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

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dc.contributor.authorO’ Donnell, Martin
dc.contributor.authorHankey, Graeme J.
dc.contributor.authorRangarajan, Sumathy
dc.contributor.authorChin, Siu Lim
dc.contributor.authorRao-Melacini, Purnima
dc.contributor.authorFerguson, John
dc.contributor.authorXavier, Denis
dc.contributor.authorLisheng, Liu
dc.contributor.authorZhang, Hongye
dc.contributor.authorPais, Prem
dc.contributor.authorLopez-Jaramillo, Patricio
dc.contributor.authorDamasceno, Albertino
dc.contributor.authorLanghorne, Peter
dc.contributor.authorRosengren, Annika
dc.contributor.authorDans, Antonio L.
dc.contributor.authorElsayed, Ahmed
dc.contributor.authorAvezum, Alvaro
dc.contributor.authorMondo, Charles
dc.contributor.authorSmyth, Andrew
dc.contributor.authorJudge, Conor
dc.contributor.authorDiener, Hans-Christoph
dc.contributor.authorRyglewicz, Danuta
dc.contributor.authorCzlonkowska, Anna
dc.contributor.authorPogosova, Nana
dc.contributor.authorWeimar, Christian
dc.contributor.authorIqbal, Romana
dc.contributor.authorDiaz, Rafael
dc.contributor.authorYusoff, Khalid
dc.contributor.authorYusufali, Afzalhussein
dc.contributor.authorOguz, Aytekin
dc.contributor.authorWang, Xingyu
dc.contributor.authorPenaherrera, Ernesto
dc.contributor.authorLanas, Fernando
dc.contributor.authorOgah, Okechukwu Samuel
dc.contributor.authorOgunniyi, Adensola
dc.contributor.authorIversen, Helle K.
dc.contributor.authorMalaga, German
dc.contributor.authorRumboldt, Zvonko
dc.contributor.authorOveisgharan, Shahram
dc.contributor.authorAlHussain, Fawaz
dc.contributor.authorDaliwonga, Magazi
dc.contributor.authorNilanont, Yongchai
dc.contributor.authorYusuf, Salim
dc.contributor.researchgroupMasiraspa
dc.date.accessioned2022-02-18T14:07:30Z
dc.date.available2022-02-18T14:07:30Z
dc.date.issued2020-12-14
dc.descriptionDigitalspa
dc.description.abstractABSTRACT 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 (pheterogeneity<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 lowerincome regions, PAR 36.3%, 26.3%, 19.8% to 10.4% by increasing GNI of countries. Lifetime nonmeasurement 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.spa
dc.description.researchareaCiencias Médicas y de la Saludspa
dc.format.extent8 p.spa
dc.format.mimetypeapplication/pdfspa
dc.identifier.doihttp://dx.doi.org/10.1136/heartjnl-2019-316515
dc.identifier.urihttps://repositorio.udes.edu.co/handle/001/6044
dc.language.isoengspa
dc.publisherBMJ Journalsspa
dc.publisher.placeReino Unidospa
dc.relation.citationendpage289spa
dc.relation.citationissue4spa
dc.relation.citationstartpage282spa
dc.relation.citationvolume107spa
dc.relation.citesO' Donnell M, Hankey GJ, Rangarajan S, et alVariations in knowledge, awareness and treatment of hypertension and stroke risk by country income levelHeart 2021;107:282-289.
dc.relation.indexedScopusspa
dc.relation.ispartofjournalHeartspa
dc.rights© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial 4.0 Internacional (CC BY-NC 4.0)spa
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/spa
dc.sourcehttps://heart.bmj.com/content/107/4/282spa
dc.titleVariations in knowledge, awareness and treatment of hypertension and stroke risk by country income levelspa
dc.typeArtículo de revistaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_6501spa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/articlespa
dc.type.redcolhttp://purl.org/redcol/resource_type/ARTspa
dc.type.versioninfo:eu-repo/semantics/publishedVersionspa
dcterms.audienceTodas las Audienciasspa
dspace.entity.typePublication
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2spa
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85spa
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