Journal
HYPERTENSION RESEARCH
Volume 36, Issue 8, Pages 711-717Publisher
SPRINGERNATURE
DOI: 10.1038/hr.2013.14
Keywords
developing countries; epidemiology; epidemiological transition; HYDY study; proteinuria; urbanization
Categories
Funding
- Ministero dell'Universita e della Ricerca (Direzione Generale per le strategie e lo sviluppo dell'internazionalizzazione della ricerca scientifica e tecnologica), Rome, Italy
- Menarini International Operations Luxembourg SA
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Although globalization can contribute to increased blood pressure by spreading unhealthy behaviors, it also provides powerful means to tackle hypertension. The dissemination of information about and advice on cardiovascular prevention and facilitated contact with health services are valuable resources. To investigate the effects of urbanization, geographical area, and air temperature on hypertension burden and kidney damage, a survey was performed in 2008 with a door-to-door approach among urban and rural adult dwellers of three geographic areas (capital, inland, coast) of Yemen. Subjects (n = 10 242) received two visits several days apart to confirm the diagnosis of hypertension. Proteinuria (dipstick test >= + 1) was used as a marker of kidney damage. Prevalence rates were weighted to represent the Yemen population aged 15-69 years in 2008. Rates of hypertension and proteinuria progressively increased from the capital (6.4%; 95% confidence level (CI) 5.8-7.0 and 5.1%; 4.4-5.9, respectively), to inland areas (7.9%; 7.0-8.7 and 6.1%; 5.1-7.1), to the coastal area (10.1%; 8.9-11.4 and 8.9%; 7.3-10.4). When compared with urban dwellers, rural dwellers had similar hypertension prevalence (adjusted odds ratios (ORs) 1.03; 95% CI 0.91-1.17) but higher proteinuria rates (adjusted ORs 1.55; 1.31-1.85). Overall, home temperature was associated with a lower hypertension rate (adjusted OR 0.98; 0.96-0.99). This large population study reveals that the highest burden of hypertension and kidney damage is detectable in remote areas of the country.
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