Impact of urbanisation and altitude on the incidence of, and risk factors for, hypertension. Issue 11 (23rd January 2017)

• Record Type: Journal Article
• Authors: Bernabé-Ortiz, Antonio; Carrillo-Larco, Rodrigo M; Gilman, Robert H; Checkley, William; Smeeth, Liam; Miranda, J Jaime
• Other Names: author non-byline.; Casas Juan P. author non-byline.; Smith George Davey author non-byline.; Ebrahim Shah author non-byline.; García Héctor H. author non-byline.; Huicho Luis author non-byline.; Málaga Germán author non-byline.; Montori Víctor M. author non-byline.; Diette Gregory B. author non-byline.; Gilman Robert H. author non-byline.; Huicho Luis author non-byline.; León-Velarde Fabiola author non-byline.; Rivera María author non-byline.; Wise Robert A. author non-byline.; Checkley William author non-byline.; García Héctor H. author non-byline.; Gilman Robert H. author non-byline.; Miranda J. Jaime author non-byline.; Sacksteder Katherine author non-byline.
• Is Part Of: Heart. Volume 103:Issue 11(2017)
• Page Start: 827
• Page End: 833
• Publication Date: 2017-01-23
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2016-310347
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Background: Most of the data regarding the burden of hypertension in low-income and middle-income countries comes from cross-sectional surveys instead of longitudinal studies. We estimated the incidence of, and risk factors for, hypertension in four study sites with different degree of urbanisation and altitude. Methods: Data from the CRONICAS Cohort Study, conducted in urban, semiurban and rural areas in Peru, was used. An age-stratified and sex-stratified random sample of participants was taken from the most updated census available in each site. Hypertension was defined as systolic blood pressure ≥140 mm Hg, or diastolic blood pressure ≥90 mm Hg, or self-report physician diagnosis and current treatment. The exposures were study site and altitude as well as modifiable risk factors. Incidence, incidence rate ratios (IRRs), 95% CIs and population-attributable fractions (PAFs) were estimated using generalised linear models. Results: Information from 3237 participants, mean age 55.8 (SD±12.7) years, 48.4% males, was analysed. Overall baseline prevalence of hypertension was 19.7% (95% CI 18.4% to 21.1%). A total of 375 new cases of hypertension were recorded, including 5266 person-years of follow-up, with an incidence of 7.12 (95% CI 6.44 to 7.88) per 100 person-years. Individuals from semiurban site were at higher risk of hypertension compared with highly urbanised areas (IRR=1.76; 95% CI 1.39 to 2.23); however, those from high-altitude sites had a reduced risk (IRR=0.74; 95% CI 0.58 to 0.95). Obesity was the leading risk factor for hypertension with a great variation according to study site with PAF ranging from 12.5% to 42.4%. Conclusions: Our results suggest heterogeneity in the progression towards hypertension depending on urbanisation and site altitude.