Hypertension prevalence, awareness, treatment, and control in Surinamese living in Suriname and The Netherlands: the HELISUR and HELIUS studies

Abstract

We studied hypertension prevalence, awareness, treatment, and control among persons living in a middle-income country compared with those of similar ethnicity living in a high-income country. Data from the cross-sectional HELISUR and HELIUS studies were used among 1000 Surinamese and 6971 Surinamese migrants living in The Netherlands (18–70 years), respectively. Groups were formed based on country and self-defined ethnicity, and stratified by sex. Age-adjusted odds ratios (OR) with 95% confidence intervals (CI) were calculated for hypertension prevalence, awareness, treatment, and control. Subsequently, we focused on hypertension prevalence and adjusted for risk factors for hypertension: BMI and waist circumference (model 2), educational level, physical activity, and smoking (model 3). After adjustment for age, no significant differences in hypertension prevalence, awareness, treatment, and control between countries were seen in men. However, women in Suriname were more often hypertensive with lower levels of awareness and control than those in The Netherlands (African: OR 1.54 [95% CI 1.19, 2.00]; South-Asian: 1.90 [1.35, 2.67]; awareness: 0.62 [0.43, 0.88] in African women; control: 0.48 [0.28, 0.84] in South-Asian women). Higher hypertension prevalence was explained by differences in BMI and waist circumference in African women (adjusted OR 1.26 [0.96, 1.65]) and by education, physical activity, and smoking in South-Asian women (adjusted OR 1.29 [0.87, 1.89]). Particularly, women in Suriname bear a relatively high hypertension burden with lower levels of awareness and control. As the higher hypertension prevalence was mainly explained by lifestyle-related risk factors, health promotion interventions may reduce the hypertension burden in Suriname.

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Acknowledgements

The HELISUR study is conducted by the Academic Hospital Paramaribo with no external funding. The HELIUS study is conducted by the Academic Medical Center Amsterdam and the Public Health Service of Amsterdam. Both organizations provided core support for HELIUS. The HELIUS study is also funded by the Dutch Heart Foundation, The Netherlands Organization for Health Research and Development, the European Commission, and the European Fund for the Integration of non-EU immigrants (EIF). We are most grateful to the participants, research assistants, interviewers, and other staff who have taken part in gathering the data of these two studies.

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FSD drafted the manuscript. MBS, KS, and LMB made substantial contributions in the interpretation of the data and in revising the manuscript. All authors critically reviewed the manuscript.

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Correspondence to Karien Stronks.

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The authors declare that they have no conflict of interest.

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The study protocols were approved by the respective ethic committees of both research institutes and in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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All participants gave written informed consent prior to the enrolment in the studies.

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Diemer, F.S., Snijder, M.B., Agyemang, C. et al. Hypertension prevalence, awareness, treatment, and control in Surinamese living in Suriname and The Netherlands: the HELISUR and HELIUS studies. Intern Emerg Med 15, 1041–1049 (2020). https://doi.org/10.1007/s11739-019-02269-z

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Keywords

  • Hypertension
  • Prevalence
  • Awareness
  • Treatment
  • Control
  • Ethnicity