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2.4 Presentation and interpretation of the results
Level 1
In Level 1, the results should be presented using simple figures usually
for men and women separately. Also results for different age groups should be presented
separately if the nature of the results requires that. Figures should be easy to read,
include only limited number of details and convey a clear message.
Major concerns about the data quality should be indicated and low quality
data should be omitted from the presentations.
The figures should have a short written explanation of the results,
followed by a brief interpretation (see Example 2.4.1 and 2.4.2 Interpretation of the results).
EXAMPLE 2.4.1 Presentation of the
results. Prevalence of hypertension, its awareness and treatment in Finland in 1992. Level
1 information.
Public health impact of hypertension
Hypertension is an important and modifiable risk factor for brain
haemorrhage, heart failure and other cardiovascular diseases and renal failure. Blood
pressure can be reduced by increasing the physical activity, reducing the overweight,
reducing salt intake and fat content of food and also by pharmacological treatment. All
these except pharmacological treatment can be modified by changes in lifestyle.
Prevalence of hypertension in Finland in 1992
Hypertension
In 1992, the estimated prevalence of hypertension varied from 32% to 71%
in men and from 11% to 70% in women between age groups. The prevalence is high in
international comparison. The prevalence of hypertension increased by age in both men and
women. In young men (aged 25-34 years) the prevalence was substantially higher than among
women of the same age. (Figure 2.4.1.)
Figure 2.4.1 Prevalence (%) of hypertension in Finland in 1992
Proportion of population with blood pressure measurement in the past
year
Most of Finns have had their blood pressure measured in the past year.
Among young men (25-34 years of age) the proportion was much lower than in young women.
The difference between men and women disappeared with increasing age (Figure 2.4.2.)
Figure 2.4.2 Proportion (%) of population with blood pressure
measurement in the past year
Awareness of hypertension
Among hypertensives (see Section 2.3), less
than 20% of the 25-34 years old population were aware of their elevated blood pressure.
The proportion increased with age but remained below 50% in all age groups. (Figure
2.4.3.).
Figure 2.4.3 Awareness (%) of elevated blood pressure among
hypertensives
Drug treatment of hypertension
Among 25-34 years old hypertensives (see Section
2.3), 2% of men and 3% of women had antihypertensive drug treatment. The treatment
remained below 40% in all age groups in both sexes. (Figure 2.4.4.)
Figure 2.4.4 Prevalence (%) of drug treatment of hypertension
among hypertensives
Results should also be presented by area, and time trends should be given
when ever the information is available. Also comparisons between countries are of
interest, as they facilitate international collaboration in the interpretation of the
results and in the search for methods to improve the public health. The presentations of
the comparisons follow the same basic structure than presentation of results from a single
population. The feasibility of assessment of time trends and international comparisons is
dependent on the standardization of the measurements and reporting.
Level 2
In Level 2, the Level 1 information should be complemented with basic
tables giving the number of subjects in each group and standard errors of reported
mean values and prevalences.
The explanation should include results from the figures and additional
tables and have an interpretation of the results (see 2.4.2 Interpretation of the results).
Level 3
For Level 3 more details behind the basic figures are needed. This
detailed information can be presented in tables or with additional figures, but can also
presented as references to separate publications and reports. (see 2.4.2 Interpretation of the results).
The explanations and interpretations should be more extensive, discussing
different aspects of the results and possible implications or problems. In discussion also
some questions can be raised. The explanations and discussion are typically presented as
references to separate scientific publications.
Level 1
The public health impact of the results should be discussed, taking into
account possible quality issues and representativeness of the results. (see Example 2.4.2).
EXAMPLE 2.4.2 Interpretation of the
results. Prevalence of hypertension, its awareness and treatment in Finland in 1992. Level
1 information.
Limitations of the data
These results are not representative for whole Finland but only for three
areas, two in eastern Finland and one in the western part of the country. Nonetheless, the
results give some idea of situation in the country as a whole.
The actual prevalence of hypertension in population is likely to be
somewhat lower than estimated here. Clinical definition of hypertension requires a series
of blood pressure measurements over time. Here the definition is based on one time
measurement during the survey examination when the blood pressure could have been elevated
due to several other reasons than actual hypertension.
Conclusions
The results show that hypertension is a major public health problem in the
country. The higher prevalence in men than women is striking but in accordance with
results from other countries. This phenomenon can have several reasons. One potential
reason is that among the youngest age group (25-34 years), women's blood pressure is
monitored during pregnancy and also measured during annual visits to the physician if they
are using oral contraceptives. The same is suggested by the big sex difference in the
proportion of women whose blood pressure was measured in the past year (Figure 2.4.2).
Among the older age groups, the proportion of the population with blood
pressure measurement in the past year is reasonably high, and therefore cannot explain the
high prevalence of hypertension. Although the measurement rate is high, the awareness of
hypertension is relatively low. It is likely that that current internationally agreed
definition of hypertension, which uses lower cut-points for systolic and diastolic blood
pressure than the old definition, has not reached the medical practice. Lower levels of
single measurement of blood pressure than in the past should be followed up for diagnosing
of possible hypertension.
The low proportion on hypertensives receiving antihypertensive medication
can be explained partly by non-pharmacological therapy, which should be the first step in
the treatment. However, it is likely that there also exists undertreatment of
hypertension.
Level 2
Level 2, additional to the Level 1, should give possible instructions to
the health care personnel on issues raised by the results. For the case of example 2.4.4,
references to national and/or international guidelines for the management of
hypertension could be given (e.g: Guidelines subcommittee. 1999 World Health Organization
- International Society of Hypertension guidelines for the management of hypertension. J
Hypertens 1999; 17: 151-183. Also available from http://www.eshonline.org/documents/whoish99.pdf).
Level 3
Possible questions for more thorough investigation, risen by the results,
could be specified and discussed here.
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