Abstract
BACKGROUND: The objective of our study was to investigate the associations of characteristics inherent in large Russian Federation (RF) regions with prevalence, awareness, treatment and control of hypertension at the individual level. METHODS: Regional characteristics were obtained from the official website of the Federal State Statistics Service of the RF. We employed principal component analysis to reduce the dimensionality of data, which allowed defining five integral regional indices. Prevalence, awareness, treatment and control of hypertension were assessed from the data of the cross-sectional stage of ESSE-RF study conducted in 2013-2014. The final sample included 19,791 patients from 12 RF regions. Generalized estimating equations were used to identify the associations of regional indices with prevalence, awareness, treatment and control of hypertension at the individual level, taking into consideration nested data structures (study subjects in the regions). RESULTS: The index characterizing deterioration of social living conditions and societal marginalization exhibited positive associations with the prevalence of hypertension among men (OR = 1.18; 95% CI: 1.05-1.32) and elderly people (OR = 1.16; 95% CI: 1.02-1.32). Moreover, deterioration in the social environment was associated with a reduction in treatment (OR = 0.76; 95% CI: 0.64-0.90) and control of hypertension (OR = 0.79; 95% CI: 0.69-0.90). Hypertension awareness was directly connected with demographic crisis (OR = 1.13; 95% CI: 1.02-1.25) and augmented industrial development (OR = 1.15; 95% CI: 1.01-1.33) in the regions. The association of regional living conditions with the prevalence of hypertension is relatively weak, compared to predictors at the individual level, but this influence is important for awareness, treatment and control of hypertension. CONCLUSION: The study contributed to evaluating the associations of the vital characteristics inherent in population of large RF regions with arterial hypertension prevalence, as well as with awareness, treatment and control of this disease. Our results provided original insights from the standpoint of cardiovascular disease epidemiology in the RF, as well as in the context of investigating the impact of living conditions on population health.