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Awareness and control of hypertension in Bangladesh: follow-up of a hypertensive cohort.

Abstract：

OBJECTIVES:To assess the effect of awareness and advice to seek care on blood pressure (BP) control among patients with hypertension in Bangladesh. DESIGN:Longitudinal study. SETTING:The study was carried out in icddr,b surveillance sites at rural Matlab in Chandpur district and semi-urban Kamalapur in Dhaka, Bangladesh. PARTICIPANTS:Randomly selected men and non-pregnant women aged 20 years or older without any acute illness or history of any vascular events such as stroke or acute myocardial infarction. MAIN OUTCOME MEASURE:Hypertension was defined as systolic BP (SBP) ≥140 and/or diastolic BP (DBP) ≥90 mm Hg or as self-reported hypertension under medication. We advised patients to seek care from a qualified provider and to adopt a healthy lifestyle. We compared changes in BP from baseline to follow-up at around 6 months. RESULTS:Overall, 17.1% (n=287) of participants had hypertension at baseline with significantly higher prevalence in the semi-urban than in the rural population (23.6% vs 10.8%; p<0.001); half were unaware of their condition. At follow-up, 83% (n=204) reported a visit to any healthcare provider. In the semi-urban area, a higher proportion of patients visited medically qualified practitioners than in the rural area (76.7% vs 36.6%, p<0.000). SBP (-3.3±20.7 mm Hg; p<0.01) and DBP (-2.0±13.0 mm Hg; p<0.02) were lower at follow-up. Those who visited medically qualified practitioners had significant SBP (-3.9±22.4 mm Hg; p<0.03) and DBP (-2.7±14.1 mm Hg; p<0.02) reduction. BP reduction did not reach statistical significance among those visiting a pharmacist or their village doctors. Overall, half of the patients with hypertension achieved the BP control goal (BP<140/90 mm Hg). CONCLUSIONS:Awareness and simple health messages increase provider visit, reduce blood pressure and improve BP control in hypertensive Bangladeshis. Longer-term follow-up is required to verify the sustainability.

journal_name

BMJ Open

journal_title

BMJ open

authors

Alam DS,Chowdhury MA,Siddiquee AT,Ahmed S,Niessen LW

doi

10.1136/bmjopen-2014-004983

subject

Has Abstract

pub_date

2014-12-23 00:00:00

pages

e004983

issue

12

issn

2044-6055

pii

bmjopen-2014-004983

journal_volume

4

pub_type

临床试验,杂志文章

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