{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T18:22:17Z","timestamp":1775845337907,"version":"3.50.1"},"reference-count":23,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2012,6,29]]},"published-print":{"date-parts":[[2012]]},"abstract":"<jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>The prevalence of hypertension in developing countries is coming closer to values found in developed countries. However, surveys usually rely on readings taken at a single visit, the option to implement the diagnosis on readings taken at multiple visits, being limited by costs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To estimate more accurately the magnitude and extent of the resource that should be allocated to the prevention of hypertension.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Population-based cross-sectional survey with triplicate blood pressure (BP) readings taken on two separate home-visits.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Rural and urban locations in three areas of Yemen (capital, inland and coast).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>A nationally representative sample of the Yemen population aged 15\u201369\u2005years (5063 men and 5179 women), with an overall response rate of 92% in urban and 94% in rural locations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measure<\/jats:title>\n                  <jats:p>Hypertension diagnosed as systolic BP \u2265140\u2005mm\u2005Hg and\/or diastolic BP \u226590\u2005mm\u2005Hg and\/or self-reported use of antihypertensive drugs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Hypertension prevalence (age-standardised to the WHO world population 2001) based on fulfilling the same criteria on both visits (11.3%; 95% Cl 10.7% to 11.9%), was 35% lower than estimation based on the first visit (17.3%; 16.5% to 18.0%). Advanced age, blood glucose \u22657\u2005mmol\/l or proteinuria \u22651+ at dipstick test at visit one were significant predictors of confirmation at visit 2. The 959 participants found to be hypertensive at visit 1 or at visit 2 only and thus excluded from the final diagnosis had a rate of proteinuria (5.0%; 3.8% to 6.5%) comparable to rates of the general population (6.1%; 5.6% to 6.6%), and of subjects normotensive at both visits (5.6%; 5.1% to 6.2%). Only 1.9% of Yemen population classified at high or very high cardiovascular (CV) risk at visit 1 moved to average, low or moderate CV risk categories after two visits.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Hypertension prevalence based on readings obtained after two visits is 35% lower than estimation based on the first visit, subjects were excluded from final diagnosis belonging to low CV risk classes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2012-001062","type":"journal-article","created":{"date-parts":[[2012,8,9]],"date-time":"2012-08-09T01:31:10Z","timestamp":1344475870000},"page":"e001062","source":"Crossref","is-referenced-by-count":27,"title":["Impact of one or two visits strategy on hypertension burden estimation in HYDY, a population-based cross-sectional study: implications for healthcare resource allocation decision making"],"prefix":"10.1136","volume":"2","author":[{"given":"Pietro Amedeo","family":"Modesti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Rapi","sequence":"additional","affiliation":[{"name":"Department of Laboratory, Azienda Ospedaliero Universitaria Careggi, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Bamoshmoosh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Science and Technology, Science and Technology University Hospital, Sana'a, Yemen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marzia","family":"Baldereschi","sequence":"additional","affiliation":[{"name":"Istituto di Biometeorologia, Italian National Research Council, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciano","family":"Massetti","sequence":"additional","affiliation":[{"name":"Istituto di Biometeorologia, Italian National Research Council, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Padeletti","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian Franco","family":"Gensini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Capital Medical University Affiliated Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawood","family":"Al-Hidabi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Science and Technology, Science and Technology University Hospital, Sana'a, Yemen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Husni","family":"Al Goshae","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Science and Technology, Science and Technology University Hospital, Sana'a, Yemen"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2012,8,8]]},"reference":[{"key":"2025101810462412000_2.4.e001062.1","unstructured":"Rodgers A Vaughan P . World health report 2002: reducing risks, promoting healthy life. Geneva, Switzerland: World Health Organization, 2002. http:\/\/www.who.int\/whr\/2002\/en\/ (accessed 26 Jan 2012)."},{"key":"2025101810462412000_2.4.e001062.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)17741-1"},{"key":"2025101810462412000_2.4.e001062.3","doi-asserted-by":"publisher","DOI":"10.1161\/hc4601.099487"},{"key":"2025101810462412000_2.4.e001062.4","unstructured":"WHO. Global Health Risks. Mortality and Burden of Disease Attributable to Selected Major Risk Factors. Geneva, Switzerland: WHO, 2009. http:\/\/www.who.int\/healthinfo\/global_burden_disease\/global_health_risks\/en\/index.html (accessed 26 Jan 2012)."},{"key":"2025101810462412000_2.4.e001062.5","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e3283282f65"},{"key":"2025101810462412000_2.4.e001062.6","first-page":"151","article-title":"Guidelines Subcommittee","volume":"17","author":"1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension","year":"1999","journal-title":"J Hypertens"},{"key":"2025101810462412000_2.4.e001062.7","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e3281fc975a"},{"key":"2025101810462412000_2.4.e001062.8","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-200303000-00016"},{"key":"2025101810462412000_2.4.e001062.9","first-page":"775","article-title":"Definition of hypertension: the impact of number of visits for blood pressure measurement","volume":"28","author":"Figueiredo","year":"2009","journal-title":"Rev Port Cardiol"},{"key":"2025101810462412000_2.4.e001062.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60308-X"},{"key":"2025101810462412000_2.4.e001062.11","unstructured":"U.S.Census Bureau. International Data Base (IDB). Midyear population by age and sex: Yemen: 2008. http:\/\/www.census.gov\/population\/international\/data\/idb\/country.php (accessed 26 Jan 2012)."},{"key":"2025101810462412000_2.4.e001062.12","unstructured":"WHO STEP programme. http:\/\/www.who.int\/chp\/steps\/en\/ (accessed 26 Jan 2012)."},{"key":"2025101810462412000_2.4.e001062.13","unstructured":"Tolonen H Kuulasmaa K Laatikainen T . Recommendation for indicators, international collaboration, protocol and manual of operations for chronic disease risk factor surveys.(2002). http:\/\/www.ktl.fi\/publications\/ehrm\/product2\/title.htm (accessed 26 Jan 2012)."},{"key":"2025101810462412000_2.4.e001062.14","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-S055"},{"key":"2025101810462412000_2.4.e001062.15","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.19.2486"},{"key":"2025101810462412000_2.4.e001062.16","unstructured":"Rothman KJ Greenland S Lash TL . Modern epidemiology. 3rd edn. Philadelphia: Lippincott Williams & Wilkins, 2008."},{"key":"2025101810462412000_2.4.e001062.17","unstructured":"Ahmad O Boschi-Pinto C Lopez AD . Age standardization of rates: a new WHO standard. GPE Discussion Paper Series: No.31, World Health Organization, 2001. http:\/\/www.who.int\/healthinfo\/paper31.pdf . (accessed 26 Jan 2012)."},{"key":"2025101810462412000_2.4.e001062.18","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.38.3.449"},{"key":"2025101810462412000_2.4.e001062.19","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-148-10-200805200-00004"},{"key":"2025101810462412000_2.4.e001062.20","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-199715030-00004"},{"key":"2025101810462412000_2.4.e001062.21","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.26.6.886"},{"key":"2025101810462412000_2.4.e001062.22","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e32833a38f2"},{"key":"2025101810462412000_2.4.e001062.23","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jhh.1000824"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2012-001062","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T17:46:33Z","timestamp":1760809593000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2012-001062"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012]]},"references-count":23,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2012,8,8]]},"published-print":{"date-parts":[[2012]]}},"alternative-id":["10.1136\/bmjopen-2012-001062"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2012-001062","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012]]}}}