Hypertension: Its prevalence and population-attributable fraction for mortality from cardiovascular disease in the Asia-Pacific region

Alexandra Lc Martiniuk, Crystal My Lee, Carlene M M Lawes, Hirotsugu Ueshima, Il Suh, Tai Hing Lam, Dongfeng Gu, Valery Feigin, Konrad Jamrozik, Takayoshi Ohkubo, Mark Woodward

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: About half of the world's burden of cardiovascular disease is carried by countries in the Asia-Pacific region. This study aimed to quantify the contribution of hypertension to cardiovascular diseases (CVD) at the country level, by calculating the sex-specific, population-attributable fractions (PAFs) for fatal ischaemic heart disease (IHD) and stroke (haemorrhagic and ischaemic) for the World Health Organization Western Pacific and South-east Asian regions. METHODS: The most recent sex-specific prevalence data on hypertension were sought. Age-adjusted hazard ratio (HR) estimates for fatal IHD and stroke associated with hypertension were obtained using Cox analyses of individual participant cohort data from 600 000 adult participants in the Asia-Pacific Cohort Studies Collaboration. HR estimates and prevalence were then used to calculate sex-specific PAFs for fatal IHD and stroke, by country. RESULTS: In 15 countries with available data, the prevalence of hypertension ranged from 5-47% in men and from 7-38% in women. Overall, the fraction of IHD attributable to hypertension ranged from 4-28% in men and from 8-39% in women. Corresponding ranges for haemorrhagic stroke were 18-66% and 15-49%, and for ischaemic stroke were 8-44% and 12-45%. CONCLUSIONS: In the Asia-Pacific region, up to 66% of some subtypes of CVD can be attributed to hypertension, underscoring the immense impact that blood pressure- lowering strategies could have in this populous region.

Original languageEnglish (US)
Pages (from-to)73-79
Number of pages7
JournalJournal of Hypertension
Volume25
Issue number1
DOIs
StatePublished - Jan 2007
Externally publishedYes

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Cardiovascular Diseases
Hypertension
Stroke
Myocardial Ischemia
Mortality
Population
Cohort Studies
Blood Pressure

Keywords

  • Attributable fraction
  • Heart disease
  • Hypertension
  • South-east Asia
  • Stroke
  • Western Pacific

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology

Cite this

Hypertension : Its prevalence and population-attributable fraction for mortality from cardiovascular disease in the Asia-Pacific region. / Martiniuk, Alexandra Lc; Lee, Crystal My; Lawes, Carlene M M; Ueshima, Hirotsugu; Suh, Il; Lam, Tai Hing; Gu, Dongfeng; Feigin, Valery; Jamrozik, Konrad; Ohkubo, Takayoshi; Woodward, Mark.

In: Journal of Hypertension, Vol. 25, No. 1, 01.2007, p. 73-79.

Research output: Contribution to journalArticle

Martiniuk, AL, Lee, CM, Lawes, CMM, Ueshima, H, Suh, I, Lam, TH, Gu, D, Feigin, V, Jamrozik, K, Ohkubo, T & Woodward, M 2007, 'Hypertension: Its prevalence and population-attributable fraction for mortality from cardiovascular disease in the Asia-Pacific region', Journal of Hypertension, vol. 25, no. 1, pp. 73-79. https://doi.org/10.1097/HJH.0b013e328010775f
Martiniuk, Alexandra Lc ; Lee, Crystal My ; Lawes, Carlene M M ; Ueshima, Hirotsugu ; Suh, Il ; Lam, Tai Hing ; Gu, Dongfeng ; Feigin, Valery ; Jamrozik, Konrad ; Ohkubo, Takayoshi ; Woodward, Mark. / Hypertension : Its prevalence and population-attributable fraction for mortality from cardiovascular disease in the Asia-Pacific region. In: Journal of Hypertension. 2007 ; Vol. 25, No. 1. pp. 73-79.
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AU - Lee, Crystal My

AU - Lawes, Carlene M M

AU - Ueshima, Hirotsugu

AU - Suh, Il

AU - Lam, Tai Hing

AU - Gu, Dongfeng

AU - Feigin, Valery

AU - Jamrozik, Konrad

AU - Ohkubo, Takayoshi

AU - Woodward, Mark

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N2 - OBJECTIVE: About half of the world's burden of cardiovascular disease is carried by countries in the Asia-Pacific region. This study aimed to quantify the contribution of hypertension to cardiovascular diseases (CVD) at the country level, by calculating the sex-specific, population-attributable fractions (PAFs) for fatal ischaemic heart disease (IHD) and stroke (haemorrhagic and ischaemic) for the World Health Organization Western Pacific and South-east Asian regions. METHODS: The most recent sex-specific prevalence data on hypertension were sought. Age-adjusted hazard ratio (HR) estimates for fatal IHD and stroke associated with hypertension were obtained using Cox analyses of individual participant cohort data from 600 000 adult participants in the Asia-Pacific Cohort Studies Collaboration. HR estimates and prevalence were then used to calculate sex-specific PAFs for fatal IHD and stroke, by country. RESULTS: In 15 countries with available data, the prevalence of hypertension ranged from 5-47% in men and from 7-38% in women. Overall, the fraction of IHD attributable to hypertension ranged from 4-28% in men and from 8-39% in women. Corresponding ranges for haemorrhagic stroke were 18-66% and 15-49%, and for ischaemic stroke were 8-44% and 12-45%. CONCLUSIONS: In the Asia-Pacific region, up to 66% of some subtypes of CVD can be attributed to hypertension, underscoring the immense impact that blood pressure- lowering strategies could have in this populous region.

AB - OBJECTIVE: About half of the world's burden of cardiovascular disease is carried by countries in the Asia-Pacific region. This study aimed to quantify the contribution of hypertension to cardiovascular diseases (CVD) at the country level, by calculating the sex-specific, population-attributable fractions (PAFs) for fatal ischaemic heart disease (IHD) and stroke (haemorrhagic and ischaemic) for the World Health Organization Western Pacific and South-east Asian regions. METHODS: The most recent sex-specific prevalence data on hypertension were sought. Age-adjusted hazard ratio (HR) estimates for fatal IHD and stroke associated with hypertension were obtained using Cox analyses of individual participant cohort data from 600 000 adult participants in the Asia-Pacific Cohort Studies Collaboration. HR estimates and prevalence were then used to calculate sex-specific PAFs for fatal IHD and stroke, by country. RESULTS: In 15 countries with available data, the prevalence of hypertension ranged from 5-47% in men and from 7-38% in women. Overall, the fraction of IHD attributable to hypertension ranged from 4-28% in men and from 8-39% in women. Corresponding ranges for haemorrhagic stroke were 18-66% and 15-49%, and for ischaemic stroke were 8-44% and 12-45%. CONCLUSIONS: In the Asia-Pacific region, up to 66% of some subtypes of CVD can be attributed to hypertension, underscoring the immense impact that blood pressure- lowering strategies could have in this populous region.

KW - Attributable fraction

KW - Heart disease

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KW - South-east Asia

KW - Stroke

KW - Western Pacific

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