Socioeconomic inequalities in prevalence, awareness, treatment and control of hypertension: evidence from the PERSIAN cohort study

Authors

Mahin Amini 1, Mahdi Moradinazar 1, Fatemeh Rajati 2, Moslem Soofi 3, Sadaf G Sepanlou 4, Hossein Poustchi 5, Sareh Eghtesad 5, Mahmood Moosazadeh 6, Javad Harooni 7, Javad Aghazadeh-Attari 8, Majid Fallahi 9, Mohammad Reza Fattahi 10, Alireza Ansari-Moghaddam 11, Farhad Moradpour 12, Azim Nejatizadeh 13, Mehdi Shahmoradi 14, Fariborz Mansour-Ghanaei 15, Alireza Ostadrahimi 16, Ali Ahmadi 17, Arsalan Khaledifar 17, Mohammad Hossien Saghi 9, Nader Saki 18, Iraj Mohebbi 8, Reza Homayounfar 19, Mojtaba Farjam 19, Ali Esmaeili Nadimi 20, Mahmood Kahnooji 20, Farhad Pourfarzi 21, Bijan Zamani 21, Abbas Rezaianzadeh 22, Masoumeh Ghoddusi Johari 23, Masoud Mirzaei 24, Ali Dehghani 25, Seyed Fazel Zinat Motlagh 7, Zahra Rahimi 26, Reza Malekzadeh 27, Farid Najafi 28

  1. Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
  2. 2Department of Health Education and Promotion, Research Center for Environmental Determinants of Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
  3. 3Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
  4. 4Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
  5. 5Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
  6. 6Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
  7. 7Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
  8. 8Clinical Research Institute,Occupational Medicine Center, Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran.
  9. 9Department of Occupational Health Engineering, School of Public Health, Non Communicable Disease Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.
  10. 10Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
  11. 11Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
  12. 12Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
  13. 13Molecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
  14. 14Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
  15. 15Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
  16. 16Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
  17. 17Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
  18. 18Hearing Research Center, Department of Otolaryngology, Head and Neck Surgery, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
  19. 19NonCommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
  20. 20Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
  21. 21Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
  22. 22Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
  23. 23Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
  24. 24Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  25. 25Centre For Healthcare Data Modeling, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  26. 26Hearing Research Center, Department of Biostatistics and Epidemiology, School of Public Health, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
  27. 27Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
  28. 28Department of Epidemiology, School of Health, Research Center for Environmental Determinants of Health, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran. farid_n32@yahoo.com.
BMC Public Health

Abstract

Background: Elevated blood pressure is associated with cardiovascular disease, stroke and chronic kidney disease. In this study, we examined the socioeconomic inequality and its related factors in prevalence, Awareness, Treatment and Control (ATC) of hypertension (HTN) in Iran.

Method: The study used data from the recruitment phase of The Prospective Epidemiological Research Studies in IrAN (PERSIAN). A sample of 162,842 adults aged > = 35 years was analyzed. HTN was defined according to the Joint National Committee)JNC-7(. socioeconomic inequality was measured using concentration index (Cn) and curve.

Results: The mean age of participants was 49.38(SD = ± 9.14) years and 44.74% of the them were men. The prevalence of HTN in the total population was 22.3%(95% CI: 20.6%; 24.1%), and 18.8%(95% CI: 16.8%; 20.9%) and 25.2%(95% CI: 24.2%; 27.7%) in men and women, respectively. The percentage of awareness treatment and control among individuals with HTN were 77.5%(95% CI: 73.3%; 81.8%), 82.2%(95% CI: 70.2%; 81.6%) and 75.9%(95% CI: 70.2%; 81.6%), respectively. The Cn for prevalence of HTN was -0.084. Two factors, age (58.46%) and wealth (32.40%), contributed most to the socioeconomic inequality in the prevalence of HTN.

Conclusion: The prevalence of HTN was higher among low-SES individuals, who also showed higher levels of awareness. However, treatment and control of HTN were more concentrated among those who had higher levels of SES, indicating that people at a higher risk of adverse event related to HTN (the low SES individuals) are not benefiting from the advantage of treatment and control of HTN. Such a gap between diagnosis (prevalence) and control (treatment and control) of HTN needs to be addressed by public health policymakers.

Keywords: Awareness; Control; Hypertension; Inequality; PERSIAN Cohort; Treatment.

How to Cite

Shafiee G, Ostovar A, Heshmat R, Darabi H, Sharifi F, Raeisi A, Mehrdad N, Shadman Z, Razi F, Amini MR, Arzaghi SM, Meybodi HA, Soltani A, Nabipour I, Larijani B. Bushehr Elderly Health (BEH) programme: study protocol and design of musculoskeletal system and cognitive function (stage II). BMJ Open. 2017 Aug 4;7(8):e013606. doi: 10.1136/bmjopen-2016-013606. PMID: 28780537; PMCID: PMC5577871.

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Socioeconomic inequalities in prevalence, awareness, treatment and control of hypertension: evidence from the PERSIAN cohort study