, "The sodium content of processed foods in South Africa during the introduction of mandatory sodium limits", Nutrients, 9(4), pp.404~ (2017)
  44. Williams B, "2018 ESC", ESH guidelines for the management of arterial hypertension, 2018, pp.39(33), 3021~3104
  45. Siddique S, "Office blood pressure measurement : a comprehensive review", J Clin Hypertens, 23(3), pp.440~449 (2021)
  46. Godil SS, "White coat hypertension is not a benign entity : a cross-sectional study at a tertiary care hospital in Pakistan", J Pak Med Assoc, 61(9), pp.938~943 (2011)
  47. Shahab H, "The Post Clinic Ambulatory Blood Pressure(PC-ABP)study correlates Post Clinic Blood Pressure(PCBP)with the gold standard Ambulatory Blood Pressure", BMC Res Notes, 11(1), pp.460~ (2018)
  48. Chia Y, "Target blood pressure and control status in Asia", J Clin Hypertens, 22(3), pp.344~350 (2020)
  49. Nadeem MK, "Hypertension-related knowledge and its relationship with blood pressure control in hypertensive patients visiting a semi-private tertiary-care charity hospital in Karachi, Pakistan", Cureus, 11(10), pp.e5986~ (2019)
  50. Almas A, "Good knowledge about hypertension is linked to better control of hypertension; a multicentre cross sectional study in Karachi, Pakistan", BMC Res Notes, 5(1), pp.579~ (2012)
  51. Jafar TH, "Determinants of uncontrolled hypertension in rural communities in South Asia—Bangladesh, Pakistan, and Sri Lanka", Am J Hypertens, 31(11), pp.1205~1214 (2018)
  52. Khan MN, "Perceptions and practices towards medication non-adherence among hypertensive patients : an observational study", Cureus, 11(10), pp.e5917~ (2019)
  53. Legido-Quigley H, "Patients’ experiences on accessing health care services for management of hypertension in rural Bangladesh, Pakistan and Sri Lanka : a qualitative study", PLoS One, 14(1), pp.e0211100~ (2019)
  54. Gowani A, "Facilitators and barriers to NCD prevention in Pakistanis-invincibility or inevitability : a qualitative research study", BMC Res Notes, 9, pp.282~ (2016)
  55. Hugtenburg J, "Definitions, variants, and causes of nonadherence with medication: a challenge for tailored interventions", Patient Prefer Adherence, pp.675~682 (2013)
  56. Almas A, "Compliance to antihypertensive therapy", J Coll Physicians Surg Pak, 16(1), pp.23~26 (2006)
  57. Almas A, "Depression is linked to uncontrolled hypertension : a case–control study from Karachi, Pakistan", J Ment Health, 23(6), pp.292~296 (2014)
  58. Saqlain M, "Medication adherence and its association with health literacy and performance in activities of daily livings among elderly hypertensive patients in Islamabad, Pakistan", Medicina(B Aires), 55(5), pp.163~ (2019)
  59. Ali K, "Drug compliance and its associated factors among hypertensive patients in Pakistan : a cross-sectional study", Hosp Pharm, 53(6), pp.389~392 (2018)
  60. "Universal Health Coverage"[URL]
  61. Datta BK, "The crowding out effect of out-of-pocket medication expenses of two major non-communicable diseases in Pakistan", Int Health, 12(1), pp.50~59 (2019)
  62. Aslam N, "Out of pocket(OOP)cost of treating hypertension in Karachi, Pakistan", Pak J Pharm Sci, 31(3(Supplementary)), pp.1039~1044 (2018)
  63. Almas A, "Better physician-patient communication;an important milestone in control of hypertension, a multicenter study from Karachi, Pakistan", J Coll Physicians Surg Pak, 24(12), pp.952~954 (2014)
  64. Ashfaq T, "Awareness of hypertension among patients attending primary health care centre and outpatient department of tertiary care hospital of Karachi", J Pak Med Assoc, 57(8), pp.396~399 (2007)
  65. Amer M, "Impact of pharmacist’s intervention on disease related knowledge, medication adherence, HRQoL and control of blood pressure among hypertensive patients", Pak J Pharm Sci, 31(6(Supplementary)), pp.2607~2616 (2018)
  66. Al-Makki A, "Hypertension pharmacological treatment in adults : a world health organization guideline executive summary", Hypertension, 79(1), pp.293~301 (2022)
  67. Schwartz GL, "A review of the sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure", Curr Opin Cardiol, 14(2), pp.161~168 (1999)
  68. Hussain IM, "Current trends in treatment of hypertension in Karachi and cost minimization possibilities", Pak J Med Sci, 31(5), pp.1021~1026 (2015)
  69. Mohydin B, "Arterial hypertension management trends in Pakistan; cross-sectional observational study of a sample of Pakistani doctors", J Hypertens, 39(Supplement 1), pp.e162~ (2021)
  70. Arshad V, "Prescribing patterns of antihypertensive medications in low-and middle-income countries : a systematic review", Asia Pac J Public Health, 33(1), pp.14~22 (2021)
  71. Majeed F, "Can community based interventions control hypertension in developing countries? What is the evidence from Pakistan?", J Pak Med Assoc, 62(3), pp.301~302 (2012)
  72. Khan MA, "Enhanced hypertension care through private clinics in Pakistan : a cluster randomised trial", BJGP Open, 3(1) (2019)
  73. Dzau VJ, "Future of hypertension", Hypertension, 74(3), pp.450~457 (2019)
  74. Zaman MJ, "Socio-economic distribution of cardiovascular risk factors and knowledge in rural India", Int J Epidemiol, 41(5), pp.1302~1314 (2012)
  75. Mills KT, "Global disparities of hypertension prevalence and control : a systematic analysis of population-based studies from 90 countries", Circulation, 134(6), pp.441~450 (2016)
  76. Murphy A, "Inequalities in the use of secondary prevention of cardiovascular disease by socioeconomic status : evidence from the PURE observational study", Lancet Glob Health, 6(3), pp.e292~ (2018)
  77. Moran AE, "Cost-effectiveness of hypertension therapy according to 2014 guidelines", N Engl J Med, 372(5), pp.447~455 (2015)
  78. Axon RN, "The role of individual time preferences in health behaviors among hypertensive adults : a pilot study", J Am Soc Hypertens, 3(1), pp.35~41 (2009)
  79. Vedanthan R, "Innovative approaches to hypertension control in lowand middle-income countries", Cardiol Clin, 35(1), pp.99~115 (2017)

관련 논문AI추천

Prevalence, awareness, and control of hypertension among Bangladeshi adults: an analysis of demographic and health survey 2017–18Al Kibria Gulam Muhammed, Gupta Rajat Das, Jannatun Nayeem대한고혈압학회 · Clinical Hypertension2021 · 제27권 제4호Hypertension prevalence and its trend in Bangladesh: evidence from a systematic review and meta-analysisAhmed Arifa, Akhter Tania, Akter Tanjila, Chowdhury Mohammad Ziaul Islam, Chowdhury Nashit, Farhana Zaki, Rahman Meshbahur, Shovon Minhajul Arifin, Turin Tanvir C.대한고혈압학회 · Clinical Hypertension2020 · 제26권 제3호Prevalence, awareness, treatment, control, and risk factors of hypertension among adults: a cross-sectional study in IranMaryam Eghbali한국역학회 · Epidemiology and Health2018 · 제40권 Suboptimal control status of young hypertensive population이해영, JungMin Choi, Shin Donghun대한고혈압학회 · Clinical Hypertension2023 · 제29권 Determining the Prevalence of and the Factors Associated with Antihypertensive Medication Non-Adherence in the Gaza StripAkbar Fotouhi, Elham Shakibazadeh, Khalid Khadoura, Mohammad Ali Mansournia, Yousef Aljeesh대한가정의학회 · Korean Journal of Family Medicine2021 · 제42권 제2호Interventions in hypertension: systematic review and meta-analysis of natural and quasi-experimentsFan Zhao, Roch A. Nianogo, Tong Xia대한고혈압학회 · Clinical Hypertension2022 · 제28권

이 간행물의 다른 논문 (32건)

Withdrawal of antihypertensaive medication in young to middle-aged adults: a prospective, single-group, intervention study이해영, 이경숙pp. 1-1Role of home blood pressure monitoring in resistant hypertension김혜미, 신진호pp. 2-2Ideal cardiovascular health metrics and the risk of nonalcoholic fatty liver disease in Korean adultsJung Sun Jae, Kim Seung Up, 김현창, 심선영pp. 3-3The association between carbon and nitrogen stable isotope ratios of human hair and hypertensionJong‑Ku Park, 안성복pp. 4-4Fok I and Bsm I gene polymorphism of vitamin D receptor and essential hypertension: a mechanistic linkRajesh Kumar Khare, Priyanka Thapa Manger, Richa Awasthipp. 5-5
원문 보기