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Wolsink A, Cliteur MP, van Asch CJ, Boogaarts HD, Dammers R, Hannink G, Schreuder FH, Klijn CJ. Incidence, case fatality, and functional outcome of intracerebral haemorrhage, according to age, sex, and country income level: a systematic review and meta-analysis. THE LANCET REGIONAL HEALTH. EUROPE 2025; 49:101180. [PMID: 39759582 PMCID: PMC11699750 DOI: 10.1016/j.lanepe.2024.101180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Revised: 11/23/2024] [Accepted: 12/02/2024] [Indexed: 01/03/2025]
Abstract
Background Intracerebral haemorrhage (ICH) accounts for approximately 28% of all strokes worldwide. ICH has a high case fatality, and only few survivors recover to independent living. Over the past decades, demographic changes, and changes in prevalence and management of risk factors may have influenced incidence. Widespread implementation of stroke units and improved care in general may have affected case fatality and outcome. We aimed to update the evidence on incidence, case fatality, and functional outcome of ICH, according to age, sex, and country income level. Methods We systematically searched PubMed and Embase from 2008 to April 2023 for prospective population-based studies on incidence, case fatality, or functional outcome of first-ever ICH. We excluded studies in which less than 80% of cases was confirmed with imaging or autopsy. Quality of the studies was assessed based on the used case finding methods. We used inverse variance-based random-effects meta-analyses to pool the crude incidence, case fatality at 1 month, and the percentage of patients with good functional outcome after 3, 6, or 12 months, as defined by the authors of the individual studies. Time trends were assessed using weighted linear meta-regression. Funnel plots were constructed to study publication bias. The review was registered on PROSPERO (CRD42023413314). Findings We identified 70 eligible studies, describing 19,470 ICH patients from 26 different countries. Of these, 62 studies reported on crude incidence, 41 on case fatality, and 10 on functional outcome. Overall crude incidence was 29.2 per 100,000 person-years (95% CI 23.3-36.4; I2 = 100%). Incidence was lower in women than in men and increased with age. Incidence was highest in lower-middle income countries, followed by high and upper-middle income countries. Case fatality at 1 month was 35.5% (95% CI 32.3-38.9; I2 = 90%). The percentage of patients with good functional outcome (mRS 0-2 in nine studies, mRS 0-3 in one) after 3-12 months was 31.2% (95% CI 24.7-38.6; I2 = 76%). We found no time trends in incidence, case fatality, or functional outcome. Interpretation Our results demonstrate the persistently high burden and devastating consequences of ICH, stressing the need for better preventive strategies and acute treatments. Funding None.
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Affiliation(s)
- Axel Wolsink
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands
| | - Maaike P. Cliteur
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands
| | - Charlotte J. van Asch
- Stichting Epilepsie Instellingen Nederland (SEIN), Dr. Denekampweg 20, 8025 BV, Zwolle, the Netherlands
| | - Hieronymus D. Boogaarts
- Department of Neurosurgery, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands
| | - Ruben Dammers
- Department of Neurosurgery, Erasmus Medical Centre, Erasmus MC Stroke Centre, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
| | - Gerjon Hannink
- Department of Medical Imaging, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands
| | - Floris H.B.M. Schreuder
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands
| | - Catharina J.M. Klijn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands
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Inagaki Y, Matsushita K, Appel LJ, Perry HB, Neupane D. Task-sharing with community health workers to treat hypertension: a scoping review. J Hypertens 2024; 42:2041-2054. [PMID: 39469922 PMCID: PMC11556888 DOI: 10.1097/hjh.0000000000003834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 07/01/2024] [Accepted: 07/29/2024] [Indexed: 10/30/2024]
Abstract
Many studies have implemented and evaluated task-sharing interventions with community health workers (CHWs) to manage hypertension. To identify gaps in research, we conducted a scoping review. We searched original articles published in PubMed and EMBASE between 2010 and 2022 and found 122 articles meeting our inclusion criteria. Only seven articles were from low-income countries (LICs), most of which were qualitative studies or mixed methods studies. In the identified 122 articles, CHWs often performed health education (61.3%) and measured blood pressure (60.4%). Whereas CHWs carried out pharmacological treatment in only three studies. Participant homes (75.0%) were the most common setting for receiving interventions. Our study identified specific needs for future research, specifically, studies in LICs that are experimental in design and that collect relevant qualitative information, and studies in which CHWs do advanced task. In addition, publications of CHW studies should provide a more comprehensive list of intervention features.
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Affiliation(s)
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
- Welch Center for Prevention, Epidemiology, and Clinical Research
- Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Lawrence J. Appel
- Department of International Health
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
- Welch Center for Prevention, Epidemiology, and Clinical Research
- Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | | | - Dinesh Neupane
- Department of International Health
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
- Welch Center for Prevention, Epidemiology, and Clinical Research
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Swambulu TM, Mundedi YS, Nsimbi YL, Bompeka FL, Natuhoyila AN, Risasi JRM, Ilunga C, Kintoki Vita E, Kiese DK, Onembo NO, Minga RK, Madoda OT, M'buyamba-Kabangu JR, Phanzu BK. Masked uncontrolled hypertension among elderly black sub-saharan africans compared to younger adults: a cross-sectional in-hospital study. BMC Cardiovasc Disord 2024; 24:472. [PMID: 39232715 PMCID: PMC11373142 DOI: 10.1186/s12872-024-04150-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 08/29/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Although aging and being of African descent are well-known risk factors for masked uncontrolled hypertension (MUCH), data on MUCH among elderly black sub-Saharan Africans (BSSA) are limited. Furthermore, it is unclear whether the determinants of MUCH in younger individuals differ from those in the elderly. OBJECTIVE This study aimed to determine the prevalence and risk factors associated with MUCH in both elderly and younger BSSA individuals. METHODS In this study, 168 patients with treated hypertension were assessed for medical history, clinical examination, fundoscopy, echocardiography, and laboratory data. All patients underwent ambulatory blood pressure (BP) monitoring for 24 h. MUCH was diagnosed if the average 24-h mean BP ≥ 130/80 mmHg, the daytime mean BP ≥ 135/85 mmHg, and/or the nighttime mean BP ≥ 120/70 mmHg, despite controlled clinic BP (≤ 140/90 mmHg). Logistic regression analysis was performed to assess independent factors associated with MUCH, including elderly and younger adults separately. P-values < 0.05 were used to indicate statistical significance. RESULTS Of the 168 patients aged 53.6 ± 11.6 years, 92 (54.8%) were men, with a sex ratio of 1.2, and, 66 (39%) were aged ≥ 60 years. The proportion of patients with MUCH (27.4% for all patients) was significantly higher (p = 0.002) among elderly patients than among younger patients (45.5% vs. 15.7%). Diabetes mellitus (adjusted odds ratio [aOR], 2.44; 95% confidence interval [CI], 1.27-4.46; p = 0.043), anemia (aOR, 3.18; 95% CI, 1.07-5.81; p = 0.043), hypertensive retinopathy (aOR, 4.50; 95% CI, 1.57-5.4; p = 0.043), and left ventricular hypertrophy (aOR, 4.48; 95% CI, 2.26-8.35; p = 0.043) were independently associated with MUCH in the elderly. In younger individuals, male gender (aOR, 2.16; 95% CI, (1.33-4.80); p = 0.029), obesity (aOR, 3.02; 95% CI, (1.26-5.32); p = 0.001), and left ventricular hypertrophy (LVH) (aOR, 3.08; 95% CI, (2.14-6.24); p = 0.019) were independently associated with MUCH were independently associated with MUCH. CONCLUSION MUCH is more prevalent among elderly than among younger BSSA individuals. Determinants of MUCH vary by age. MUCH prevention and management strategies should be age-specific.
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Affiliation(s)
- Tresor Mvunzi Swambulu
- Cardiology Unit, University of Kinshasa, Kinshasa 1, PO Box 1038, Kinshasa, Democratic Republic of Congo
| | - Yannick Samafundu Mundedi
- Cardiology Unit, University of Kinshasa, Kinshasa 1, PO Box 1038, Kinshasa, Democratic Republic of Congo
| | - Yves Lubenga Nsimbi
- Cardiology Unit, University of Kinshasa, Kinshasa 1, PO Box 1038, Kinshasa, Democratic Republic of Congo
| | - François Lepira Bompeka
- Division of Nephrology, Department of Internal Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Aliocha Nkodila Natuhoyila
- Department of Family Medicine and Primary Health Care, Protestant University in the Congo, Kinshasa, Democratic Republic of Congo
| | - Jean-Robert Makulo Risasi
- Division of Nephrology, Department of Internal Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Cédric Ilunga
- Division of Nephrology, Department of Internal Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Eleuthère Kintoki Vita
- Cardiology Unit, University of Kinshasa, Kinshasa 1, PO Box 1038, Kinshasa, Democratic Republic of Congo
| | - Diane Kuntonda Kiese
- Cardiology Unit, University of Kinshasa, Kinshasa 1, PO Box 1038, Kinshasa, Democratic Republic of Congo
| | - Noel Otshudi Onembo
- Cardiology Unit, University of Kinshasa, Kinshasa 1, PO Box 1038, Kinshasa, Democratic Republic of Congo
| | - Roger Kongo Minga
- Unit of cardiology, Clinique Ngaliema, Kinshasa, Democratic Republic of Congo
| | | | | | - Bernard Kianu Phanzu
- Cardiology Unit, University of Kinshasa, Kinshasa 1, PO Box 1038, Kinshasa, Democratic Republic of Congo.
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Zhang X, Li C. Major depressive disorder increased the risk of hypertension: A Mendelian randomization study. J Affect Disord 2024; 355:184-189. [PMID: 38556096 DOI: 10.1016/j.jad.2024.03.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/23/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Despite the high prevalence of comorbid hypertension in patients with major depressive disorder (MDD), the relationship between the two diseases has received little attention. Previous observational studies have descripted the association between MDD and hypertension, the causality from MDD on hypertension remained unknown. The present Mendelian randomization (MR) study aimed to assess the causal effect of MDD on hypertension. METHODS A set of genetics instrument was used for analysis, derived from publicly available genetic meta-analysis data. A total of 44 single-nucleotide polymorphisms (SNPs) associated with MDD. The largest genome-wide association study (GWAS) for hypertension (54,358 cases and 408,652 controls) was used to assess the effect of MDD on hypertension. Inverse variance weighted method (IVW), weighted median method (WM), and MR-Egger regression were used for MR analyses. The MR-Egger_intercept test and Cochran's Q statistic were used to determine the pleiotropy and the heterogeneity, respectively. RESULTS A total of 28 independent and effective MDD genetic instrumental variables were extracted from the hypertension GWAS summary statistics. Pleiotropy analysis suggested no significant pleiotropic variant among the 28 selected MDD genetic instrument variants in hypertension GWAS datasets. As MDD based on genetic changes increased, the risk of hypertension increased using MR-Egger (OR = 1.004436, 95%CI 0.9884666-1.020663, P = 0.5932928), WM (OR = 1.000499, 95%CI 1.0000188-1.000980, P = 0.0416871), and IVW (OR = 1.000573, 95%CI 1.0000732-1.001074, P = 0.0246392). Our results were robust, with no obvious bias based on investigating the single MDD SNP on hypertension. CONCLUSIONS Our result suggested a causal associated between genetically increased MDD and increased hypertension risk in European population.
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Affiliation(s)
- Xu Zhang
- Department of Cardiovascular Surgery, the Second Hospital of Jilin University, Changchun, Jilin, China.
| | - Cheng Li
- Department of Cardiovascular Center, the First Hospital of Jilin University, Changchun, Jilin, China.
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Dimitrijev I, Radovanovic S, Vesic Z, Colakovic G, Selakovic V, Lackovic A, Djordjevic SS, Pesic M, Nesovic D, Lazarevic R, Djordjevic O, Mihaljevic O, Obradovic A, Vukicevic V, Janicijevic N, Radovanovic J. Demographic and Socioeconomic Predictors of Prehypertension and Hypertension in the Adult Population: Serbian National Health Survey. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:824. [PMID: 38793007 PMCID: PMC11122849 DOI: 10.3390/medicina60050824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Prehypertension and hypertension are the most common cardiovascular disorders worldwide and are increasingly considered one of the most serious public health problems, particularly in developing countries. The objective of this study was to determine the frequency and demographic and socioeconomic predictors of prehypertension and hypertension in the adults in Serbia, and to examine the relationship between prehypertension and hypertension and health behavior determinants (smoking, alcohol use, physical activity) and individual aspects of health (a health self-assessment, multimorbidity, BMI, depressive symptoms). Materials and Methods: The research is part of the fourth National Population Health Survey conducted in 2019, which was conducted by the Republic Institute of Statistics, in cooperation with the Institute of Public Health of Serbia and the Ministry of Health of the Republic of Serbia. As a research instrument, questionnaires were used in accordance with the methodology of the European Health Survey. For the purposes of this research, data on the adult population aged 20 and over were used. Results: Women are at a reduced risk for both prehypertension (OR = 0.328) and hypertension (OR = 0.349) by nearly 70%. Similarly, those aged below 60 years have a lower risk for prehypertension and those younger than 40 years have a lower risk for hypertension (OR = 0.995), whereas people with a lower education have a 4.3 times higher risk of prehypertension (OR = 4.323) and a 1.6 times higher risk of hypertension (OR = 1.614). The poor have a 1.4 times higher risk of prehypertension (OR = 1.413) and a 1 times higher risk of hypertension (OR = 1.035). People with multimorbidity have a 1.2 times higher risk of both prehypertension (OR = 1.218) and a 4.8 times higher risk of hypertension (OR = 4.867). Conclusions: Male gender, lower education, poverty, age and the presence of multimorbidity are significant predictors of prehypertension and hypertension in the Serbian adult population, so preventive strategies should be aimed at these sensitive population groups.
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Affiliation(s)
- Igor Dimitrijev
- Department of the High School of Health, Academy of Applied Studies Belgrade, 11000 Belgrade, Serbia; (I.D.); (S.S.D.)
| | - Snezana Radovanovic
- Department of Social Medicine, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Institute for Public Health Kragujevac, 34000 Kragujevac, Serbia
- Center for Research on Harmfull Effects of Biological and Chemical Hazards, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Zoran Vesic
- Faculty of Political Sciences, University of Belgrade, 11000 Belgrade, Serbia;
| | - Goran Colakovic
- Institute for Emergency Medicine of Belgrade, 11000 Belgrade, Serbia; (G.C.); (A.O.); (V.V.)
| | - Viktor Selakovic
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (V.S.); (M.P.); (J.R.)
| | - Ana Lackovic
- Health Center “Dr Milutin Ivković” Palilula, 11000 Belgrade, Serbia;
| | - Slavica S. Djordjevic
- Department of the High School of Health, Academy of Applied Studies Belgrade, 11000 Belgrade, Serbia; (I.D.); (S.S.D.)
| | - Maja Pesic
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (V.S.); (M.P.); (J.R.)
| | - Danijela Nesovic
- Clinical Hospital Center Zemun, Surgery Clinic, Baromedicine Department, 11000 Belgrade, Serbia;
| | | | - Ognjen Djordjevic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Olgica Mihaljevic
- Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Aleksandra Obradovic
- Institute for Emergency Medicine of Belgrade, 11000 Belgrade, Serbia; (G.C.); (A.O.); (V.V.)
| | - Verica Vukicevic
- Institute for Emergency Medicine of Belgrade, 11000 Belgrade, Serbia; (G.C.); (A.O.); (V.V.)
| | - Nikoleta Janicijevic
- Department of Hygiene and Ecology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Jovana Radovanovic
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (V.S.); (M.P.); (J.R.)
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Samaan F, Silveira RC, Mouro A, Kirsztajn GM, Sesso R. Laboratory-based surveillance of chronic kidney disease in people with private health coverage in Brazil. BMC Nephrol 2024; 25:162. [PMID: 38730393 PMCID: PMC11088147 DOI: 10.1186/s12882-024-03597-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 05/03/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Although approximately 25% of Brazilians have private health coverage (PHC), studies on the surveillance of chronic kidney disease (CKD) in this population are scarce. The objective of this study was to estimate the prevalence of CKD in individuals under two PHC regimes in Brazil, who total 8,335,724 beneficiaries. METHODS Outpatient serum creatinine and proteinuria results of individuals from all five regions of Brazil, ≥ 18 years of age, and performed between 10/01/2021 and 10/31/2022, were analyzed through the own laboratory network database. People with serum creatinine measurements were evaluated for the prevalence and staging of CKD, and those with simultaneous measurements of serum creatinine and proteinuria were evaluated for the risk category of the disease. CKD was classified according to current guidelines and was defined as a glomerular filtration rate (GFR) < 60 ml/min/1.73 m² estimated by the 2021 CKD-EPI equation. RESULTS The number of adults with serum creatinine results was 1,508,766 (age 44.0 [IQR, 33.9-56.8] years, 62.3% female). The estimated prevalence of CKD was 3.8% (2.6%, 0.8%, 0.2% and 0.2% in CKD stages 3a, 3b, 4 and 5, respectively), and it was higher in males than females (4.0% vs. 3.7%, p < 0.001, respectively) and in older age groups (0.2% among 18-29-year-olds, 0.5% among 30-44-year-olds, 2.0% among 45-59-year-olds, 9.4% among 60-74-year-olds, and 32.4% among ≥ 75-year-olds, p < 0.001) Adults with simultaneous results of creatinine and proteinuria were 64,178 (age 57.0 [IQR, 44.8-67.3] years, 58.1% female). After adjusting for age and gender, 70.1% were in the low-risk category of CKD, 20.0% were in the moderate-risk category, 5.8% were in the high-risk category, and 4.1% were in the very high-risk category. CONCLUSION The estimated prevalence of CKD was 3.8%, and approximately 10% of the participants were in the categories of high or very high-risk of the disease. While almost 20% of beneficiaries with PHC had serum creatinine data, fewer than 1% underwent tests for proteinuria. This study was one of the largest ever conducted in Brazil and the first one to use the 2021 CKD-EPI equation to estimate the prevalence of CKD.
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Affiliation(s)
- Farid Samaan
- Department of High Complexity Patients, Hapvida NotreDame Intermédica, Rua Hipódromo, 987 - Mooca, São Paulo, SP, 03164-140, Brazil.
- Secretaria de Estado da Saúde de São Paulo, São Paulo, SP, Brazil.
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
| | | | - Amilton Mouro
- Department of High Complexity Patients, Hapvida NotreDame Intermédica, Rua Hipódromo, 987 - Mooca, São Paulo, SP, 03164-140, Brazil
| | | | - Ricardo Sesso
- Disciplina de Nefrologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Lacombe K, Moh R, Chazallon C, Lemoine M, Sylla B, Fadiga F, Le Carrou J, Marcellin F, Kouanfack C, Ciaffi L, Sartre MT, Sida MB, Diallo A, Gozlan J, Seydi M, Cissé V, Danel C, Girard PM, Toni TD, Minga A, Boyer S, Carrieri P, Attia A. Feasibility, safety, efficacy and potential scaling-up of sofosbuvir-based HCV treatment in Central and West Africa: (TAC ANRS 12311 trial). Sci Rep 2024; 14:10244. [PMID: 38702350 PMCID: PMC11068860 DOI: 10.1038/s41598-024-57013-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/13/2024] [Indexed: 05/06/2024] Open
Abstract
Access to Hepatis C treatment in Sub-Saharan Africa is a clinical, public health and ethical concern. The multi-country open-label trial TAC ANRS 12311 allowed assessing the feasibility, safety, efficacy of a specific care model of HCV treatment and retreatment in patients with hepatitis C in Sub Saharan Africa. Between November 2015 and March 2017, with follow-up until mid 2019, treatment-naïve patients with HCV without decompensated cirrhosis or liver cancer were recruited to receive 12 week-treatment with either sofosbuvir + ribavirin (HCV genotype 2) or sofosbuvir + ledipasvir (genotype 1 or 4) and retreatment with sofosbuvir + velpatasvir + voxilaprevir in case of virological failure. The primary outcome was sustained virological response at 12 weeks after end of treatment (SVR12). Secondary outcomes included treatment adherence, safety and SVR12 in patients who were retreated due to non-response to first-line treatment. The model of care relied on both viral load assessment and educational sessions to increase patient awareness, adherence and health literacy. The study recruited 120 participants, 36 HIV-co-infected, and 14 cirrhotic. Only one patient discontinued treatment because of return to home country. Neither death nor severe adverse event occurred. SVR12 was reached in 107 patients (89%): (90%) in genotype 1 or 2, and 88% in GT-4. All retreated patients (n = 13) reached SVR12. HCV treatment is highly acceptable, safe and effective under this model of care. Implementation research is now needed to scale up point-of-care HCV testing and SVR assessment, along with community involvement in patient education, to achieve HCV elimination in Sub-Saharan Africa.
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Affiliation(s)
- Karine Lacombe
- Infectious Diseases Department, Inserm IPLESP, UMR-S1136, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, Paris, France.
- Service des Maladies Infectieuses et Tropicales, Hôpital St Antoine, 184 rue du Fbg St Antoine, 75012, Paris, France.
| | - Raoul Moh
- Unité Pédagogique de Dermatologie et Infectiologie, Université Félix Houphouet-Boigny, Abidjan, Côte d'Ivoire
- Programme PAC-CI, Site ANRS de Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Corine Chazallon
- National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, University of Bordeaux, Bordeaux, France
| | - Maud Lemoine
- Hepatology Unit, Digestive Disease Division, Imperial College London, St Mary's Hospital, London, UK
| | - Babacar Sylla
- IMEA, Hôpital Bichat - Claude Bernard, Paris, France
| | - Fatoumata Fadiga
- Programme PAC-CI, Site ANRS de Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Jerôme Le Carrou
- National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, University of Bordeaux, Bordeaux, France
| | - Fabienne Marcellin
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Aix Marseille Univ, Marseille, France
| | | | - Laura Ciaffi
- TransVIHMI - IRD UMI233 - INSERM U1175, Université de Montpellier, Montpellier, France
| | | | - Magloire Biwole Sida
- Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé 1, Yaoundé, Cameroon
| | - Alpha Diallo
- Service de Pharmacovigilance, ANRS, Paris, France
| | - Joel Gozlan
- Department of Virology, INSERM, UMR_S 938, Centre de Recherche Saint-Antoine, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, Paris, France
| | - Moussa Seydi
- Service des Maladies Infectieuses et Tropicales, CHNU de Fann, Dakar, Senegal
| | - Viviane Cissé
- Service des Maladies Infectieuses et Tropicales, Centre Régional de Recherche et de Formation, Site ANRS, CHNU de Fann, Dakar, Senegal
| | | | - Pierre Marie Girard
- Infectious Diseases Department, Inserm IPLESP, UMR-S1136, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, Paris, France
| | - Thomas d'Aquin Toni
- Service de Virologie, Centre de diagnostic et de recherche sur le SIDA, CHU Treichville, Abidjan, Côte d'Ivoire
| | - Albert Minga
- Centre National des Donneurs de Sang, Abidjan, Côte d'Ivoire
| | - Sylvie Boyer
- Hôpital de Jour, Hôpital Central, Yaoundé, Cameroon
| | | | - Alain Attia
- Service d'hépatologie, CHU de Yopougon, Abidjan, Côte d'Ivoire
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Abebe AT, Kebede YT, Mohammed BD. An Assessment of the Prevalence and Risk Factors of Hypertensive Crisis in Patients Who Visited the Emergency Outpatient Department (EOPD) at Adama Hospital Medical College, Adama, Oromia, Ethiopia: A 6-Month Prospective Study. Int J Hypertens 2024; 2024:6893267. [PMID: 38711482 PMCID: PMC11073854 DOI: 10.1155/2024/6893267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 04/02/2024] [Accepted: 04/09/2024] [Indexed: 05/08/2024] Open
Abstract
Background Over 1 billion people worldwide suffer from the common chronic medical condition of hypertension. A hypertensive crisis occurs when blood pressure exceeds 180/110 mmHg. Depending on whether the target organ is harmed, the situation may be presented as a hypertensive emergency or urgency. Objective To assess the prevalence and risk factors of patients with hypertensive crises who visited the Emergency Outpatient Department (EOPD) at Adama Hospital Medical College in Adama, Oromia, Ethiopia, between January 01 and August 31, 2021, G.C. Methodology. A cross-sectional, prospective study on the hypertensive crisis was conducted at Adama Hospital Medical College from January 01 to August 31, 2021, G.C. The data were collected using a standardized questionnaire, validated for completeness, and analyzed using SPSS. The findings were tabulated, and conclusions and recommendations were conveyed. Result Out of 9,082 patients who visited the EOPD during the six-month period, 444 individuals with hypertensive crises were identified, representing a prevalence of 4.9%. Of these, 56.8% were men, resulting in a M : F ratio of 1.31 : 1. Those between the ages of 66 and 75 were the most affected. At presentation, 91.0% of the study participants were known hypertensive patients. Among the known hypertensive patients, the majority (34.9%) were known to have been hypertensive for 5-10 years. Of the known hypertensive patients, 48.6% were found to be adherent. Hypertensive urgency was discovered to be far more common than hypertensive emergencies (63.5% vs. 36.5%). Headache was the most common presenting symptom, and most patients (36.5%) presented to the health setup in less than 24 hours. The main risk variables identified were drug discontinuation, family history of hypertension, salt consumption, and alcohol usage. The main excuse for the lack of adherence was the cost of the medications. More than half of the patients do not have any additional comorbidities, and of those who do, diabetes mellitus is the most prevalent. A stroke was identified as a major complication. Conclusions and Recommendations. Hypertensive crises are one of the most prevalent reasons for EOPD admission and are linked to significant consequences. At presentation, most of the study subjects were known hypertension patients. Diabetes mellitus was discovered to be a comorbid condition in one-quarter of them. Although more than half of the patients had improved, the death rate still remained high. Infrastructure and capacity building to provide hospitals with the requisite baseline investigations are among the government's recommendations. Health practitioners are expected to make improvements, such as by educating the public about the need for lifestyle changes and evaluating and managing any hypertension problems.
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Affiliation(s)
- Abel Tezera Abebe
- School of Medicine, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Yabets Tesfaye Kebede
- School of Medicine, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Bekri Delil Mohammed
- School of Medicine, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Mohammadi E, Yoosefi M, Shaker E, Shahmohamadi E, Ghasemi E, Ahmadi N, Azadnajafabad S, Rashidi MM, Rezaei N, Koolaji S, Dilmaghani-Marand A, Fateh SM, Kazemi A, Haghshenas R, Rezaei N. 'Inequalities in prevalence of hypertension, prehypertension, anti-hypertensive coverage, awareness, and effective treatment in 429 districts of Iran; a population-based STEPS 2016 small area spatial estimation model'. J Diabetes Metab Disord 2023; 22:1095-1103. [PMID: 37975079 PMCID: PMC10638340 DOI: 10.1007/s40200-023-01186-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 01/10/2023] [Indexed: 11/19/2023]
Abstract
Purpose While many studies have reported hypertension (HTN) and pre-hypertension (PHTN) in large geographic locations of Iran, information regarding district levels is missing. We aimed to examine inequalities in the prevalence of hypertension, prehypertension, anti-hypertensive coverage, awareness, and effective treatment of adults in districts of Iran. Methods We used 27,165 participants' data from the STEPS 2016 study in Iran. A small area estimation model was carried out to predict HTN in the 429 districts of Iran. HTN and PHTN were defined based on the American Heart Association Guideline. Awareness of being hypertensive, treatment coverage, and effective treatment were also estimated. Results HTN's crude prevalence was estimated to be in the range of 11.5-42.2% in districts. About PHTN, it was estimated to be 19.9-56.1%. Moreover, for awareness, treatment coverage, and effective treatment crude estimates ranged from 24.3 to 79.9%, 9.1 - 64.6%, and 19.5 - 68.3%, respectively, indicating inequalities in the distribution of aforementioned variables in 429 districts of Iran. Overall, better conditions were detected in central geographical locations and in females. Conclusion The inequality of increased blood pressure disorder and related measures are high in districts of Iran and pave the way for policymakers and local health organizers to use the findings of this study to address the inequity of existing resources and improve HTN control. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01186-5.
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Affiliation(s)
- Esmaeil Mohammadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, 1411713136 Tehran, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, 1411713136 Tehran, Iran
| | - Elaheh Shaker
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, 1411713136 Tehran, Iran
| | - Elnaz Shahmohamadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, 1411713136 Tehran, Iran
| | - Erfan Ghasemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, 1411713136 Tehran, Iran
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, 1411713136 Tehran, Iran
| | - Sina Azadnajafabad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, 1411713136 Tehran, Iran
| | - Mohammad-Mahdi Rashidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, 1411713136 Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, 1411713136 Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sogol Koolaji
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, 1411713136 Tehran, Iran
| | - Arezou Dilmaghani-Marand
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, 1411713136 Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Mohammadi Fateh
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, 1411713136 Tehran, Iran
| | - Ameneh Kazemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, 1411713136 Tehran, Iran
| | - Rosa Haghshenas
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, 1411713136 Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, 1411713136 Tehran, Iran
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Ying M, Shao X, Qin H, Yin P, Lin Y, Wu J, Ren J, Zheng Y. Disease Burden and Epidemiological Trends of Chronic Kidney Disease at the Global, Regional, National Levels from 1990 to 2019. Nephron Clin Pract 2023; 148:113-123. [PMID: 37717572 PMCID: PMC10860888 DOI: 10.1159/000534071] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 08/17/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a serious public health issue worldwide, but the disease burden of CKD caused by different etiologies and changing trends has not been fully examined. METHODS We collected data from Global Burden of Disease Study 2019 (GBD 2019), including incident cases, age-standardized incidence rate (ASIR), disability-adjusted life years (DALYs), and age-standardized DALY rate between 1990 and 2019 by region, etiology, age, and sex, and calculated the estimated annual percentage change (EAPC) of the rate to evaluate the epidemiological trends. RESULTS Globally, incident cases of CKD increased from 7.80 million in 1990 to 18.99 million in 2019, and DALYs increased from 21.50 million to 41.54 million. ASIR increased with an EAPC of 0.69 (95% uncertainty interval [UI] 0.49-0.89) and reached 233.65 per 100,000 in 2019, while the age-standardized DALY rate increased with an EAPC of 0.30 (95% UI 0.17-0.43) and reached 514.86 per 100,000. North Africa and the Middle East, central Latin America, and North America had the highest ASIR in 2019. Central Latin America had the highest age-standardized DALY rate, meanwhile. Almost all countries experienced an increase in ASIR, and over 50% of countries had an increasing trend in age-standardized DALY rate from 1990 to 2019. CKD due to diabetes mellitus type 2 and hypertension accounted for the largest disease burden with 85% incident cases and 66% DALYs in 2019 of known causes, with the highest growth in age-standardized DALY rate and a similar geographic pattern to that of total CKD. Besides, the highest incidence rate of total and four specific CKDs were identified in people aged 70 plus years, who also had the highest DALY rate with a stable trend after 2010. Females had a higher ASIR, while males had a higher age-standardized DALY rate, the gap of which was most distinctive in CKD due to hypertension. CONCLUSION The disease burden of CKD remains substantial and continues to grow globally. From 1990 to 2019, global incident cases of CKD have more than doubled and DALYs have almost doubled, and surpassed 40 million years. CKD due to diabetes mellitus type 2 and hypertension contributed nearly 2/3 of DALYs in 2019 of known causes, and had witnessed the highest growth in age-standardized DALY rate. Etiology-specific prevention strategies should be placed as a high priority on the goal of precise control of CKD.
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Affiliation(s)
- Meike Ying
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xue Shao
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hongli Qin
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Pei Yin
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yushi Lin
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jingjing Ren
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yang Zheng
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Koleva G, Hristova I, Georgieva D, Yotov Y. Blood pressure reduction in difficult-to-control patients and the effect of a nurse-led program in Bulgaria. JOURNAL OF VASCULAR NURSING 2023; 41:125-131. [PMID: 37684090 DOI: 10.1016/j.jvn.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 04/21/2023] [Accepted: 05/29/2023] [Indexed: 09/10/2023]
Abstract
Hypertension is a major contributor to cardiovascular morbidity and mortality. Although there has been significant improvement in blood pressure (BP) control during the last decades, it is still far from optimal. Several strategies for hypertension management have been proposed, and among all - nurse-led programs seem encouraging. AIM To evaluate the effect of a complex nurse program aiming to reduce BP in patients with uncontrolled hypertension. PATIENTS AND METHODS In a cardiologist's office, a trained nurse included patients with uncontrolled hypertension and newly referred patients with high BP in a program for hypertension management. It consisted of patient education, assessment of quality of life, lifestyle advice, medication improvement and adherence stimulation. All patients were followed for 6 months and their BP, lifestyle indicators, and quality of life measurements were recorded. Statistical analyses included two- and one sample t-tests, chi-square test, correlation and multivariate linear regression. RESULTS Overall, 47 patients, presenting with uncontrolled hypertension and with BP>140/90 mm Hg were included in this research. Their BP was reduced within 6 months by mean 30 /11 mm Hg and after 6 months, from 162/88 to 133/77 mm Hg. The drop of BP values was present at the first month with mean BP 140/82 mm Hg. Control of hypertension improved from 2% to 55% at the 1st month mark and to 79% at the 6th month, p<0.0001. The decrease in SBP was positively correlated to decrease in waist circumference, p = 0.47, p = 0.009. In multivariate linear regression analysis, the difference in BP was significantly related to self-assessment health scoring and marginally significant with renal impairment. CONCLUSIONS The development of a complex nurse-led program, tailored to patients with uncontrolled hypertension, leads to significant positive effect on BP decrease and improves hypertension control in primary care. This may be cost effective and improve BP control in low- to middle-income countries.
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Affiliation(s)
- Greta Koleva
- Ruse University "Angel Kanchev", Department of Health care, Faculty of public health and health care, Bulgaria
| | - Irinka Hristova
- Ruse University "Angel Kanchev", Department of Health care, Faculty of public health and health care, Bulgaria.
| | - Despina Georgieva
- Ruse University "Angel Kanchev", Department of Health care, Faculty of public health and health care, Bulgaria
| | - Yoto Yotov
- First Department of Internal Medicine, Faculty of Medicine, Medical University "Prof. Dr. P. Stoyanov"-Varna, Bulgaria
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Ezeala-Adikaibe BA, Mbadiwe CN, Okafor UH, Nwobodo UM, Okwara CC, Okoli CP, Anyim OB, Anigbo EG, Chime PE, Ezeme MS, Onyebueke CG, Abonyi CM, Udeh CA, Okechukwu CU, Onodugo PN, Okpara CT, Nnaji OT, Obumneme-Anyim I, Orjioke C, Ekochin CF, Onyekonwu LC, Onodugo OD, Nwosu IN. Prevalence of hypertension in a rural community in southeastern Nigeria; an opportunity for early intervention. J Hum Hypertens 2023; 37:694-700. [PMID: 37120682 DOI: 10.1038/s41371-023-00833-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 04/01/2023] [Accepted: 04/18/2023] [Indexed: 05/01/2023]
Abstract
Hypertension is a leading cause of non-communicable morbidity in Sub Saharan Africa. Recent studies suggest and increase in the prevalence of hypertension in rural Sub-Saharan Africa. Using a three-phase approach, a structured questionnaire was used to determine the prevalence of hypertension in a rural settlement is Enugu State, Southeast Nigeria. Blood pressure measurement was done according to the guidelines of the European Society of Hypertension. Out of 1576 participants aged 18 years and above, 1082 (68.7%) completed the full survey, their blood pressure was measured, and data analyzed. The prevalence of hypertension in this study was 27.6%, (95%CI 25-30.4), similar in males 29.2, (95%CI 24.7-30.4) and females 26.8%, (95%CI 23.5-30.2). p = 0.39. The prevalence of hypertension increased with age reaching a peak of 32.8% (95%CI 26.2-40) in the 40-49 age group, however this was not statistically significant P = 0.22. This age-related increase in the prevalence of hypertension tended towards significance in males (p = 0.05) but not in females (p = 0.44). Awareness of hypertension was 7.2%. Systolic blood pressure positively correlated with older age, higher blood glucose levels and waist-hip ratio. Diastolic blood pressure correlated with the type of work the patients is involved in and blood glucose levels. In conclusion, the prevalence of hypertension in a rural southeastern Nigeria community was 27.6%, however awareness was very low (7.9%). Most participants had mild hypertension thus offering a window of opportunity for public health educators in preventing the complications of hypertension. There is therefore the need for awareness campaigns to be intensified in rural communities.
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Affiliation(s)
- Birinus A Ezeala-Adikaibe
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria.
- Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria.
| | - Chigekwu Nkeiruka Mbadiwe
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
- Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | | | - Ume Monday Nwobodo
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | - Chibuzo Celestine Okwara
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
- Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Chibuike Paul Okoli
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | | | - Ekene Gideon Anigbo
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | - Peter Ekpunobi Chime
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | - Mark Sunday Ezeme
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | | | | | - Callistus Afam Udeh
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | | | - Pauline Nkiruka Onodugo
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
- Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | | | - Obiora Thomas Nnaji
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | | | - Casmir Orjioke
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
| | | | - Laura Chinwe Onyekonwu
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
- Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | | | - Ikechukwu Nnamdi Nwosu
- Department of Medicine, Enugu State University Teaching Hospital, Enugu, Nigeria
- Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
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Kumagai N, Nishimura S, Jakovljević M. Could high continuity of care (COC) have a negative impact on subjective health of hypertensive patients? A Japanese perspective. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2023; 21:39. [PMID: 37344814 DOI: 10.1186/s12962-023-00448-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 06/14/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Cardiovascular diseases, such as stroke and ischemic heart disease attributable to hypertension, are major causes of premature death in Japan and worldwide. Nevertheless, a low rate of blood pressure control among hypertensive patients has been observed in most countries. No previous studies have explored the effectiveness of physician visits among hypertensive patients in Japan. METHODS To quantify the effects of persistence in physician visits among hypertensive patients, we evaluated the causal effect of physician visits on the health of hypertensive patients. We used 16 waves of nationally representative longitudinal data drawn from the Longitudinal Survey of Middle-aged and Elderly Persons in Japan (2005-2020). To examine the causal effect of physician visits on patients' health outcomes, we used inverse probability treatment weights and doubly robust estimation and obtained the estimates of the average treatment effects on the treated (ATETs). RESULTS Covariates were well balanced among patients who had physician visits during the past two consecutive years (N = 67,210; 64.9% among hypertensive patients). The estimated ATETs suggest that three consecutive years of physician visits had a negative impact on poor subjective health. Furthermore, patients without habitual exercise tended to not continue physician visits and perceived poor subjective health. CONCLUSIONS Although the impact of frequent physician visits on blood pressure stability remains uncertain, regular appointments every 30 days can be effective for individuals with hypertension, particularly if they receive continuous instruction from their family physician. Because it is important for physicians to strengthen hypertensive patients' blood pressure control, promoting consecutive physician visits to hypertensive patients with diabetes, lower educational attainment, or smoking habits is needed.
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Affiliation(s)
- Narimasa Kumagai
- Faculty of Economics, Seinan Gakuin University, 6-2-92 Nishijin Sawara-Ku, Fukuoka, 814-8511, Japan.
| | - Shuzo Nishimura
- Professor Emeritus of Kyoto University, Kyoto, Japan
- Faculty of Economics and Business Administration, Kyoto University of Advanced Science, Kyoto, Japan
| | - Mihajlo Jakovljević
- Institute of Advanced Manufacturing Technologies, Peter the Great St. Petersburg Polytechnic University, St. Petersburg, Russia
- Institute of Comparative Economic Studies, Hosei University, Chiyoda-Ku, Tokyo, Japan
- Department of Global Health Economics and Policy, University of Kragujevac, Kragujevac, Serbia
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Sebastião CS, Sacomboio E, Francisco NM, Paixão J, Cassinela EK, de Vasconcelos JN, Pimentel V, Morais J. Demographic characteristics and risk factors related to high blood pressure among healthy blood donors from Luanda, Angola: A retrospective study. Health Sci Rep 2023; 6:e1300. [PMID: 37305153 PMCID: PMC10248479 DOI: 10.1002/hsr2.1300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 06/13/2023] Open
Abstract
Background and Aims Hypertension is a public health concern, mainly in resource-limited countries. We investigated the characteristics and risk factors related to high blood pressure in healthy blood donors from, Luanda, the capital city of Angola. Methods This was a retrospective study that included 343 healthy donors from December 2019 to September 2020. Results The mean age was 32 ± 9 years. Men represented 93% of the population. Mean systolic blood pressure (SBP) was 131 ± 12.3 mmHg (ranging from 100 to 160 mmHg) and diastolic blood pressure (DBP) was 80.1 ± 9.72 mmHg (from 56.0 to 100 mmHg). DBP was related to age and gender (p < 0.05). About 7.3% of the donors had high-pressure (>140/90 mmHg). Age between 20 and 40 years (odds ratio [OR]: 2.52, p = 0.043), women (OR: 1.87, p = 0.548), nonurbanized areas (OR: 0.39, p = 0.067), high educational level (OR: 0.76, p = 0.637), employed (OR: 0.49, p = 0.491), voluntary donors (OR: 0.87, p = 0.799), blood group B (OR: 2.06, p = 0.346), and Rh- (OR: 0.26, p = 0.104), were potentially related with high-pressure. The high-pressure cases increased from December 2019 (4%) to September 2020 (28%) (p = 0.019). Conclusion We showed high pressure among the healthy blood donors population. Demographic characteristics, ABO/Rh blood group, and year period are features that should be considered in cardiovascular disease control strategies. Biological and nonbiological features related to blood pressure changes should be considered for further studies in the Angolan population.
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Affiliation(s)
- Cruz S. Sebastião
- Instituto Nacional de Investigação em Saúde (INIS)LuandaAngola
- Centro de Investigação em Saúde de Angola (CISA)CaxitoAngola
- Instituto de Ciências da Saúde (ICISA)LuandaAngola
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT)LisbonPortugal
| | - Euclides Sacomboio
- Instituto Nacional de Investigação em Saúde (INIS)LuandaAngola
- Instituto de Ciências da Saúde (ICISA)LuandaAngola
- Centro de Estudos, Investigação Cientifica e Pós‐graduação (CEIP)LuandaAngola
| | | | - Joana Paixão
- Instituto Nacional de Investigação em Saúde (INIS)LuandaAngola
| | - Edson K. Cassinela
- Centro de Estudos, Investigação Cientifica e Pós‐graduação (CEIP)LuandaAngola
- Centro Nacional de Investigação Científica (CNIC)LuandaAngola
| | - Jocelyne Neto de Vasconcelos
- Instituto Nacional de Investigação em Saúde (INIS)LuandaAngola
- Centro de Investigação em Saúde de Angola (CISA)CaxitoAngola
| | - Victor Pimentel
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT)LisbonPortugal
| | - Joana Morais
- Instituto Nacional de Investigação em Saúde (INIS)LuandaAngola
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT)LisbonPortugal
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Baah-Nyarkoh E, Alhassan Y, Dwomoh AK, Kretchy IA. Medicated-related burden and adherence in patients with co-morbid type 2 diabetes mellitus and hypertension. Heliyon 2023; 9:e15448. [PMID: 37151709 PMCID: PMC10161589 DOI: 10.1016/j.heliyon.2023.e15448] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/03/2023] [Accepted: 04/09/2023] [Indexed: 05/09/2023] Open
Abstract
Background Medication adherence is an integral component in the management of patients with co-morbid type 2 diabetes mellitus (T2DM) and hypertension. However due to their combined conditions, there is likelihood of polypharmacy and medication-related burden, which could negatively impact adherence to therapy. This study aimed to assess the perceived medication-related burden among patients with co-morbid T2DM and hypertension and to evaluate the association between the perceived burden and adherence to medication therapy. Methods A cross-sectional study was conducted among adult patients with co-morbid T2DM and hypertension attending a primary health facility. The living with medicines questionnaire and the medication adherence report scale were used to assess extent of medication-related burden and adherence respectively. Binary logistic regression model was used to estimate the adjusted odds and their corresponding 95% confidence interval for medication-related burden and adherence outcomes. All observed categorical variables were considered for the multivariable binary logistic regression model. Results The total number of participants was 329 with a median age of 57.5 ± 13.2 years. The median score for the overall burden was 99 (IQR: 93-113), and this significantly varied by sex (p = 0.012), monthly income (p = 0.025), monthly expenditure on medications (p = 0.012), frequency of daily dose of medications (p = 0.020) and family history of T2DM (p < 0.001). About 30.7% and 36.8% of participants reported moderate/high burden and medication adherence respectively. Uncontrolled diastolic blood pressure (AOR: 2.46, 95% CI: 1.20-5.05, p = 0.014), high glucose (AOR: 4.24, 95% CI: 2.13-8.46, p < 0.001) and no family history of T2DM (AOR: 2.14, 95% CI: 1.14-4.02, p = 0.026) were associated with moderate/high medication burden. Uncontrolled diastolic blood pressure (AOR: 0.48, 95% CI: 0.25-0.94, p = 0.031), at least 5 years since hypertension diagnosis (AOR: 0.55, 95% CI: 0.30-0.99, p = 0.045) and moderate/high medication-related burden (AOR: 0.33, 95% CI: 0.16-0.69, p = 0.003) were associated with lower odds of medication adherence. Conclusion These findings suggest that to improve the preventive and optimal care of patients with T2DM and hypertension, interventions that aim to reduce medication-related burden and morbidity are recommended. The study proposes that health stakeholders such as clinicians, pharmacists, and policy makers, develop multidisciplinary clinical and pharmaceutical care interventions to include provision of counselling to patients on adherence. In addition, developing policies and sensitization activities on deprescribing and fixed-dose drug combinations aimed at reducing medication-related burden, while promoting better adherence, blood pressure and blood glucose outcomes are recommended.
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Affiliation(s)
- Emmanuella Baah-Nyarkoh
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, P. O. Box LG 43, Legon, Ghana
| | - Yakubu Alhassan
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, P. O. Box LG13, Legon, Ghana
| | - Andrews K. Dwomoh
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, P. O. Box LG 43, Legon, Ghana
| | - Irene A. Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, P. O. Box LG 43, Legon, Ghana
- Corresponding author.
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A Oseni TI, Emonriken A, Ahmed SD, Dic-Ijiewere M. Determinants of blood pressure control among hypertensive patients attending a rural teaching hospital in Southern Nigeria. Niger J Clin Pract 2023; 26:260-266. [PMID: 37056097 DOI: 10.4103/njcp.njcp_1678_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
Background Hypertension (HTN) is the commonest cardiovascular risk factor in sub-Saharan Africa. It is a global public health threat, often associated with significant morbidities and mortality with rising prevalence both in rural and semi-urban areas of economically disadvantaged countries. Aim This study aimed to assess the determinants of blood pressure control among patients with hypertension receiving care at the Irrua Specialist Teaching Hospital in Southern Nigeria. Patients and Methods A cross-sectional study of 502 consenting hypertensive adults receiving care at the Irrua Specialist Teaching Hospital, Irrua in Edo State, South-south Nigeria. A pre-tested semi-structured interviewer-administered questionnaire was used to collect data which was analyzed using SPSS version 21 and the level of significance was set at P < 0.05. Results Five hundred and two participants (226 males, 276 females) completed the study with a mean age of 52.98 ± 12.82 years. Optimal blood pressure control was found in 15.5% of the study participants. Blood pressure control was significantly associated with being married (OR 1.549, CI: 1.040-2.309), having a monthly household income of over N50,000 (OR 1.691, CI: 0.999-2.863), engaging in physical activity (OR = 1.537, CI: 0.989-2.388), and not being obese evidenced by a normal Waist Hip Ratio (OR = 2.276, CI: 1.555-3.332). Conclusion Blood pressure control to target goal was low in the study population and achieved only in less than one-fifth of respondents on antihypertensive therapy. Numerous socio-demographic and lifestyle variables were shown to be associated with blood pressure control. Physicians should emphasize medication adherence and lifestyle modification approaches in hypertensive adults.
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Affiliation(s)
- T I A Oseni
- Department of Family Medicine, Ambrose Alli University, Ekpoma, Edo State, Nigeria
| | - A Emonriken
- Department of Internal Medicine, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - S D Ahmed
- Department of Internal Medicine, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - M Dic-Ijiewere
- Department of Internal Medicine, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
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17
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Oyagbemi AA, Ajibade TO, Esan OO, Adetona MO, Obisesan AD, Adeogun AV, Awoyomi OV, Badejo JA, Adedapo ADA, Omobowale TO, Olaleye OI, Ola-Davies OE, Saba AB, Adedapo AA, Nkadimeng SM, McGaw LJ, Kayoka-Kabongo PN, Yakubu MA, Nwulia E, Oguntibeju OO. Naringin abrogates angiotensin-converting enzyme (ACE) activity and podocin signalling pathway in cobalt chloride-induced nephrotoxicity and hypertension. Biomarkers 2023; 28:206-216. [PMID: 36480283 DOI: 10.1080/1354750x.2022.2157489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PurposeThe persistent and alarming rates of increase in cardiovascular and renal diseases caused by chemicals such as cobalt chloride (CoCl2) in mammalian tissues have led to the use of various drugs for the treatment of these diseases. This study aims at evaluating the nephron-protective action of Naringin (NAR), a metal-chelating antioxidant against CoCl2-induced hypertension and nephrotoxicity.MethodsForty-two male Wistar rats were randomly distributed to seven rats of six groups and classified into Group A (Control), Group B (300 part per million; ppm CoCl2), Group C (300 ppm CoCl2 + 80 mg/kg NAR), Group D (300 ppm CoCl2 + 160 mg/kg NAR), Group E (80 mg/kg NAR), and Group F (160 mg/kg NAR). NAR and CoCl2 were administered via oral gavage for seven days. Biomarkers of renal damage, oxidative stress, antioxidant status, blood pressure parameters, immunohistochemistry of renal angiotensin-converting enzyme and podocin were determined.ResultsCobalt chloride intoxication precipitated hypertension, renal damage, and oxidative stress. Immunohistochemistry revealed higher expression of angiotensin-converting enzyme (ACE) and podocin in rats administered only CoCl2.ConclusionTaken together, the antioxidant and metal-chelating action of Naringin administration against cobalt chloride-induced renal damage and hypertension could be through abrogation of angiotensin-converting enzyme and podocin signalling pathway.
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Affiliation(s)
- Ademola Adetokunbo Oyagbemi
- Department of Veterinary Physiology and Biochemistry, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | - Temitayo Olabisi Ajibade
- Department of Veterinary Physiology and Biochemistry, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oluwaseun Olanrewaju Esan
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | - Moses Olusola Adetona
- Department of Anatomy, Faculty of Basic Medical Sciences, University of Ibadan, Ibadan, Nigeria
| | - Ayobami Deborah Obisesan
- Department of Veterinary Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adewumi Victoria Adeogun
- Department of Veterinary Physiology and Biochemistry, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Joseph Ayotunde Badejo
- Department of Pharmacology & Therapeutics, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Aduragbenro Deborah A Adedapo
- Department of Pharmacology & Therapeutics, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Temidayo Olutayo Omobowale
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olayinka Israel Olaleye
- Department of Pathology, Histopathology Laboratory, University College Hospital, University of Ibadan, Ibadan, Nigeria
| | - Olufunke Eunice Ola-Davies
- Department of Veterinary Physiology and Biochemistry, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adebowale Benard Saba
- Department of Veterinary Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adeolu Alex Adedapo
- Department of Veterinary Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | - Sanah Malomile Nkadimeng
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa Florida Campus, Florida, South Africa
| | - Lyndy Joy McGaw
- Phytomedicine Programme, Department of Paraclinical Science, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Prudence Ngalula Kayoka-Kabongo
- Department of Agriculture and Animal Health, College of Agriculture and Environmental Sciences, University of South Africa, Florida, South Africa
| | - Momoh Audu Yakubu
- Department of Environmental & Interdisciplinary Sciences, College of Science, Engineering & Technology, COPHS, Texas Southern University, Houston, TX, USA
| | - Evaristus Nwulia
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Howard University Hospital, Howard University, Washington, DC, USA
| | - Oluwafemi Omoniyi Oguntibeju
- Department of Biomedical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, South Africa
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Wang W, Sa R, Dang S, Qiu L, Liu F. Prevalence, awareness, treatment, and control of hypertension and their risk factors in Shaanxi Province in 2004-18. Sci Rep 2023; 13:2548. [PMID: 36781890 PMCID: PMC9925732 DOI: 10.1038/s41598-023-28407-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 01/18/2023] [Indexed: 02/15/2023] Open
Abstract
To investigate trends in the prevalence, awareness, treatment and control of hypertension and their demographic determinants in Shaanxi Province. Six successive cross-sectional surveys on non-communicable chronic diseases and their risk factors were conducted between 2004 and 2018 in Shaanxi. Complex multistage stratified sampling was adopted to select participants. The information was collected through face-to-face interviews and on-site health examinations. Changes in hypertension prevalence and its management across survey years were estimated. Demographics associated with hypertension prevalence and its management was explored by multivariable logistic regression using pooled data from 2004 to 2018. The prevalence of hypertension increased from 16.71% in 2004 to 31.96% in 2018 with an estimated increase of 1.09% (95% CI 0.31-1.87) per year. However, the rate of awareness, treatment and control among these with hypertension was unexpectedly low and there were no significant change from 2004 to 2018. The corresponding changes were - 0.08% (95% CI - 0.85-0.69) per year for awareness, - 0.06% (95% CI - 1.11-1.00) per year for treatment, and - 0.23% (95% CI - 0.53-0.07) per year for control, respectively. Sensitivity analysis showed the same trend. Adults who were old, male, divorced/Widowed/Separated, retired were more likely to develop hypertension. Among these with hypertension, those who were more educated and retired were more likely to manage their hypertension compared with their counterparts. The overall hypertension prevalence from 2004 to 2018 increased rapidly, while awareness, treatment and control of hypertension remained unexpectedly low. This suggested urgent intervention should be implemented to improve hypertension control in Shaanxi Province.
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Affiliation(s)
- Weihua Wang
- Shaanxi Provincial Center for Disease Control and Prevention, No.3, Jiandong Road, Xi'an, Shaanxi, People's Republic of China
| | - Rina Sa
- Shaanxi Provincial Center for Disease Control and Prevention, No.3, Jiandong Road, Xi'an, Shaanxi, People's Republic of China
| | - Shaonong Dang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, People's Republic of China
| | - Lin Qiu
- Shaanxi Provincial Center for Disease Control and Prevention, No.3, Jiandong Road, Xi'an, Shaanxi, People's Republic of China.
| | - Feng Liu
- Shaanxi Provincial Center for Disease Control and Prevention, No.3, Jiandong Road, Xi'an, Shaanxi, People's Republic of China.
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Muacevic A, Adler JR, Alghamdi A, Alhammad QA, Almadhi AA, Bin Abbas F, Alnamshan AZ, Khalaf AM, Alyami AM, Aljafar A, Alyousef AA, Alahmadi GM. Increasing Awareness of Hypertensive Patients About Their Blood Pressure Readings During Clinic Visits in a Tertiary Hospital in Riyadh. Cureus 2023; 15:e33257. [PMID: 36741652 PMCID: PMC9891237 DOI: 10.7759/cureus.33257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2023] [Indexed: 01/03/2023] Open
Abstract
Introduction Hypertension (HTN) is one of the most important cardiovascular risk factors. It is associated with significant complications, such as coronary artery disease, stroke, and chronic kidney disease. Awareness among hypertensive patients regarding their blood pressure (BP) is low in the Kingdom of Saudi Arabia. Aim This study aimed to evaluate the awareness of patients regarding their BP readings and to identify which aspects of HTN they needed to be informed about. Patients and methods A descriptive cross-sectional study was conducted among hypertensive patients attending outpatient clinics at King Fahad Medical City, Riyadh, Saudi Arabia. An electronic questionnaire was used by a trained physician to collect data from patients during telephone interviews. The information included socio-demographic data (i.e., age, gender, and education), family history, compliance with medications, and BP measurements. Patients were asked to answer questions to assess their awareness of their BP readings. Results Of the 475 hypertensive patients included in this study, 32.7% were aged between 56 and 65 years and 60.4% were female. The proportion of patients who had knowledge of their target BP (systolic: 120-129 mmHg; diastolic: 80-84 mmHg) was 74.4%. The significant independent predictors of increased knowledge about BP were a high level of education, regular measurement of BP, and having received education about a healthy lifestyle. The significant independent predictor of decreased knowledge about BP was having an acceptable or poor understanding of chronic BP. Conclusion Hypertensive patients visiting the outpatient clinic at King Fahad Hospital had a good understanding of their target BP readings. Educated patients who regularly measured their BP and who received education about a healthy lifestyle tended to exhibit a higher motivation to achieve their BP targets. More research is needed to gain more insights into the knowledge of hypertensive patients and into how they manage their BP to determine the factors that influence their knowledge.
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20
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Missed opportunities for initiation of treatment and control of hypertension among older adults in India. Prev Med Rep 2022; 30:102057. [DOI: 10.1016/j.pmedr.2022.102057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/03/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022] Open
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Moussouni A, Sidi-Yakhlef A, Hamdaoui H, Aouar A, Belkhatir D. Prevalence and risk factors of prehypertension and hypertension in Algeria. BMC Public Health 2022; 22:1571. [PMID: 35982441 PMCID: PMC9386961 DOI: 10.1186/s12889-022-13942-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 07/27/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Hypertension, also referred to as the silent killer, is known to be one of the most common chronic diseases in the world today. This study aimed to identify the prevalence and risk factors of prehypertension and hypertension among Algerian population. METHODS This is a descriptive cross-sectional epidemiological study involving individuals aged 18 to 69 years old who were identified in the database of the national survey on non-communicable diseases (NCDs) risk factors conducted in Algeria between 2016 and 2017 using the World Health Organization's (WHO) STEPwise approach. Differences in prevalence between normotensives, prehypertensives and hypertensives were assessed using the chi-square test. We also looked at the role of numerous socio-demographic, economic, geographical, and behavioural factors in blood pressure status using a logistic regression model. RESULTS The prevalence of prehypertension and hypertension was 36.2% (95% confidence interval: 35.2-37.5%) and 31.6% (95% CI: 30.5-32.7%) respectively. Prehypertension was shown to be substantially higher in males than in women, while hypertension was found to be higher in females compared to men. In addition, both sexes had a rise in the prevalence of blood pressure as they grew older. A according to multivariate logistic regression analysis, the main common risk factors for prehypertension and hypertension were ageing, obesity, and abdominal obesity. Moreover hypercholesterolemia, and marital status (separated/divorced) were correlated to hypertension. CONCLUSION Prehypertension and hypertension are high and epidemic in Algeria. Therefore, the urgent quantification and monitoring of their risk factors becomes a necessity to plan appropriate preventive measures, in order to fight against NCDs in general.
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Affiliation(s)
- Abdellatif Moussouni
- National Center for Prehistoric, Anthropological and Historical Research (CNRPAH, Tlemcen's station), Algeria, 03, Rue Franklin Roosevelt, 16500, Alger, Algeria.
- University of Abou Bekr Belkaïd, Algeria. Laboratory of Anthropology, 22, Rue Abi Ayed Abdelkrim Fg Pasteur B. P 119, 13000, Tlemcen, Algeria.
| | - Adel Sidi-Yakhlef
- University of Abou Bekr Belkaïd, Algeria. Laboratory of Human Actions' Valorisation for Protection of Environment and Application in Public Health, 22, Rue Abi Ayed Abdelkrim Fg Pasteur B. P 119, 13000, Tlemcen, Algeria
| | - Houari Hamdaoui
- University of Abou Bekr Belkaïd, Algeria. Laboratory of Human Actions' Valorisation for Protection of Environment and Application in Public Health, 22, Rue Abi Ayed Abdelkrim Fg Pasteur B. P 119, 13000, Tlemcen, Algeria
| | - Amaria Aouar
- University of Abou Bekr Belkaïd, Algeria. Laboratory of Human Actions' Valorisation for Protection of Environment and Application in Public Health, 22, Rue Abi Ayed Abdelkrim Fg Pasteur B. P 119, 13000, Tlemcen, Algeria
| | - Djamel Belkhatir
- University of Abou Bekr Belkaïd, Algeria. Laboratory of Human Actions' Valorisation for Protection of Environment and Application in Public Health, 22, Rue Abi Ayed Abdelkrim Fg Pasteur B. P 119, 13000, Tlemcen, Algeria
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22
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Denche-Zamorano Á, Pérez-Gómez J, Mendoza-Muñoz M, Carlos-Vivas J, Oliveira R, Brito JP. Risk of Hypertension and Use of Antihypertensive Drugs in the Physically Active Population under-70 Years Old—Spanish Health Survey. Healthcare (Basel) 2022; 10:healthcare10071283. [PMID: 35885810 PMCID: PMC9319692 DOI: 10.3390/healthcare10071283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/28/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction: Reducing the prevalence of hypertension is a major priority of the World Health Organization (WHO). Its high prevalence and associated risks generate high economic and social costs. Physical activity (PA) is associated with a decrease in hypertension and in the use of antihypertensive drugs. Objective: To explore the association between PA levels (PAL), prevalence of hypertension and the use of antihypertensive drugs in Spanish population. To calculate risks of hypertension and use of antihypertensive in the inactive versus physically active population. Method: This cross-sectional study used data from 17717 individuals, sampled in the 2017 National Health Survey. Interaction by sex, age groups, body mass index (BMI), hypertension prevalence, antihypertensive drugs use and PAL, using a pairwise z-test, and dependence relationships between variables, were studied using a chi square test. Odds ratios of hypertension and antihypertensive drug use were calculated among the inactive and the physically active populations. Results: The findings showed a significant inverse association between prevalence of hypertension, antihypertensive use, and PAL in both sexes and different age and BMI groups, with lower prevalence of hypertension and antihypertensive use when PAL were higher. The risks of hypertension and antihypertensive use seems to be reduced when related to higher PAL compared to inactive people. Conclusions: High PAL is associated with lower prevalence of hypertension and lower antihypertensive use. Thus, being physically active or very active may reduce the risks of suffering from hypertension and the need to use antihypertensives compared to inactive people or walkers.
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Affiliation(s)
- Ángel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Jorge Pérez-Gómez
- Health Economy Motricity and Education (HEME) Research Group, Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain
| | - Maria Mendoza-Muñoz
- Research Group on Physical and Health Literacy and Health-Related Quality of Life (PHYQOL), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
| | - Jorge Carlos-Vivas
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Rafael Oliveira
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-403 Rio Maior, Portugal
| | - João Paulo Brito
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-403 Rio Maior, Portugal
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Smith DH, Grewal J, Mehboob S, Mohan S, Pombo LF, Rodriguez P, Gonzalez JC, Zevallos J, Barengo NC. Association between ethnicity and hypertension in Northern Colombia in 2015. Clin Hypertens 2022; 28:18. [PMID: 35701852 PMCID: PMC9199244 DOI: 10.1186/s40885-022-00203-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 03/03/2022] [Indexed: 12/03/2022] Open
Abstract
Background Studies in the United States have shown a genetic predisposition to hypertension in individuals of African descent. However, studies on the associations between ethnic groups and hypertension in Latin America are lacking and the limited results have been inconsistent. The objective of this study is to determine whether Afro-Colombian ethnicity increases the risk of hypertension. Methods This study is a secondary data analysis of a cross sectional study from five provinces in Northern Colombia. Randomly selected individuals (N = 2613; age-range 18–74 years) enrolled in a health care insurance company underwent physical examinations and completed questionnaires regarding ethnicity, lifestyle, and other risk factors. Hypertension in these patients was determined. Unadjusted and adjusted logistic regression analysis were calculated to determine the association between ethnicity and hypertension. Results No association between Afro-Colombian ethnicity and hypertension was found (odds ratio [OR], 0.85; 95% confidence interval [CI], 0.66–1.09). As expected, people with a body mass index (BMI) of 30 or higher were at a greater risk of having hypertension (OR, 3.12; 95% CI, 2.35–4.16) compared with those with a normal BMI. Conclusions Findings from this study suggest no independent association between Afro-Colombian ethnicity and hypertension. Further research should focus on genotyping or socioeconomic factors such as income level.
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Affiliation(s)
- Drew H Smith
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA. .,Florida International University Herbert Wertheim College of Medicine, 11200 SW 8th Street, 33199, Miami, FL, USA.
| | - Jaskaran Grewal
- American University of Antigua, Osbourn, Antigua and Barbuda
| | - Saba Mehboob
- American University of Antigua, Osbourn, Antigua and Barbuda
| | - Shiva Mohan
- American University of Antigua, Osbourn, Antigua and Barbuda
| | - Luisa F Pombo
- Observatorio de Diabetes de Colombia, Organización para la Excelencia de la Salud, Bogotá, Colombia
| | - Pura Rodriguez
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Juan Carlos Gonzalez
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Juan Zevallos
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.,Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Miami, FL, USA.,Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Kim J, Cho SI, Park JH, Song J, Ahn S, Cho H, Moon S. Risk of hypertension and treatment on out-of-hospital cardiac arrest incidence: A case-control study. Medicine (Baltimore) 2022; 101:e29161. [PMID: 35665725 PMCID: PMC9276230 DOI: 10.1097/md.0000000000029161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/15/2022] [Indexed: 01/04/2023] Open
Abstract
Hypertension (HTN) is a high risk factor for major cardiovascular adverse events. This study aimed to investigate the effect of HTN risk on out-of-hospital cardiac arrest (OHCA) incidence and determine whether the effect of HTN on OHCA incidence differs according to antihypertensive medication.This case-control study used the Korean Cardiac Arrest Resuscitation Consortium and Korean Community Health Survey (CHS). Cases were defined as emergency medical service-treated adult OHCA patients presumed to have a cardiac etiology from 2015 to 2017. Patients without information on HTN diagnosis were excluded from the study. The Korean CHS database's controls were matched at a 1:2 ratio with strata, including age, gender, and county of residence. Multivariable conditional logistic regression analysis was conducted to estimate HTN risk and antihypertensive treatment on OHCA incidence,A total of 2633 OHCA patients and 5266 community-based controls were enrolled in this study. Among them, 1176 (44.7%) patients and 2049 (38.9%) controls were diagnosed with HTN. HTN was associated with an increased risk of OHCA (adjusted odds ratio [AOR]: 1.19 [1.07-1.32]). On comparing HTN with or without the antihypertensive treatment group with the non-HTN-diagnosed group (as a reference), the HTN without treatment group had the highest AOR (95% confidence interval) (3.41 [2.74-4.24]). The AOR in the HTN treatment group was reduced to that in the non-HTN-diagnosed group (0.96 [0.86-1.08]).HTN increased OHCA risk, and the HTN without treatment group had the highest OHCA risk. Conversely, OHCA risk decreased to the non-HTN-diagnosed group level with HTN treatment.
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Affiliation(s)
- Jooyeong Kim
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Sung-il Cho
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Jong-Hak Park
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
| | - Juhyun Song
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
| | - Sejoong Ahn
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
| | - Hanjin Cho
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
| | - Sungwoo Moon
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
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Ortiz P, Vásquez Y, Arévalo E, Van der Stuyft P, Londoño Agudelo E. Gaps in Hypertension Management in a Middle-Income Community of Quito-Ecuador: A Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5832. [PMID: 35627369 PMCID: PMC9141875 DOI: 10.3390/ijerph19105832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/21/2022] [Accepted: 03/30/2022] [Indexed: 11/18/2022]
Abstract
Optimal hypertension care and control at population level significantly reduces cardiovascular morbidity and mortality. The study objective was to measure the gaps in the diagnosis, care, and control of hypertension in residents of an urban community in Quito, Ecuador. A cross-sectional population-based study with a sample of 2160 persons was performed using a survey and direct blood pressure measurement. Logistical regression models were used for analyzing factors associated with the gaps, expressed as percentages. The prevalence of hypertension was 17.6% [CI 95% 17.3-17.9%]. The diagnosis gap was 6.1% [CI 95% 5.9-6.2%] among the entire population and 34.5% [CI 95% 33.7-35.3%] among persons with hypertension. No access gaps were detected; whereas the follow-up gap was 22.7% [CI 95% 21.8-23.6%] and control gap reached 43.5% [CI 95% 42.6-44.2%]. Results indicated that being male, older than 64 years, an employee, without health insurance, and not perceiving a need for healthcare, increased the risk of experiencing these gaps. Data showed appropriate access to health services and high coverage in the diagnosis was due to the application of a community and family healthcare model. Notwithstanding, we found significant gaps in the follow-up and control of hypertensive patients, especially among older males, which should warrant the attention of the Ministry of Health.
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Affiliation(s)
- Patricia Ortiz
- Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito 170143, Ecuador; (Y.V.); (E.A.)
- Consortium Latin-American Network for Multidisciplinary Research on Chronic Non-Communicable Diseases, Medellin 050010, Colombia; (P.V.d.S.); (E.L.A.)
- Departamento de Pediatría, Obstetricia y Ginecología y de Medicina Preventiva, Universidad Autónoma de Barcelona, 08193 Barcelona, Spain
| | - Yajaira Vásquez
- Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito 170143, Ecuador; (Y.V.); (E.A.)
- Consortium Latin-American Network for Multidisciplinary Research on Chronic Non-Communicable Diseases, Medellin 050010, Colombia; (P.V.d.S.); (E.L.A.)
| | - Esperanza Arévalo
- Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito 170143, Ecuador; (Y.V.); (E.A.)
- Consortium Latin-American Network for Multidisciplinary Research on Chronic Non-Communicable Diseases, Medellin 050010, Colombia; (P.V.d.S.); (E.L.A.)
| | - Patrick Van der Stuyft
- Consortium Latin-American Network for Multidisciplinary Research on Chronic Non-Communicable Diseases, Medellin 050010, Colombia; (P.V.d.S.); (E.L.A.)
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
| | - Esteban Londoño Agudelo
- Consortium Latin-American Network for Multidisciplinary Research on Chronic Non-Communicable Diseases, Medellin 050010, Colombia; (P.V.d.S.); (E.L.A.)
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium
- Department of Public Health, Institute of Tropical Medicine, 2000 Antwerp, Belgium
- Grupo de Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín 50010, Colombia
- Facultad de Medicina, Universidad CES, Medellín 0510, Colombia
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Najafipour H, Nasri HR, Rostamzadeh F, Amirzadeh R, Shadkam M, Mirzazadeh A. Prevalence and incidence of pre-hypertension and hypertension (awareness/control) in Iran: findings from Kerman coronary artery diseases risk factors study 2 (KERCADRS). J Hum Hypertens 2022; 36:461-472. [PMID: 32929131 DOI: 10.1038/s41371-020-00392-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 07/09/2020] [Accepted: 07/29/2020] [Indexed: 12/22/2022]
Abstract
Hypertension (HTN) is an important cause of cardiovascular-related morbidity and mortality. The present study was conducted to investigate the prevalence and incidence rate of pre-HTN, diagnosed and undiagnosed HTN, as well as its control and associated factors in adult population in southeast Iran. In a randomized household survey, 9987 participants aged 15-80 years were recruited into the study. HTN was confirmed through examination or using antihypertensive drug(s). Pre-HTN and HTN were defined as 120-139/80-89 and ≥140/90 mmHg for systolic and diastolic BP, respectively. The prevalence of pre-HTN was 28.5%. The prevalence of HTN was 19.2% (13.9% diagnosed and 5.3% undiagnosed). HTN increased with age (from 4% in 15-24 to 67.8% in 75-80 years). Men had higher pre-HTN (35.6% vs. 23.4%) and undiagnosed HTN (7.5% vs. 3.8%) than women. Of those diagnosed, 46.5% had uncontrolled BP, in which, women had better conditions than men (45.6% vs. 47.4%). Obesity, positive family history of HTN, anxiety, and low physical activity were the most significant predictors of HTN. The prevalence of pre-HTN decreased but there was no change in the prevalence of HTN during the last 5 years. The 5-year incidence rate/100 person-years of pre-HTN and HTN was 6.6 and 3.7, respectively. Although there are some promising signs of reducing pre-HTN and slowing HTN rise, currently, almost one-fifth of the adult population suffers from HTN. Given the poor BP control in patients with diagnosed HTN, especially in men, alarms that more effective interventions and strategies are needed to reduce deleterious consequences of HTN.
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Affiliation(s)
- Hamid Najafipour
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.,Department of Physiology and Pharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Reza Nasri
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences and Department of Cardiology, Kerman University of Medical Sciences, Kerman, Iran.
| | - Farzaneh Rostamzadeh
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Raheleh Amirzadeh
- Social Determinants of Health Research Center, Institute of Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mitra Shadkam
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Mirzazadeh
- Institute for Health Policy Studies, University of California, San Francisco, CA, USA
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Uthman OA, Ayorinde A, Oyebode O, Sartori J, Gill P, Lilford RJ. Global prevalence and trends in hypertension and type 2 diabetes mellitus among slum residents: a systematic review and meta-analysis. BMJ Open 2022; 12:e052393. [PMID: 35210339 PMCID: PMC8883228 DOI: 10.1136/bmjopen-2021-052393] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE First, to obtain regional estimates of prevalence of hypertension and type 2 diabetes in urban slums; and second, to compare these with those in urban and rural areas. DESIGN Systematic review and meta-analysis. ELIGIBILITY CRITERIA Studies that reported hypertension prevalence using the definition of blood pressure ≥140/90 mm Hg and/or prevalence of type 2 diabetes. INFORMATION SOURCES Ovid MEDLINE, Cochrane CENTRAL and EMBASE from inception to December 2020. RISK OF BIAS Two authors extracted relevant data and assessed risk of bias independently using the Strengthening the Reporting of Observational Studies in Epidemiology guideline. SYNTHESIS OF RESULTS We used random-effects meta-analyses to pool prevalence estimates. We examined time trends in the prevalence estimates using meta-regression regression models with the prevalence estimates as the outcome variable and the calendar year of the publication as the predictor. RESULTS A total of 62 studies involving 108 110 participants met the inclusion criteria. Prevalence of hypertension and type 2 diabetes in slum populations ranged from 4.2% to 52.5% and 0.9% to 25.0%, respectively. In six studies presenting comparator data, all from the Indian subcontinent, slum residents were 35% more likely to be hypertensive than those living in comparator rural areas and 30% less likely to be hypertensive than those from comparator non-slum urban areas. LIMITATIONS OF EVIDENCE Of the included studies, only few studies from India compared the slum prevalence estimates with those living in non-slum urban and rural areas; this limits the generalisability of the finding. INTERPRETATION The burden of hypertension and type 2 diabetes varied widely between countries and regions and, to some degree, also within countries. PROSPERO REGISTRATION NUMBER CRD42017077381.
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Affiliation(s)
| | - Abimbola Ayorinde
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Oyinlola Oyebode
- Warwick Centre for Global Health, Warwick Medical School, University of Warwick, Coventry, UK
| | - Jo Sartori
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Paramjit Gill
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - R J Lilford
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Su Y, Li C, Long Y, He L, Ding N. Association between sleep duration on workdays and blood pressure in non-overweight/obese population in NHANES: a public database research. Sci Rep 2022; 12:1133. [PMID: 35064191 PMCID: PMC8782988 DOI: 10.1038/s41598-022-05124-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/29/2021] [Indexed: 11/09/2022] Open
Abstract
This study aimed to explore the association between sleep duration on workdays and blood pressure (BP) including systolic blood pressure (SBP) and diastolic blood pressure (DBP) in non-overweight/obese population. A cross-sectional study composed of 2887 individuals from NHANES was conducted. Subjective sleep duration on workdays were evaluated by the questionnaire. Multiple linear regression analyses were done to explore the relationship between sleep duration and BP. Compared with sleep duration of 6-8 h, both sleep duration < 6 h and ≥ 8 h on workdays were significantly associated with increased SBP (β, 3.58 [95% CI 1.60, 5.56] and 1.70 [95% CI 0.76, 2.64], respectively). However, the significant association was not founded in DBP. The stratified analyses showed that in females, sleep duration (< 6 h or ≥ 8 h) on workdays were associated with SBP (β = 5.99 and 2.41, respectively, both P < 0.0005). In addition, the SBP levels were much higher among participants aged (≥ 60) with sleep duration < 6 h. The effect size was 7.23 (P = 0.0217). In the subgroup classified by race, a significantly positive association between sleep duration (< 6 h, ≥ 8 h) and SBP can be seen in the White population (β = 6.64 (P = 0.0007) and 1.91 (P = 0.0215), respectively). In non-overweight/obese population, both short sleep duration (< 6 h) and long sleep duration (≥ 8 h) on workdays were correlated with higher level of SBP.
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Affiliation(s)
- Yingjie Su
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, No. 161 Shaoshan South Road, Changsha, 410004, Hunan, China
| | - Changluo Li
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, No. 161 Shaoshan South Road, Changsha, 410004, Hunan, China
| | - Yong Long
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, No. 161 Shaoshan South Road, Changsha, 410004, Hunan, China
| | - Liudang He
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, No. 161 Shaoshan South Road, Changsha, 410004, Hunan, China.
| | - Ning Ding
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, No. 161 Shaoshan South Road, Changsha, 410004, Hunan, China.
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Angeli F, Reboldi G, Verdecchia P. African Ancestry and Uncontrolled Hypertension: Current Knowledge and Future Perspectives. Am J Hypertens 2021; 34:1255-1258. [PMID: 34543377 DOI: 10.1093/ajh/hpab148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/16/2021] [Indexed: 01/09/2023] Open
Affiliation(s)
- Fabio Angeli
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
- Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institute, IRCCS Tradate, Varese, Italy
| | - Gianpaolo Reboldi
- Department of Medicine, and Centro di Ricerca Clinica e Traslazionale (CERICLET), University of Perugia, Perugia, Italy
| | - Paolo Verdecchia
- Fondazione Umbra Cuore e Ipertensione-ONLUS and Division of Cardiology, Hospital S. Maria della Misericordia, Perugia, Italy
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30
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Senarathne R, Hettiaratchi U, Dissanayake N, Hafiz R, Zaleem S, Athiththan L. Metabolic syndrome in hypertensive and non-hypertensive subjects. Health Sci Rep 2021; 4:e454. [PMID: 34938898 PMCID: PMC8670729 DOI: 10.1002/hsr2.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND AIMS Hypertension is a major risk factor of cardiovascular diseases (CVDs), which attributes to one-third of all deaths worldwide. It is also considered as a key feature of metabolic syndrome (MetS). The aim of the present study was to compare the presence of characteristic features of MetS in hypertensive and non-hypertensive males and females and find out the percentages of MetS in hypertensive and non-hypertensive adults. METHODS This was a cross-sectional study, involving 120 participants that included 60 hypertensives and 60 non-hypertensives (35-55 years). Data were obtained through an interviewer-administered questionnaire. Fasting blood sugar (FBS) and lipid parameters [triglyceride-(TG), high density lipoprotein (HDL)] were analyzed, and waist circumference (WC) was measured. Percentages of MetS among hypertensive and non-hypertensive groups were determined according to both modified Adult Treatment Panel III (ATP III) and new International Diabetes Federation (IDF) criteria. Results were analyzed using SPSS version 21. RESULTS Among the characteristic features of MetS, mean FBS and WC were significantly higher in hypertensive males compared with non-hypertensive males (P < .001 and P = .002 respectively), while mean value of TG was significantly higher (P = .005) in hypertensive females compared with non-hypertensive females. Further, the percentage of subjects in the total hypertensive group with increased FBS and increased WC was significantly higher than the non- hypertensive group. The percentage of subjects with MetS was significantly (P < .001) higher in hypertensive group (68%) compared with non-hypertensive group (20%) according to modified ATP III criteria. When compared with new IDF criteria, it was 63% and 20%, respectively. CONCLUSION The percentage of subjects with increased FBS, WC, and MetS was significantly higher in the hypertensive group compared with non-hypertensives group. These findings emphasize the urgent need to develop national strategies for early detection, and to take preventive measures to make people aware of the impact of metabolic syndrome.
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Affiliation(s)
- Roshali Senarathne
- Faculty of Allied Health SciencesUniversity of Sri JayewardenepuraNugegodaColomboSri Lanka
| | - Usha Hettiaratchi
- Department of Biochemistry, Faculty of Medical SciencesUniversity of Sri JayewardenepuraNugegodaColomboSri Lanka
| | - Nirodha Dissanayake
- Faculty of Allied Health SciencesUniversity of Sri JayewardenepuraNugegodaColomboSri Lanka
| | - Riyaza Hafiz
- Faculty of Allied Health SciencesUniversity of Sri JayewardenepuraNugegodaColomboSri Lanka
| | - Sumara Zaleem
- Faculty of Allied Health SciencesUniversity of Sri JayewardenepuraNugegodaColomboSri Lanka
| | - Lohini Athiththan
- Department of Biochemistry, Faculty of Medical SciencesUniversity of Sri JayewardenepuraNugegodaColomboSri Lanka
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31
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PTML modeling for peptide discovery: in silico design of non-hemolytic peptides with antihypertensive activity. Mol Divers 2021; 26:2523-2534. [PMID: 34802116 DOI: 10.1007/s11030-021-10350-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/05/2021] [Indexed: 01/19/2023]
Abstract
Hypertension is a medical condition that affects millions of people worldwide. Despite the high efficacy of the current antihypertensive drugs, they are associated with serious side effects. Peptides constitute attractive options for chemical therapy against hypertension, and computational models can accelerate the design of antihypertensive peptides. Yet, to the best of our knowledge, all the in silico models predict only the antihypertensive activity of peptides while neglecting their inherent toxic potential to red blood cells. In this work, we report the first sequence-based model that combines perturbation theory and machine learning through multilayer perceptron networks (SB-PTML-MLP) to enable the simultaneous screening of antihypertensive activity and hemotoxicity of peptides. We have interpreted the molecular descriptors present in the model from a physicochemical and structural point of view. By strictly following such interpretations as guidelines, we performed two tasks. First, we selected amino acids with favorable contributions to both the increase of the antihypertensive activity and the diminution of hemotoxicity. Then, we assembled those suitable amino acids, virtually designing peptides that were predicted by the SB-PTML-MLP model as antihypertensive agents exhibiting low hemotoxicity. The potentiality of the SB-PTML-MLP model as a tool for designing potent and safe antihypertensive peptides was confirmed by predictions performed by online computational tools reported in the scientific literature. The methodology presented here can be extended to other pharmacological applications of peptides.
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32
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Trends and age-period-cohort effects on hypertension mortality rates from 1998 to 2018 in Mexico. Sci Rep 2021; 11:17553. [PMID: 34475436 PMCID: PMC8413460 DOI: 10.1038/s41598-021-96175-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 07/05/2021] [Indexed: 11/08/2022] Open
Abstract
Arterial hypertension is a major global health problem. It is the main risk factor for preventable death and the leading cause of premature death in the world. This study aims to describe the changes in hypertension-related mortality in Mexico between 1998 and 2018. Using death certificates and national population public data sets, a total of 335,863 deaths due to hypertension were found in Mexico, disaggregated by sex and age, during the time period covered in this study. An age-period-cohort analysis was conducted to show trends in hypertension mortality rates. Mortality due to hypertension in Mexico affects more women than men. In the most recent cohorts, the risk of dying from hypertension is two times higher in men compared to women. Hypertensive kidney disease is found to be the main underlying cause, with an average increase throughout the period studied. Our results indicate that mortality rates due to hypertension continue to grow and point to an alarming trend of mortality shifting towards younger ages, with sex-based disparities in absolute numbers and in changing trends.
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Iqbal A, Ahsan KZ, Jamil K, Haider MM, Khan SH, Chakraborty N, Streatfield PK. Demographic, socioeconomic, and biological correlates of hypertension in an adult population: evidence from the Bangladesh demographic and health survey 2017-18. BMC Public Health 2021; 21:1229. [PMID: 34174868 PMCID: PMC8235611 DOI: 10.1186/s12889-021-11234-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 06/08/2021] [Indexed: 02/08/2023] Open
Abstract
Background Bangladesh is well advanced in the epidemiologic transition from communicable to noncommunicable diseases, which now account for two out of three deaths annually. This paper examines the latest nationally representative hypertension prevalence estimates, awareness, treatment, and control—to identify their association with potential correlates. Methods The analyses are based on the recent Bangladesh Demographic and Health Survey 2017–18 data. Univariate analyses and bivariate analyses between the outcome variables and individual covariates were carried out. Then chi-square tests were done to see the proportional differences between them. To examine the demographic, socioeconomic and biological factors affecting hypertension, awareness, treatment and control, we used multivariate logistic regression models. Results We found that prevalence of hypertension for females and males together aged 35 or more has risen by half between 2011 (25.7%) to 2017 (39.4%). With the broader age range used in 2017, the prevalence is now 27.5% in the population aged 18 years or more. The factors associated with hypertension included older age, being female, urban residence, higher wealth status, minimal education, higher body mass index and high blood glucose level. Following multivariate analyses, many of these characteristics were no longer significant, leaving only age, being female, nutritional status and elevated blood glucose level as important determinants. Over half (58%) of females and males who were found to be hypertensive were not aware they had the condition. Only one in eight (13%) had the condition under control. Conclusion In the coming years, a rising trend in hypertension in Bangladeshi adults is expected due to demographic transition towards older age groups and increase in overweight and obesity among the population of Bangladesh. With more women being hypertensive than men, a targeted approach catering to high risk groups should be thoroughly implemented following the Multisectoral NCD Action Plan 2018–2025. Acting in close collaboration with other ministries/relevant sectors to bring an enabling environment for the citizens to adopt healthy lifestyle choices is a prerequisite for adequate prevention. While screening the adult population is essential, the public sector cannot possibly manage the ever-expanding numbers of hypertensives. The private sector and NGOs need to be drawn into the program to assist. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11234-5.
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Affiliation(s)
- Afrin Iqbal
- Maternal and Child Health Division, icddr,b, Dhaka, Bangladesh.
| | - Karar Zunaid Ahsan
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Kanta Jamil
- IAP, World Services, Alexandria, Virginia, USA
| | - M Moinuddin Haider
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
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Koohi F, Steyerberg EW, Cheraghi L, Abdshah A, Azizi F, Khalili D. Validation of the Framingham hypertension risk score in a middle eastern population: Tehran lipid and glucose study (TLGS). BMC Public Health 2021; 21:790. [PMID: 33894756 PMCID: PMC8070324 DOI: 10.1186/s12889-021-10760-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 03/31/2021] [Indexed: 11/23/2022] Open
Abstract
Background The Framingham hypertension risk score is a well-known and simple model for predicting hypertension in adults. In the current study, we aimed to assess the predictive ability of this model in a Middle Eastern population. Methods We studied 5423 participants, aged 20–69 years, without hypertension, who participated in two consecutive examination cycles of the Tehran Lipid and Glucose Study (TLGS). We assessed discrimination based on Harrell’s concordance statistic (c-index) and calibration (graphical comparison of predicted vs. observed). We evaluated the original, recalibrated (for intercept and slope), and revised (for beta coefficients) models. Results Over the 3-year follow-up period, 319 participants developed hypertension. The Framingham hypertension risk score performed well in discriminating between individuals who developed hypertension and those who did not (c-index = 0.81, 95% CI: 0.79–0.83). Initially, there was a systematic underestimation of the original risk score (events predicted), which was readily corrected by a simple model revision. Conclusions The revised Framingham hypertension risk score can be used as a screening tool in public health and clinical practice to facilitate the targeting of preventive interventions in high-risk Middle Eastern people. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10760-6.
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Affiliation(s)
- Fatemeh Koohi
- Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ewout W Steyerberg
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, The Netherlands
| | - Leila Cheraghi
- Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Abdshah
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Yu J, Wei Y, Jing Y, Gao Y. Effect of acupuncture on essential hypertension: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25572. [PMID: 33847686 PMCID: PMC8051966 DOI: 10.1097/md.0000000000025572] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Essential hypertension is a risk factor for early cardiovascular disease and is a major preventable risk factor for premature death and disability worldwide. However, some antihypertensive drugs cannot be used for treatment because of their cost-effectiveness or side effects. Non-drug treatments for hypertension include weight loss, salt restriction, smoking cessation, alcohol withdrawal, and exercise, although these methods are difficult to maintain and to achieve. This study will investigate the efficacy and safety of acupuncture and moxibustion in the treatment of different grades of essential hypertension. METHODS AND ANALYSIS A systematic search of the Cochrane, PubMed, EMBASE, CNKI, WanFang, VIP, and CBM databases will be performed, which will include randomized controlled trials on acupuncture for essential hypertension. The main results will include systolic and diastolic blood pressure before and after treatment, whereas the secondary outcomes will be efficacy rate and adverse events. The possible adverse reactions include dizziness, headache, edema, cough, nausea, electrolyte disorders, and hypotension. RevMan Manager 5.3 (Cochrane Collaboration) and STATA 16.0 software will be used to calculate mean deviation, standard deviation, confidence interval, and P values. For continuous variables, we will use the standardized mean difference of 95% confidence intervals as the summary statistics of the meta-analysis. RESULTS This study will assess the efficacy and safety of acupuncture for essential hypertension. CONCLUSIONS Our study will determine the efficacy and safety of acupuncture in treating primary hypertension, and provide the basis for clinical decision-making. INPLASY REGISTRATION NUMBER INPLASY202130042.
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Affiliation(s)
- Jing Yu
- West China School of Nursing
| | - Yi Wei
- Department of Central Medical Transportation, West China Hospital, Sichuan University
| | - Yang Jing
- Department of Cardiology, Sichuan Hospital of Integrated Traditional and Western Medicine
| | - Yongli Gao
- Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China
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Conversano C, Orrù G, Pozza A, Miccoli M, Ciacchini R, Marchi L, Gemignani A. Is Mindfulness-Based Stress Reduction Effective for People with Hypertension? A Systematic Review and Meta-Analysis of 30 Years of Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2882. [PMID: 33799828 PMCID: PMC8000213 DOI: 10.3390/ijerph18062882] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 12/13/2022]
Abstract
Background: Hypertension is among the most important risk factors for cardiovascular diseases, which are considered high mortality risk medical conditions. To date, several studies have reported positive effects of mindfulness-based stress reduction (MBSR) interventions on physical and psychological well-being in other medical conditions, but no meta-analysis on MBSR programs for hypertension has been conducted. Objectives: The objective of this study was to determine the effectiveness of MBSR programs for hypertension. Methods: A systematic review and meta-analysis of randomized controlled trials examining the effects of MBSR on systolic and diastolic blood pressure (BP), anxiety, depression, and perceived stress in people with hypertension or pre-hypertension was conducted. The PubMed/MEDLINE and PsycINFO databases were searched in November 2020 to identify relevant studies. Results: Six studies were included. The comparison of MBSR versus control conditions on diastolic BP was associated with a statistically significant mean effect size favoring MBSR over control conditions (MD = -2.029; 95% confidence interval (CI): -3.676 to -0.383, p = 0.016, k = 6; 22 effect sizes overall), without evidence of heterogeneity (I2 = 0.000%). The comparison of MBSR versus control conditions on systolic BP was associated with a mean effect size which was statistically significant only at a marginal level (MD = -3.894; 95% CI: -7.736-0.053, p = 0.047, k = 6; 22 effect sizes overall), without evidence of high heterogeneity (I2 = 20.772%). The higher the proportion of participants on antihypertensive medications was, the larger the effects of MBSR were on systolic BP (B = -0.750, z = -2.73, p = 0.003). Conclusions: MBSR seems to be a promising intervention, particularly effective on the reduction of diastolic BP. More well-conducted trials are required.
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Affiliation(s)
- Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (O.G.); (R.C.); (L.M.); (A.G.)
| | - Graziella Orrù
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy;
| | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Rebecca Ciacchini
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (O.G.); (R.C.); (L.M.); (A.G.)
| | - Laura Marchi
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (O.G.); (R.C.); (L.M.); (A.G.)
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56126 Pisa, Italy; (C.C.); (O.G.); (R.C.); (L.M.); (A.G.)
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van der Linden EL, Collard D, Beune EJAJ, Nieuwkerk PT, Galenkamp H, Haafkens JA, Moll van Charante EP, van den Born BJH, Agyemang C. Determinants of suboptimal blood pressure control in a multi-ethnic population: The Healthy Life in an Urban Setting (HELIUS) study. J Clin Hypertens (Greenwich) 2021; 23:1068-1076. [PMID: 33675159 PMCID: PMC8678779 DOI: 10.1111/jch.14202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/08/2021] [Accepted: 01/14/2021] [Indexed: 11/27/2022]
Abstract
Among ethnic minority groups in Europe, blood pressure (BP) control is often suboptimal. We aimed to identify determinants of suboptimal BP control in a multi‐ethnic population. We analyzed cross‐sectional data of the Healthy Life in an Urban Setting (HELIUS) study, including 3571 participants aged 18‐70 with prescribed antihypertensive medication, of various ethnic backgrounds (500 Dutch, 1052 African Surinamese, 656 South‐Asian Surinamese, 637 Ghanaian, 433 Turkish, and 293 Moroccan) living in Amsterdam, the Netherlands. 53.3% of the population had suboptimal BP control, defined as BP ≥140/90 mmHg despite prescribed antihypertensives. Using multivariate logistic regression analysis, female sex (OR 0.50, 95%CI 0.43‐0.59), being married (0.83, 0.72‐0.96), smoking (0.78, 0.65‐0.94), alcohol intake (0.80, 0.66‐0.96), obesity (1.67, 1.35‐2.06), cardiovascular disease (CVD) history (0.56, 0.46‐0.68), non‐adherence to antihypertensives (1.26, 1.00‐1.58), and family history of hypertension (1.19, 1.02‐1.38) were identified to be independently associated with suboptimal BP control in the total population. In the ethnic‐stratified analysis, factors associated with better BP control were female sex (all ethnic groups), smoking (Turks), and CVD history (Dutch, South‐Asian Surinamese, and African Surinamese), whereas factors associated with suboptimal BP control were older age (Turks), obesity (Dutch, African Surinamese, Ghanaian, and Turks), and non‐adherence to antihypertensives (Dutch). In conclusion, our analysis identifies several key determinants that are independently associated with suboptimal BP control in a multi‐ethnic population, with some important variations between ethnic groups. Targeting these determinants may help to improve BP control.
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Affiliation(s)
- Eva L van der Linden
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands.,Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Didier Collard
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Erik J A J Beune
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Pythia T Nieuwkerk
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Henrike Galenkamp
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Joke A Haafkens
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Eric P Moll van Charante
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands.,Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Bert-Jan H van den Born
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands.,Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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Wei J, Mi Y, Li Y, Xin B, Wang Y. Factors associated with awareness, treatment and control of hypertension among 3579 hypertensive adults in China: data from the China Health and Nutrition Survey. BMC Public Health 2021; 21:423. [PMID: 33648483 PMCID: PMC7919311 DOI: 10.1186/s12889-021-10417-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 02/09/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The prevalence of hypertension is high and rising in China, but most people with hypertension do not have their blood pressure under control. This study investigated hypertension awareness, treatment, and control and their associated factors among Chinese adults. METHODS Data collected from the 2011 China Health and Nutrition Survey (CHNS) from 12,991 Chinese adults were used. Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, self-reported prior diagnosed hypertension, or taking antihypertensive medications. Hypertension awareness, treatment, and control were defined as a self-reported diagnosis of hypertension, current use of antihypertensive medication, and blood pressure < 140/90 mmHg, respectively. Multivariate logistic regression was performed to examine factors associated with hypertension awareness, treatment, and control. RESULTS Overall, 3579 (27.6%) of the CHNS adult participants had hypertension, of whom 55.7% were aware of their diagnosis, 46.5% were treated with antihypertensive medications, but only 20.3% had their blood pressure under control. Higher hypertension treatment was associated with older age (OR = 2.57; 95%CI, 1.65-4.02), urban residency (1.50; 1.14-1.97), living in the Eastern region (1.52; 1.14-2.01), and being overweight/obese (1.99; 1.39-2.84). Hypertension awareness was associated with similar factors as hypertension treatment but was also associated with being female (1.37, 1.12-1.66). Poor hypertension control was associated with being overweight/obese (0.56; 0.42-0.76) and minority ethnicity (0.52; 0.31-0.86). CONCLUSION Hypertension is a major public health challenge in China. The prevalence of hypertension awareness, treatment, and control are still low despite existing public health policies and programs to reduce the burden of hypertension. More intensive hypertension screening and treatment programs are warranted in China.
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Affiliation(s)
- Junxiang Wei
- Department of Obstetrics, Northwest Women's and Children's Hospital, Xi'an, 710061, Shaanxi, China.
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
| | - Yang Mi
- Department of Obstetrics, Northwest Women's and Children's Hospital, Xi'an, 710061, Shaanxi, China
| | - Yan Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bo Xin
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Youfa Wang
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
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Dai H, Bragazzi NL, Younis A, Zhong W, Liu X, Wu J, Grossman E. Worldwide Trends in Prevalence, Mortality, and Disability-Adjusted Life Years for Hypertensive Heart Disease From 1990 to 2017. Hypertension 2021; 77:1223-1233. [PMID: 33583201 DOI: 10.1161/hypertensionaha.120.16483] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Haijiang Dai
- From the Department of Cardiology, The Third Xiangya Hospital (H.D., X.L.), Central South University, Changsha, China
- Centre for Disease Modelling, Department of Mathematics and Statistics, York University, Toronto, ON, Canada (H.D., N.L.B., J.W.)
| | - Nicola Luigi Bragazzi
- Centre for Disease Modelling, Department of Mathematics and Statistics, York University, Toronto, ON, Canada (H.D., N.L.B., J.W.)
| | - Arwa Younis
- Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, NY (A.Y.)
| | - Wen Zhong
- Department of General Medicine, Xiangya Hospital (W.Z.), Central South University, Changsha, China
| | - Xinyao Liu
- From the Department of Cardiology, The Third Xiangya Hospital (H.D., X.L.), Central South University, Changsha, China
| | - Jianhong Wu
- Centre for Disease Modelling, Department of Mathematics and Statistics, York University, Toronto, ON, Canada (H.D., N.L.B., J.W.)
| | - Ehud Grossman
- Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel (E.G.)
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel (E.G.)
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Phthalamide derivatives as ACE/AChE/BuChE inhibitors against cardiac hypertrophy: an in silico, in vitro, and in vivo modeling approach. Med Chem Res 2021. [DOI: 10.1007/s00044-021-02707-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Levene LS, Coles BD, Gillies CL, Shabnam S, Zaccardi F, Khunti K. Predictors of hypertension detection in English general practices: a cross sectional study. J Public Health (Oxf) 2021; 44:e1-e9. [PMID: 33434926 DOI: 10.1093/pubmed/fdaa224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/23/2020] [Accepted: 11/09/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Worldwide, high systolic blood pressure is the leading risk factor for deaths and disability-adjusted life-years but has been historically under-detected. This study aimed to quantify differences between estimated and practice-detected prevalences of hypertension across English general practices, and to determine how variations in detected prevalence could be explained by population-level and service-level factors. METHODS Descriptive statistics, pair wise correlations between the independent variables and a multivariable regression analysis were undertaken. In the regression model, the outcome was detected hypertension prevalence, adjusted for estimated prevalence, person-related and disease-related determinants of illness and characteristics of general practices. RESULTS Detected prevalence was substantially lower than estimated prevalence (mean difference 16.23%; standard deviation 2.88%). Higher detected prevalence was associated with increased deprivation, increased non-white ethnicity and urban location. Lower detected prevalence was associated with larger list sizes, more general practitioners and being located in the South outside London. The final multivariable model's adjusted R2 value was 0.75. CONCLUSIONS Substantial under-detection of hypertension is widespread across England. Independent of estimated prevalence, factors associated with greater morbidity and population density predicted higher detected prevalence. Identifying patients with undetected hypertension and coordinating care for these patients will require further resources and logistical support in community settings.
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Affiliation(s)
- Louis S Levene
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK.,Department of Health Sciences, George Davies Centre, College of Life Sciences, University of Leicester, Leicester LE1 7RH, UK
| | - Briana D Coles
- Department of Health Sciences, George Davies Centre, College of Life Sciences, University of Leicester, Leicester LE1 7RH, UK
| | - Clare L Gillies
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK
| | - Sharmin Shabnam
- Department of Mechanical Engineering, 137 Reber Building, The Pennsylvania State University, University Park, PA 16802-4400, USA
| | - Francesco Zaccardi
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK
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Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension. Nat Rev Cardiol 2021; 18:785-802. [PMID: 34050340 PMCID: PMC8162166 DOI: 10.1038/s41569-021-00559-8] [Citation(s) in RCA: 665] [Impact Index Per Article: 166.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 02/07/2023]
Abstract
High blood pressure is one of the most important risk factors for ischaemic heart disease, stroke, other cardiovascular diseases, chronic kidney disease and dementia. Mean blood pressure and the prevalence of raised blood pressure have declined substantially in high-income regions since at least the 1970s. By contrast, blood pressure has risen in East, South and Southeast Asia, Oceania and sub-Saharan Africa. Given these trends, the prevalence of hypertension is now higher in low-income and middle-income countries than in high-income countries. In 2015, an estimated 8.5 million deaths were attributable to systolic blood pressure >115 mmHg, 88% of which were in low-income and middle-income countries. Measures such as increasing the availability and affordability of fresh fruits and vegetables, lowering the sodium content of packaged and prepared food and staples such as bread, and improving the availability of dietary salt substitutes can help lower blood pressure in the entire population. The use and effectiveness of hypertension treatment vary substantially across countries. Factors influencing this variation include a country's financial resources, the extent of health insurance and health facilities, how frequently people interact with physicians and non-physician health personnel, whether a clear and widely adopted clinical guideline exists and the availability of medicines. Scaling up treatment coverage and improving its community effectiveness can substantially reduce the health burden of hypertension.
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Arterial hypertension and morphologic abnormalities of cardiac chambers: results from the Copenhagen General Population Study. J Hypertens 2020; 39:703-710. [PMID: 33394866 DOI: 10.1097/hjh.0000000000002705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES In patients with arterial hypertension (AH), hypertension-mediated organ damage may be manifested by cardiac chamber enlargement and/or remodeling. Cardiac computed tomography imaging has emerged as an important method for morphological assessment of cardiac chambers. We tested the hypothesis that prevalence of cardiac chamber abnormalities is specifically related to clinical categories of AH in the general population. METHODS We studied 4747 individuals, mean age was 60 years (range: 40-93), 46% were men, undergoing 320-detector computed tomography in the Copenhagen General Population Study. Clinical categories of AH were: normotensive (n = 2484), untreated hypertensive (n = 1301), treated controlled hypertensive (n = 412) and treated uncontrolled hypertensive (n = 550). Chamber abnormalities in the form of left ventricular (LV) concentric remodeling, LV eccentric hypertrophy, LV concentric hypertrophy or left atrial enlargement were assessed, in addition to LV or right ventricular enlargement. RESULTS Chamber abnormalities were present in 23% of all individuals. Combined LV and left atrial abnormalities were rare (<2%). LV concentric remodeling (10%) was the most prevalent abnormality, and most commonly found in individuals with treated hypertension. LV and right ventricular enlargements were unrelated to hypertension. The highest frequencies of chamber abnormalities were found in individuals of elevated blood pressure (BP) with (40%) or without (32%) treatment, as opposed to individuals of normal BP with (27%) or without (14%) treatment, P less than 0.0001. CONCLUSION In a general population cohort, untreated or inadequately treated AH was associated with the highest prevalence of cardiac chamber enlargement and remodeling. These observations suggest a strong link between elevated BPs and development of hypertension-mediated organ damage.
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Hypertension Prevalence Based on Blood Pressure Measurements on Two vs. One Visits: A Community-Based Screening Programme and a Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249395. [PMID: 33333948 PMCID: PMC7765379 DOI: 10.3390/ijerph17249395] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 11/27/2020] [Accepted: 12/12/2020] [Indexed: 12/12/2022]
Abstract
We assessed the difference in the prevalence of hypertension in community surveys when blood pressure (BP) was measured on two vs. one visits and its impact on hypertension awareness, treatment and control proportions. A community-based BP screening programme was conducted in public places in the Seychelles (619 adults) and BP was rechecked a few days later among untreated participants with high BP (≥140/90 mmHg). A narrative review of the literature on this question was also conducted. Only 64% of untreated participants with high BP still had high BP at the second visit. The prevalence of hypertension in the whole sample decreased by 13% (from 33.8% to 29.5%) when BP was measured on two vs. one visits. These results concurred with our findings in our narrative review based on 10 surveys. In conclusion, the prevalence of hypertension can be markedly overestimated in community surveys when BP is measured on two vs. one visits. The overestimation could be addressed by measuring BP on a second visit among untreated individuals with high BP or, possibly, by taking more readings at the first visit. These findings have relevance for clinical practice, policy and surveillance.
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Kostagiolas P, Milkas A, Kourouthanassis P, Dimitriadis K, Tsioufis K, Tousoulis D, Niakas D. The impact of health information needs' satisfaction of hypertensive patients on their clinical outcomes. ASLIB J INFORM MANAG 2020. [DOI: 10.1108/ajim-03-2020-0082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe ultimate aim of this study is to investigate how health information needs’ satisfaction actually makes a difference to the patients' management of a chronic clinical condition. The literature falls short of providing evidence on the interaction between patients' health information seeking behaviour and the successful management of a clinical condition. On the other hand, patient education and good information seeking practices are deemed necessary for hypertension management daily decisions.Design/methodology/approachA specially designed questionnaire study was developed: The survey design was informed by the information seeking behaviour model of Wilson for studying hypertension patients' information needs, information resources and obstacles patients face while seeking hypertension-related information. Moreover, clinical information was collected in order to make associations and inference on the impact of information seeking on patients' clinical outcomes.FindingsThe study included 111 patients submitted to the outpatient hypertension clinic of a university hospital in Athens for a 24-h ambulatory blood pressure measurement (ABPM). The analysis showed that those reporting higher satisfaction level of their information needs achieved lower values in ABPM (ABPM<130/80mmHg, p = 0.049). Stepwise the logistic regression analysis revealed three independent factors to predict the possibility of being optimally treated (ABPM<130/80mmHg). Dipping status (OR: 14.052, 95% CI: 4.229–46.688, p = 0.0001) patients with high satisfaction level of their disease (OR: 13.450, 95% CI: 1.364–132.627, p = 0.026) and interpersonal relationships were used as the main source of information (OR: 1.762, 95% CI: 1.024–3.031, p = 0.41).Originality/valueHypertensive patients with high satisfaction level of information achieve better disease control. Among different sources of information, interpersonal relationships emerge as the most appropriate factor for patients' disease control.
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Groenland EH, van Kleef MEAM, Bots ML, Visseren FLJ, van der Elst KCM, Spiering W. Plasma Trough Concentrations of Antihypertensive Drugs for the Assessment of Treatment Adherence: A Meta-Analysis. Hypertension 2020; 77:85-93. [PMID: 33249865 PMCID: PMC7720878 DOI: 10.1161/hypertensionaha.120.16061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Supplemental Digital Content is available in the text. Biochemical drug screening by liquid chromatography-tandem mass spectrometry in plasma is an accurate method for the quantification of plasma concentrations of antihypertensive medications in patients with hypertension. Trough concentrations could possibly be used as drug-specific cutoff values in the biochemical assessment of (non-)adherence. We performed a literature review and meta-analysis of pharmacokinetic studies to determine plasma trough concentrations of amlodipine, hydrochlorothiazide, and valsartan. PubMed was searched for pharmacokinetic studies up to September 2020. Eligible studies reported steady-state mean trough concentration and their variance. Pooled trough concentrations were estimated using a three-level random effects meta-analytic model. Moderator analyses were performed to explore sources of heterogeneity. One thousand three hundred eighteen potentially relevant articles were identified of which 45 were eligible for inclusion. The pooled mean trough concentration was 9.2 ng/mL (95% CI, 7.5–10.8) for amlodipine, 41.0 ng/mL (95% CI, 17.4–64.7) for hydrochlorothiazide, and 352.9 ng/mL (95% CI, 243.5–462.3) for valsartan. Substantial heterogeneity was present for all 3 pooled estimates. Moderator analyses identified dosage as a significant moderator for the pooled trough concentration of amlodipine (β1=0.9; P<0.05), mean age, and mean body weight for the mean trough concentration of hydrochlorothiazide (β1=2.2, P<0.05, respectively, β1=−4.0, P<0.05) and no significant moderators for valsartan. Plasma trough concentrations of amlodipine, hydrochlorothiazide, and valsartan, measured with liquid chromatography-tandem mass spectrometry, are highly heterogeneous over the different studies. Use of the pooled trough concentration as a cutoff in the biochemical assessment of adherence can result in inaccurate diagnosis of (non-)adherence, which may seriously harm the patient-physician relationship, and is therefore not recommended.
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Affiliation(s)
- Eline H Groenland
- From the Department of Vascular Medicine (E.H.G., M.E.A.M.v.K., F.L.J.V., W.S.), University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Monique E A M van Kleef
- From the Department of Vascular Medicine (E.H.G., M.E.A.M.v.K., F.L.J.V., W.S.), University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care (M.L.B.), University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Frank L J Visseren
- From the Department of Vascular Medicine (E.H.G., M.E.A.M.v.K., F.L.J.V., W.S.), University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Kim C M van der Elst
- Department of Clinical Pharmacy (K.C.M.v.d.E.), University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Wilko Spiering
- From the Department of Vascular Medicine (E.H.G., M.E.A.M.v.K., F.L.J.V., W.S.), University Medical Center Utrecht, Utrecht University, the Netherlands
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Ho BK, Omar MA, Sooryanarayana R, Ghazali SS, Zainal Abidin SBI, Krishnapillai A, Ariaratnam S, Tohit NM, Majid NLBA, Yusof MFBM. Trends in population blood pressure and prevalence, awareness, treatment and control of hypertension among older persons: The 2006 & 2015 National Health and Morbidity Survey in Malaysia. PLoS One 2020; 15:e0238780. [PMID: 32911521 PMCID: PMC7482969 DOI: 10.1371/journal.pone.0238780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 08/24/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Hypertension is one of the most important risk factors for cardiovascular diseases. Thus, it is an important public health challenge worldwide. In Malaysia, only a few studies have focused on the trends of hypertension specifically for the aging population. In view of the rapid growth of the elderly population in Malaysia, there is an urgent need to explore the condition of hypertension in this aging population. Hence, the objectives of this study were to determine the trends of population mean systolic and diastolic blood pressure (BP) levels, the prevalence, awareness, treatment and control of hypertension, and its' associated factors among older persons in two cross-sectional national surveys that were conducted in 2006 and 2015 in Malaysia. METHODS This was a subanalysis of secondary data collected from the two cross-sectional national population-based surveys conducted in Malaysia in 2006 and 2015. Adults aged 60 and older who had participated in these two surveys were included in the study. RESULTS A total of 4954 (2295 males and 2659 females) and 3790 (1771 males and 2019 females) respondents completed the hypertension module surveys in 2006 and 2015, respectively. The mean age of the respondents was 68.5±6.9 years in 2006 and 68.6±7.1 years in 2015 and the difference was not significant. The prevalence of hypertension significantly reduced from 73.8% in 2006 to 69.2% in 2015 (p<0.001). Among the respondents with hypertension, the awareness, treatment and control of hypertension significantly increased from 49.7% to 60.2%, 86.7% to 91.5% and 23.3% to 44.8%, respectively, from 2006 to 2015. Logistic regression analysis showed that female sex and unemployed/retiree were significantly associated with higher hypertension prevalence in both 2006 and 2015. Being unemployed/ retiree was significantly associated with higher awareness of hypertension in both 2006 and 2015. In both 2006 and 2015, Chinese ethnicity were significantly associated with higher awareness and control of hypertension. CONCLUSIONS The mean population BP levels and hypertension prevalence among the elderly population in Malaysia have reduced significantly over the past decade. Although the awareness, treatment and control of hypertension among older adults have improved significantly, the awareness and control rates remain suboptimal. As population aging is inevitable, appropriate public health programs and optimal treatment strategies targeting this vulnerable group are urgently needed to improve the overall awareness and control of hypertension and to prevent hypertension-related complications.
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Affiliation(s)
- Bee Kiau Ho
- Bandar Botanic Health Center, Bandar Botanic, Klang, Selangor, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistic & Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | | | - Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Selangor, Malaysia
- Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, Seri Kembangan, Selangor, Malaysia
| | | | - Ambigga Krishnapillai
- Department of Family Medicine, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia
| | - Suthahar Ariaratnam
- Department of Psychiatry, Faculty of Medicine, Universiti Technologi MARA (UiTM), Selayang Campus, Batu Caves, Selangor, Malaysia
| | - Noorlaili Mohd Tohit
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Liana bt Abdul Majid
- Sector for Biostatistic & Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Muhammad Fadhli bin Mohd Yusof
- Sector for Biostatistic & Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
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Muhihi AJ, Anaeli A, Mpembeni RNM, Sunguya BF, Leyna G, Kakoko D, Kessy AT, Mwanyika Sando M, Njelekela M, Urassa DP. Prevalence, Awareness, Treatment, and Control of Hypertension among Young and Middle-Aged Adults: Results from a Community-Based Survey in Rural Tanzania. Int J Hypertens 2020; 2020:9032476. [PMID: 32963821 PMCID: PMC7491449 DOI: 10.1155/2020/9032476] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/25/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Hypertension, which is the single most important risk factor for CVDs, is increasing at an alarming rate in most developing countries. This study estimated the prevalence, awareness, treatment, and control of hypertension among young and middle-aged adults in rural Morogoro, Tanzania. Furthermore, it explored factors associated with both prevalence and awareness of hypertension. METHODS A cross-sectional survey was conducted as part of the cluster randomized controlled study of community health workers (CHWs) interventions for reduction of blood pressure in a randomly selected sample of young and middle-aged population in rural Morogoro. Sociodemographics, lifestyle-related factors, history of diagnosis, and treatment for hypertension were collected using a questionnaire adopted from the STEPS survey tool. Blood pressure, height, and weight were measured at home following standard procedures. Descriptive statistics were used to estimate prevalence, awareness, treatment, and control of hypertension. Multiple logistic regression models were used to assess determinants of hypertension and awareness. RESULT The prevalence of hypertension was 29.3% (95% CI: 27.7-31.0). Among individuals with hypertension, only 34.3% were aware of their hypertension status. Only around one-third (35.4%) of those who were aware of their hypertension status were currently on antihypertensive medication. Hypertension control was attained in only 29.9% among those on medications. Older age (p < 0.001), use of raw table salt (p < 0.001), and being overweight/obese (p < 0.001) were associated with hypertension. Predictors of awareness of hypertension status were older age, being a female, higher socioeconomic status, use of raw table salt, a history of diabetes, and overweight/obesity (all p < 0.001). Alcohol drinking was associated with low awareness for hypertension status (p < 0.001). CONCLUSION There is high prevalence of hypertension with low rates of awareness, treatment, and control among young and middle-aged adults in rural Tanzania. Community-level health promotion and screening campaigns for hypertension and other CVD risk factors should be intensified.
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Affiliation(s)
- Alfa J. Muhihi
- Department of Community Health, Muhimbili University of Health and Allied Sciences, United Nations Road, Upanga, Dar es Salaam, Tanzania
- Africa Academy for Public Health, Plot # 802, Mwai Kibaki Road, Mikocheni, Dar es Salaam, Tanzania
- The Lown Scholars Program, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Amani Anaeli
- Department of Development Studies, Muhimbili University of Health and Allied Sciences, United Nations Road, Upanga, Dar es Salaam, Tanzania
| | - Rose N. M. Mpembeni
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, United Nations Road, Upanga, Dar es Salaam, Tanzania
| | - Bruno F. Sunguya
- Department of Community Health, Muhimbili University of Health and Allied Sciences, United Nations Road, Upanga, Dar es Salaam, Tanzania
| | - Germana Leyna
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, United Nations Road, Upanga, Dar es Salaam, Tanzania
| | - Deodatus Kakoko
- Department of Behavioral Sciences, Muhimbili University of Health and Allied Sciences, United Nations Road, Upanga, Dar es Salaam, Tanzania
| | - Anna Tengia Kessy
- Department of Community Health, Muhimbili University of Health and Allied Sciences, United Nations Road, Upanga, Dar es Salaam, Tanzania
| | - Mary Mwanyika Sando
- Africa Academy for Public Health, Plot # 802, Mwai Kibaki Road, Mikocheni, Dar es Salaam, Tanzania
| | - Marina Njelekela
- Department of Physiology, Muhimbili University of Health and Allied Sciences, United Nations Road, Upanga, Dar es Salaam, Tanzania
- Deloitte Consulting Limited, Aris House, Plot # 152, Haile Selassie Road, Oysterbay, Dar es Salaam, Tanzania
| | - David P. Urassa
- Department of Community Health, Muhimbili University of Health and Allied Sciences, United Nations Road, Upanga, Dar es Salaam, Tanzania
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Soo MJ, Chow ZY, Ching SM, Tan CH, Lee KW, Devaraj NK, Salim HS, Ramachandran V, Lim PY, Sivaratnam D, Hoo FK, Cheong AT, Chia YC. Prevalence, awareness and control of hypertension in Malaysia from 1980-2018: A systematic review and meta-analysis. World J Meta-Anal 2020; 8:320-344. [DOI: 10.13105/wjma.v8.i4.320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/22/2020] [Accepted: 08/31/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hypertension is a common public health problem worldwide and is a well-known risk factor for increased risk of cardiovascular diseases, contributing to high morbidity and mortality. However, there has been no systematic review and meta-analysis of a multiethnic population such as that of Malaysia.
AIM To determine the trend in prevalence, awareness and control rate of hypertension in Malaysia.
METHODS Systematic searches were conducted in six databases (PubMed, Scopus, Ovid, CINAHL, Malaysian Medical Repository and Malaysia Citation Index) for articles published between 1980 and 2018. Two authors reviewed the studies and performed quality assessment and data extraction independently. Pooled estimates of hypertension prevalence, awareness and control rate were calculated using the DerSimonian-Laird random-effects model. Subgroup and sensitivity analyses were performed.
RESULTS We included 56 studies involving a total of 241796 participants. The overall pooled prevalence of hypertension aged ≥ 18 years was 29.7%. The prevalence of hypertension was the lowest in the 1980s (16.2%, 95% confidence interval (CI): 13.4, 19.0), increasing up to 36.8% (95%CI: 6.1, 67.5) in the 1990s, then decreasing to 28.7% (95%CI: 21.7, 35.8) in the 2000s and 26.8% (95%CI: 21.3, 32.3) in the 2010s. The prevalence of awareness was 51.4% (95%CI: 46.6, 56.3), while 33.3% (95%CI: 28.4, 38.2) of those on treatment had achieved control of their blood pressure.
CONCLUSION In Malaysia, three in ten adults aged ≥ 18 years have hypertension, while four in ten adults aged ≥ 30 years have hypertension. Five out of ten people are aware of their hypertension status and only one-third of those under treatment achieved control of their hypertension. Concerted efforts by policymakers and healthcare professionals to improve awareness and control of hypertension should be of high priority.
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Affiliation(s)
- Man Jun Soo
- Department of Family Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | | | - Siew Mooi Ching
- Department of Family Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | | | - Kai Wei Lee
- Department of Family Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Navin Kumar Devaraj
- Department of Family Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Hani Syahida Salim
- Department of Family Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Vasudevan Ramachandran
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Poh Ying Lim
- Department of Community Health, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | | | - Fan Kee Hoo
- Department of Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Ai Theng Cheong
- Department of Family Medicine, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Yook Chin Chia
- Department of Medical Sciences, Sunway University, Bandar Sunway 47500, Malaysia
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Teh XR, Lim MT, Tong SF, Husin M, Khamis N, Sivasampu S. Quality of hypertension management in public primary care clinics in Malaysia: An update. PLoS One 2020; 15:e0237083. [PMID: 32780769 PMCID: PMC7418969 DOI: 10.1371/journal.pone.0237083] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 07/20/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Adequate control of hypertension is a global challenge and is the key to reduce cardiovascular disease risk factors. This study evaluates management of hypertensive patients in primary care clinics in Malaysia. METHODS A cross-sectional analysis of 13 784 medical records from 20 selected public primary care clinics in Malaysia was performed for patients aged ≥30 years old who were diagnosed with hypertension and had at least one visit between 1st November 2016 and 30th June 2019. Multivariable logistic regression adjusted for complex survey design was used to determine the association between process of care and blood pressure (BP) control among the hypertensive patients. RESULTS Approximately 50% of hypertensive patients were obese, 38.4% of age ≥65 years old, 71.2% had at least one comorbidity and approximately one-third were on antihypertensive monotherapy. Approximately two-third of the hypertensive patients with diabetic proteinuria were prescribed with the appropriate choice of antihypertensive agents. Approximately half of the patients received at least 70% of the target indicated care and 42.8% had adequately controlled BP. After adjusting for covariates, patients who received counseling on exercise were positively associated with adequate BP control. Conversely, patients who were prescribed with two or more antihypertensive agents were negatively associated with good BP control. CONCLUSIONS These findings indicated that BP control was suboptimal and deficient in the process of care with consequent gaps in guidelines and actual clinical practices. This warrants a re-evaluation of the current strategies and approaches to improve the quality of hypertension management and ultimately to improve outcome.
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Affiliation(s)
- Xin Rou Teh
- Centre for Clinical Outcomes Research, Institute for Clinical Research, National Institute of Health (NIH), Ministry of Health, Selangor, Malaysia
| | - Ming Tsuey Lim
- Centre for Clinical Outcomes Research, Institute for Clinical Research, National Institute of Health (NIH), Ministry of Health, Selangor, Malaysia
| | - Seng Fah Tong
- Department of Family Medicine, University Kebangsaan Malaysia, Selangor, Malaysia
| | - Masliyana Husin
- Centre for Clinical Outcomes Research, Institute for Clinical Research, National Institute of Health (NIH), Ministry of Health, Selangor, Malaysia
| | - Noraziani Khamis
- Center for Clinical Governance Development, Institute for Health Management, National Institutes of Health, Ministry of Health (NIH), Selangor, Malaysia
| | - Sheamini Sivasampu
- Centre for Clinical Outcomes Research, Institute for Clinical Research, National Institute of Health (NIH), Ministry of Health, Selangor, Malaysia
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