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Impact of urbanisation and altitude on the incidence of, and risk factors for, hypertension

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dc.contributor.author Bernabé Ortiz, Antonio
dc.contributor.author Carrillo Larco, Rodrigo Martín
dc.contributor.author Gilman, Robert Hugh
dc.contributor.author Checkley, William
dc.contributor.author Smeeth, Liam
dc.contributor.author Miranda, J. Jaime
dc.date.accessioned 2019-01-25T15:18:37Z
dc.date.available 2019-01-25T15:18:37Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/20.500.12866/4678
dc.description.abstract BACKGROUND: Most of the data regarding the burden of hypertension in low-income and middle-income countries comes from cross-sectional surveys instead of longitudinal studies. We estimated the incidence of, and risk factors for, hypertension in four study sites with different degree of urbanisation and altitude. METHODS: Data from the CRONICAS Cohort Study, conducted in urban, semiurban and rural areas in Peru, was used. An age-stratified and sex-stratified random sample of participants was taken from the most updated census available in each site. Hypertension was defined as systolic blood pressure >/=140 mm Hg, or diastolic blood pressure >/=90 mm Hg, or self-report physician diagnosis and current treatment. The exposures were study site and altitude as well as modifiable risk factors. Incidence, incidence rate ratios (IRRs), 95% CIs and population-attributable fractions (PAFs) were estimated using generalised linear models. RESULTS: Information from 3237 participants, mean age 55.8 (SD+/-12.7) years, 48.4% males, was analysed. Overall baseline prevalence of hypertension was 19.7% (95% CI 18.4% to 21.1%). A total of 375 new cases of hypertension were recorded, including 5266 person-years of follow-up, with an incidence of 7.12 (95% CI 6.44 to 7.88) per 100 person-years. Individuals from semiurban site were at higher risk of hypertension compared with highly urbanised areas (IRR=1.76; 95% CI 1.39 to 2.23); however, those from high-altitude sites had a reduced risk (IRR=0.74; 95% CI 0.58 to 0.95). Obesity was the leading risk factor for hypertension with a great variation according to study site with PAF ranging from 12.5% to 42.4%. CONCLUSIONS: Our results suggest heterogeneity in the progression towards hypertension depending on urbanisation and site altitude. en_US
dc.language.iso eng
dc.publisher BMJ Publishing Group
dc.relation.ispartofseries Heart
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Follow-Up Studies en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Aged en_US
dc.subject Middle Aged en_US
dc.subject Prospective Studies en_US
dc.subject Risk Factors en_US
dc.subject Cross-Sectional Studies en_US
dc.subject Blood Pressure en_US
dc.subject Prevalence en_US
dc.subject Self Report en_US
dc.subject Incidence en_US
dc.subject Disease Progression en_US
dc.subject Peru/epidemiology en_US
dc.subject Rural Population en_US
dc.subject Hypertension/epidemiology en_US
dc.subject Risk Assessment/methods en_US
dc.subject Urbanization/trends en_US
dc.title Impact of urbanisation and altitude on the incidence of, and risk factors for, hypertension en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1136/heartjnl-2016-310347
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.04
dc.relation.issn 1468-201X


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