Online Supplemental Material.

PA Modesti et al.

Epidemiology of hypertension in Yemen; effects of urbanization and geographical area

Table 1S. Age specific and age-standardized* systolic and diastolic blood pressure (BP) values in HYDY study participants. Values are expressed as mean±SD with 95% confidence limits.

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Age groups n Systolic BP (mmHg) n Diastolic BP (mmHg)
mean±SD (95% Cl) mean±SD (95% Cl)
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All participants
15–24 years 2070 115.1±10.3 (114.7 to 115.6) 2069 71.9±7.7 (71.6 to 72.2)
25–34 years 2065 116.9±11.5 (116.4 to 117.4) 2064 74.3±7.8 (74.0 to 74.7)
35–44 years 2028 120.1±13.0 (119.5 to 120.6) 2027 76.3±8.2 (75.9 to 76.6)
45–54 years 2045 127.5±18.4 (126.7 to 128.3) 2044 79.5±10.0 (79.1 to 80.0)
55–69 years 2024 130.6±19.9 (129.7 to 131.4) 2023 80.4±10.5 (79.9 to 80.8)
Standardized* 10232 118.9±12.7 (118.3 to 119.4) 10227 74.7±8.3 (74.3 to 75.1)
Men
15–24 years 1013 115.7±10.5 (115.1 to 116.4) 1012 71.0±7.6 (70.6 to 71.5)
25–34 years 1019 118.1±11.2 (117.4 to 118.8) 1019 74.8±7.4 (74.4 to 75.3)
35–44 years 1008 120.2±12.1 (119.4 to 120.9) 1007 76.3±8.1 (75.8 to 76.8)
45–54 years 988 126.6±17.5 (125.5 to 127.7) 987 79.6±9.9 (79.0 to 80.2)
55–69 years 1028 130.8±19.1 (129.7 to 132.0) 1028 80.8±10.3 (80.2 to 81.4)
Standardized* 5056 119.4±12.4 (118.5 to 120.1) 5053 74.5±8.1 (74.0 to 75.0)
Women
15–24 years 1057 114.6±10.0 (114.0 to 115.2) 1057 72.7±7.7 (72.3 to 73.2)
25–34 years 1046 115.7±11.7 (115.0 to 116.4) 1045 73.8±8.2 (73.3 to 74.3)
35–44 years 1020 120.0±13.9 (119.1 to 120.8) 1020 76.2±8.3 (75.7 to 76.8)
45–54 years 1057 128.2±19.2 (127.1 to 129.4) 1057 79.5±10.1 (78.9 to 80.1)
55–69 years 996 130.3±20.8 (129.0 to 131.6) 995 80.0±10.6 (79.3 to 80.6)
Standardized* 5176 118.4±12.9 (117.8 to 119.3) 5174 74.8±8.4 (74.4 to 75.4)

* to the Yemen population aged 15 to 69 years in 2008


Table 2S. Age specific rates of hypertension (among all participants), awareness, drug treatment (among hypertensives), and blood pressure control (among treated hypertensives).

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Age groups Hypertensives Prevalence Aware Treated Control
n % (95% Cl) n (%) n (%) n (%)
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All participants
15-24 years 32 1.5 (1.0 to 2.1) 5 (15.6) 4 (12.5) 1 (25.0)
25-34 years 87 4.2 (3.3 to 5.1) 29 (33.3) 23 (26.4) 6 (26.1)
35-44 years 178 8.8 (7.5 to 10.1) 74 (41.6) 67 (37.6) 29 (43.3)
45-54 years 473 23.1 (21.0 to 25.2) 223 (47.1) 197 (41.6) 45 (22.8)
55-69 years 537 26.5 (24.3 to 28.8) 251 (46.7) 237 (44.1) 46 (19.4)
Men
15-24 years 15 1.5 (0.7 to 2.2) 4 (26.7) 3 (20.0) 1 (33.3)
25-34 years 41 4.0 (2.8 to 5.3) 13 (31.7) 10 (24.4) 0 (0.0)
35-44 years 73 7.2 (5.6 to 8.9) 20 (27.4) 17 (23.3) 7 (41.2)
45-54 years 188 19.0 (16.3 to 21.7) 85 (45.2) 73 (38.8) 14 (19.2)
55-69 years 272 26.4 (23.3 to 29.6) 118 (43.4) 112 (41.2) 15 (13.4)
Women
15-24 years 17 1.6 (0.8 to 2.4) 1 (5.9) 1 (5.9) 0 (0.0)
25-34 years 46 4.4 (3.1 to 5.7) 16 (34.8) 13 (28.3) 6 (46.2)
35-44 years 105 10.3 (8.3 to 12.3) 54 (51.4) 50 (47.6) 22 (44.0)
45-54 years 285 27.0 (23.8 to 30.1) 138 (48.4) 124 (43.5) 31 (25.0)
55-69 years 265 26.6 (23.4 to 29.8) 133 (50.2) 125 (47.2) 31 (24.8)

Table 3S. Risk Ratio for the associations between investigated conditions and hypertension (unadjusted and adjusted for decades of age, gender, urban or rural location, geographical area, and level of education).

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Categories Total Yes Unadjusted Adjusted

RR RR (95% Cl)

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Demographics and life environment

Age (per class)

15–24 years 2074 32 1.00 1.00

25–34 years 2067 87 2.80 2.68 (1.77 to 4.06)

35–44 years 2029 178 6.14 5.25 (3.55 to 7.76)

45–54 years 2047 473 19.18 14.31 (9.74 to 21.03)

55–69 years 2025 537 23.03 16.36 (11.08 to 24.16)

Gender

Men 5063 589 1.00 1.00

Women 5179 718 1.22 1.08 (0.94 to 1.24)

Location

Urban 5109 631 1.00 1.00

Rural 5133 676 1.08 1.05 (0.93 to 1.19)

Geographical area

Capital 5017 573 1.00 1.00

Inland 3046 422 1.25 1.23 (1.07 to 1.42)

Coast 2179 312 1.30 1.34 (1.15 to 1.57)

Air temperature (per °C) 8660 1303 1.05 0.98 (0.96 to 0.99)

Level of education

Illiterate 3652 809 1.00 1.00

Can read and write 1205 201 0.70 0.79 (0.65 to 0.95)

Primary school 1346 94 0.26 0.66 (0.52 to 0.84)

Secondary school 1374 58 0.16 0.57 (0.42 to 0.77)

High school 1278 61 0.18 0.61 (0.45 to 0.82)

College or post 1378 84 0.23 0.59 (0.45 to 0.77)

Health behavior and relationship with the Health Care System

Smoking status

Never 7419 862 1.00 1.00

Past 536 142 2.74 1.69 (1.36 to 2.11)

Current occasional 401 72 1.67 1.24 (0.93 to 1.64)

Current daily 1886 231 1.06 0.80 (0.67 to 0.95)

Physical activity

Sedentary 2692 390 1.00 1.00

Active 6722 930 0.79 0.77 (0.68 to 0.88)

Fruit

≤1 day/week 4827 657 1.00 1.00

2–4 day/week 3909 499 0.93 0.97 (0.85 to 1.11)

≥5 days/week 1484 151 0.72 0.73 (0.60 to 0.89)

Vegetables

≤1 day/week 2141 316 1.00 1.00

2–4 day/week 2799 417 1.01 1.01 (0.85 to 1.20)

≥5 days/week 5289 572 0.70 0.69 (0.58 to 0.81)

Last BP measurement

>1 year 7132 580 1.00 1.00

<1 year 2720 664 3.65 3.25 (2.86 to 3.71)

Last FG measurement

>1 year 9630 1057 1.00 1.00

<1 year 605 247 5.60 4.21 (3.49 to 5.08)

Antiplatelet treatment

No 9878 1073 1.00 1.00

Yes 346 228 15.86 12.19 (9.49 to 15.65)

Visited by traditional healer (for hypertension)

No 10134 1225 1.00 1.00

Yes 100 82 33.13 24.21 (13.86 to 42.30)

Treated with traditional medicine (for hypertension)

No 10151 1245 1.00 1.00

Yes 74 59 28.14 25.81 (13.52 to 49.28)

Physical Examination

BMI

1st tertiles 2566 171 1.00 1.00

2nd tertiles 3121 322 1.61 1.25 (1.02 to 1.54)

3rd tertiles 4518 810 3.06 2.00 (1.66 to 2.41)

Risk factors and self-reported established CV conditions

Fasting glucose

Normal 7981 749 1.00 1.00

IFG 1375 262 2.27 1.71 (1.45 to 2.01)

Diabetes 538 237 7.60 4.58 (3.77 to 5.58)

Total cholesterol

<5.0 mmol/L 8742 993 1.00 1.00

≥5.0 mmol/L 1396 307 2.20 1.58 (1.36 to 1.84)

Triglycerides

<1.7 mmol/L 6348 681 1.00 1.00

≥1.7 mmol/L 3894 626 1.59 1.36 (1.20 to 1.55)

Self-reported stroke No 8920 4 1.00 1.00

Yes 1280 25 43.5 43.56 (15.13 to 125.35)

Self-reported myocardial infarction

No 8911 17 1.00 1.00

Yes 1281 22 9.00 9.00 (4.77 to 17.00)

Hypertension= systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg at the two visits and/or self-reported use of antihypertensive drugs at the time of the interview; Diabetes = fasting blood glucose ≥7.0 mmol/L at both the two visits or self-reported use of insulin or oral hypoglycemic medications at the time of the interview.

BMI = body mass index; 1st tertiles = M <20.0, W <20.5 kg/m2; 2nd tertiles = M 20.0 to 23.2, W 20.5 to 24.3 kg/m2; 3rd tertiles = M >23.2, W >24.3 kg/m2.

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Online Supplemental Material.

PA Modesti et al.

Epidemiology of hypertension in Yemen; effects of urbanization and geographical area

Table 4S. Stratification of participants according to the five categories of blood pressure of the European Society of Hypertension/European Society of Cardiology (Normal, N, SBP 120-129 mmHg or DBP 80-84 mmHg; High Normal, HN, SBP 130-139 mmHg or DBP 85-89 mmHg; Grade 1 hypertension, G1HT, SBP 140-159 mmHg or DBP 90-99 mmHg; Grade 2 hypertension, G2HT, SBP 160-179 mmHg or DBP 100-109 mmHg; Grade 3 hypertension, G3HT, SBP ≥180 mmHg or DBP ≥110 mmHg) by age group, gender, and urban/rural location.

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Age group All Urban Rural

N HN G1HT G2HT G3HT N HN G1HT G2HT G3HT N HN G1HT G2HT G3HT

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Overall

15–24 years 1857 164 46 1 2 905 84 19 0 1 952 80 27 1 1

25–34 years 1769 183 97 13 3 871 89 57 4 2 898 94 40 9 1

35–44 years 1574 264 154 31 5 784 147 75 16 3 790 117 79 15 2

45–54 years 1213 349 321 118 44 593 198 153 52 18 620 151 168 66 26

55–69 years 1111 348 372 114 79 600 162 191 46 34 511 186 181 68 45

≥15 years 7524 1308 990 277 133 3753 680 495 118 58 3771 628 495 159 75

Men

15–24 years 908 84 20 0 1 436 42 10 0 1 472 42 10 0 0

25–34 years 873 92 45 7 2 418 49 32 3 2 455 43 13 4 0

35–44 years 781 135 79 12 1 386 78 39 6 1 395 57 40 6 0

45–54 years 613 169 129 55 22 294 103 64 23 11 319 66 65 32 11

55–69 years 543 188 199 59 39 281 82 109 29 16 262 106 90 30 23

≥15 years 3718 668 472 133 65 1815 354 254 61 31 1903 314 218 72 34

Women

15–24 years 949 80 26 1 1 469 42 9 0 0 480 38 17 1 1

25–34 years 896 91 52 6 1 453 40 25 1 0 443 51 27 5 1

35–44 years 793 129 75 19 4 398 69 36 10 2 395 60 39 9 2

45–54 years 600 180 192 63 22 299 95 89 29 7 301 85 103 34 15

55–69 years 568 160 173 55 40 319 80 82 17 18 249 80 91 38 22

≥15 years 3806 640 518 144 68 1938 326 241 57 27 1868 314 277 87 41

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