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Assessment of hypertension management and control : a registry-based observational study in two municipalities in Cuba

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Abstract
Background: To determine the prevalence of hypertension treatment and control among hypertensive patients in the Cuban municipalities of Cardenas and Santiago and to explore the main associated predictors. Methods: Cross-sectional study, with multistage cluster sampling, conducted between February 2012 and January 2013 in two Cuban municipalities. We interviewed and measured blood pressure in 1333 hypertensive patients aged 18years or older. Hypertension control was defined as blood pressure lower than 140/90mmHg. Results: The mean agestandard deviation (SD) of participants was 59.8 +/- 14years, the mean systolic and diastolic blood pressure +/- SD was 130.0 +/- 14.4 and 83.1 +/- 9.0mmHg respectively. The majority of patients (91, 95%CI 90-93) were on pharmacological treatment, 49% with a combination of 2 or more classes of drugs. Among diagnosed hypertensive patients 58% (95%CI 55-61) had controlled hypertension. There was no association between hypertension control and gender, age and socio-economic condition. Levels of hypertension control depended on health area and control furthermore was positively associated with post-primary education, not being obese and white ethnicity: adjusted Odds Ratio (95% CI) 1.71 (1.26-2.34), 1.43 (1.09-1.88) and 1.41 (1.09-1.81) respectively. Conclusions: The observed figures are outstanding at the international level and illustrate that hypertension treatment and control are achievable in a resource-constrained setting such as Cuba. The country's primary health care approach and social equity in access to health care can be seen as key determinants of this success. Nevertheless, there is still room for improvement, as over a third of patients did not have controlled hypertension.
Keywords
HIGH BLOOD-PRESSURE, NONCOMMUNICABLE DISEASES, HEALTH-SYSTEMS, PRIMARY-CARE, RISK-FACTORS, LOW-INCOME, PREVENTION, MEDICATION, MIDDLE, Hypertension, Cuba, Chronic disease, Treatment, Antihypertensive agents, Primary health care

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MLA
Agudelo, Esteban Londono et al. “Assessment of Hypertension Management and Control : a Registry-based Observational Study in Two Municipalities in Cuba.” BMC CARDIOVASCULAR DISORDERS 19 (2019): n. pag. Print.
APA
Agudelo, E. L., Rodriguez Salva, A., Diaz Pinera, A., Garcia Roche, R., De Vos, P., Battaglioli, T., & Van Der Stuyft, P. (2019). Assessment of hypertension management and control : a registry-based observational study in two municipalities in Cuba. BMC CARDIOVASCULAR DISORDERS, 19.
Chicago author-date
Agudelo, Esteban Londono, Armando Rodriguez Salva, Addys Diaz Pinera, Rene Garcia Roche, Pol De Vos, Tullia Battaglioli, and Patrick Van Der Stuyft. 2019. “Assessment of Hypertension Management and Control : a Registry-based Observational Study in Two Municipalities in Cuba.” Bmc Cardiovascular Disorders 19.
Chicago author-date (all authors)
Agudelo, Esteban Londono, Armando Rodriguez Salva, Addys Diaz Pinera, Rene Garcia Roche, Pol De Vos, Tullia Battaglioli, and Patrick Van Der Stuyft. 2019. “Assessment of Hypertension Management and Control : a Registry-based Observational Study in Two Municipalities in Cuba.” Bmc Cardiovascular Disorders 19.
Vancouver
1.
Agudelo EL, Rodriguez Salva A, Diaz Pinera A, Garcia Roche R, De Vos P, Battaglioli T, et al. Assessment of hypertension management and control : a registry-based observational study in two municipalities in Cuba. BMC CARDIOVASCULAR DISORDERS. 2019;19.
IEEE
[1]
E. L. Agudelo et al., “Assessment of hypertension management and control : a registry-based observational study in two municipalities in Cuba,” BMC CARDIOVASCULAR DISORDERS, vol. 19, 2019.
@article{8607937,
  abstract     = {Background: To determine the prevalence of hypertension treatment and control among hypertensive patients in the Cuban municipalities of Cardenas and Santiago and to explore the main associated predictors.
Methods: Cross-sectional study, with multistage cluster sampling, conducted between February 2012 and January 2013 in two Cuban municipalities. We interviewed and measured blood pressure in 1333 hypertensive patients aged 18years or older. Hypertension control was defined as blood pressure lower than 140/90mmHg.
Results: The mean agestandard deviation (SD) of participants was 59.8 +/- 14years, the mean systolic and diastolic blood pressure +/- SD was 130.0 +/- 14.4 and 83.1 +/- 9.0mmHg respectively. The majority of patients (91, 95%CI 90-93) were on pharmacological treatment, 49% with a combination of 2 or more classes of drugs. Among diagnosed hypertensive patients 58% (95%CI 55-61) had controlled hypertension. There was no association between hypertension control and gender, age and socio-economic condition. Levels of hypertension control depended on health area and control furthermore was positively associated with post-primary education, not being obese and white ethnicity: adjusted Odds Ratio (95% CI) 1.71 (1.26-2.34), 1.43 (1.09-1.88) and 1.41 (1.09-1.81) respectively.
Conclusions: The observed figures are outstanding at the international level and illustrate that hypertension treatment and control are achievable in a resource-constrained setting such as Cuba. The country's primary health care approach and social equity in access to health care can be seen as key determinants of this success. Nevertheless, there is still room for improvement, as over a third of patients did not have controlled hypertension.},
  articleno    = {29},
  author       = {Agudelo, Esteban Londono and Rodriguez Salva, Armando and Diaz Pinera, Addys and Garcia Roche, Rene and De Vos, Pol and Battaglioli, Tullia and Van Der Stuyft, Patrick},
  issn         = {1471-2261},
  journal      = {BMC CARDIOVASCULAR DISORDERS},
  keywords     = {HIGH BLOOD-PRESSURE,NONCOMMUNICABLE DISEASES,HEALTH-SYSTEMS,PRIMARY-CARE,RISK-FACTORS,LOW-INCOME,PREVENTION,MEDICATION,MIDDLE,Hypertension,Cuba,Chronic disease,Treatment,Antihypertensive agents,Primary health care},
  language     = {eng},
  pages        = {10},
  title        = {Assessment of hypertension management and control : a registry-based observational study in two municipalities in Cuba},
  url          = {http://dx.doi.org/10.1186/s12872-019-1006-6},
  volume       = {19},
  year         = {2019},
}

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