A COMPARATIVE-STUDY OF HYPERTENSION PREVALENCE, AWARENESS, TREATMENT AND CONTROL RATES IN ST-LUCIA, JAMAICA AND BARBADOS

Background Cardiovascular diseases represent the most common cause of death in the English-speaking Caribbean, and hypertension represents t he most important predisposing condition. However, direct between-coun try comparative studies in the Caribbean have not previously been unde rtaken, Objective To obtain estimates of hypertension prevalence, awar eness, treatment and control in three countries in the Caribbean. Desi gn Population-based samples of adults aged 25-74 years in St Lucia, Ba rbados and Jamaica were surveyed regarding their cardiovascular health and their blood pressures were measured using a highly standardized p rotocol. A reference site was available from a collaborative study amo ng blacks in metropolitan Chicago, Illinois, USA. Results At the 160/9 5 mmHg threshold, age-adjusted hypertension prevalence estimates for J amaica, St Lucia and Barbados were 17.5, 18.3 and 21.5%, respectively, and 24.7, 26.9 and 27.9%, respectively, at the 140/90 mmHg threshold, The corresponding estimate for the Chicago site at the 140/90 mmHg th reshold was 33.2%. The gradient in prevalence resembled the gradient i n body mass index (25.7 kg/m(2) in Jamaica to 29.3 kg/m(2) in the USA) . At the 160/95 mmHg threshold, the proportion of all hypertensives wh o were aware of their disease, pharmacologically treated and controlle d was highest in Barbados (90, 85 and 72%, respectively) and lowest in St Lucia (74, 59 and 35%, respectively), Men, particularly those aged less than 55 years, were less likely to have their hypertension treat ed and controlled, Conclusions Compared with estimates from earlier in dependent surveys, considerable progress has been made in hypertension detection and control in these countries, which should lead to sizabl e reductions in the burden of cardiovascular disease.