Risk-based antihypertensive treatment allocation in Peru: comparison of local and international guidelines analysing national health surveys between 2015-2020

Rodrigo M. Carrillo-Larco, Wilmer Cristobal Guzman-Vilca, Antonio Bernabe-Ortiz

Producción científica: Contribución a una revistaArtículorevisión exhaustiva

Resumen

Background: While there is a growing interest in antihypertensive medication rates among people with hypertension in low- and middle-income countries, little has been described about antihypertensive medication rates among eligible people based on the absolute cardiovascular risk approach. Following the risk-based approach, we described the proportion of eligible people receiving antihypertensive medication in Peru. Methods: Analysis of six (2015-2020) national health surveys. Absolute cardiovascular risk was computed with the 2019 WHO cardiovascular risk charts and based on local guidelines. Antihypertensive treatment allocation based on the absolute cardiovascular risk was defined using the Package of essential noncommunicable (PEN) disease interventions for primary health care in low-resource settings and the HEARTS guidelines by the WHO; we also followed the recommendations by local guidelines. Results: There were 120,059 people. Overall, according to the local guidelines the 17.9% of the population would be eligible for antihypertensive medication while this estimate was 8.1% based on the WHO guidelines. At the national level, depending on the guidelines, we observed a steady trend of eligible people receiving antihypertension medication (e.g., men, local guidelines), a decreasing trend (e.g., men, <60, local guidelines) or an increasing trend (e.g., men, ≥60, local guidelines). At the sub-national level, seventeen regions showed an increasing antihypertensive treatment rate based on the local guidelines; when based on the WHO guidelines, eleven regions showed a decreasing rate. Conclusions: Peru needs to define a tool for surveillance of absolute cardiovascular risk and to monitor antihypertensive treatment allocation among high-risk people. Funding: Wellcome Trust (214185/Z/18/Z).

Idioma originalInglés
Número de artículo100022
PublicaciónThe Lancet Regional Health - Americas
Volumen1
DOI
EstadoPublicada - set. 2021

Huella

Profundice en los temas de investigación de 'Risk-based antihypertensive treatment allocation in Peru: comparison of local and international guidelines analysing national health surveys between 2015-2020'. En conjunto forman una huella única.

Citar esto