Evaluating Hypertension Risk in Low-Income Countries
Author Information
Author(s): Montalvo Gregorio, Avanzini Fausto, Anselmi Mariella, Prandi Rosanna, Ibarra Samuel, Marquez Monica, Armani Daniela, Moreira Juan-Martín, Caicedo Cynthia, Roncaglioni Maria Carla, Colombo Fabio, Camisasca Paola, Milani Valentina, Quimì Simon, Gonzabay Felix, Tognoni Gianni
Primary Institution: Centro de Epidemiología Comunitaria y Medicina Tropical (CECOMET), Esmeraldas, Ecuador
Hypothesis
Can a simplified risk stratification method for hypertension be as effective as the WHO-ISH guidelines in low-income settings?
Conclusion
The essential risk stratification method for hypertension is as effective as the WHO-ISH method in predicting cardiovascular events and mortality.
Supporting Evidence
- Up to three quarters of all cardiovascular events were reported among people classified as high or very high risk.
- The predictive discrimination of the essential method is comparable with the WHO-ISH method.
- Both methods showed a significant association between predicted risk and incidence of cardiovascular events.
- Laboratory investigations increased the identification of participants with multiple cardiovascular risk factors.
Takeaway
This study shows that a simple way to check if people with high blood pressure are at risk of heart problems works just as well as a more complicated method that needs more tests.
Methodology
A prospective cohort study was conducted in a rural area of Ecuador, monitoring 504 hypertensive patients over a mean of 6.7 years, comparing an essential risk stratification method with the WHO-ISH guidelines.
Potential Biases
Potential bias due to reliance on verbal autopsies for cause of death and the limited availability of laboratory tests.
Limitations
Some variables could not be measured due to lack of equipment or technical skills, and the study may have underestimated the overall rate of cardiovascular events.
Participant Demographics
Participants were primarily black (93%), with a mean age of 55.5 years, and 67% were female.
Statistical Information
P-Value
p<0.001
Confidence Interval
0.721 to 0.855
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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