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Title: Wealth and cardiovascular health : A cross-sectional study of wealth-related inequalities in the awareness, treatment and control of hypertension in high-, middle- and low-income countries
Authors: López Jaramillo, Patricio
Palafox, Benjamin
Balabanova, Dina
AlHabib, Khalid F.
Avezum, Alvaro
Bahonar, Ahmad
Ismail, Noorhassim
Chifamba, Jephat
Chow, Clara K.
Corsi, Daniel J.
Dagenais, Gilles
Diaz, Rafael
Gupta, Rajeev
Iqbal, Romaina
Kaur, Manmeet
Khatib, Rasha
Kruger, Annamarie
Kruger, Iolanthe Marike
Lanas, Fernando
Minfan, Fu
Mohan, Viswanathan
Mony, Prem
Oguz, Aytekin
Palileo Villaneuva, Lia
Perel, Pablo
Poirier, Paul P.
Rangarajan, Sumathy
Rensheng, Lei
Rosengren, Annika
Soman, Biju
Stuckler, David
Subramanian, S. V.
Teo, Koon
Tsolekile, Lungiswa P.
Wielgosz, Andreas
Yaguang, Peng
Yeates, Karen
Yongzhen, Mo
Yusoff, Khalid
Yusuf, Rita
Yusufali, Afzalhussein
Zatonska, Katarzyna
Yusuf, Salim
Issue Date: 8-Dec-2016
Abstract: Background Effective policies to control hypertension require an understanding of its distribution in the population and the barriers people face along the pathway from detection through to treatment and control. One key factor is household wealth, which may enable or limit a household’s ability to access health care services and adequately control such a chronic condition. This study aims to describe the scale and patterns of wealth-related inequalities in the awareness, treatment and control of hypertension in 21 countries using baseline data from the Prospective Urban and Rural Epidemiology study. Methods A cross-section of 163,397 adults aged 35 to 70 years were recruited from 661 urban and rural communities in selected low-, middle- and high-income countries (complete data for this analysis from 151,619 participants). Using blood pressure measurements, self-reported health and household data, concentration indices adjusted for age, sex and urban-rural location, we estimate the magnitude of wealth-related inequalities in the levels of hypertension awareness, treatment, and control in each of the 21 country samples. Results Overall, the magnitude of wealth-related inequalities in hypertension awareness, treatment, and control was observed to be higher in poorer than in richer countries. In poorer countries, levels of hypertension awareness and treatment tended to be higher among wealthier households; while a similar pro-rich distribution was observed for hypertension control in countries at all levels of economic development. In some countries, hypertension awareness was greater among the poor (Sweden, Argentina, Poland), as was treatment (Sweden, Poland) and control (Sweden). Conclusion Inequality in hypertension management outcomes decreased as countries became richer, but the considerable variation in patterns of wealth-related inequality - even among countries at similar levels of economic development - underscores the importance of health systems in improving hypertension management for all. These findings show that some, but not all, countries, including those with limited resources, have been able to achieve more equitable management of hypertension; and strategies must be tailored to national contexts to achieve optimal impact at population level.
Description: 14 p.
ISSN: 1475-9276
Appears in Collections:DCABA. Artículos de Investigación

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