Prevalence and Determinants of Hypertension Awareness, Treatment, and Control in Botswana: A Nationally Representative Population-Based Survey
Introduction. Hypertension is a leading risk factor for cardiovascular mortality and an emerging public health concern in sub-Saharan Africa. Few studies have examined performance on the management of hypertension in this region, where the context may be distinct from other developing regions. Objec...
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Wiley
2020-01-01
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| Series: | International Journal of Hypertension |
| Online Access: | http://dx.doi.org/10.1155/2020/8082341 |
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| author | Neo M. Tapela Lei Clifton Gontse Tshisimogo Moagi Gaborone Tebogo Madidimalo Virginia Letsatsi Tiny Masupe Mosepele Mosepele Joseph Makhema Shahin Lockman David J. Hunter |
| author_facet | Neo M. Tapela Lei Clifton Gontse Tshisimogo Moagi Gaborone Tebogo Madidimalo Virginia Letsatsi Tiny Masupe Mosepele Mosepele Joseph Makhema Shahin Lockman David J. Hunter |
| author_sort | Neo M. Tapela |
| collection | DOAJ |
| description | Introduction. Hypertension is a leading risk factor for cardiovascular mortality and an emerging public health concern in sub-Saharan Africa. Few studies have examined performance on the management of hypertension in this region, where the context may be distinct from other developing regions. Objectives. We aimed to determine the prevalence and correlates of hypertension, awareness, treatment, and control among adults in Botswana, a middle-income African country undergoing rapid demographic transition and with high HIV burden. Methods. In this 2014 cross-sectional survey of adults aged 15–69 years, information on sociodemographic characteristics, lifestyle behavior, and medical history was collected through in-person interviews and physical measurements (body mass index and triplicate blood pressure (BP)). Hypertension was defined as self-report of use of antihypertensives in the previous two weeks and/or having elevated BP (≥140/90 mmHg). Multivariable logistic regression was employed to explore factors associated with hypertension, awareness (report of previous diagnosis), treatment (antihypertensives), and control (BP < 140/90). Results. Our analysis (N = 4,007) yielded an age-standardized hypertension prevalence of 30% (95% CI: 28%–32%, N = 1,393). Among hypertensives, 54% (50–58%) were unaware of their condition, 45% (40–50%) of those aware were untreated, and 63% (55–70%) of those on medications were suboptimally treated (BP ≥ 140/90 mmHg). A fifth of hypertensives who were diagnosed but not on medications had BP ≥ 180/110 mmHg. Diabetes was the strongest correlate of hypertension and awareness (aOR 4.00, 1.86–8.59; aOR 3.30, 1.44–7.55, respectively). Males were less likely to be aware (aOR 0.62, 0.41–0.94) or controlled (aOR 0.36, 0.16–0.83). Obese individuals were more likely to be treated (aOR 2.17, 1.12–4.22), yet less likely to be controlled (aOR 0.32, 0.15–0.66). Conclusions. We report the first nationally representative estimates of the hypertension care cascade performance in Botswana, which will support planning and future policy evaluations. Findings contribute to the relatively sparse evidence on this subject and may inform development of innovations that improve quality of hypertension management and adherence support in similar settings. |
| format | Article |
| id | doaj-art-0982155241584a959da4239c74412a47 |
| institution | Kabale University |
| issn | 2090-0384 2090-0392 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
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| series | International Journal of Hypertension |
| spelling | doaj-art-0982155241584a959da4239c74412a472025-02-03T06:46:37ZengWileyInternational Journal of Hypertension2090-03842090-03922020-01-01202010.1155/2020/80823418082341Prevalence and Determinants of Hypertension Awareness, Treatment, and Control in Botswana: A Nationally Representative Population-Based SurveyNeo M. Tapela0Lei Clifton1Gontse Tshisimogo2Moagi Gaborone3Tebogo Madidimalo4Virginia Letsatsi5Tiny Masupe6Mosepele Mosepele7Joseph Makhema8Shahin Lockman9David J. Hunter10Nuffield Department of Population Health, University of Oxford, Oxford, UKNuffield Department of Population Health, University of Oxford, Oxford, UKNational NCD Program, Ministry of Health and Wellness, Gaborone, BotswanaWorld Health Organization, Gaborone, BotswanaWorld Health Organization, Gaborone, BotswanaNational NCD Program, Ministry of Health and Wellness, Gaborone, BotswanaUniversity of Botswana, Gaborone, BotswanaUniversity of Botswana, Gaborone, BotswanaBotswana Harvard AIDS Institute Partnership, Gaborone, BotswanaBotswana Harvard AIDS Institute Partnership, Gaborone, BotswanaNuffield Department of Population Health, University of Oxford, Oxford, UKIntroduction. Hypertension is a leading risk factor for cardiovascular mortality and an emerging public health concern in sub-Saharan Africa. Few studies have examined performance on the management of hypertension in this region, where the context may be distinct from other developing regions. Objectives. We aimed to determine the prevalence and correlates of hypertension, awareness, treatment, and control among adults in Botswana, a middle-income African country undergoing rapid demographic transition and with high HIV burden. Methods. In this 2014 cross-sectional survey of adults aged 15–69 years, information on sociodemographic characteristics, lifestyle behavior, and medical history was collected through in-person interviews and physical measurements (body mass index and triplicate blood pressure (BP)). Hypertension was defined as self-report of use of antihypertensives in the previous two weeks and/or having elevated BP (≥140/90 mmHg). Multivariable logistic regression was employed to explore factors associated with hypertension, awareness (report of previous diagnosis), treatment (antihypertensives), and control (BP < 140/90). Results. Our analysis (N = 4,007) yielded an age-standardized hypertension prevalence of 30% (95% CI: 28%–32%, N = 1,393). Among hypertensives, 54% (50–58%) were unaware of their condition, 45% (40–50%) of those aware were untreated, and 63% (55–70%) of those on medications were suboptimally treated (BP ≥ 140/90 mmHg). A fifth of hypertensives who were diagnosed but not on medications had BP ≥ 180/110 mmHg. Diabetes was the strongest correlate of hypertension and awareness (aOR 4.00, 1.86–8.59; aOR 3.30, 1.44–7.55, respectively). Males were less likely to be aware (aOR 0.62, 0.41–0.94) or controlled (aOR 0.36, 0.16–0.83). Obese individuals were more likely to be treated (aOR 2.17, 1.12–4.22), yet less likely to be controlled (aOR 0.32, 0.15–0.66). Conclusions. We report the first nationally representative estimates of the hypertension care cascade performance in Botswana, which will support planning and future policy evaluations. Findings contribute to the relatively sparse evidence on this subject and may inform development of innovations that improve quality of hypertension management and adherence support in similar settings.http://dx.doi.org/10.1155/2020/8082341 |
| spellingShingle | Neo M. Tapela Lei Clifton Gontse Tshisimogo Moagi Gaborone Tebogo Madidimalo Virginia Letsatsi Tiny Masupe Mosepele Mosepele Joseph Makhema Shahin Lockman David J. Hunter Prevalence and Determinants of Hypertension Awareness, Treatment, and Control in Botswana: A Nationally Representative Population-Based Survey International Journal of Hypertension |
| title | Prevalence and Determinants of Hypertension Awareness, Treatment, and Control in Botswana: A Nationally Representative Population-Based Survey |
| title_full | Prevalence and Determinants of Hypertension Awareness, Treatment, and Control in Botswana: A Nationally Representative Population-Based Survey |
| title_fullStr | Prevalence and Determinants of Hypertension Awareness, Treatment, and Control in Botswana: A Nationally Representative Population-Based Survey |
| title_full_unstemmed | Prevalence and Determinants of Hypertension Awareness, Treatment, and Control in Botswana: A Nationally Representative Population-Based Survey |
| title_short | Prevalence and Determinants of Hypertension Awareness, Treatment, and Control in Botswana: A Nationally Representative Population-Based Survey |
| title_sort | prevalence and determinants of hypertension awareness treatment and control in botswana a nationally representative population based survey |
| url | http://dx.doi.org/10.1155/2020/8082341 |
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