Articles

Diagnosis, Prevention, and Control of Hypertension in Iran: A SWOT Analysis

Abstract

Abstract
Background: Hypertension is one of the most important risk factors of cardiovascular morbidity and mortality that holds a unique place in population health and health care.
Objectives: Given the exponential rise of high blood pressure as one of the major health problems, this study aimed to investigate the current situation and provide a strengths, weaknesses, opportunities, and threats (SWOT) analysis in the management of hypertension.
Methods: A qualitative study of 12 interviews was conducted with policymakers and managers. The sampling method was purposive sampling. Data collection was performed from January to July 2020. A thematic approach was used to analyze the data. The consolidated criteria for reporting qualitative research 32-item (COREQ-32) checklist was applied to ensure quality control in the study design, analysis, and data reporting.
Results: A total of 12 factors were identified as SWOT. The most important strengths included universal coverage of health services, provision of team-based care, and self-care training. The weaknesses were related to the therapeutic approach, long-term planning, and continuity of programs. Cooperation of other sectors with the health system and the existence of health management training centers were noted as opportunities to better implement hypertension management programs and confront threats such as conflicts of interest between guilds and organizations and crises.
Conclusions: High blood pressure can be prevented. The present direction toward health-oriented policies can be changed in all sectors by taking advantage of the existing strengths and opportunities.

1. Kario K, Chia YC, Sukonthasarn A, Turana Y, Shin J, Chen CH, et al. Diversity of and initiatives for hypertension management in Asia—Why we need the HOPE Asia Network. The Journal of Clinical Hypertension. 2020;22(3):331-43.
2. Olsen MH, Angell SY, Asma S, Boutouyrie P, Burger D, Chirinos JA, et al. A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations: the Lancet Commission on hypertension. The Lancet. 2016;388(10060):2665-712.
3. Kjeldsen SE. Hypertension and cardiovascular risk: general aspects. Pharmacological research. 2018;129:95-9.
4. Fuchs FD, Whelton PK. High blood pressure and cardiovascular disease. Hypertension. 2020;75(2):285-92.
5. Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation. 2016;134(6):441-50.
6. Skeete J, Connell K, Ordunez P, DiPette DJ. Approaches to the Management of Hypertension in Resource-Limited Settings: Strategies to Overcome the Hypertension Crisis in the Post-COVID Era. Integrated Blood Pressure Control. 2020;13:125.
7. Skeete J, Connell K, Ordunez P, DiPette DJ. The American College of Cardiology/American Heart Association 2017 hypertension guideline: Implications for incorporation in Latin America, the Caribbean, and other resource‐limited settings. Wiley Online Library; 2018.
8. Ibrahim MM, Damasceno A. Hypertension in developing countries. The Lancet. 2012;380(9841):611-9.
9. Peters SA, Dunford E, Ware LJ, Harris T, Walker A, Wicks M, et al. The sodium content of processed foods in South Africa during the introduction of mandatory sodium limits. Nutrients. 2017;9(4):404.
10. Wyness LA, Butriss JL, Stanner SA. Reducing the population's sodium intake: the UK Food Standards Agency's salt reduction programme. Public health nutrition. 2012;15(2):254-61.
11. Bader P, Boisclair D, Ferrence R. Effects of tobacco taxation and pricing on smoking behavior in high risk populations: a knowledge synthesis. International journal of environmental research and public health. 2011;8(11):4118-39.
12. Joseph P, Leong D, McKee M, Anand SS, Schwalm J-D, Teo K, et al. Reducing the global burden of cardiovascular disease, part 1: the epidemiology and risk factors. Circulation research. 2017;121(6):677-94.
13. Terzić Z, Vukašinović Z, Bjegović-Mikanović V, Jovanović V, Janičić R. SWOT analysis: The analytical method in the process of planning and its application in the development of orthopaedic hospital department. Srp Arh Celok Lek. 2010;138(7-8):473-9.
14. Gürel E, Tat M. SWOT analysis: a theoretical review. Journal of International Social Research. 2017;10(51).
15. Mirzakhani M, Parsaamal E, Golzar A. Strategy Formulation with SWOT Matrix: A Case Study of an Iranian Company. Global Business & Management Research. 2014;6(2).
16. Li C, Negnevitsky M, Wang X. Prospective assessment of methanol vehicles in China using FANP-SWOT analysis. Transport Policy. 2020;96:60-75.
17. Gao C-Y, Peng D-H. Consolidating SWOT analysis with nonhomogeneous uncertain preference information. Knowledge-Based Systems. 2011;24(6):796-808.
18. Gebremichael GB, Berhe KK, Beyene BG, Gebrekidan KB. Self-care practices and associated factors among adult hypertensive patients in Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia, 2018. BMC research notes. 2019;12(1):1-6.
19. Tan FCJH, Oka P, Dambha-Miller H, Tan NC. The association between self-efficacy and self-care in essential hypertension: a systematic review. BMC Fam Pract. 2021;22(1):1-12.
20. Nerenberg KA, Zarnke KB, Leung AA, Dasgupta K, Butalia S, McBrien K, et al. Hypertension Canada’s 2018 guidelines for diagnosis, risk assessment, prevention, and treatment of hypertension in adults and children. Canadian Journal of Cardiology. 2018;34(5):506-25.
21. Karimi M, Clark AM. How do patients’ values influence heart failure self-care decision-making?: A mixed-methods systematic review. International journal of nursing studies. 2016;59:89-104.
22. Kitt J, Fox R, Tucker KL, McManus RJ. New approaches in hypertension management: a review of current and developing technologies and their potential impact on hypertension care. Current hypertension reports. 2019;21(6):1-8.
23. Tucker KL, Sheppard JP, Stevens R, Bosworth HB, Bove A, Bray EP, et al. Self-monitoring of blood pressure in hypertension: a systematic review and individual patient data meta-analysis. PLoS medicine. 2017;14(9):e1002389.
24. Sajadi HS, Ehsani-Chimeh E, Majdzadeh R. Universal health coverage in Iran: where we stand and how we can move forward. Medical journal of the Islamic Republic of Iran. 2019;33:9.
25. Andermann A. Screening for social determinants of health in clinical care: moving from the margins to the mainstream. Public health reviews. 2018;39(1):1-17.
26. Dubois A, St-Pierre L, Veras M. A scoping review of definitions and frameworks of intersectoral action. Cienc. 2015;20:2933-42.
Files
IssueVol 6, No 2 (2022) QRcode
SectionArticles
DOI https://doi.org/10.18502/htaa.v6i2.12202
Keywords
Hypertension, Prevention, SWOT analysis, Policy, Health services

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How to Cite
1.
Gholizadeh M, Janati A, Khodayari -Zarnaq R, Pezeshki MZ, Arabi Basharic F, rafiee N. Diagnosis, Prevention, and Control of Hypertension in Iran: A SWOT Analysis. Health Tech Ass Act. 2023;6(2).