Evidence map›Paper›PMID 38536787›Full record

ArticlePLOS global public health2024

Multiple cardiovascular risk factor care in 55 low- and middle-income countries: A cross-sectional analysis of nationally-representative, individual-level data from 280,783 adults.

Alpha Oumar Diallo, Maja E Marcus, David Flood, Michaela Theilmann, Nicholas E Rahim, Alan Kinlaw, Nora Franceschini, Til Stürmer, Dessie V Tien, Mohsen Abbasi-Kangevari and 39 more

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Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

49 authors.

Alpha Oumar DialloDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
Maja E MarcusDepartment of Economics and Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany.
David FloodUniversity of Michigan, Ann Arbor, Michigan, United States of America.ORCID https://orcid.org/0000-0002-4372-7387
Michaela TheilmannFaculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.ORCID https://orcid.org/0000-0003-3413-232X
Nicholas E RahimMedical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America.
Alan KinlawDivision of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina School of Pharmacy at Chapel Hill, Chapel Hill, North Carolina, United States of America.
Nora FranceschiniDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
Til StürmerDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.ORCID https://orcid.org/0000-0002-9204-7177
Dessie V TienMedical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America.
Mohsen Abbasi-KangevariNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Kokou AgoudaviTogo Ministry of Health, Lome, Togo.
Glennis Andall-BreretonCaribbean Public Health Agency, Port of Spain, Trinidad and Tobago.
Krishna AryalNepal Health Sector Programme 3, Monitoring Evaluation and Operational Research Project, Abt Associates, Kathmandu, Nepal.
Silver BahendekaSaint Francis Hospital Nsambya, Kampala, Uganda.ORCID https://orcid.org/0000-0001-8080-7872
Brice BicabaInstitut Africain de Santé Publique, Ouagadougou, Burkina Faso.
Pascal BovetMinistry of Health, Victoria, Seychelles.ORCID https://orcid.org/0000-0002-0242-4259
Maria DorobantuDepartment of Cardiology, Emergency Hospital of Bucharest, Bucharest, Romania.
Farshad FarzadfarNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Seyyed-Hadi GhamariNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Gladwell GathechaDivision of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya.
David GuwatuddeDepartment of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda.ORCID https://orcid.org/0000-0003-3563-0224
Mongal GurungHealth Research and Epidemiology Unit, Ministry of Health, Thimphu, Bhutan.
Corine HouehanouLaboratory of Epidemiology of Chronic and Neurological Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin.
Dismand HouinatoLaboratory of Epidemiology of Chronic and Neurological Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin.
Nahla HwallaFaculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon.ORCID https://orcid.org/0000-0002-0685-6323
Jutta JorgensenDept of Public Health and Epidemiology, Institute of Global Health, Copenhagen University, Copenhagen, Denmark.ORCID https://orcid.org/0000-0002-1075-3036
Gibson KagarukiNational Institute for Medical Research, Dar es Salaam, Tanzania.
Khem KarkiDepartment of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Joao MartinsFaculty of Medicine and Health Sciences, Universidade Nacional Timor Lorosa'e, Dili, Timor-Leste.
Mary MayigeNational Institute for Medical Research, Dar es Salaam, Tanzania.
Roy Wong McClureOffice of Epidemiology and Surveillance, Costa Rican Social Security Fund, San José, Costa Rica.
Sahar Saeedi MoghaddamEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Omar MwalimMinistry of Health, Zanzibar City, Tanzania.
Kibachio Joseph MwangiDivision of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya.
Bolormaa NorovNutrition Department, National Center for Public Health, Ulaanbaatar, Mongolia.
Sarah Quesnel-CrooksCaribbean Public Health Agency, Port of Spain, Trinidad and Tobago.ORCID https://orcid.org/0000-0003-0622-6695
Abla SibaiDepartment of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Lela SturuaNon-Communicable Disease Department, National Center for Disease Control and Public Health, Tbilisi, Georgia.
Lindiwe TsabedzeMinistry of Health, Mbabane, Eswatini.
Chea WessehMinistry of Health, Monrovia, Liberia.
Pascal GeldsetzerFaculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.
Rifat AtunDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
Sebastian VollmerDepartment of Economics and Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany.ORCID https://orcid.org/0000-0002-7863-0462
Till BärnighausenFaculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.
Justine DaviesMRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of Witwatersrand, Johannesburg, South Africa.ORCID https://orcid.org/0000-0001-6834-1838
Mohammed K AliHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.ORCID https://orcid.org/0000-0001-7266-2503
Jacqueline A SeiglieDiabetes Unit, Massachusetts General Hospital, Boston, MA, United States of America.
Emily W GowerDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.ORCID https://orcid.org/0000-0003-1016-9910
Jennifer Manne-GoehlerDepartment of Economics and Centre for Modern Indian Studies, University of Goettingen, Göttingen, Germany.ORCID https://orcid.org/0000-0001-9295-0035

Funding

Implementation research for comprehensive cardiometabolic care in GuatemalaK23HL161271 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI David Clifford Flood · 2022 to 2026
$949k
Mentored Training in Molecular Epidemiology of Chronic Kidney Disease in Diverse PopulationsK26DK138425 · NIDDK · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Nora Franceschini · 2023 to 2026
$277k
NHLBI NIH HHS K23 HL161271NIDDK NIH HHS K26 DK138425
6 · The paper itself

Abstract

The prevalence of multiple age-related cardiovascular disease (CVD) risk factors is high among individuals living in low- and middle-income countries. We described receipt of healthcare services for and management of hypertension and diabetes among individuals living with these conditions using individual-level data from 55 nationally representative population-based surveys (2009-2019) with measured blood pressure (BP) and diabetes biomarker. We restricted our analysis to non-pregnant individuals aged 40-69 years and defined three mutually exclusive groups (i.e., hypertension only, diabetes only, and both hypertension-diabetes) to compare individuals living with concurrent hypertension and diabetes to individuals with each condition separately. We included 90,086 individuals who lived with hypertension only, 11,975 with diabetes only, and 16,228 with hypertension-diabetes. We estimated the percentage of individuals who were aware of their diagnosis, used pharmacological therapy, or achieved appropriate hypertension and diabetes management. A greater percentage of individuals with hypertension-diabetes were fully diagnosed (64.1% [95% CI: 61.8-66.4]) than those with hypertension only (47.4% [45.3-49.6]) or diabetes only (46.7% [44.1-49.2]). Among the hypertension-diabetes group, pharmacological treatment was higher for individual conditions (38.3% [95% CI: 34.8-41.8] using antihypertensive and 42.3% [95% CI: 39.4-45.2] using glucose-lowering medications) than for both conditions jointly (24.6% [95% CI: 22.1-27.2]).The percentage of individuals achieving appropriate management was highest in the hypertension group (17.6% [16.4-18.8]), followed by diabetes (13.3% [10.7-15.8]) and hypertension-diabetes (6.6% [5.4-7.8]) groups. Although health systems in LMICs are reaching a larger share of individuals living with both hypertension and diabetes than those living with just one of these conditions, only seven percent achieved both BP and blood glucose treatment targets. Implementation of cost-effective population-level interventions that shift clinical care paradigm from disease-specific to comprehensive CVD care are urgently needed for all three groups, especially for those with multiple CVD risk factors.

Identifiers

PMID38536787
PMCPMC10971750

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