Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12963-019-0197-5
Title: Prevalence, determinants and association of unawareness of diabetes, hypertension and hypercholesterolemia with poor disease control in a multi-ethnic Asian population without cardiovascular disease
Authors: Man, R.E.K.
Gan, A.H.W.
Fenwick, E.K.
Gan, A.T.L.
Gupta, P.
Sabanayagam, C. 
Tan, N. 
Wong, K.H.
Wong, T.Y. 
Cheng, C.-Y. 
Lamoureux, E.L. 
Keywords: Awareness
Cardiovascular risk factor
Determinant
Diabetes
Hypercholesterolemia
Hypertension
Issue Date: 2019
Publisher: BioMed Central Ltd.
Citation: Man, R.E.K., Gan, A.H.W., Fenwick, E.K., Gan, A.T.L., Gupta, P., Sabanayagam, C., Tan, N., Wong, K.H., Wong, T.Y., Cheng, C.-Y., Lamoureux, E.L. (2019). Prevalence, determinants and association of unawareness of diabetes, hypertension and hypercholesterolemia with poor disease control in a multi-ethnic Asian population without cardiovascular disease. Population Health Metrics 17 (1) : 17. ScholarBank@NUS Repository. https://doi.org/10.1186/s12963-019-0197-5
Rights: Attribution 4.0 International
Abstract: Background: To explore the prevalence and determinants of unawareness of diabetes, hypertension and hypercholesterolemia and its association with poor disease control in a multi-ethnic Asian population without cardiovascular disease (CVD). Methods: We included 6904 Chinese, Malay and Indian individuals (mean age [SD] 58.2 [10.2] years; 52.6% female) with diabetes, hypertension and/or hypercholesterolemia from the cross-sectional population-based Singapore Epidemiology of Eye Diseases study (2004-2011). Diabetes was defined as random blood glucose ? 11.1 mmol/L or HbA1c > 6.5% or self-reported use of diabetes medication; hypertension as systolic blood pressure ? 140 mmHg or diastolic blood pressure ? 90 mmHg or self-reported use of anti-hypertensive treatment; and hypercholesterolemia as total cholesterol ? 6.2 mmol/L or self-reported use of lipid-lowering medications. Unawareness was based on participants' answers to the questions: "Did your medical practitioner ever tell you that you have diabetes/hypertension/high cholesterol?" The determinants of unawareness, and its association with poor disease control, were assessed using multivariable binary logistic regression models adjusted for known potential confounders. Results: Of the 2380 (34.5%), 5386 (78.0%) and 3607 (52.2%) with diabetes, hypertension and hypercholesterolemia, respectively, unawareness rates were 30.7%, 43.1% and 40.9%, respectively. Having a higher BMI, particularly if obese, and Malay ethnicity were associated with greater unawareness of diabetes; Malay and Indian ethnicities and current smoking with greater unawareness of hypertension; and education ?6 years, current smoking, and blue collar jobs or unemployment with greater unawareness of hypercholesterolemia (all P < 0.05). Lack of awareness of each condition was independently associated with poorer disease control in the case of hypertension and hypercholesterolemia, while the converse was true for diabetes (all P < 0.05). Conclusions: Unawareness of diabetes, hypertension, or hypercholesterolemia is high in Singapore, with risk factors varying across all three diseases, although Malay ethnicity is a consistent one. Unawareness was also associated with poor management for hypertension and hypercholesterolemia. Public health education and screening programs should target at-risk individuals, especially Malays, to reduce the likelihood of incident CVD. © 2019 The Author(s).
Source Title: Population Health Metrics
URI: https://scholarbank.nus.edu.sg/handle/10635/213238
ISSN: 1478-7954
DOI: 10.1186/s12963-019-0197-5
Rights: Attribution 4.0 International
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