MELİH KAAN SÖZMEN, Gül ERGÖR, Belgin ÜNAL

Hipertansiyon sıklığı, farkındalığı, tedavi alma ve kan basıncı kontrolünü etkileyen etmenler

Amaç: Bu çalışmada İzmir ili Balçova İlçesinde yaşayan 30 yaş ve üzeri bireylerde hipertansiyon (HT) sıklığı ve HT farkındalık, tedavi ve kontrol düzeylerini etkileyen etmenlerin değerlendirilmesi amaçlanmıştır. Yöntemler: Balçovanın Kalbi Projesi kapsamında 2007- 2009 yılları arasında durum saptama aşamasına katılan 12,742 kişinin verisi değerlendirilmiştir. Ortalama kan basıncı ≥140/90 mmHg üzerinde olan ya da antihipertansif ilaç kullanan bireyler hipertansiyonu var olarak kabul edilmişlerdir. HT varlığı, farkındalık, tedavi ve kontrol düzeylerini etkileyen etmenler çok değişkenli lojistik regresyon analizi ile değerlendirilmiştir. Bulgular: Hipertansiyon sıklığı erkeklerde %39,5, kadınlarda %41,6 ve toplamda %40,9 olarak bulunmuştur. Hipertansif olan bireylerin % 73,3ü sağlık durumlarının farkındadır. HT varlığının farkında olan bireylerin ise %90,9u ilaç tedavisi almakta ve %49,6sının kan basıncı kontrol altında bulunmaktadır. Artan yaş, kadın cinsiyet, sağlık algısının kötü olması, fiziksel inaktivite, bel çevresinin sınır değerin üstünde olması koroner kalp hastalığı (KKH), Diyabet (DM) veya hiperlipidemi tanısı ve ailede KKH öyküsü HT görülme olasılığını artırmıştır. HT farkındalığını ise artan yaş, erkek cinsiyet, KKH, inme, DM, hiperlipidemi varlığı ve ailede KKH öyküsü olması olumlu etkiler iken tadına bakmadan tuz kullanan bireylerde farkındalık düzeyi anlamlı olarak düşük bulunmuştur. HT kontrolü artan yaş ile birlikte azalırken, erkeklerde daha yüksek bulunmuştur. Sonuç: Bu çalışmada HT farkındalık, tedavi ve kontrol oranları diğer çalışmalara göre daha yüksektir. Kadın cinsiyet, kronik hastalık ve ailede KKH hikayesi varlığı farkındalık ve kontrolü artırırken erkek cinsiyet ve obezite varlığı kontrol düzeylerini olumsuz etkilemektedir. Farkındalığın yüksek olmasına rağmen kontrol oranlarının düşük olmasının nedenleri ileri çalışmalarla incelenmesi gerekmektedir.

Determinants of prevalence, awareness, treatment and control of high blood p ressure

Objective: The aim of the study was to evaluate prevalence, awareness, treatment and control rates of hypertension (HT) and associated factors among individuals over 30 years old living in Balcova District of Izmir. Methods: Data from 12,742 individuals who participated the baseline study of Heart of Balcova Project during 2007-2009 was evaluated. HT was defined as mean blood pressure ≥140/90mmHg or being on antihypertensive medication. Multivariate logistic regression analysis was applied to assess the determinants of prevalence, awareness, treatment and control of high blood pressure. Results: The overall prevalence of HT was 39,5% in male, 41.6% in female and 40,9% in total. Among participants with HT, 73.3% were aware of it. Among participants aware of HT 90.9% were treated, 49.6% of those treated were controlled (BP <140/90 mmHg). HT presence was associated with increasing age, female gender, poor self assessed health, physical inactivity, high waist circumference, diagnosis of coronary heart disease(CHD), diabetes or hyperlipidemia, family history of CHD. Awareness of HT was positively associated with increasing age, male gender, CHD, stroke, DM, hyperlipidemia, and history of CHD. Awareness was lower among individuals who added salt without tasting the meal. HT control was significantly higher among men while it decreased with increasing age. Conclusion: In this study awareness, treatment and control rates for HT were higher compared to other studies. While female gender, presence of chronic diseases and family history of CHD increased awareness and control, male gender and obesity had negative impact on control rates. The reasons behind low control rates despite high awareness should be explored in further studies.

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