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      The Risk Factors for Undiagnosed and Known Hypertension among Malaysians

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          Abstract

          Background

          The prevalence of known hypertension has resulted from the progression of undiagnosed hypertension. This study is targeted to examine and compare the risk factors based on the estimated odds ratios of modifiable and non-modifiable risk factors on different outcome levels of hypertension.

          Methods

          A nationwide representative secondary data from the Fourth National Health of Morbidity Survey (NHMS IV) which consists of 24,632 non-institutionalised Malaysian population conducted by the Ministry of Health in 2011 has been used. Odds ratio (OR) with 95% confidence interval has been estimated using multinomial logistic regression.

          Results

          Obese and overweight respondents exhibit increased likelihood of having undiagnosed and known hypertension. Physically inactive, ex-smokers and unclassified drinkers are found having higher likelihood to have known hypertension. However, current drinkers are found to have higher likelihood of having undiagnosed hypertension. Elderly, retirees, home makers and lower educated respondents are shown higher odds to have undiagnosed hypertension. Likewise, the likelihood of having known hypertension has been found to increase among the elderly and other Bumiputra.

          Conclusion

          Through this research, significant predictors which consist of obese and overweight respondents, current drinkers, older respondents (above 65 years old) and primary educated respondents are having higher likelihood to have undiagnosed hypertension.

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          Diet and lifestyle risk factors associated with incident hypertension in women.

          John P. Forman, Meir J. Stampfer, Gary Curhan (2009)
          Hypertension is an important preventable risk factor for death among women. While several modifiable risk factors have been identified, their combined risk and distribution in the population have not been assessed. To estimate the hypothetical fraction of hypertension incidence associated with dietary and lifestyle factors in women. Prospective cohort study of 83,882 adult women aged 27 to 44 years in the second Nurses' Health Study who did not have hypertension, cardiovascular disease, diabetes, or cancer in 1991, and who had normal reported blood pressure (defined as systolic blood pressure of or = 400 microg/d) low-risk factors and the risk of developing hypertension was analyzed. Adjusted hazard ratios for incident self-reported hypertension and population attributable risks (PARs). A total of 12,319 incident cases of hypertension were reported. All 6 modifiable risk factors were independently associated with the risk of developing hypertension during follow-up after also adjusting for age, race, family history of hypertension, smoking status, and use of oral contraceptives. For women who had all 6 low-risk factors (0.3% of the population), the hazard ratio for incident hypertension was 0.22 (95% confidence interval [CI], 0.10-0.51); the hypothetical PAR was 78% (95% CI, 49%-90%) for women who lacked these low-risk factors. The corresponding hypothetical absolute incidence rate difference (ARD) was 8.37 cases per 1000 person-years. The PARs were 72% (95% CI, 57%-82%; ARD, 7.76 cases per 1000 person-years) for 5 low-risk factors (0.8% of the population), 58% (95% CI, 46%-67%; ARD, 6.28 cases per 1000 person-years) for 4 low-risk factors (1.6% of the population), and 53% (95% CI, 45%-60%; ARD, 6.02 cases per 1000 person-years) for 3 low-risk factors (3.1% of the population). Body mass index alone was the most powerful predictor of hypertension, with a BMI of 25 or greater having an adjusted PAR of 40% (95% CI, 38%-41%) compared with a BMI of less than 25. Adherence to low-risk dietary and lifestyle factors was associated with a significantly lower incidence of self-reported hypertension. Adopting low-risk dietary and lifestyle factors has the potential to prevent a large proportion of new-onset hypertension occurring among young women.
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            Prevalence of Hypertension in China: A Cross-Sectional Study

            Yun-Ying Gao, Gang Chen, Haoming Tian … (2013)
            Aims The present study aimed to assess the prevalence of hypertension among Chinese adults. Methods Data were obtained from sphygmomanometer measurements and a questionnaire administered to 46239 Chinese adults ≥20 years of age who participated in the 2007–2008 China National Diabetes and Metabolic Disorders Study. Hypertension was defined as blood pressure ≥140/90 mm Hg or use of antihypertensive medication. Results A total of 26.6% of Chinese adults had hypertension, and a significantly greater number of men were hypertensive than women (29.2% vs 24.1%, p<0.001). The age-specific prevalence of hypertension was 13.0%, 36.7%, and 56.5% among persons aged 20 to 44 years (young people), 45 to 64 years (middle-aged people), and ≥65 years (elderly people), respectively. In economically developed regions, the prevalence of hypertension was significantly higher among rural residents than among urban residents (31.3% vs 29.2%, p = 0.001). Among women or individuals who lived in the northern region, the disparity in the prevalence of hypertension between urban and rural areas disappeared (women: 24.0% vs. 24.0%, p = 0.942; northern region: 31.6% vs. 31.2%, p = 0.505). Among hypertensive patients, 45.0% were aware of their condition, 36.2% were treated, and 11.1% were adequately controlled. Conclusions The prevalence of hypertension in China is increasing. The trend of an increase in prevalence is striking in young people and rural populations. Hypertension awareness, treatment, and control are poor. Public health efforts for further improving awareness and enhancing effective control are urgently needed in China, especially in emerging populations.
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              Country actions to meet UN commitments on non-communicable diseases: a stepwise approach.

              C J Hospedales, Deborah Malta, Kavumpurathu Thankappan … (2013)
              Strong leadership from heads of state is needed to meet national commitments to the UN political declaration on non-communicable diseases (NCDs) and to achieve the goal of a 25% reduction in premature NCD mortality by 2025 (the 25 by 25 goal). A simple, phased, national response to the political declaration is suggested, with three key steps: planning, implementation, and accountability. Planning entails mobilisation of a multisectoral response to develop and support the national action plan, and to build human, financial, and regulatory capacity for change. Implementation of a few priority and feasible cost-effective interventions for the prevention and treatment of NCDs will achieve the 25 by 25 goal and will need only few additional financial resources. Accountability incorporates three dimensions: monitoring of progress, reviewing of progress, and appropriate responses to accelerate progress. A national NCD commission or equivalent, which is independent of government, is needed to ensure that all relevant stakeholders are held accountable for the UN commitments to NCDs. Copyright © 2013 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Malays J Med Sci
                Journal ID (iso-abbrev): Malays J Med Sci
                Journal ID (publisher-id): Malaysian Journal of Medical Sciences
                Title: The Malaysian Journal of Medical Sciences : MJMS
                Publisher: Penerbit Universiti Sains Malaysia
                ISSN (Print): 1394-195X
                ISSN (Electronic): 2180-4303
                Publication date (Print): September 2019
                Publication date (Electronic): 04 November 2019
                Volume: 26
                Issue: 5
                Pages: 98-112
                Affiliations
                [1 ]Malaysia Foundation Programme, Heriot-Watt University Malaysia, Putrajaya, Malaysia
                [2 ]Faculty of Economics and Administration University of Malaya, Kuala Lumpur, Malaysia
                Author notes
                Correspondence: Dr Lim Ooi Wei, PhD in Health Economics (University Malaya, Malaysia), Assistant Professor, Malaysia Foundation Programme, Heriot-Watt University Malaysia, No. 1, Venna P5/2, Precint 5, 62200 Putrajaya, Malaysia. Tel: +603 8894 3714, Fax: +603 8894 3999, E-mail: ms.erinlim@ 123456gmail.com
                Article
                Publisher ID: 09mjms26052019_oa6
                DOI: 10.21315/mjms2019.26.5.9
                PMC ID: 6839659
                PubMed ID: 31728122
                SO-VID: 4a0bcf41-b209-49d0-910b-2e4658682724
                Copyright © © Penerbit Universiti Sains Malaysia, 2019
                License:

                This work is licensed under the terms of the Creative Commons Attribution (CC BY) ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 11 June 2019
                Date accepted : 14 September 2019
                Categories
                Subject: Original Article

                Keywords: undiagnosed hypertension,known hypertension,modifiable risk factors,non-modifiable risk factors
                Data availability:
                Keywords: undiagnosed hypertension, known hypertension, modifiable risk factors, non-modifiable risk factors

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