Prevalence, Awareness, Treatment, and Control of Hypertension in Rural and Urban Communities from High-, Middle-, and Low-Income Countries

Supplementary Online Content

Chow CK, Koon KT, Rangarajan S, et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities from high-, middle-, and low-income countries. JAMA. doi:10.1001/jama.2013.184182.

eTable 1. Prevalence of Different Stages of Hypertension (Defined by Blood Pressure Measurements at Time of Survey Only) by Country Income, Gender, and Region eTable 2. Adjusted Mean BP and Prevalence of Hypertension (Adjusted for Age, Sex, Urban/Rural Location) eTable 3. Prevalence of Hypertension by Age Group, Income Status, Sex, and Geographic Region (Unadjusted) eTable 4. Prevalence of Different Stages of Hypertension Stratified by Education (Age, Gender, Location, and Education Adjusted as Relevant) eTable 5. Use of 2 or More BP-Lowering Medications as a Percentage of Those With Hypertension and as a Percentage of Those on Treatments for Hypertension by Economic Status of Country eTable 6. Use of 2 or More BP-Lowering Medications by Education (Age, Gender, Location, and Economic Status Adjusted as Relevant Among All Hypertensive Participants) eTable 7. Prevalence of Hypertension, Awareness, Treatment, and Control in PURE—Absolute Numbers and Percentages eTable 8. PURE Study—Location of Communities and Methodology of Household Sampling eTable 9. Prevalence of Hypertension Stratified by Education (Age, Gender, Location, and Country Economic Status Adjusted as Relevant) (Figure 1A) eTable 10. Awareness of Hypertension Stratified by Education (Age, Gender, Location, and Country Economic Status Adjusted As Relevant) (Figure 1B) eTable 11. Treated Hypertension Stratified by Education (Age, Gender, Location, and Country Economic Status Adjusted as Relevant) (Figure 1C) eTable 12. Controlled Hypertension Stratified by Education (Age, Gender, Location, and Country Economic Status Adjusted as Relevant) (Figure 1D)

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Downloaded From: https://jamanetwork.com/ on 10/02/2021 eTable 1. Prevalence of Different Stages of Hypertension (Defined by Blood Pressure Measurements at Time of Survey Only) by Country Income, Gender, and Region Stage 1 HT Stage 2 HT Stage 3 HT Pre hypertension (120- SBP >= 140 or DBP >= SBP >= 160 or DBP SBP >= 180 or DBP Optimal BP (<120/80) 139/80-89) 90 >= 100 >= 110 Number No. [%] No. [%] No. [%] No. [%] No. [%] HIC 15418 3919(25.4) 6408(41.6) 3566(23.1) 1171( 7.6) 354( 2.3) UMIC 36463 8262(22.7) 12901(35.4) 9251(25.4) 3909(10.7) 2140( 5.9) LMIC 58476 15829(27.1) 21660(37.0) 12766(21.8) 5562( 9.5) 2659( 4.5) LIC 31685 11444(36.1) 11331(35.8) 5613(17.7) 2129( 6.7) 1168( 3.7)

Female 82607 25833(31.3) 28975(35.1) 17093(20.7) 7143( 8.6) 3563( 4.3) Male 59435 13621(22.9) 23325(39.2) 14103(23.7) 5628( 9.5) 2758( 4.6)

South Asia 30903 11289(36.5) 11105(35.9) 5441(17.6) 2026( 6.6) 1042( 3.4) China 45108 11165(24.8) 16542(36.7) 10428(23.1) 4702(10.4) 2271( 5.0) Malaysia 11324 2490(22.0) 4190(37.0) 2840(25.1) 1194(10.5) 610( 5.4) Africa 3813 680(17.8) 1109(29.1) 980(25.7) 571(15.0) 473(12.4) N.America/ EU 20449 5208(25.5) 8137(39.8) 4778(23.4) 1688( 8.3) 638( 3.1) Middle East 6931 2508(36.2) 2703(39.0) 1193(17.2) 396( 5.7) 131( 1.9) S. America 23514 6114(26.0) 8514(36.2) 5536(23.5) 2194( 9.3) 1156( 4.9) All Countries 142042 39454(27.8) 52300(36.8) 31196(22.0) 12771( 9.0) 6321( 4.5) Cut off points for description of the population distribution based on the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7).14 Stage 1,2 and 3 HT groups are not mutually exclusive, stage 1 HT includes stage 2 & 3, Stage 2 HT includes stage 3.

Downloaded From: https://jamanetwork.com/ on 10/02/2021 eTable 2. Adjusted Mean BP and Prevalence of Hypertension (Adjusted for Age, Sex, Urban/Rural Location)

% (95% CI) mm Hg (95% CI) Self-Reported Hypertension on Treatment Country SBP DBP or BP ≥140/90 or BP ≥160/100 Stage 1 HT Stage 2 HT Stage 3 HT Overall 132.7(130.8-134.5) 83.5( 82.5- 84.4) 44.2(40.8-47.7) 24.5(22.3-26.8) 22.3(20.6-24.1) 8.5( 7.7- 9.5) 4.2( 3.5- 4.9) Canada 127.1(121.9-132.4) 79.4( 76.6- 82.1) 30.7(22.7-40.1) 16.0(11.7-21.5) 18.9(14.7-24.0) 4.2( 3.0- 5.8) 1.0( 0.6- 1.7) Sweden 131.7(122.6-140.7) 86.5( 81.8- 91.3) 42.3(26.4-59.9) 19.8(11.7-31.5) 24.2(16.0-34.9) 10.1( 5.9-16.8) 3.6( 1.5- 8.6) UAE 136.9(127.8-146.0) 84.4( 79.6- 89.2) 55.6(37.9-72.0) 33.6(21.2-48.9) 29.9(20.1-42.1) 12.0( 6.9-19.9) 3.9( 1.5- 9.6) Argentina 135.0(126.0-144.1) 82.8( 78.1- 87.5) 50.3(33.2-67.3) 29.6(18.5-44.0) 26.6(17.8-37.8) 9.6( 5.6-15.9) 4.3( 1.8-10.1) Brazil 131.5(122.4-140.5) 86.5( 81.8- 91.3) 50.1(33.0-67.1) 33.3(21.2-48.2) 23.3(15.3-33.7) 8.5( 4.9-14.3) 4.7( 2.0-11.1) Chile 130.7(121.6-139.8) 82.3( 77.6- 87.1) 44.3(28.1-61.9) 26.5(16.2-40.2) 22.3(14.6-32.6) 7.2( 4.1-12.2) 4.2( 1.7-10.0) Malaysia 134.9(129.7-140.1) 81.1( 78.4- 83.8) 44.2(34.4-54.4) 24.3(18.3-31.5) 23.6(18.6-29.5) 8.9( 6.5-12.1) 4.6( 2.7- 7.6) Poland 143.3(134.2-152.4) 85.8( 81.1- 90.6) 63.8(46.3-78.3) 37.8(24.5-53.2) 32.0(21.8-44.2) 14.0( 8.3-22.6) 6.6( 2.8-15.2) South Africa 140.1(133.7-146.5) 90.1( 86.7- 93.5) 63.0(50.6-73.8) 36.2(26.7-47.0) 28.0(21.1-36.0) 15.7(10.9-22.0) 11.2( 6.2-19.5) Turkey 129.2(126.0-132.5) 80.0( 78.2- 81.8) 38.8(32.8-45.3) 23.5(19.5-28.0) 19.2(16.2-22.6) 6.3( 5.0- 8.0) 3.2( 2.2- 4.6) China 132.5(129.9-135.2) 82.6( 81.3- 84.0) 38.5(33.7-43.5) 19.1(16.5-22.0) 21.4(18.9-24.0) 8.8( 7.5-10.2) 3.9( 3.0- 5.1) Colombia 128.1(123.6-132.7) 80.7( 78.4- 83.1) 34.4(26.8-42.9) 19.3(14.8-24.7) 18.0(14.4-22.3) 6.6( 5.0- 8.8) 3.4( 2.1- 5.3) Iran 126.2(117.1-135.2) 78.0( 73.3- 82.7) 27.7(15.8-43.8) 15.2( 8.8-25.1) 16.0(10.2-24.2) 4.7( 2.7- 8.2) 1.5( 0.6- 3.7) Bangladesh 130.5(121.5-139.6) 85.4( 80.6- 90.1) 46.7(30.0-64.1) 25.6(15.6-39.2) 21.2(13.7-31.1) 12.7( 7.5-20.7) 8.3( 3.5-18.6) India 128.9(124.9-133.0) 80.8( 78.7- 83.0) 33.3(26.7-40.7) 15.5(12.2-19.5) 18.6(15.4-22.4) 6.0( 4.7- 7.6) 2.7( 1.8- 4.0) Pakistan 126.9(117.8-136.0) 83.4( 78.6- 88.1) 37.6(22.7-55.2) 20.3(11.9-32.5) 19.1(12.2-28.7) 6.9( 3.9-12.1) 3.8( 1.5- 9.2) Zimbabwe 141.8(132.7-151.0) 88.8( 83.9- 93.6) 54.4(36.7-71.1) 32.3(20.1-47.4) 21.3(13.6-31.7) 11.3( 6.5-19.0) 13.1( 5.6-27.6)

HIC 130.0(125.2-134.8) 81.8( 78.8- 84.8) 37.6(29.1-46.9) 19.6(15.0-25.2) 21.8(17.9-26.3) 6.2( 4.4- 8.8) 1.7( 1.0- 2.9) UMIC 133.0(130.4-135.6) 82.5( 80.8- 84.1) 45.9(40.8-51.2) 27.0(23.6-30.7) 22.8(20.4-25.3) 8.5( 7.0-10.3) 4.5( 3.3- 6.0) LMIC 131.1(128.5-133.7) 81.9( 80.3- 83.6) 36.8(32.1-41.8) 18.9(16.3-21.7) 20.2(18.1-22.4) 7.9( 6.6- 9.5) 3.6( 2.7- 4.8) LIC- 130.5(126.7-134.3) 82.7( 80.3- 85.1) 37.9(31.1-45.2) 18.8(15.2-23.1) 19.3(16.4-22.5) 7.2( 5.5- 9.5) 4.0( 2.6- 6.0)

Downloaded From: https://jamanetwork.com/ on 10/02/2021 eTable 3. Prevalence of Hypertension by Age Group, Income Status, Sex, and Geographic Region (Unadjusted)

Overall <50 years 50 to 60 years ≥60 years

N % N % N % N % HIC 6263 40.73 1360 23.67 2304 43.25 2599 60.39 UMIC 18123 49.73 5490 33.17 6736 57.42 5897 72.25 LMIC 23269 39.85 6925 25.46 8820 46.21 7524 62.18 LIC 10185 32.20 3996 22.60 3114 40.14 3075 49.71

Female 32649 39.58 9913 24.57 12164 47.63 10572 63.67 Male 25191 42.45 7858 29.29 8810 47.97 8523 60.25

South Asia 9751 31.61 3862 22.24 2936 39.28 2953 49.14 China 18915 42.01 5565 27.69 7287 47.54 6063 63.18 Malaysia 5321 47.01 1674 32.16 2004 54.40 1643 67.64 Africa 2160 56.78 891 45.53 778 65.00 491 75.54 North America/ EU 8682 42.56 1935 24.44 3335 47.00 3412 63.33 Middle East 2074 29.92 716 17.81 711 39.30 647 58.71 South America 10937 46.52 3128 29.45 3923 53.64 3886 69.68 All Countries 57840 40.78 17771 26.45 20974 47.77 19095 62.09 Total Number 141834 100.00 67179 100.00 43903 100.00 30752 100.00

Downloaded From: https://jamanetwork.com/ on 10/02/2021 eTable 4. Prevalence of Different Stages of Hypertension Stratified by Education (Age, Gender, Location, and Education Adjusted as Relevant) Overall Low education Middle education High education Sub-Group (%, 95%CI) (%, 95%CI) (%, 95%CI) (%, 95%CI) P value for trend Stage 2 Hypertension by education and country economic level HIC 6.5( 4.6- 9.2) 7.4( 5.1-10.7) 6.7( 4.6- 9.5) 5.6( 3.9- 7.9) 0.0108 UMIC 8.2( 6.7-10.0) 8.7( 7.1-10.5) 8.5( 7.0-10.4) 7.5( 6.0- 9.2) 0.0022 LMIC 7.5( 6.2- 9.0) 8.8( 7.3-10.6) 7.5( 6.2- 9.1) 6.2( 5.1- 7.6) <.0001 LIC 7.4( 5.6- 9.7) 6.7( 5.0- 8.8) 8.3( 6.3-10.9) 7.3( 5.5- 9.8) 0.6565 Stage 3 hypertension by education and country economic level HIC 1.8( 1.0- 3.1) 2.3( 1.3- 4.1) 1.9( 1.1- 3.2) 1.3( 0.7- 2.3) <.0001 UMIC 4.0( 2.9- 5.3) 4.9( 3.6- 6.5) 4.4( 3.3- 6.0) 2.9( 2.0- 4.0) <.0001 LMIC 3.2( 2.4- 4.3) 4.3( 3.3- 5.8) 3.1( 2.4- 4.2) 2.4( 1.7- 3.2) <.0001 LIC 3.8( 2.5- 5.7) 4.0( 2.6- 6.0) 4.7( 3.1- 7.1) 2.9( 1.9- 4.6) 0.0003

Low education =none or primary only education, Middle education = Secondary Education, High education = trade, college or university education.

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eTable 5. Use of 2 or More BP-Lowering Medications as a Percentage of Those With Hypertension and as a Percentage of Those on Treatments for Hypertension by Economic Status of Country Overall HIC UMIC LMIC LIC Total N= 57840 N= 6263 N=18123 N=23269 N=10185 No,(%) No,(%) No,(%) No,(%) No,(%) Percentage of those with 7232(12.5) 1137(18.1) 2638(14.5) 3294(14.1) 163(1.6) hypertension Overall HIC UMIC LMIC LIC Total N= 23510 N= 2924 N=8761 N=8595 N=3230 No,(%) No,(%) No,(%) No,(%) No,(%) Percentage of those on 7273(30.8) 1137(38.9) 2638(30.1) 3294(38.3% 163(5.1) treatment for Hypertension

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eTable 6. Use of 2 or More BP-Lowering Medications by Education (Age, Gender, Location, and Economic Status Adjusted as Relevant Among All Hypertensive Participants)

No education or primary Trade, College or University Overall education Secondary education education Sub-Group %, 95% CI %, 95% CI %, 95% CI %, 95% CI P –value for trend Overall 7.5( 5.8- 9.6) 7.7( 5.9- 9.9) 8.1( 6.2-10.4) 6.8( 5.2- 8.8) 0.0006 Female 8.1( 6.3-10.4) 9.1( 7.0-11.7) 8.9( 6.9-11.5) 6.5( 5.0- 8.5) <.0001 Male 6.9( 5.3- 9.0) 6.5( 5.0- 8.5) 7.3( 5.6- 9.4) 7.0( 5.4- 9.1) 0.9542

Age<50years 4.5( 3.5- 5.9) 5.4( 4.1- 7.0) 5.0( 3.8- 6.6) 3.4( 2.5- 4.6) 0.0019 Age≥50years 9.5( 7.4-12.2) 10.2( 7.9-13.0) 9.6( 7.5-12.4) 8.8( 6.8-11.3) <.0001

Urban 8.0( 6.2-10.3) 8.4( 6.5-10.9) 8.6( 6.6-11.1) 7.2( 5.5- 9.3) 0.0073 Rural 7.3( 5.7- 9.5) 7.5( 5.7- 9.6) 7.5( 5.8- 9.8) 7.1( 5.3- 9.4) 0.8594

HIC 16.2( 8.5-28.8) 16.8( 8.7-30.1) 17.9( 9.4-31.5) 14.0( 7.2-25.5) 0.1697 UMIC 13.2( 9.2-18.6) 15.6(11.0-21.8) 13.8( 9.6-19.5) 10.6( 7.2-15.4) <.0001 LMIC 9.8( 6.8-14.0) 9.3( 6.4-13.4) 10.0( 6.9-14.2) 10.1( 6.9-14.6) 0.4482 LIC 1.6( 0.9- 2.8) 0.8( 0.4- 1.5) 1.9( 1.0- 3.5) 2.4( 1.3- 4.7) 0.0019 Note: Analysis from Mixed Model to take into the effect of clustering.

There is a significant trend by education in women (P<0.0001) but not in men (p=0.9542); in younger (p=0.0019) and older (p=<0.0001); in urban (p=0.0092) and rural (p=0.0387); and LIC (p=0.0003) There are significant interactions of sex X education (p<0.001); age X education (p<0.0046); economic status of countries X education (p<0.0001) but not in urban/rural location X education (p=0.4342).

Downloaded From: https://jamanetwork.com/ on 10/02/2021 eTable 7. Prevalence of Hypertension, Awareness, Treatment, and Control in PURE—Absolute Numbers and Percentages (See Also Table 3 in Main Paper for Adjusted Proportions) Hypertension Awareness Treatment Control Overall Urban Rural Overall Urban Rural Overall Urban Rural Overall Urban Rural HIC 6263(40.7) 4291(39.2) 1972(44.6) 3070(49.0) 2084(48.6) 986(50.0) 2924(46.7) 1978(46.1) 946(48.0) 1189(19.0) 815(19.0) 374(19.0) UMIC 18123(49.7) 9432(48.7) 8691(50.9) 9516(52.5) 5065(53.7) 4451(51.2) 8761(48.3) 4675(49.6) 4086(47.0) 2833(15.6) 1621(17.2) 1212(13.9) LMIC 23269(39.9) 11610(39.9) 11659(39.8) 10134(43.6) 5836(50.3) 4298(36.9) 8595(36.9) 5192(44.7) 3403(29.2) 2314( 9.9) 1618(13.9) 696( 6.0) LIC 10185(32.2) 5787(38.7) 4398(26.4) 4157(40.8) 2689(46.5) 1468(33.4) 3230(31.7) 2169(37.5) 1061(24.1) 1298(12.7) 895(15.5) 403( 9.2) Overall 57840(40.8) 31120(41.9) 26720(39.6) 26877(46.5) 15674(50.4) 11203(41.9) 23510(40.6) 14014(45.0) 9496(35.5) 7634(13.2) 4949(15.9) 2685(10.0) Overall Female Male Overall Female Male Overall Female Male Overall Female Male HIC 6263(40.7) 2958(35.3) 3305(47.2) 3070(49.0) 1547(52.3) 1523(46.1) 2924(46.7) 1447(48.9) 1477(44.7) 1189(19.0) 640(21.6) 549(16.6) UMIC 18123(49.7) 10526(48.1) 7597(52.2) 9516(52.5) 6062(57.6) 3454(45.5) 8761(48.3) 5626(53.4) 3135(41.3) 2833(15.6) 2017(19.2) 816(10.7) LMIC 23269(39.9) 13393(39.0) 9876(41.1) 10134(43.6) 6306(47.1) 3828(38.8) 8595(36.9) 5515(41.2) 3080(31.2) 2314( 9.9) 1474(11.0) 840( 8.5) LIC 10185(32.2) 5772(32.3) 4413(32.1) 4157(40.8) 2525(43.7) 1632(37.0) 3230(31.7) 1903(33.0) 1327(30.1) 1298(12.7) 760(13.2) 538(12.2) Overall 57840(40.8) 32649(39.6) 25191(42.5) 26877(46.5) 16440(50.4) 10437(41.4) 23510(40.6) 14491(44.4) 9019(35.8) 7634(13.2) 4891(15.0) 2743(10.9) Overall Age<50 Age≥50 Overall Age<50 Age≥50 Overall Age<50 Age≥50 Overall Age<50 Age≥50 HIC 6263(40.7) 1360(23.7) 4903(50.9) 3070(49.0) 430(31.6) 2640(53.8) 2924(46.7) 360(26.5) 2564(52.3) 1189(19.0) 159(11.7) 1030(21.0) UMIC 18123(49.7) 5490(33.2) 12633(63.5) 9516(52.5) 2128(38.8) 7388(58.5) 8761(48.3) 1796(32.7) 6965(55.1) 2833(15.6) 686(12.5) 2147(17.0) LMIC 23269(39.9) 6925(25.5) 16344(52.4) 10134(43.6) 2114(30.5) 8020(49.1) 8595(36.9) 1635(23.6) 6960(42.6) 2314( 9.9) 459( 6.6) 1855(11.3) LIC 10185(32.2) 3996(22.6) 6189(44.4) 4157(40.8) 1261(31.6) 2896(46.8) 3230(31.7) 886(22.2) 2344(37.9) 1298(12.7) 450(11.3) 848(13.7) Overall 57840(40.8) 17771(26.5) 40069(53.7) 26877(46.5) 5933(33.4) 20944(52.3) 23510(40.6) 4677(26.3) 18833(47.0) 7634(13.2) 1754( 9.9) 5880(14.7)

Downloaded From: https://jamanetwork.com/ on 10/02/2021 eTable 8. PURE Study—Location of Communities and Methodology of Household Sampling Country Region Method of household sampling Argentina Pampas region, Santa Fe Province All households in a community Bangladesh Dhaka division, Population weighted stratified random sample [from 30 villages Urban - Dhaka city (Rural) and 30 Mohallas (Urban)] Rural - Garpara Union in Manikganj Sadar Sub-District in Manikganj District For each community (either rural or urban), a complete household listing was done and a random sample of households was chosen. Brazil South East region, Sao Paolo State All households in a community (Urban - Sao Paulo City, Angatuba city, Campina do Monte Alegre City, Guarei City) (Rural – regions near Angatuba, Campina do Monte Alegre, Guarei) Canada Ontario – Hamilton and Ottawa, All households in a postcode Quebec – Quebec city, British Colombia - Vancouver Chile Araucania region, Cautin Province Random sample of households in a community China  Beijing – Shuni, Xicheng, Shijingshan district  Inner Mongolia – Bayannor city, Wulate and Line he district  Jiangsu – Nan Jing and Changzhou city, Jianye, Yuhutai, Wujin district  JiangXi – Nanchang City, Qing Shan Hu and Nanchang district  Liaoning – Shenyang city, Yuhong and Shenghe district  Qinghai  ShaanXi – Xian city, Yanta and Yangliang district  Sichuan  Shandong – Jinan city, Licheng, Lixia, Zhangqiu districts  Shanxi – Taiyuan and Xinyhou city, Xinhualing, Xiao dian districts and Yangqu and Jingle counties  Yunnan  Xin Jiang – Hetian city, Hetian and Muyu counties Colombia  Caribbean region – Atlántico, Bolivar and Cesar department All households in a community  Andean Region – Nariño, Cauca, Quindío and Caldas department  Central region – Tolima, Cundinamarca and Santander department  Eastern region – Casanare department India  Karnataka, Bangalore (Palamner rural) All households in a community  Haryana, Chandigarrh (Panchkula rural)  Tamil Nadu, Chennai (Kancheepuram and Thiruvallur District rural)  Rajasthan, Jaipur (Bikaner district rural)  Kerala, Trivandrum district Iran Isfahan province Urban – Random sample of households Rural – All households in a community Malaysia  Selangor/ Negeri/ Sembilan/ Kuala Lumper All households in a community  Kelantan  Pahang/Sabah Pakistan Sindh province All households in a community Poland Lower Silesian Province (Voivoidship) All households in selected representative communities

Downloaded From: https://jamanetwork.com/ on 10/02/2021 …continued eTable 8. PURE Study—Location of Communities and Methodology of Household Sampling Country Region Method of household sampling South  North west province - Southern region and Bophirima region -North West province: Random sample of households in a community Africa  Western Cape- Cape Town -Western & Eastern cape:  Eastern Cape - Mount Frare Urban- Systematic sampling of households in randomly selected streets; Rural- Cluster sampling of 5 randomly selected villages Sweden Västra Götaland Random samples of individuals to identify households in a community Turkey  Istanbul (Maltepe and Sile), Urban-random sample of households in the community;  Eastern Anatolia (Malatya) Rural: all households in the community  Central Anatolia (Nevşehir)  Aegean (Aydin)  Blacksea (North) (Samsun)  Marmara (Kocaeli)  Mediterranean (Antalya)  Southeastern Anatolia (Gaziantep) UAE Dubai Emirate – Dubai city, Mamzer and Hatta (rural) All households in a community Zimbabwe Mashonaland – Urban (Warren Park) and Rural (Seke and Domboshava) Urban - Stratified sampling then all households in sample; Rural - all households in a community

Downloaded From: https://jamanetwork.com/ on 10/02/2021 eTable 9. Prevalence of Hypertension Stratified by Education (Age, Gender, Location, and Country Economic Status Adjusted as Relevant) (Figure 1A)

Low Education (None, Primary Middle education High Education (completed Trade Overall education or Unknown) (Completed high school) or College or University) P value for Sub-Group % % % % trend Overall 38.39 38.40 40.70 36.12 <.0001 Female 36.59 40.83 38.84 30.48 <.0001 Male 40.23 36.03 42.58 42.19 <.0001

Age<50 years 25.73 26.80 27.19 23.31 <.0001 Age≥50 years 52.47 54.92 53.00 49.46 <.0001

Urban 39.73 42.51 40.47 36.28 <.0001 Rural 39.62 37.16 40.94 40.82 0.0038

HIC 40.52 52.59 38.54 31.24 <.0001 UMIC 47.45 49.96 48.71 43.71 <.0001 LMIC 37.76 39.86 38.88 34.62 0.0148 LIC 35.91 28.04 38.20 42.20 <.0001 P values for Interaction of sex, age, location (urban/rural) and country economic group (HIC, UMIC, LMIC, LIC) with education Prob Obs Source DF ChiSq ChiSq 1 ASEX*educ 2 527.47 <.0001 1 age50*educ 2 14.29 0.0008 1 location*educ 2 140.76 <.0001 1 incCtry*educ 6 699.86 <.0001

Downloaded From: https://jamanetwork.com/ on 10/02/2021 eTable 10. Awareness of Hypertension Stratified by Education (Age, Gender, Location, and Country Economic Status Adjusted As Relevant) (Figure 1B) Middle education (Completed High Education (completed Overall Low Education (None, Primary high school) Trade or College or University) Sub-Group % education or Unknown)% % % P value for trend Overall 44.89 42.46 45.24 46.99 <.0001 Female 49.39 49.53 49.35 49.29 0.6666 Male 40.47 35.68 41.19 44.72 <.0001

Age<50 years 32.27 32.36 31.75 32.69 0.4084 Age≥50 years 51.31 49.55 50.59 53.80 <.0001

Urban 48.57 46.79 48.77 50.17 <.0001 Rural 42.98 39.56 41.31 48.19 <.0001

HIC 45.68 46.20 46.08 44.75 0.9592 UMIC 50.57 52.28 48.16 51.26 0.2917 LMIC 43.17 41.50 41.80 46.25 0.2441 LIC 42.97 31.09 48.17 50.48 <.0001 P values for Interaction of sex, age, location (urban/rural) and country economic group (HIC, UMIC, LMIC, LIC) with education Prob Obs Source DF ChiSq ChiSq 1 ASEX*educ 2 74.82 <.0001 1 age50*educ 2 8.75 0.0126 1 location*educ 2 13.25 0.0013 1 incCtry*educ 6 308.88 <.0001

Downloaded From: https://jamanetwork.com/ on 10/02/2021 eTable 11. Treated Hypertension Stratified by Education (Age, Gender, Location, and Country Economic Status Adjusted as Relevant) (Figure 1C) Middle education (Completed High Education (completed Low Education (None, Primary high school) Trade or College or University) Sub-Group Overall education or Unknown) % % % P value for trend Overall 38.69 35.46 39.29 41.43 <.0001 Female 43.32 42.59 43.84 43.53 0.3100 Male 34.27 28.92 34.91 39.36 <.0001

Age<50 years 25.21 25.60 24.73 25.30 0.4763 Age≥50 years 46.14 43.37 45.52 49.56 <.0001

Urban 42.79 40.41 43.02 44.97 <.0001 Rural 36.69 32.18 35.38 42.83 <.0001

HIC 42.64 43.62 42.61 41.70 0.9590 UMIC 46.17 47.34 44.16 47.03 0.0487 LMIC 36.10 33.68 35.16 39.57 0.0530 LIC- 33.43 20.47 38.71 43.81 <.0001 P values for Interaction of sex, age, location (urban/rural), and country economic group (HIC, UMIC, LMIC, LIC) with education. Prob Obs Source DF ChiSq ChiSq 1 ASEX*educ 2 80.69 <.0001 1 age50*educ 2 23.82 <.0001 1 location*educ 2 17.86 0.0001 1 incCtry*educ 6 403.25 <.0001

Downloaded From: https://jamanetwork.com/ on 10/02/2021 eTable 12. Controlled Hypertension Stratified by Education (Age, Gender, Location, and Country Economic Status Adjusted as Relevant) (Figure 1D) Low Education (None, Primary Middle education (Completed High Education (completed education or Unknown) high school) Trade or College or University) Sub-Group Overall % % % P value for trend Overall 12.89 11.13 12.72 15.07 <.0001 Female 15.50 13.94 15.02 17.75 <.0001 Male 10.66 8.84 10.73 12.72 <.0001

Age<50 years 9.76 9.81 9.18 10.30 0.2844 Age≥50 years 14.63 12.47 14.36 17.41 <.0001

Urban 15.52 13.92 15.21 17.59 <.0001 Rural 11.28 9.12 10.43 14.97 <.0001

HIC 15.89 14.20 15.88 17.77 0.0001 UMIC 14.20 14.39 13.03 15.27 0.0140 LMIC 9.59 8.48 9.07 11.43 0.3026 LIC 12.54 7.18 14.60 18.22 <.0001 P values for Interaction of sex, age, location (urban/rural) and country economic group (HIC, UMIC, LMIC, LIC) with education. Prob Obs Source DF ChiSq ChiSq 1 ASEX*educ 2 5.28 0.0714 1 age50*educ 2 22.17 <.0001 1 location*educ 2 10.82 0.0045 1 incCtry*educ 6 153.26 <.000

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