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Variations in knowledge, awareness and treatment of hypertension and stroke risk by country income level

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Harvard

O' Donnell, M, Hankey, GJ, Rangarajan, S, Chin, SL, Rao-Melacini, P, Ferguson, J, Xavier, D, Lisheng, L, Zhang, H, Pais, P, Lopez-Jaramillo, P, Damasceno, A, Langhorne, P, Rosengren, A, Dans, AL, Elsayed, A, Avezum, A, Mondo, C, Smyth, A, Judge, C, Diener, H-C, Ryglewicz, D, Czlonkowska, A, Pogosova, N, Weimar, C, Iqbal, R, Diaz, R, Yusoff, K, Yusufali, A, Oguz, A, Wang, X, Penaherrera, E, Lanas, F, Ogah, OS, Ogunniyi, A, Iversen, HK, Malaga, G, Rumboldt, Z, Oveisgharan, S, AlHussain, F, Daliwonga, M, Nilanont, Y & Yusuf, S 2021, 'Variations in knowledge, awareness and treatment of hypertension and stroke risk by country income level', Heart (British Cardiac Society), vol. 107, no. 4, pp. 282-289. https://doi.org/10.1136/heartjnl-2019-316515

APA

O' Donnell, M., Hankey, G. J., Rangarajan, S., Chin, S. L., Rao-Melacini, P., Ferguson, J., Xavier, D., Lisheng, L., Zhang, H., Pais, P., Lopez-Jaramillo, P., Damasceno, A., Langhorne, P., Rosengren, A., Dans, A. L., Elsayed, A., Avezum, A., Mondo, C., Smyth, A., ... Yusuf, S. (2021). Variations in knowledge, awareness and treatment of hypertension and stroke risk by country income level. Heart (British Cardiac Society), 107(4), 282-289. https://doi.org/10.1136/heartjnl-2019-316515

CBE

O' Donnell M, Hankey GJ, Rangarajan S, Chin SL, Rao-Melacini P, Ferguson J, Xavier D, Lisheng L, Zhang H, Pais P, Lopez-Jaramillo P, Damasceno A, Langhorne P, Rosengren A, Dans AL, Elsayed A, Avezum A, Mondo C, Smyth A, Judge C, Diener H-C, Ryglewicz D, Czlonkowska A, Pogosova N, Weimar C, Iqbal R, Diaz R, Yusoff K, Yusufali A, Oguz A, Wang X, Penaherrera E, Lanas F, Ogah OS, Ogunniyi A, Iversen HK, Malaga G, Rumboldt Z, Oveisgharan S, AlHussain F, Daliwonga M, Nilanont Y, Yusuf S. 2021. Variations in knowledge, awareness and treatment of hypertension and stroke risk by country income level. Heart (British Cardiac Society). 107(4):282-289. https://doi.org/10.1136/heartjnl-2019-316515

MLA

Vancouver

Author

O' Donnell, Martin ; Hankey, Graeme J ; Rangarajan, Sumathy ; Chin, Siu Lim ; Rao-Melacini, Purnima ; Ferguson, John ; Xavier, Denis ; Lisheng, Liu ; Zhang, Hongye ; Pais, Prem ; Lopez-Jaramillo, Patricio ; Damasceno, Albertino ; Langhorne, Peter ; Rosengren, Annika ; Dans, Antonio L ; Elsayed, Ahmed ; Avezum, Alvaro ; Mondo, Charles ; Smyth, Andrew ; Judge, Conor ; Diener, Hans-Christoph ; Ryglewicz, Danuta ; Czlonkowska, Anna ; Pogosova, Nana ; Weimar, Christian ; Iqbal, Romana ; Diaz, Rafael ; Yusoff, Khalid ; Yusufali, Afzalhussein ; Oguz, Aytekin ; Wang, Xingyu ; Penaherrera, Ernesto ; Lanas, Fernando ; Ogah, Okechukwu Samuel ; Ogunniyi, Adensola ; Iversen, Helle K ; Malaga, German ; Rumboldt, Zvonko ; Oveisgharan, Shahram ; AlHussain, Fawaz ; Daliwonga, Magazi ; Nilanont, Yongchai ; Yusuf, Salim. / Variations in knowledge, awareness and treatment of hypertension and stroke risk by country income level. In: Heart (British Cardiac Society). 2021 ; Vol. 107, No. 4. pp. 282-289.

Bibtex

@article{9b7bcbe99bb04fd18141bf18059d7a2d,
title = "Variations in knowledge, awareness and treatment of hypertension and stroke risk by country income level",
abstract = "OBJECTIVE: Hypertension is the most important modifiable risk factor for stroke globally. We hypothesised that country-income level variations in knowledge, detection and treatment of hypertension may contribute to variations in the association of blood pressure with stroke.METHODS: We undertook a standardised case-control study in 32 countries (INTERSTROKE). Cases were patients with acute first stroke (n=13 462) who were matched by age, sex and site to controls (n=13 483). We evaluated the associations of knowledge, awareness and treatment of hypertension with risk of stroke and its subtypes and whether this varied by gross national income (GNI) of country. We estimated OR and population attributable risk (PAR) associated with treated and untreated hypertension.RESULTS: Hypertension was associated with a graded increase in OR by reducing GNI, ranging from OR 1.92 (99% CI 1.48 to 2.49) to OR 3.27 (2.72 to 3.93) for highest to lowest country-level GNI (p-heterogeneity<0.0001). Untreated hypertension was associated with a higher OR for stroke (OR 5.25; 4.53 to 6.10) than treated hypertension (OR 2.60; 2.32 to 2.91) and younger age of first stroke (61.4 vs 65.4 years; p<0.01). Untreated hypertension was associated with a greater risk of intracerebral haemorrhage (OR 6.95; 5.61 to 8.60) than ischaemic stroke (OR 4.76; 3.99 to 5.68). The PAR associated with untreated hypertension was higher in lower-income regions, PAR 36.3%, 26.3%, 19.8% to 10.4% by increasing GNI of countries. Lifetime non-measurement of blood pressure was associated with stroke (OR 1.80; 1.32 to 2.46).CONCLUSIONS: Deficits in knowledge, detection and treatment of hypertension contribute to higher risk of stroke, younger age of onset and larger proportion of intracerebral haemorrhage in lower-income countries.",
keywords = "epidemiology, hypertension, stroke",
author = "{O' Donnell}, Martin and Hankey, {Graeme J} and Sumathy Rangarajan and Chin, {Siu Lim} and Purnima Rao-Melacini and John Ferguson and Denis Xavier and Liu Lisheng and Hongye Zhang and Prem Pais and Patricio Lopez-Jaramillo and Albertino Damasceno and Peter Langhorne and Annika Rosengren and Dans, {Antonio L} and Ahmed Elsayed and Alvaro Avezum and Charles Mondo and Andrew Smyth and Conor Judge and Hans-Christoph Diener and Danuta Ryglewicz and Anna Czlonkowska and Nana Pogosova and Christian Weimar and Romana Iqbal and Rafael Diaz and Khalid Yusoff and Afzalhussein Yusufali and Aytekin Oguz and Xingyu Wang and Ernesto Penaherrera and Fernando Lanas and Ogah, {Okechukwu Samuel} and Adensola Ogunniyi and Iversen, {Helle K} and German Malaga and Zvonko Rumboldt and Shahram Oveisgharan and Fawaz AlHussain and Magazi Daliwonga and Yongchai Nilanont and Salim Yusuf",
note = "{\textcopyright} Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2021",
month = feb,
day = "1",
doi = "10.1136/heartjnl-2019-316515",
language = "English",
volume = "107",
pages = "282--289",
journal = "Heart",
issn = "1355-6037",
publisher = "B M J Group",
number = "4",

}

RIS

TY - JOUR

T1 - Variations in knowledge, awareness and treatment of hypertension and stroke risk by country income level

AU - O' Donnell, Martin

AU - Hankey, Graeme J

AU - Rangarajan, Sumathy

AU - Chin, Siu Lim

AU - Rao-Melacini, Purnima

AU - Ferguson, John

AU - Xavier, Denis

AU - Lisheng, Liu

AU - Zhang, Hongye

AU - Pais, Prem

AU - Lopez-Jaramillo, Patricio

AU - Damasceno, Albertino

AU - Langhorne, Peter

AU - Rosengren, Annika

AU - Dans, Antonio L

AU - Elsayed, Ahmed

AU - Avezum, Alvaro

AU - Mondo, Charles

AU - Smyth, Andrew

AU - Judge, Conor

AU - Diener, Hans-Christoph

AU - Ryglewicz, Danuta

AU - Czlonkowska, Anna

AU - Pogosova, Nana

AU - Weimar, Christian

AU - Iqbal, Romana

AU - Diaz, Rafael

AU - Yusoff, Khalid

AU - Yusufali, Afzalhussein

AU - Oguz, Aytekin

AU - Wang, Xingyu

AU - Penaherrera, Ernesto

AU - Lanas, Fernando

AU - Ogah, Okechukwu Samuel

AU - Ogunniyi, Adensola

AU - Iversen, Helle K

AU - Malaga, German

AU - Rumboldt, Zvonko

AU - Oveisgharan, Shahram

AU - AlHussain, Fawaz

AU - Daliwonga, Magazi

AU - Nilanont, Yongchai

AU - Yusuf, Salim

N1 - © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2021/2/1

Y1 - 2021/2/1

N2 - OBJECTIVE: Hypertension is the most important modifiable risk factor for stroke globally. We hypothesised that country-income level variations in knowledge, detection and treatment of hypertension may contribute to variations in the association of blood pressure with stroke.METHODS: We undertook a standardised case-control study in 32 countries (INTERSTROKE). Cases were patients with acute first stroke (n=13 462) who were matched by age, sex and site to controls (n=13 483). We evaluated the associations of knowledge, awareness and treatment of hypertension with risk of stroke and its subtypes and whether this varied by gross national income (GNI) of country. We estimated OR and population attributable risk (PAR) associated with treated and untreated hypertension.RESULTS: Hypertension was associated with a graded increase in OR by reducing GNI, ranging from OR 1.92 (99% CI 1.48 to 2.49) to OR 3.27 (2.72 to 3.93) for highest to lowest country-level GNI (p-heterogeneity<0.0001). Untreated hypertension was associated with a higher OR for stroke (OR 5.25; 4.53 to 6.10) than treated hypertension (OR 2.60; 2.32 to 2.91) and younger age of first stroke (61.4 vs 65.4 years; p<0.01). Untreated hypertension was associated with a greater risk of intracerebral haemorrhage (OR 6.95; 5.61 to 8.60) than ischaemic stroke (OR 4.76; 3.99 to 5.68). The PAR associated with untreated hypertension was higher in lower-income regions, PAR 36.3%, 26.3%, 19.8% to 10.4% by increasing GNI of countries. Lifetime non-measurement of blood pressure was associated with stroke (OR 1.80; 1.32 to 2.46).CONCLUSIONS: Deficits in knowledge, detection and treatment of hypertension contribute to higher risk of stroke, younger age of onset and larger proportion of intracerebral haemorrhage in lower-income countries.

AB - OBJECTIVE: Hypertension is the most important modifiable risk factor for stroke globally. We hypothesised that country-income level variations in knowledge, detection and treatment of hypertension may contribute to variations in the association of blood pressure with stroke.METHODS: We undertook a standardised case-control study in 32 countries (INTERSTROKE). Cases were patients with acute first stroke (n=13 462) who were matched by age, sex and site to controls (n=13 483). We evaluated the associations of knowledge, awareness and treatment of hypertension with risk of stroke and its subtypes and whether this varied by gross national income (GNI) of country. We estimated OR and population attributable risk (PAR) associated with treated and untreated hypertension.RESULTS: Hypertension was associated with a graded increase in OR by reducing GNI, ranging from OR 1.92 (99% CI 1.48 to 2.49) to OR 3.27 (2.72 to 3.93) for highest to lowest country-level GNI (p-heterogeneity<0.0001). Untreated hypertension was associated with a higher OR for stroke (OR 5.25; 4.53 to 6.10) than treated hypertension (OR 2.60; 2.32 to 2.91) and younger age of first stroke (61.4 vs 65.4 years; p<0.01). Untreated hypertension was associated with a greater risk of intracerebral haemorrhage (OR 6.95; 5.61 to 8.60) than ischaemic stroke (OR 4.76; 3.99 to 5.68). The PAR associated with untreated hypertension was higher in lower-income regions, PAR 36.3%, 26.3%, 19.8% to 10.4% by increasing GNI of countries. Lifetime non-measurement of blood pressure was associated with stroke (OR 1.80; 1.32 to 2.46).CONCLUSIONS: Deficits in knowledge, detection and treatment of hypertension contribute to higher risk of stroke, younger age of onset and larger proportion of intracerebral haemorrhage in lower-income countries.

KW - epidemiology

KW - hypertension

KW - stroke

UR - http://www.scopus.com/inward/record.url?scp=85097961252&partnerID=8YFLogxK

U2 - 10.1136/heartjnl-2019-316515

DO - 10.1136/heartjnl-2019-316515

M3 - Journal article

C2 - 33318082

VL - 107

SP - 282

EP - 289

JO - Heart

JF - Heart

SN - 1355-6037

IS - 4

ER -

ID: 61829494