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Using the HIV Treatment Cascade to Identify Implementation Gaps in Hypertension Management in Jamaica

DOI: 
10.7727/wimj.2017.140

ABSTRACT

Objective: Hypertension is the biggest contributor to cardiovascular disease – the leading cause of death in Jamaica and the Caribbean.  In this paper, we utilized the HIV treatment cascade model to identify research, treatment and implementation gaps for hypertension in Jamaica 

Methods: Data from the second Jamaica Health and Lifestyle Survey, collected between November 2007 and February 2008, were utilized.  Trained interviewers completed questionnaires and measured blood pressure using standardized techniques in a randomly selected sample of 15-74-year-old Jamaicans. Questionnaire responses and the blood pressure measurement were used to create a hypertension treatment cascade.

Results: The biggest gap in hypertension care was in disease awareness with only 50% aware of the presence of the disease.  Most patients (99%) aware of their diagnosis had been seen by a doctor at some point for hypertension,  with 91% of those who had seen a doctor remaining in care and 84% of those in care prescribed blood pressure medications. Only 40% of patients on treatment in the health care system had achieved a target blood pressure of ≤ 140/90mmHg.   

Conclusions: There is an urgent need for more mixed methods research to explain Jamaica’s hypertension treatment cascade, develop culturally-relevant, targeted interventions to address these issues and implement proven strategies to address hypertension awareness and control. 

Accepted: 
12 Dec, 2017
e-Published: 13 Dec, 2017

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