Aging and hypertension among the global poor—Panel data evidence from Malawi

Author:

Kohler Iliana V.ORCID,Sudharsanan NikkilORCID,Bandawe Chiwoza,Kohler Hans-Peter

Abstract

Hypertension is a rapidly growing disease burden among older persons in low-income countries (LICs) that is often inadequately diagnosed and treated. Yet, most LIC research on hypertension is based on cross-sectional data that does not allow inferences about the onset or persistence of hypertension, its correlates, and changes in hypertension as individuals become older. The Mature Adults Cohort of the Malawi Longitudinal Study of Families and Health (MLSFH-MAC) is used to provide among the first panel analyses of hypertension for older individuals in a sub-Saharan LIC using blood pressure measurements obtained in 2013 and 2017. We find that high blood pressure is very common among mature adults aged 45+, and hypertension is more prevalent among older as compared to middle-aged respondents. Yet, in panel analyses for 2013–17, we find no increase in the prevalence of hypertension as individuals become older. Hypertension often persists over time, and the onset of hypertension is predicted by factors such as being overweight/obese, or being in poor physical health. Otherwise, however, hypertension has few socioeconomic predictors. There is also no gender differences in the level, onset or persistence in hypertension. While hypertension is associated with several negative health or socioeconomic consequences in longitudinal analyses, cascade-of-care analyses document significant gaps in the diagnosis and treatment of hypertension. Overall, our findings indicate that hypertension and related high cardiovascular risks are widespread, persistent, and often not diagnosed or treated in this rural sub-Saharan population of older individuals. Prevalence, onset and persistence of hypertension are common across all subgroups—including, importantly, both women and men. While age is an important predictor of hypertension risk, even in middle ages 45–55 years, hypertension is already widespread. Hypertension among adults aged 45+ in Malawi is thus more similar to a “generalized epidemic” than in high-income countries where cardiovascular risk has strong socioeconomic gradients.

Funder

National Institute of Child Health and Human Development

National Institute on Aging

SNF

Publisher

Public Library of Science (PLoS)

Reference51 articles.

1. Worldwide trends in blood pressure from 1975 to 2015: A pooled analysis of 1479 population-based measurement studies with 19.1 million participants;NCD Risk Factor Collaboration (NCD-RisC);Lancet,2017

2. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants;Collaboration (NCD-RisC) NCD Risk Factor;Lancet,2021

3. The state of hypertension care in 44 low-income and middle-income countries: a cross-sectional study of nationally representative individual-level data from 1.1 million adults;P Geldsetzer;Lancet,2019

4. The Economist. Daily chart: The curious case of high blood pressure around the world. Economist. 2017. Available from: https://www.economist.com/graphic-detail/2017/01/13/the-curious-case-of-high-blood-pressure-around-the-world

5. United Nations Population Division. World Population Prospects, the 2019 Revision; 2019. Available from: https://population.un.org/wpp/.

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3