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Current Hypertension Reports
Published in: Current Hypertension Reports 5/2018

01-05-2018 | Blood Pressure Monitoring and Management (J Cockcroft, Section Editor)

Hypertension in Developing Countries: A Major Challenge for the Future

Author: M Mohsen Ibrahim

Published in: Current Hypertension Reports | Issue 5/2018

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Abstract

Purpose of Review

Outline recent epidemiologic data regarding hypertension in developing countries, distinguish differences from developed countries, and identify challenges in management and future perspectives.

Recent Findings

Increased sugar intake, air and noise pollution, and low birth weight are emerging hypertension risk factors. The major challenges in management are difficulties in accurate diagnosis of hypertension and adequate blood pressure control.

Summary

In contrast to developed countries, hypertension prevalence rates are on the rise in developing countries with no improvement in awareness or control rates. The increasing burden of hypertension is largely attributable to behavioral factors, urbanization, unhealthy diet, obesity, social stress, and inactivity. Health authorities, medical societies, and drug industry can collaborate to improve hypertension control through education programs, public awareness campaigns, legislation to limit salt intake, encourage generic drugs, development and dissemination of national guidelines, and involving nurses and pharmacists in hypertension management. More epidemiologic data are needed in the future to identify reasons behind increased prevalence and poor blood pressure control and examine trends in prevalence, awareness, treatment, and control. National programs for better hypertension control based on local culture, economic characteristics, and available resources in the population are needed. The role of new tools for hypertension management should be tested in developing world.
Literature
1.
•• Danaei G, Finucane MM, Lin JK, Singh GM, Paciorek CJ, Cowan MJ, et al. National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5·4 million participants. Lancet. 2011;377(9765):568–77. Data for trends in blood pressure in 199 countries and territories from health surveys and epidemiologic studies. Authors estimated worldwide trends in population mean systolic blood pressure.
2.
Agyemang C, Bruijnzeels MA, Owusu-Dabo E. Factors associated with hypertension awareness, treatment, and control in Ghana, West Africa. J Hum Hypertens. 2005;20(1):67–71.CrossRef
3.
• Bernabé-Ortiz A, Carrillo-Larco RM, Gilman RH, Checkley W, Smeeth L, Miranda JJ, et al. Impact of urbanisation and altitude on the incidence of, and risk factors for hypertension. Heart. 2017;103(11):827–33. Data from the CRONICAS cohort study. Urbanization can negatively affect population health.
4.
Godfrey R, Julien M. Urbanisation and health. Clin Med (Lond) 2005; 5(2):137–141.
5.
Danaei G, Singh GM, Paciorek CJ, Lin JK, Cowan MJ, Finucane MM, et al. The global cardiovascular risk transition: associations of four metabolic risk factors with national income, urbanization, and Western diet in 1980 and 2008. Circulation. 2013;127:1493–502.
6.
Zeba AN, Yaméogo MT, Tougouma SJ, Kassié D, Fournet F. Can urbanization, social and spatial disparities help to understand the rise of cardiometabolic risk factors in Bobo-Dioulasso? A study in a secondary city of Burkina Faso, West Africa. Int J Environ Res Public Health. 2017;14(4):378.
7.
• Mannucci PM, Franchini M. Health effects of ambient air pollution in developing countries. Int J Environ Res Public Health. 2017;14(9):1048–56. Review of the deleterious effects of ambient air pollution in financially deprived population. Both outdoor and indoor air pollutions pose a threat to human health. CrossRefPubMedCentral
8.
Ezejimofor MC, Uthman OA, Maduka O, Ezeabasili AC, Onwuchekwa AC, Ezejimofor BC, et al. The burden of hypertension in an oil- and gas-polluted environment: a comparative cross-sectional study. Am J Hypertens. 2016 Aug;29(8):925–33.
9.
Dong GH, Qian ZM, Xaverius PK, Trevathan E, Maalouf S, Parker J, et al. Association between long-term air pollution and increased blood pressure and hypertension in China. Hypertension. 2013 Mar;61(3):578–84.
10.
Shrestha A, Shiqi M. Occupational noise exposure in relation to hypertension: a cross-sectional study in the steel factory. Occup Med Health Aff. 2017;5:306–16.CrossRef
11.
12.
Ediriweera DS, Dilina N, Perera U, Flores F, Samita S. Risk of low birth weight on adulthood hypertension—evidence from a tertiary care hospital in a South Asian country, Sri Lanka: a retrospective cohort study. BMC Public Health. 2017;17(1):358.CrossRefPubMedPubMedCentral
13.
• Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global disparities of hypertension prevalence and control a systematic analysis of population-based studies from 90 countries. Circulation. 2016;134:441–50. This is an analysis of population-based studies from 90 countries showing that global disparities are large and increasing.
14.
•• Chow CK, Teo KK, Rangarajan S, Islam S, Gupta R, Avezum A, et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA. 2013;310(9):959–68. A cross-sectional study of 153996 adults from 628 communities in high, middle, and low-income countries. There were differences in hypertension awareness, treatment, and control rates between high- and low-income countries.
15.
16.
Joffres M, Falaschetti E, Gillespie C, Robitaille C, Loustalot F, Poulter N, et al. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: a cross-sectional study. BMJ Open. 2013;3(8):e003423.
17.
Hussain MA, Al Mamun A, Peters SA, Woodward M, Huxley RR. The burden of cardiovascular disease attributable to major modifiable risk factors in Indonesia. J Epidemiol. 2016;26(10):515–21.CrossRefPubMedPubMedCentral
18.
Wang J, Zhang L, Wang F, Liu L, Wang H, China National Survey of Chronic Kidney Disease Working Group. Prevalence, awareness, treatment, and control of hypertension in China: results from a national survey. Am J Hypertens. 2014;27(11):1355–61.CrossRefPubMedPubMedCentral
19.
Irazola VE, Gutierrez L, Bloomfield GS, Carrillo-Larco RM, Prabhakaran D, Gaziano T, et al. Hypertension prevalence, awareness, treatment, and control in selected communities of nine low- and middle income countries: results from the NHLBI/UHG network of centers of excellence for chronic diseases. Glob Heart. 2016;11(1):47–59.
20.
•• Popkin BM. Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr. 2006;84:289–98. Author discusses the nutrition transition, obesity prevalence, and trends in higher and lower income countries. There are higher intakes of animal and partially hydrogenated fats and lower intakes of fibers and reduced energy expenditure. PubMedCrossRef
21.
• Siervo M, Montagnese C, Mathers JC, Soroka KR, Stephan BC, Wells JC. Sugar consumption and global prevalence of obesity and hypertension: an ecological analysis. Public Health Nutr. 2014;17(3):587–96. Information from 72 countries. Consumption of sugar and animal products were directly associated with GDP and urbanization rates. Prevalence of overweight and consumption of cereals were significantly predictors of hypertension. CrossRefPubMed
22.
Noubiap JJ, Bigna JJ, Nansseu JR. Low sodium and high potassium intake for cardiovascular prevention: evidence revisited with emphasis on challenges in sub-Saharan Africa. J Clin Hypertens (Greenwich). 2015;17(1):81–3.CrossRef
23.
Luma GB, Spiotta RT. Hypertension in children and adolescents. Am Fam Physician. 2006;73:1558–68.PubMed
24.
Önsüz FM, Demir F. Prevalence of hypertension and its association with obesity among school children aged 6-15 living in Sakarya Province in Turkey. Turk J Med Sci. 2015;45(4):907–12.CrossRefPubMed
25.
Te Morenga LA, Howatson AJ, Jones RM, Mann J. Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids. Am J Clin Nutr. 2014;100(1):65–79.CrossRef
26.
Malik AH, Akram Y, Shetty S, Malik SS, Yanchou Njike V. Impact of sugar-sweetened beverages on blood pressure. Am J Cardiol. 2014;113(9):1574–80.CrossRefPubMed
27.
• Brown IJ, Stamler J, Van Horn L, et al. Sugar-sweetened beverage, sugar intake of individuals and their blood pressure: INTERMAP Study. Hypertension. 2011;57(4):695–701. Authors report cross-sectional associations of sugar-sweetened beverages, diet beverages, and sugars with blood pressure in an international study. There were significant sugar-sodium interactions. CrossRefPubMedPubMedCentral
28.
Johnson RJ, Segal MS, Sautin Y, Nakagawa T, Feig DI, Kang DH, et al. Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease. Am J Clin Nutr. 2007;86(4):899–906.
29.
Schmidhuber J, Shetty P. The nutrition transition to 2030. Why developing countries are likely to bear the major burden. Acta Agric Scand Sect C Food Econ. 2005;2(3–4):150–66.
30.
Ruxton CH, Gardner EJ, McNulty HM. Is sugar consumption detrimental to health? A review of the evidence 1995–2006. Crit Rev Food Sci Nutr. 2010;50(1):1–19.CrossRefPubMed
31.
Johnson RK, Appel LJ, Brands M, Howard BV, Lefevre M, Lustig RH, et al. Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation. 2009;120(11):1011–20.
32.
Lee AC, Katz J, Blencowe H, Cousens S, Kozuki N, Vogel JP, et al. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010. Lancet Glob Health. 2013;1(1):e26–36.
33.
34.
Law CM, Egger P, Dada O, Delgado H, Kylberg E, Lavin P, et al. Body size at birth and blood pressure among children in developing countries. Int J Epidemiol. 2001;30(1):52–7.
35.
36.
Sliwa K, Stewart S. A low-cost solar-powered blood-pressure device. Lancet. 2011;378(9792):647–8.CrossRefPubMed
37.
Krause T, Lovibond K, Caulfield M, McCormack T, Williams B, Guideline Development Group. Management of hypertension: summary of NICE guidance. BMJ. 2011;343:d4891.CrossRefPubMed
38.
•• Gabb GM, Mangoni AA, Anderson CS, Cowley D, Dowden JS, Golledge J, et al. Guideline for the diagnosis and management of hypertension in adults—2016. Med J Aust. 2016;25(2):85–9. Update of the Australian guidelines for the management of hypertension. There are changes in management as a result of guidelines which include ambulatory and/or home blood pressure monitoring and lower blood pressure target for high risk patients.
39.
• Leung AA, Daskalopoulou SS, Dasgupta K, McBrien K, Butalia S, Zarnke KB, et al. Hypertens Canada’s 2017 GUIDELINES for diagnosis, risk assessment, prevention, and treatment of hypertension in adults. Can J Cardiol. 2017;33(5):557–76. The Canadian guidelines are updated every year. The most recent 2017 guidelines recommend automated office blood pressure for hypertension diagnosis and combination drug therapy as initial step in pharmacologic management.
40.
Campbell NR, Berbari AE, Cloutier L, Gelfer M, Kenerson JG, Khalsa TK, et al. Policy statement of the world hypertension league on noninvasive blood pressure measurement devices and blood pressure measurement in the clinical or community setting. J Clin Hypertens (Greenwich). 2014;16(5):320–2.
41.
World Health Organization. Affordable technology, blood pressure measuring devices for low resource settings. Report 1-26. Geneva: World Health Organization; 2005.
42.
Adeloye D, Basquill C. Estimating the prevalence and awareness rates of hypertension in Africa: a systematic analysis. Schnabel RB, ed. PLoS One. 2014;9(8):e104300.CrossRefPubMedPubMedCentral
43.
Devkota S, Dhungana RR, Pandey AR, Bista B, Panthi S, Thakur KK, et al. Barriers to treatment and control of hypertension among hypertensive participants: a community-based cross-sectional mixed method study in municipalities of Kathmandu, Nepal. Front Cardiovasc Med. 2016;3:26. https://​doi.​org/​10.​3389/​fcvm.​2016.​00026.
44.
Marshall IJ, Wolfe CD, McKevitt C. Lay perspectives on hypertension and drug adherence: systematic review of qualitative research. BMJ. 2012;344:e3953.CrossRef
45.
Risso-Gill I, Balabanova D, Majid F, Ng KK, Yusoff K, Mustapha F, et al. Understanding the modifiable health systems barriers to hypertension management in Malaysia: a multi-method health systems appraisal approach. BMC Health Serv Res. 2015;15:254.
46.
•• Attaei MW, Khatib R, McKee M, Lear S, Dagenais G, Igumbor EU, et al. Availability and affordability of blood pressure-lowering medicines and the effect on blood pressure control in high-income, middle-income, and low-income countries: an analysis of the PURE study data. Lancet Public Health. 2017;2(9):e411–9. Authors analyzed the availability, costs, and affordability of blood pressure-lowering medicines and blood pressure control in 20 countries participating in the PURE study. A large proportion of communities in low-income and middle-income countries do not have access to affordable therapy.
47.
• Agarwal R, Bills JE, Hecht TJ, Light RP. Role of home blood pressure monitoring in overcoming therapeutic inertia and improving hypertension control: a systematic review and meta-analysis. Hypertension. 2011;57(1):29–38. Blood pressure improved with home-based blood pressure monitoring and to more frequent antihypertensive medication reductions. An important study supporting home blood pressure monitoring for management of hypertension. CrossRefPubMed
48.
Angell S, Guthartz S, Dalal M, Foster V, Pogue V, Wei A, et al. Integrating self blood pressure monitoring into the routine management of uncontrolled hypertension: translating evidence to practice. J Clin Hypertens. 2013;15:180–5.
49.
Anderson C, Dadabhai S, Damasceno A, Dzudie A, Islam SMS, Kamath D, et al. Home blood pressure management intervention in low- to middle-income countries: protocol for a mixed methods study. JMIR Res Protoc. 2017;6(10):e188.
50.
Piette JD, Datwani H, Gaudioso S, Foster SM, Westphal J, Perry W, et al. Hypertension management using mobile technology and home blood pressure monitoring: results of a randomized trial in two low/middle-income countries. Telemed J E Health. 2012;18(8):613–20.
51.
• McManus RJ, Mant J, Haque MS, Bray EP, Bryan S, Greenfield SM, et al. Effect of self-monitoring and medication self-titration on systolic blood pressure in hypertensive patients at high risk of cardiovascular disease: the TASMIN-SR randomized clinical trial. JAMA. 2014;312(8):799–808. Authors study the effects of self-monitoring with self-titration of antihypertensive medication in high-risk hypertensive patients. This approach resulted in lower systolic blood pressure at 12 months.
52.
Choudhry NK, Denberg TD, Qaseem A. Improving adherence to therapy and clinical outcomes while containing costs: opportunities from the greater use of generic medications: best practice advice from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. 2016;164:41–9.CrossRefPubMed
53.
HE J, Irazola V, Mills KT, Poggio R, et al. Effect of a community health worker-led multicomponent intervention on blood pressure control in low-income patients in Argentina: a randomized clinical trial. JAMA. 2017;318:1016–25.CrossRefPubMedPubMedCentral
54.
• Himmelfarb CR, Commodore-Mensah Y, Hill MN. Expanding the role of nurses to improve hypertension care and control globally. Ann Glob Health. 2016;82(2):243–53. This is a state-of-the-art review outlining the role of nurses in hypertension management involving all aspects of care. Multi-disciplinary team improves care processes and control rates. CrossRefPubMed
55.
Kengne AP, Awah PK, Fezeu LL, Sobngwi E, Mbanya JC. Primary health care for hypertension by nurses in rural and urban sub-Saharan Africa. J Clin Hypertens (Greenwich). 2009;11(10):564–72.CrossRef
56.
Garcia-Peña C, Thorogood M, Armstrong B, Reyes-Frausto S, Muñoz O. Pragmatic randomized trial of home visits by a nurse to elderly people with hypertension in Mexico. Int J Epidemiol. 2001;30(6):1485–91.CrossRefPubMed
57.
Santschi V, Chiolero A, Burnand B, Colosimo AL, Paradis G. Impact of pharmacist care in the management of cardiovascular disease risk factors: a systematic review and meta-analysis of randomized trials. Arch Intern Med. 2011;171:1441–53.CrossRefPubMed
58.
Carter BL, Bosworth HB, Green BB. The hypertension team: the role of the pharmacist, nurse, and teamwork in hypertension therapy. J Clin Hypertens (Greenwich). 2012;14(1):51–65.CrossRef
59.
• Nielsen JØ, Shrestha AD, Neupane D, Kallestrup P. Non-adherence to anti-hypertensive medication in low- and middle-income countries: a systematic review and meta-analysis of 92443 subjects. J Hum Hypertens. 2017;31(1):14–21. This is a review of 22 studies using medical adherence scale. There is considerable variation of non-adherence to antihypertensive medication in low- and middle-income countries depending upon the methods used to estimate non-adherence. CrossRefPubMed
60.
•• Burnier M, Wuerzner G, Struijker-Boudier H, Urquhart J. Measuring, analyzing, and managing drug adherence in resistant hypertension. Hypertension. 2013;62:218–25. The review discusses diagnosis and how to improve drug adherence. Electronic monitoring methods of assessing adherence provide a unique description of the temporal patterns of drug intake and behavior in the population. Approximately half of the patients abandon treatment during the first year of treatment. CrossRefPubMed
61.
Vrijens B, Vincze G, Kristanto P, Urquhart J, Burnier M. Adherence to prescribed antihypertensive drug treatments: longitudinal study of electronically compiled dosing histories. BMJ. 2008;336(7653):1114–7.CrossRefPubMedPubMedCentral
62.
Chapman RH, Kowal SL, Cherry SB, Ferrufino CP, Roberts CS, Chen L. The modeled lifetime cost-effectiveness of published adherence-improving interventions for antihypertensive and lipid-lowering medications. Value Health. 2010;13:685–94.CrossRefPubMed
63.
Schroeder K, Fahey T, Ebrahim S. Interventions for improving adherence to treatment in patients with high blood pressure in ambulatory settings. Cochrane Database Syst Rev. 2004;2:CD004804.
64.
Hogerzeil HV, Liberman J, Wirtz VJ, Kishore SP, Selvaraj S, Kiddell-Monroe R, et al. Promotion of access to essential medicines for non-communicable diseases: practical implications of the UN political declaration. Lancet. 2013;381(9867):680–9.
65.
• Macquart de Terline D, Diop BI, Bernard M, Do B, Ikama MS, N’guetta R, Balde DM, Tchabi Y, Sidi Aly A, Ali Toure I, Zabsonre P, Damorou JF, Takombe JL, Narayanan K, Fernandez C, Tafflet M, Plouin PF, Empana JP, Marijon E, Jouven X, Antignac M. Substandard drugs among five common antihypertensive generic medications: an analysis from 10 African countries. J Hypertens. 2017;36(2):395–401. A study in ten sub-Saharan African countries. Nearly one quarter of the available generic antihypertensive drugs were found to be of poor quality. The study stresses the limitations of generic antihypertensive drugs in developing countries.
66.
67.
Twagirumukiza M, Cosijns A, Pringels E, Remon JP, Vervaet C, Van Bortel L. Influence of tropical climate conditions on the quality of antihypertensive drugs from Rwandan pharmacies. Am J Trop Med Hyg. 2009;81(5):776–81.CrossRefPubMed
68.
Cameron A, Ewen M, Ross-Degnan D, Ball D, Laing R. Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis. Lancet. 2009;373(9659):240–9.
69.
Newson RS, Lion R, Meijer GW, Neufingerl N, van Zweden R, Feunekes GIJ, et al. Barriers for progress in salt reduction in the general population. An international study. Appetite. 2013;71(1):22–3. This is an international study conducted to drive knowledge on salt intake and associated behaviors in the general population. One third of participants were not interested in salt reduction. People were unaware of the main dietary sources of salt.
70.
71.
Campbell NR, Lackland DT, Chockalingam A, Lisheng L, Harrap SB, Touyz RM, et al. The International Society of Hypertension and World Hypertension League call on governments, nongovernmental organizations and the food industry to work to reduce dietary sodium. J Hypertens. 2014;32(2):446–7.
72.
• Modesti PA, Agostoni P, Agyemang C, Basu S, Benetos A, Cappuccio FP, et al. Cardiovascular risk assessment in low-resource settings: a consensus document of the European Society of Hypertension Working Group on Hypertension and Cardiovascular Risk in Low Resource Settings. J Hypertens. 2014;32(5):951–60. This is a consensus document by the ESH working group on hypertension and cardiovascular risk in low-resource settings. The threshold of cardiovascular risk for deciding the start of drug treatment can be adjusted to suit the country context. Cost-effectiveness of an intervention depends on the gross domestic product per head for the country.
73.
Ibrahim MM. The Egyptian hypertension society: Egyptian hypertension guidelines. Egypt Heart J. 2014;66:79–132.CrossRef
74.
López-Jaramillo P, Coca A, Sánchez R, Zanchetti A, Latin American Society of Hypertension. Hypertension guidelines: is it time to reappraise blood pressure thresholds and targets? Position statement of the Latin American Society of Hypertension. Hypertension. 2016;68(2):257–62.CrossRefPubMed
75.
Mendis S, Lindholm LH, Mancia G, Whitworth J, Alderman M, Lim S, et al. World Health Organization (WHO) and International Society of Hypertension (ISH) risk prediction charts: assessment of cardiovascular risk for prevention and control of cardiovascular disease in low and middle-income countries. J Hypertens. 2007;25(8):1578–82.
76.
Campbell N, Young ER, Drouin D, Legowski B, Adams MA, Farrell J, et al. A framework for discussion on how to improve prevention, management and control of hypertension in Canada. Can J Cardiol. 2012;28:262–9.
77.
Go AS, Bauman MA, Coleman King SM, Fonarow GC, Lawrence W, Williams KA, et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. J Am Coll Cardiol. 2014;63(12):1230–8.
78.
Mangat BK, Campbell N, Mohan S, Niebylski ML, Khalsa TK, Berbari AE, et al. Resources for blood pressure screening programs in low resource settings: a guide from the world hypertension league. J Clin Hypertens (Greenwich). 2015;17:418–20.
79.
Maurer J, Ramos A. One-year routine opportunistic screening for hypertension in formal medical settings and potential improvements in hypertension awareness among older persons in developing countries: evidence from the Study on Global Ageing and Adult Health (SAGE). Am J Epidemiol. 2015 Feb 1;181(3):180–4.CrossRefPubMed
80.
MG1 M. Replacing manual sphygmomanometers with automated blood pressure measurement in routine clinical practice. Clin Exp Pharmacol Physiol. 2014;41(1):46–53.
81.
Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31(7):1281–357.
82.
• Mboni S, Ferrari R. The role of telemedicine in hypertension management: focus on blood pressure telemonitoring. Curr Hypertens Rep. 2015;17(4):535. This review updates and critically assesses the role of telemedicine and home blood pressure monitoring in the management of hypertensive patients. The review outlines the advantages and benefits of telemedicine in hypertension management. There was a clear benefit in terms of greater blood pressure reductions.
83.
Omboni S, Gazzola T, Carabelli G, Parati G. Clinical usefulness and cost effectiveness of home blood pressure telemonitoring: meta-analysis of randomized controlled studies. J Hypertens. 2013;31:455–68.CrossRefPubMed
84.
• Maimaris W, Paty J, Perel P, Legido-Quigley H, Balabanova D, Nieuwlaat R, et al. The influence of health systems on hypertension awareness, treatment, and control: a systematic literature review. PLoS Med. 2013;10(7):e1001490. This is a systematic review of the influence of national or regional health systems on hypertension awareness, treatment, and control. It supports the minimization of medication co-payments in health insurance plans.
85.
Su TC, Bai CH, Chang HY, You SL, Chien KL, Chen MF, et al. Evidence for improved control of hypertension in Taiwan: 1993–2002. J Hypertens. 2008;26(3):600–6.
Metadata
Title
Hypertension in Developing Countries: A Major Challenge for the Future
Author
M Mohsen Ibrahim
Publication date
01-05-2018
Publisher
Springer US
Published in
Current Hypertension Reports / Issue 5/2018
Print ISSN: 1522-6417
Electronic ISSN: 1534-3111
DOI
https://doi.org/10.1007/s11906-018-0839-1

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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