Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697637117494.pdf (Bahamas)
The Prevalence of Raised Blood Pressure and Self-Reported Hypertension in The Bahamas: Findings from the STEPS Survey, 2012 Delon Brennen Nanika Brathwaite Camille Deleveaux UWI Research Day, 19 September, 2014 Introduction • Hypertension has long been among the leading causes of illness and death in the Bahamas • In 2011, it was the leading cause of death (3rd in males, 1st in females) – 200 deaths overall – 10% of deaths – 60 mortality rate per 100,000 population • In 2001, it was the 3rd leading cause (8% deaths; 151 deaths) • Comprised around 3% of hospital visits (~ 500 visits annually) • Leading cause of public health general clinic visits – 16% of visits – ~ 38,000 visits per year Hypertension Mortality Rate per 100,000 Population Bahamas, 2001, 2003- , 0 0 0 0 0 1 r e p e t a R Prevalence from Past Surveys (Self-Reported) ) % ( t n e c r e P 30 25 20 15 10 5 0 22.9 13 14.5 11.6 12.3 9.3 6.1 Total Males Females 1989 National Health and Nutrition Survey (15-64 Yrs) 2001 Bahamas Living Condtions Survey (All Persons) 2005 CNCD and Risk Factor Survey (15-74 Yrs) Objective • To determine the prevalence of raised blood pressure and hypertension in The Bahamas Design and Methods • Data from the 2012 Bahamas STEPS Survey was used – Population based stratified multi-stage cluster sample – Adults 25 to 64 years – Islands included • New Providence • Grand Bahama • Cat Island • Inagua Design and Methods • Data collected using Personal Digital Assistants (PDAs) – entered on-site • Analyzed using Epi-Info 3.43 • Complex sample taken into account for weighting and variance estimation STEPS Approach STEP 1: To measure self-reported hypertension, questionnaire used to measure 3 questions: 1.
Have you ever had your blood pressure (BP) measured by a doctor or other health worker?

2.

Have you ever been told by a doctor or other health worker that you have raised blood pressure or hypertension?

3.

Have you been told in the past 12 months?
STEP 2: Physical measurements on a sub-sample by interviewer – height, weight – blood pressure Results – Self-Reported (n=1,632) • 27% had been told they had raised blood pressure/hypertension – 7% not within past 12 months – 20% diagnosed within past 12 months – 62% measured but not diagnosed – 11% were never measured • 22% men, 31% women Results – Self-Reported (n=1,632) Never measured 11% Measured but not diagnosed 62% Diagnosed within past 12 months 20% Diagnosed NOT within past 12 months 7% Self-Reported Prevalence by Age Group ) % ( t n e c r e P 60 50 40 30 20 10 0 52.3 33 21.2 15.3 25-34 Yrs 35-44 Yrs 45-54 Yrs 55-64 Yrs Among those Diagnosed Lifestyle Advice (n=136) • Advised to reduce salt intake – 76% – 77% men – 76% women • Advised to lose weight – 59% – 62% men – 57% women • Advised to stop smoking – 15% – 24% men – 8% women • Advised to start/do more exercise – 70% – 76% men – 66% women Among those Diagnosed Medication (n=136) • Currently taking blood pressure drugs – 58% – 54% men – 61% women • Seen a traditional healer – 13% – 14% men – 13% women • Currently taking herbal/ traditional remedy – 11% – 10% men – 11% women Results – Physical Measurements • Mean systolic blood pressure, including those currently on medication – 127.4 – 129.3 men – 125.6 women • Mean diastolic, including those on medication – 81.6 – 82.7 men – 80.5 women Results – Physical Measurements • Percent with raised BP or currently on medication – 34% – 36% men – 33% women • Percent with raised BP NOT currently on medication – 24% – 28% men – 19% women Comparisons with Previous Surveys ) % ( t n e c r e P 50 45 40 35 30 25 20 15 10 5 0 Total Males Females 22.9 31 27 22.2 13 14.5 11.6 12.3 9.3 6.1 1989 National Health and Nutrition Survey (15-64 Yrs) 2001 Bahamas Living Condtions Survey (All Persons) 2005 CNCD and Risk Factor Survey (15-74 Yrs) 2012 Bahamas STEPS Survey (25-64 Yrs) Risk Factors from STEPS Survey • Mean BMI 30.5 (no sex difference) • 80% overweight (including obese) • 49% obese • 90% ate less than 5 servings of
 fruits and/or vegetables on average daily • 73% do not engage in vigorous physical activity Limitations • Somewhat low response rate of 54% Conclusions • Around one out of three adults have raised blood pressure or hypertension • A notable proportion may have hypertension but never been measured by health practitioner ~ 10% • Ongoing screening and interventions should continue, especially for at-risk groups as defined by findings from available research • Further research is recommended Acknowledgements • Dr. Delon Brennen, Ag.
Chief Medical Officer, Ministry of Health (MOH) (Focal point) • Dr. Merceline Dahl-Regis , Former CMO (PI) • Dr. Merle Lewis, Former PAHO/WHO Representative (Advisor) • Dr. Glennis Andall-Brereton, Epidemiologist & Manager (Acting) Surveillance and Risk Assessment, CARPHA • Ms. Sarah Quesnel, Biostatistician, CARPHA • Mrs. Kathy Johnston, (Survey Coordinator/Former M & E Specialist) • • • • Mrs. Kelsie Dorsett, Director, Department of Statistics (DOS) Mrs. Cypreanna Winters, Statistician, DOS (Statistical Advisor) Ms. Nanika Brathwaite, Statistician, Ministry of Health Ms. Camille Deleveaux, Epidemiologist, Ministry of Health Thank you