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Regional Variation In Chronic Kidney Disease And Associated Factors In Hypertensive Individuals In Rural South Asia: Findings From Control Of Blood Pressure And Risk Attenuation-Bangladesh, Pakistan And Sri Lanka, Liang Feng, Hithanadura Asita De Silva, Imtiaz Jehan, Anuradhani Kasturiratne, Gulshan Himani, Mohammad Abul Hasnat, Tazeen Jafar, Cobra-Bps Study Group

Community Health Sciences

Background: We aimed to determine the prevalence of chronic kidney disease (CKD) and its cross-country variation among hypertensive individuals in rural Bangladesh, Pakistan and Sri Lanka. We also explored the factors associated with CKD in these populations.
Method: We studied baseline data from the Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan and Sri Lanka (COBRA-BPS) trial, an ongoing cluster randomized controlled trial on 2643 hypertensive adults ≥40 years of age from 30 randomly selected rural clusters, 10 in each of the three countries. CKD was defined as an estimated glomerular filtration rate (eGFR) /min/1.73 m2 or a urine albumin:creatinine …

Prevalence And Correlates Of Cardiometabolic Multimorbidity Among Hypertensive Individuals: A Cross-Sectional Study In Rural South Asia—Bangladesh, Pakistan And Sri Lanka, Liang Feng, Imtiaz Jehan, H Asita De Silva, Aliya Naheed, Hamida Farazdaq, Samina Hirani Samina Hirani, Anuradhani Kasturiratne, Channa D. Ranasinha, Md Tauhidul Islam, Ali Tanweer Siddiquee, Tazeen Jafar

Community Health Sciences

Objective: To determinate the prevalence and correlates of cardiometabolic multimorbidity (CMM), and their cross-country variation among individuals with hypertension residing in rural communities in South Asia.
Design: A cross-sectional study.
Setting: Rural communities in Bangladesh, Pakistan and Sri Lanka.
Participants: A total of 2288 individuals with hypertension aged ≥40 years from the ongoing Control of Blood Pressure and Risk Attenuation- Bangladesh, Pakistan and Sri Lanka clinical trial.
Main outcome measures: CMM was defined as the presence of ≥2 of the conditions: diabetes, chronic kidney disease, heart disease and stroke. Logistic regression was done to evaluate the correlates of CMM.
Results: …

Determinants Of Uncontrolled Hypertension In Rural Communities In South Asia-Bangladesh, Pakistan, And Sri Lanka, Tazeen Jafar, Mihir Gandhi, Imtiaz Jehan, Aliya Naheed, H Asita De Silva, Hunaina Shahab, Dewan Alam, Nathasha Luke, Ching Wee Lim Wee Lim, Cobra-Bps Study Group

Community Health Sciences

Background: Uncontrolled blood pressure (BP) is a leading risk factor for death and disability in South Asia. We aimed to determine the cross-country variation, and the factors associated with uncontrolled BP among adults treated for hypertension in rural South Asia.
Methods: We enrolled 1718 individuals aged ≥40 years treated for hypertension in a cross-sectional study from rural communities in Bangladesh, Pakistan, and Sri Lanka. Multivariable logistic regression model was used to determine the factors associated with uncontrolledBP (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg).
Results: Among hypertensive individuals, 58.0% (95% confidence interval 55.7, 60.4) had uncontrolled BP: 52.8% …

Multicomponent Intervention Versus Usual Care For Management Of Hypertension In Rural Bangladesh, Pakistan And Sri Lanka: Study Protocol For A Cluster Randomized Controlled Trial., Tazeen H. Jafar, Imtiaz Jehan, H. Asita De Silva, Aliya Naheed, Mihir Gandhi, Pryseley Assam, Eric A. Finkelstein, Helena Legido Quigley, Marcel Bilger, Aamir Hameed, John David Clemens, Shah Ebrahim, Elizabeth L. Turner, Anuradhani Kasturiratne

Community Health Sciences

BACKGROUND:

High blood pressure (BP) is the leading attributable risk for cardiovascular disease (CVD). In rural South Asia, hypertension continues to be a significant public health issue with sub-optimal BP control rates. The goal of the trial is to compare a multicomponent intervention (MCI) to usual care to evaluate the effectiveness and cost-effectiveness of the MCI for lowering BP among adults with hypertension in rural communities in Bangladesh, Pakistan and Sri Lanka.

METHODS/DESIGN:

This study is a stratified, cluster randomized controlled trial with a qualitative component for evaluation of processes and stakeholder feedback. The MCI has five components: (1) home …

Comparison Of Multiple Obesity Indices For Cardiovascular Disease Risk Classification In South Asian Adults: The Carrs Study., Shivani A. Patel, Mohan Deepa, Roopa Shivashankar, Mohammed K. Ali, Deksha Kapoor, Ruby Gupta, Dorothy Lall, Nikhil Tandon, Viswanathan Mohan, Muhammad Masood Kadir, Zafar Fatmi, Dorairaj Prabhakaran, K. M. Venkat Narayan

Community Health Sciences

BACKGROUND:

We comparatively assessed the performance of six simple obesity indices to identify adults with cardiovascular disease (CVD) risk factors in a diverse and contemporary South Asian population.

METHODS:

8,892 participants aged 20-60 years in 2010-2011 were analyzed. Six obesity indices were examined: body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), log of the sum of triceps and subscapular skin fold thickness (LTS), and percent body fat derived from bioelectric impedance analysis (BIA). We estimated models with obesity indices specified as deciles and as continuous linear variables to predict prevalent hypertension, diabetes, and high cholesterol …

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., Benjamin Palafox, Martin Mckee, Dina Balabanova, Khalid F. Khalid, Alvaro Jr Avezum, Ahmad Bahonar, Noorhassim Noorhassim, Jephat Chifamba, Clara K. Chow, Daniel J. Corsi, Gilles R. Dagenais, Rafael Diaz, Rajeev Gupta, Romaina Iqbal, Manmeet Kaur, Rasha Khatib, Annamarie Kruger, Iolanthe Marike Kruger, Fernando Lanas, Patricio Lopez-Jaramillo, Fu Minfan, Viswanathan Mohan, Prem K. Mony, Aytekin Oguz, Lia M. Palileo-Villanueva, Pablo Perel, Paul Poirier, Sumathy Rangarajan, Lei Rensheng, Annika Rosengren, Biju Soman, David Stuckler, S. V. Subramania, Koon Teo, Lungiswa P. Tsolekile, Andreas Wielgosz, Peng Yaguang, Karen Yeates, Mo Yongzhen, Khalid Yusoff, Rita Yusuf, Afzalhussein Yusufali, Katarzyna Zatońska, Salim Yusuf

Community Health Sciences

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 …