4.5 Article

Hypertension: its prevalence and population-attributable fraction for morality from cardiovascular disease in the Asia-Pacific

Journal

JOURNAL OF HYPERTENSION
Volume 25, Issue 1, Pages 73-79

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HJH.0b013e328010775f

Keywords

attributable fraction; heart disease; stroke; hypertension; western Pacific; South-east Asia

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Objective About half of the world's burden of cardiovascular disease is carried by countries in the Asia-Pacific region. This study aimed to quantify the contribution of hypertension to cardiovascular diseases (CVD) at the country level, by calculating the sex-specific, population-attributable fractions (PAFs) for fatal ischaemic heart disease (IHD) and stroke (haemorrhagic and ischaemic) for the World Health Organization Western Pacific and South-east Asian regions. Methods The most recent sex-specific prevalence data on hypertension were sought. Age-adjusted hazard ratio (HR) estimates for fatal IHD and stroke associated with hypertension were obtained using Cox analyses of individual participant cohort data from 600 000 adult participants in the Asia-Pacific Cohort Studies Collaboration. HR estimates and prevalence were then used to calculate sex-specific PAFs for fatal IHD and stroke, by country. Results In 15 countries with available data, the prevalence of hypertension ranged from 5-47% in men and from 7-38% in women. Overall, the fraction of IHD attributable to hypertension ranged from 4-28% in men and from 8-39% in women. Corresponding ranges for haemorrhagic stroke were 18-66% and 15-49%, and for ischaemic stroke were 8-44% and 12-45%. underscoring the immense impact that blood pressure-lowering strategies could have in this populous region.

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