Care for Hypertension and other Chronic Conditions in Samoa : Understanding the Bottlenecks and Closing the Implementation Gaps (original) (raw)
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Care for Hypertension and Other Chronic Conditions in Samoa
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BMC public health, 2018
To analyse trends over the period 1991-2013 in systolic blood pressure (SBP), diastolic blood pressure (DBP) and the prevalence of hypertension in adults aged 25-64 years in Samoa; and to assess the contribution of rising obesity levels to period trends. Unit record data from seven population-based surveys (n = 10,881) conducted between 1991 and 2013 were included for analysis. Surveys were adjusted to the nearest previous census to improve national representativeness. Hypertension was defined as SBP ≥140 mmHg and/or DBP ≥90 mmHg and/or on medication for hypertension. Obesity was measured by body mass index (BMI). Poisson, linear and meta-regression were used to assess period trends. Over 1991-2013 mean SBP and DBP (mmHg), and the prevalence of hypertension (%) increased in both sexes. Increases in hypertension were: from 18.3 to 33.9% (p < 0.001) in men (mean BP from 122/74 to 132/78); and from 14.3 to 26.4% (p < 0.001) in women (mean BP from 118/73 to 126/78). The estimate o...
Continued increases in hypertension over three decades in Fiji, and the influence of obesity
Journal of hypertension, 2015
To analyse trends during 1980-2011 in hypertension prevalence and SBP/DBP by sex in Fiji Melanesian (i-Taukei) and Indian adults aged 25-64 years; and to assess effects of BMI. Unit record data from five population-based surveys were included (n = 14 191). Surveys were adjusted to the nearest previous census to improve national representativeness. Hypertension was defined as SBP at least 140 mmHg and/or DBP at least 90 mmHg and/or on medication for hypertension. Regression (Poisson and linear) was used to assess period trends. Over 1980-2011 hypertension prevalence (%) and mean blood pressure (BP) (SBP/DBP mmHg) increased significantly (P < 0.001) in both sexes and ethnicities. Increases in hypertension were: from 16.2 to 41.3% in i-Taukei men (mean BP from 122/73 to 135/81); from 20.5 to 37.8% in Indian men (mean BP from 122/74 to 133/81); from 25.9 to 36.9% in i-Taukei women (mean BP from 126/76 to 132/81); and from 17.6 to 33.1% in Indian women (mean BP 117/71 to 130/81). The ...
One of the concomitants of the rapid socioeconomic and medical changes which occurred in American Samoa beginning with World War I1 has been a n increase in chronic diseases, especially cardiovascular disease and diabetes. As part of the Samoan Studies Project, a 1976 survey focusing on obesity and blood pressure was conducted in American Samoa. A total of 624 men age 18 or greater were seen at that time. In 1989 we conducted a follow-up examination of 31 of these men, reassessing blood pressure, and also examining blood glucose and previously diagnosed health problems, focusing on chronic diseases such as hyper-tension, stroke, cancer, and diabetes. In a prospective analysis of mortality, Crews (Hum. Biol. 60:417-433, 1988) found that 111 American Samoan men who had blood pressures measured in a public health department survey in 1975 and subsequently died between 1975 and 1981, had higher average systolic and dias-tolic blood pressures than the 2,588 survivors (140/88 vs. 129/84). Using these data, the 1989 sample was stratified according to the 1976 blood pressure measurement of the men and a sample of 14 normotensive men (1976 blood pressure <140/90) and 17 hypertensives (1976 blood pressure 27140190) was selected. The average age, weight, and number of cigarettes smoked per day was not signill-cantly different for these two groups a t the 12-year follow-up. However, several indicators of health status did differ. The hypertensive group had significantly higher systolic and diastolic blood pressures (P s 0.001). Additionally, the hyper-tensive group had higher random blood glucose values (P s 0.005) and were significantly more likely to be hypertensive and/or have impaired glucose tolerance (P 0.001). Change in weight was predictive of change in blood pressure, but not of absolute value of blood pressure. This paper notes the importance of elevated blood pressure as a predictor of future chronic disease risk for Samoan men.
2003
Populations in the Pacific islands undergoing economic modernization have experienced a steady rise in the prevalence of hypertension across the second part of the twentieth century. In this analysis, a comparison is made between blood pressure of the Rarotonga, Cook Islands, population in 1996 with values obtained for this population in 1964. In addition, the extent to which education and occupation, as markers of modernization, associate with blood pressure and island of origin is examined, taking into account the use of anti-hypertensive drugs by a subset of the sample. For the males, mean blood pressure shows no difference between 1964 and 1996; for the females, the characteristic increase in blood pressure across the age groups is not statistically significant in the 1996 study population. This might be due to the much more extensive use of anti-hypertension medication in the 1996 sample. Island of origin is a significant predictor of blood pressure irrespective of occupation, use of anti-hypertension medication, age and body mass index. Females born on Rarotonga had higher systolic blood pressure, which was also associated with education level, than those born on other Cook Islands. Males born on Rarotonga had significantly higher diastolic blood pressure than males born elsewhere in the Cook Islands.
Health, Culture, and Lifestyle in Contemporary Tonga: With Particular Reference to Diabetes and Diet
2015
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Health financing options for Samoa : challenges and opportunities
2013
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