Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of...Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of the adults with hypertension are unaware of their hypertensive status due to factors that bother on poor management and poor screening approaches. The implication is that people who have poor access to healthcare especially those in the rural communities are at increased risk of cardiovascular complications and all-cause mortality. Unfortunately, not much has been done to ascertain the burden of undiagnosed hypertension and associated risk factors in rural communities in Nigeria. Methods: We conducted a community-based cross-sectional study in a rural community in Imo State, Nigeria, on burden of undiagnosed hypertension with participants recruited via a multi-stage sampling method. An interviewer-administered questionnaire was used, and standardized instruments were applied to obtain, process and analyze the data. Tests of association between the independent variables and outcome were conducted using logistic regression. P-value of Results: A total of 380 adults participated in the study. The mean age was 44.2 years. The prevalence of undiagnosed hypertension was 35.8%. Logistic regression revealed that age, with the respondents in the age groups 26 - 35 years (OR = 10.647, 1.910 - 59.345, p-value = 0.007), 36 - 45 (OR = 3.680, 1.263 - 10.723, p-value = 0.017), 46 - 55 years (OR = 2.737, 1.114 - 6.727, p-value = 0.039), 56 - 65 years old (OR = 3.384, 1.610 - 7.115, p-value = 0.001);and being married (OR = 3.846, 1.118 - 13.233, p-value = 0.033), were independent risk factors for undiagnosed hypertension. Conclusion: The prevalence of undiagnosed hypertension in the rural population of South-East Nigeria is high. Younger age (26 - 35 years) had the highest odds of risk for occurrence of hypertension. Also being married was identified as a risk factor for undiagnosed hypertension.展开更多
Introduction: Obesity, excessive alcohol use, cigarette smoking, a lack of physical activity, stress, and an unhealthy diet are modifiable risk factors linked to hypertension. Non-modifiable risk factors for hypertens...Introduction: Obesity, excessive alcohol use, cigarette smoking, a lack of physical activity, stress, and an unhealthy diet are modifiable risk factors linked to hypertension. Non-modifiable risk factors for hypertension include older age and a family history of hypertension. The purpose of this study was to assess university students’ knowledge of hypertension risk factors. Methods: This was a cross-sectional study conducted at St. Augustine University of Tanzania. A pre-tested, semi-structured questionnaire was used to collect data. Out of a total score of eight, a score of four or more was considered good knowledge, and a score of less than four was considered poor. All sociodemographic characteristics were included in logistic regression to calculate the adjusted odds ratio. Results: A total of 390 undergraduate students participated in this study. Most of the participants 266 (68.2%) identified stress as a risk factor for hypertension. The median (IQR) knowledge score was 2 (2 - 3). Overall, only 43 (11.0%) of the participants had good knowledge of risk factors for hypertension. However, none of the sociodemographic factors were associated with a good level of knowledge of risk factors for hypertension. Conclusion: Our findings highlight poor knowledge of modifiable and non-modifiable risk factors for hypertension among university students in northwestern Tanzania. Only stress and older age were known by more than half of the students as risk factors for hypertension. To reduce the burden of hypertension, it is crucial for prevention and control programs to target improving university students’ knowledge of risk factors for hypertension.展开更多
Objective: To assess the prevalence of prehypertension and hypertension, their determinants and associated cardiovascular risk factors in Congolese urban dwellers. Methods: From July 2007 to March 2008, we collected i...Objective: To assess the prevalence of prehypertension and hypertension, their determinants and associated cardiovascular risk factors in Congolese urban dwellers. Methods: From July 2007 to March 2008, we collected information on lifestyle habits, medical history and anthropometric data in 1292 household members of Adoula Quarter, Kinshasa, aged 20 years or more, 731 women (56.6%). We obtained measurements of BP, blood glucose, serum lipids and qualitative proteinuria. We defined blood pressure categories according to JNC7 classification and used logistic regression analyses to assess their independent determinants. We obtained age adjustment of continuous and categorical variables using GLM and Genmod procedures, respectively. Results: Prehypertension was observed in 30.3% of subjects, 34.9% of men and 26.7% of women (P = 0.0045). The prevalence of hypertension amounted to 30.9% with no difference between genders. Participants with prehypertension had average age, BMI and waist circumference intermediate between those with normal BP and hypertensive subjects. Their glucose and lipids levels were similar to those of normotensives. The prevalence of prehypertension amounted to 33% at age 20 - 29 years and decreased to 16.7% at ≥60 years whereas the prevalence of hypertension increased from 11.2% to 71.4%. The rates of diabetes mellitus were similar accross blood pressure catogo- ries whilst prevalences of overweight/obesity, abdominal adiposity, dyslipidemia and metabolic syndrome significatively increased (P = 0.05 or less). Among participants with prehypertension, 73% had two or more additional cardiovascular risk factors. In the logistic model the probability of prehypertension was higher in men (OR: 1.429;95% CI: 1.099 - 1.857) and participants with overweight/obesity (OR: 1.666;1.146 - 2.422), lower in participants aged ≥ 55 years (0.427;0.267 - 0.683) and those with high fruit intake (0.691;0.488 - 0.977). The probability of hypertension was higher in participants aged ≥ 55 years (OR: 6.988;4.561 - 10.706), overweight/obesity (2.263;1.704 - 3.004), those with high vegetables consumption (1.152;1.003 - 1.324) and faster pulse rate (1.013;1.002 - 1.025). Conclusion: Our results suggest that fruit consumption and control of over-weight are important issues for prevention of cardiovascular disease in sub-Saharan Africa where high blood pressure is the main driver of the current epidemic.展开更多
Background: Hypertension is one of the signficant risk factors for further severe cardiovascular diseases. Furthermore, the insidence of hypertension in adult age population has increased gradually. Thus, assessment ...Background: Hypertension is one of the signficant risk factors for further severe cardiovascular diseases. Furthermore, the insidence of hypertension in adult age population has increased gradually. Thus, assessment of hypertension insidence and their risk factors in adult age people has given the beneficience for treating dan preventing program earlier. Aim: To analyze hypertension insidence in adult age and their risk factors that dominanly effect the occurance of hypertension. Method: This study was correlational with survey method. Accidental sampling was conducted to 120 respondents who live around Malioboro district. Hypertension was detected from systole and diastole value, while the risk factors of hypertension were age, gender, family disease history, type of activity, the number of cigarette each day, the length of smoking, random blood glucose, and body mass index. Analyzing the data used Pearson correlation if data were normal, or used Spearman correlation if data were not normal. Findings: From 120 participants, mean of systolic pressure was 120.7 mmHg and mean of diastolic pressure was 78.5 mmHg. Age mean was 39 years old, dominantly was woman amount 83 (69.2%), and without family disease history as 66 (55%). Mostly they had moderate physical activity amount 71 (59%). Mean of cigarette consumtion was 11 pieces/day, for 23 years. Random blood glucose mean was 131 mg/dL and mean of body mass index was 26 kg/m2. Correlation analysis mentioned that body mass index had correlate with systolic and diastolic value significantly (p 〈 0.05). Conclusion: Systolic and diastolic pressure value in adult age were still normal. Risk factor that correlated significantly with adult age blood pressure was body mass index. Another risk factors such as cholesterol level, blood glucose in fasting condition and two hour post meal, also food consumtion were considered that should be included in next study.展开更多
The Systemic Arterial Hypertension (SAH) stands out among the chronic non-transmissible pathologies that impact the cause and/or aggravation of cardiovascular diseases (CVD) on a global level, as the disease is an und...The Systemic Arterial Hypertension (SAH) stands out among the chronic non-transmissible pathologies that impact the cause and/or aggravation of cardiovascular diseases (CVD) on a global level, as the disease is an underestimated disorder due to non-perceptive symptoms and associated with factors and risk markers of another CVD. Therefore, establishing the risk of progression and aggravation of the SAH, according the Framingham Risk Score (FRS), allows to reducing morbidity and improving preventative measures for DCVs. This observational and transversal study approaches the data collection of patient records at the Health Family Strategy of Senhor do Bonfim, BA, which established differences by descriptive and inferential statistical analysis (correlation and regression). The aspects of hypertension associated with risk factors for atherosclerosis were analyzed, determining the risk of developing cardiovascular events in 10 years by FRS. From 432 families, 746 patients were selected, of which 340 are hypertensive individuals (SAH = 45.57%) and 406 (NSAH = 54.42%) non-hypertensives. Among the SAH the majority (31.17%) was in the age range of 63 - 77, but, in both groups, women were in stronger number. There was greater prevalence in SAH for all the characteristics analyzed, smoking (13.20%), sedentary (29.41%) and cardiovascular accident (22.60%). The SAH group is more susceptive to the CVD progress in 10 years by FRS (P < 0.0001 ANOVA). In the NSAH group, there were significant associations among all the variables analyzed as was expected, without differences between the linear correlation and regression, indicating the physio-metabolic equilibrium of the factors and markers evaluated by FRS. Already in SAH group, despite the correlations have been significant too, the regression analysis revealed that only Total Cholesterol (P = 0.0086);LDL (P < 0.0001), Glucose (P < 0.0006) and Age (P < 0.0001) have significative association with FRS. So, these factors and markers deserve more attention upon the health staff of Health Family Strategy, in the SAH course at studied population, attempt the highest cardiovascular risk by FRS (2.5 to 2.8 times) to SAH. The monitoring of high-risk patients should prioritize the lifestyle changes, employing preventive measures to SAH and CVD and atherosclerosis.展开更多
In 2017,American College of Cardiology(ACC)/American Heart Association(AHA)et al.jointly released the latest guidelines for adult hypertension,exactly including prevention,diagnosis,assess and treatment,in which blood...In 2017,American College of Cardiology(ACC)/American Heart Association(AHA)et al.jointly released the latest guidelines for adult hypertension,exactly including prevention,diagnosis,assess and treatment,in which blood pressure levels greater than 130/80 mm Hg were defined as hypertension[1].Based on these modified guidelines,the morbidity of hypertension in US increased from 32%to 46%.展开更多
Aim: To establish the prevalence and risk factors for hypertension, diabetes and obesity among teaching and non-teaching staff of Bishop Stuart University, Mbarara-Uganda. Background: None communicable diseases (NCDs)...Aim: To establish the prevalence and risk factors for hypertension, diabetes and obesity among teaching and non-teaching staff of Bishop Stuart University, Mbarara-Uganda. Background: None communicable diseases (NCDs) are projected to exceed communicable diseases as the most common causes of death by 2030 in Africa. Most sub-Saharan African countries however lack detailed countrywide data on hypertension and other NCDs risk factors. Cognizant of Uganda’s recent inclusion of Hypertension and diabetes in the health policy agenda, this study was conducted among the university staff in a rural setting to provide benchmark information for design of appropriate interventions. Study Design: This was a descriptive cross-sectional, institutional based survey design. Place and duration of the study: This study was conducted among the teaching and none teaching staff of Bishop Stuart University Mbarara, Uganda from 18th April-6th June 2017. Methodology: A structured questionnaire was used to gather social demographic and risk factors data from the university workers at their work stations. Blood pressure of each participant was measured and Hypertension was defined as systolic BP > 140 and/or diastolic (BP) > 90 mmHg. Anthropometric measurements: Body Mass index (BMI) was done by weight in (Kg) and Height in (M2) to establish weight levels. Obesity was considered at BMI > 40. A random Blood Sugar (RBS) > 200 mg/dl was considered as diabetic. Epi-info version 7 was used to enter data, analyzed using SPSS version 19. Results: A total of 156 University staff aged 25 - 75 years of both sexes, mean age 42 ± 8 were interviewed of whom 51% were males. About 15% were administrative staff, 55% teaching staff, 3% senior lecturers and professors and 25% non-teaching staff. The prevalences of Hypertension, Diabetes, and obesity were 7.7%, 16%, and 28% respectively. But also majority (60.2%) were found at risk of developing both hypertension and diabetes. Less than 20% of the participants were knowledgeable on causes, signs and symptoms and preventive measures for Hypertension but had moderate knowledgeable of the risk factors, the most frequently mentioned risk by 71% was lack of exercise. Despite the awareness of risk factors, majority (61.3%) had not done any form of exercise and 64.1% had not had regular Blood pressure check ups. The study also demonstrated a statistically significant relationship between those aged more than 40 years and having hypertension (X2 = 5.82, P = 0.015, OR = 4.2). Likewise the risk of Diabetes increased with increasing age. Lecturers aged 40 years and above were 5.6 times likely to have diabetes compared to those aged less than 40 years (OR = 5.6, X2 = 16 , P = 0.0005). A significant number of respondents 57/156 (36.5%) reported history of HPT among their family members. Prevalence of obesity and overweight was observed higher in senior administrative staff and lecturers than in lower cadre staff 49% and 34% (p 0.01). Conclusion: Hypertension, Diabetes and obesity are conditions prevalent among the teaching and none teaching staff of BSU, but knowledge on risk factors, clinical presentation and preventive strategies is limited. Routine physical exercises...展开更多
BACKGROUND Sessile serrated lesions(SSLs)are considered precancerous colorectal lesions that should be detected and removed to prevent colorectal cancer.Previous studies in Vietnam mainly investigated the adenoma path...BACKGROUND Sessile serrated lesions(SSLs)are considered precancerous colorectal lesions that should be detected and removed to prevent colorectal cancer.Previous studies in Vietnam mainly investigated the adenoma pathway,with limited data on the serrated pathway.AIM To evaluate the prevalence,risk factors,and BRAF mutations of SSLs in the Vietnamese population.METHODS This is a cross-sectional study conducted on patients with lower gastrointestinal symptoms who underwent colonoscopy at a tertiary hospital in Vietnam.SSLs were diagnosed on histopathology according to the 2019 World Health Organi-zation classification.BRAF mutation analysis was performed using the Sanger DNA sequencing method.The multivariate logistic regression model was used to determine SSL-associated factors.RESULTS There were 2489 patients,with a mean age of 52.1±13.1 and a female-to-male ratio of 1:1.1.The prevalence of SSLs was 4.2%[95%confidence interval(CI):3.5-5.1].In the multivariate analysis,factors significantly associated with SSLs were age≥40[odds ratio(OR):3.303;95%CI:1.607-6.790],male sex(OR:2.032;95%CI:1.204-3.429),diabetes mellitus(OR:2.721;95%CI:1.551-4.772),and hypertension(OR:1.650,95%CI:1.045-2.605).The rate of BRAF mutations in SSLs was 35.5%.CONCLUSION The prevalence of SSLs was 4.2%.BRAF mutations were present in one-third of SSLs.Significant risk factors for SSLs included age≥40,male sex,diabetes mellitus,and hypertension.展开更多
Background: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are serious diseases with similar pathophysiologic aspects. The prognosis of patients with these conditions i...Background: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are serious diseases with similar pathophysiologic aspects. The prognosis of patients with these conditions is highly uncertain, particularly incident cases. Methods: A Cox proportional hazards model was applied to a group of 85 patients (81% women, mean age 52 (18 - 82) years) with PAH (80%) and non-surgical CTEPH (20%) to evaluate risk factors for mortality. The following variables were included in the model: age, etiology, baseline 6-minute walk test (6 mWT), cardiac index, and improvement in the 6 mWT following initiation of first medical treatment. Results: In the multivariate analysis, the response to treatment, assessed by an improvement on the 6 mWT, was the most relevant prognostic factor in these patients (RR, 4.832 (95% CI, 1.888 - 12.364);p = 0.001). The remaining variables studied in this model had less influence on the prognosis: age > 50 years (RR, 0.744 (95% CI, 0.26 - 2.133);p = 0.582);etiology of connective tissue disease-associated PAH (RR, 3.145 (95% CI, 0.995-9.946);p = 0.051) or CTEPH (RR, 0.654 (95% CI, 0.179 - 2.387);p = 0.521) with respect to idiopathic PAH;baseline 6 mWT (RR, 1.173 (95% CI, 0.599 - 4.895);p = 0.315);or cardiac index (RR, 2.295 (95% CI, 0.793 - 6.642);p = 0.125). Conclusions: There is a high degree of uncer-tainty regarding the prognosis of PAH and CTEPH at the start of appropriate treatment. Our results support the idea that the initial treatment response is of paramount importance as prognostic factor in these patients.展开更多
The fight against cardiovascular diseases requires the knowledge of their modifiable risk factors. This study aimed to assess the level of modifiable cardiovascular risk factors in a rural area in order to develop a p...The fight against cardiovascular diseases requires the knowledge of their modifiable risk factors. This study aimed to assess the level of modifiable cardiovascular risk factors in a rural area in order to develop a prevention program. Methods: This is an analytical and cross-sectional study on data collected during a fairground medical consultation of adults from 20 to 25 May 2013, in both border districts of the municipality of Djidja (Agouna and Houto). The studied parameters were the capillary blood glucose profile, blood pressure profile, waist circumference (WC) and Body Mass Index (BMI). Diabetes is defined by a fasting blood glucose ≥ 1.26 g/L two times. Hypertension is defined according to the criteria of JNC VII and obesity by BMI ≥ 30 kg/m2;abdominal obesity is defined by a WC above 102 cm in men and 88 cm in women. Data were analyzed using SPSS software version 18.0. Results: A total of 926 people were included among whom 57.8% were women. The average age was 38.43 ± 15.84 years. The prevalence of diabetes mellitus was 2.9%. The prevalence of obesity (BMI ≥ 30 kg/m2) was 8.4%;10.8% of studied population had abdominal obesity and 19.2% had hypertension. Age above 35 years and obesity were significantly associated with hypertension. Risk factors of obesity (IMC ≥ 30 kg/m2) were the place of residence (Agouna), the female gender, age between 35 and 64 and abdominal obesity. Conclusion: The frequency of cardiovascular risk factors, although small compared to the national level, remains a concern in the investigated rural communities. This must lead to undertake a survey on the lifestyle and dietary habits of the inhabitants of these areas.展开更多
Objective:The aim of this study was to evaluate the effects of traditional Chinese exercises (TCEs) on stroke risk factors in patients with pre-hypertension or mild-to-moderate essential hypertension.Methods:We perfor...Objective:The aim of this study was to evaluate the effects of traditional Chinese exercises (TCEs) on stroke risk factors in patients with pre-hypertension or mild-to-moderate essential hypertension.Methods:We performed searches of seven electronic databases for studies published from their inception until July 2017.We included randomized controlled trials (RCTs) of the effects of TCEs with or without health education on stroke risk factors in patients with prehypertension or mild-to-moderate essential hypertension.Outcomes were independently extracted from each study by two authors and were pooled to determine risk ratios and standardized mean differences.materials-methodsResults:We included 15 RCTs,involving 1272 hypertensive participants.Compared with no intervention,TCEs were associated with a clinically meaningful amelioration of stroke risk factors,including reductions in systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting blood glucose,blood lipids,and waist-to-hip ratio,and improved quality of life.Compared with health education,TCEs reduced SBP but had no effect on DBP.Compared with health education alone,TCEs plus health education resulted in an amelioration of stroke risk factors.No serious adverse events were reported.resultsConclusion:TCEs may be effective alongside health education in ameliorating stroke risk factors in individuals with pre-hypertension or mild-to-moderate essential hypertension.However,the current evidence is insufficient due to poor methodology and lack of adequate safety data.Further rigorously-designed RCTs are warranted.conclusion.展开更多
Introduction: Non-communicable diseases constitute a major public health problem, due to their morbi-mortality. The aim was to study knowledge of cardiovascular risk factors among residents of Dakar. Patients and Meth...Introduction: Non-communicable diseases constitute a major public health problem, due to their morbi-mortality. The aim was to study knowledge of cardiovascular risk factors among residents of Dakar. Patients and Methods: This was a descriptive cross-sectional study. Our investigations were recruited over a six-month period (October 17, 2021 to March 21, 2022). Results: Two hundred and twenty-six (226) patients were enrolled. The mean age was 45.9 years. The under-40 age group was the most represented with 37.2%. There were 129 men (57.1%), giving a male/female sex ratio of 1.33. The highest level was represented by 159 people (70.4%). Those who responded (heart disease) were in the majority (38.1%). Hypertension was the most common CVD for 101 people (44.7%). One hundred and ninety (190) people (84%) knew the risk factors for CVD. Good knowledge of risk factors concerned 103 people (54.2%). Obesity was the best-known risk factor in 156 cases (69%). The media was the most important source of information for 121 people (53.5%). Hypertensives were the most represented with 8.4%. One hundred and thirty (130) people (57.5%) had previously paid attention to these FDRCVs. Awareness campaigns were the most effective means of communication for 170 cases (75.2%). Sixteen (16) people (35.6%) were taking antihypertensive medication. Walking was the most popular physical activity for 102 people (45%). People with a balanced diet were in the majority, with 174 respondents (77.0%). Conclusion: NCDs are a major cause of morbidity and mortality. It is essential to develop and implement a prevention and management program.展开更多
BACKGROUND Postpartum hypertension poses a considerable health risk.Despite research on gestational hypertension,comprehensive studies focusing on postpartum hypertension in communities are limited.Understanding its p...BACKGROUND Postpartum hypertension poses a considerable health risk.Despite research on gestational hypertension,comprehensive studies focusing on postpartum hypertension in communities are limited.Understanding its prevalence and associated risk factors is crucial for effective prevention and management.AIM To provide insights for postpartum hypertension’s prevention and management.METHODS In total,3297 women who gave birth between June 2021 and December 2022 in Xuhui District,Shanghai were selected.Blood pressure was measured thrice within one month post-delivery during home visits.Eighty-six women with hypertension were followed up for four months to analyze hypertension persistence and its related risk factors.A predictive model for persistent postpartum hypertension was established and verified using the Nomo diagram model.RESULTS Hypertension prevalence 1 month post-delivery was 2.61%(86/3297).Among the 86 pregnant women,32(37.21%)had persistent hypertension at four months post-delivery.Multivariate logistic regression analysis revealed that older age[odds ratio(OR)=1.212;95%confidence interval(CI):1.065–1.380]and higher pre-pregnancy body mass index(BMI)(OR=1.188;95%CI:1.006–1.404)were associated with hypertension(OR=10.781;95%CI:1.006–1.404)during pregnancy.A 95%CI of 1.243–93.480 is a risk factor for persistent postpartum hypertension.The Nomograph model accurately predicted the risk of persistent postpartum hypertension,demonstrating high precision.CONCLUSION In Xuhui,older age,higher pre-pregnancy BMI,and gestational hypertension are risk factors for persistent postpartum hypertension.Our prediction model can identify high-risk individuals,thereby improving patient quality of life.展开更多
Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The...Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The purpose of this study was to establish and validate a nomogram prediction model for assessing the risk of HDP in pregnant women based on laboratory indicators and HDP risk factors. Method: A total of 307 pregnant women who were hospitalized in the obstetrics and gynecology department of our hospital were included in this study, and were randomly divided into a training cohort and validation cohort at a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for the development of HDP on laboratory indicators as well as risk factors for HDP in the training cohort of patients. The results of the multivariate regression model were visualized by forest plots. A nomogram was constructed based on the results of multivariate logistic regression to predict the risk of HDP in pregnant women. The validity of the risk prediction model was evaluated by the area under the receiver operating characteristic curve (AUC), the consistency index (C-index), the calibration curve and the decision curve analysis (DCA). Results: BMI ≥ 25 Kg/m2, total cholesterol in early pregnancy, uric acid and proteinuria in late pregnancy were independent risk factors for HDP. The AUC and C-index of the nomogram constructed by the above four factors were both 0.848. The calibration curve is closely fitted with the ideal diagonal, showing a good consistency between the nomogram prediction and the actual observation of HDP. The DCA has demonstrated the great clinical utility of nomogram. Internal verification proves the reliability of the predicted nomograms. Conclusion: The BTUP nomogram model based on laboratory indicators and risk factors proposed in this study showed good predictive value for the risk assessment of HDP. It is expected to provide evidence for clinical prediction of the risk of HDP in pregnant women.展开更多
Background: Kidney failure, cardiovascular disease, and early mortality are just a few of the major negative effects of chronic renal disease, a serious global health issue. The considerable financial and public healt...Background: Kidney failure, cardiovascular disease, and early mortality are just a few of the major negative effects of chronic renal disease, a serious global health issue. The considerable financial and public health burden associated with chronic kidney disease can be lessened by raising awareness and adopting better practices for its impact, prevention, and early identification. Objective: In this study, individuals with hypertension and diabetes were evaluated for their knowledge of chronic kidney disease, its prevalence, and its risk factors. Method: It was a hospital-based cross-sectional study conducted on adult (>18 years) patients with diabetes mellitus and hypertension. Each participant provided written informed consent before having their data collected through interviews, medical information, and blood samples for CKD screening. The CKD epidemiology collaboration (CKD-EPI) equation was used to calculate the glomerular filtration rate (GFR) from serum creatinine, and CKD was determined using the estimated GFR (e-GFR). To find independent CKD factors, multivariate logistic regression was employed, with a p-value of 0.05 being regarded as statistically significant. This was accomplished using SPSS (Statistical Program for Social Sciences) version 22.0, IBM Corp., Armonk, NY. Result: A total of 156 participants took part in the study among which 95 (60.9%) were male, most of the participants 82 (52.6%) were aged between 51 - 70 years (mean 59.42 ± 11.007), 76 (48.7%) were unemployed and 97 (62.2%) were single. Overall, the knowledge score of participants on CKD was 65.4% for good knowledge and 34.6% for poor or inadequate knowledge of CKD. More than half of the participants (60%) had chronic kidney disease. Among these, the greatest proportion of CKD patients were those who were hypertensive (88.2%) followed by those who were both hypertensive and diabetic (70.7%). Conclusion: There is poor management of CKD in the South West Region of Cameroon which has contributed greatly to the progression of CKD and increases in the mortality rate.展开更多
Objective:This study compared the prevalence,awareness,treatment and control of hypertension and associated factors in China and the United States(US).Methods:Adult data from nationally representative samples were der...Objective:This study compared the prevalence,awareness,treatment and control of hypertension and associated factors in China and the United States(US).Methods:Adult data from nationally representative samples were derived from the Chronic Disease and Risk Factors Surveillance in 2010 and 2013 in China and the National Health and Nutrition Examination Survey in 2010 and 2013 in the US.Multivariable logistic and Poisson regression analysis were conducted to assess associations of the four outcomes with body weight status and behavioral factors.Results:Age-standardized prevalence rates of hypertension was 35.7%(95%confidence interval[CI]:35.4%to 36.1%)in 2010 and 29.8%(95%CI:29.4%to 30.2%)in 2013 in China,and 35.3%(95%CI:33.6%to 37.1%)in 2010 and 37.9%(95%CI:36.0%to 39.7%)in 2013 in the US.Among hypertensive participants,the age-standardized rates of treatment were 18.4%(95%CI:17.9%to 1&9%)in 2010 and 23.8%(95%CI:23.1%to 24.6%)in 2013 in China and 54.5%(95%CI:50.3%to 5&7%)in 2010 and 50.9%(95%CI:46.5%to 55.3%)in 2013 in the US;the age-standardized hypertension control rates were 3.2%(95%CI:3.0%to 3.5%)and 5.7%(95%CI:5.3%to 6.0%)in 2010 and 2013 in China and 50.6%(95%CI:46.2%to 55.0%)and 55.3%(95%CI:50.3%to 60.3%)in the US.Obesity was significantly associated with prevalence,awareness and control rates in both countries.Different from the US,obesity was negatively associated with hypertension control in China.Conclusion:Hypertension prevalence in China is similar to that in the US,but the control rate in China was significantly lower.Obesity was a critical risk factor for poor hypertension control in China.展开更多
Objective:To have a basic and comprehensive understanding about the prevalence,risk factors and disease management situation of hypertension among floating population in China.Method:We used“(hypertension or hyperten...Objective:To have a basic and comprehensive understanding about the prevalence,risk factors and disease management situation of hypertension among floating population in China.Method:We used“(hypertension or hypertensive or chronic disease)and(floating population or migrant worker)”as the key words,to search in the China academic literature database(CNKI),Wan Fang database,PubMed and Web of Science for relevant literature and extracted the data about the prevalence of hypertension,relevant risk factors and disease management of floating population in China from 1990 to 2016.Result:The 23 related studies that entered into final analysis were all articles in Chinese.The prevalence of hypertension in floating population is lower than that in both general population and local residents.The prevalence of hypertension in male floating population is higher than that in females.In addition,the prevalence of hypertension also increases with age growing.As for the risk factors of hypertension,the rate of drinking in floating population is higher than that in general population and local residents,while the rates of overweight and obesity in floating population are lower than that in general population in China.Finally,the rates of awareness,treatment and control of hypertension are also lower in floating population.Conclusion:The major problem of floating population is focused on their unhealthy lifestyle(drinking)and deficient disease management.Therefore,we should increase the fund and facility support for public health service system so as to improve their service delivery ability,and enforce the education and unhealthy lifestyle intervention to improve their health awareness and compliance to disease management.展开更多
BACKGROUND Type 1 diabetes(T1D)contributes to altered lipid profiles and increases the risk of cardiovascular disease(CVD).Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.AIM T...BACKGROUND Type 1 diabetes(T1D)contributes to altered lipid profiles and increases the risk of cardiovascular disease(CVD).Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.AIM To examine risk factors for dyslipidemia in young subjects with T1D.METHODS Longitudinal and cross-sectional retrospective study of 170 young subjects with T1D(86 males;baseline mean age 12.2±5.6 years and hemoglobin A1c 8.4%±1.4%)were followed in a single tertiary diabetes center for a median duration of 15 years.Predictors for outcomes of lipid profiles at last visit(total cholesterol[TC],triglycerides[TGs],low-density lipoprotein-cholesterol[LDL-c],and highdensity lipoprotein-cholesterol[HDL-c])were analyzed by stepwise linear regression models.RESULTS At baseline,79.5%of the patients had at least one additional CVD risk factor(borderline dyslipidemia/dyslipidemia[37.5%],pre-hypertension/hypertension[27.6%],and overweight/obesity[16.5%])and 41.6%had multiple(≥2)CVD risk factors.A positive family history of at least one CVD risk factor in a first-degree relative was reported in 54.1%of the cohort.Predictors of elevated TC:family history of CVD(β[SE]=23.1[8.3],P=0.006);of elevated LDL-c:baseline diastolic blood pressure(DBP)(β[SE]=11.4[4.7],P=0.003)and family history of CVD(β[SE]=20.7[6.8],P=0.017);of elevated TGs:baseline DBP(β[SE]=23.8[9.1],P=0.010)and family history of CVD(β[SE]=31.0[13.1],P=0.020);and of low HDL-c levels:baseline DBP(β[SE]=4.8[2.1],P=0.022]).CONCLUSION Our findings suggest that elevated lipid profiles are associated with DBP and a positive family history of CVD.It is of utmost importance to prevent and control modifiable risk factors such as these,as early as childhood,given that inadequate glycemic control and elevation in blood pressure intensify the risk of dyslipidemia.展开更多
Objective To investigate the association of specific functional gene ACE (I/D) variants of the renin-angiotensin system with essential hypertension (EH) and interaction between ACE (I/D) gene and risk factors for EH i...Objective To investigate the association of specific functional gene ACE (I/D) variants of the renin-angiotensin system with essential hypertension (EH) and interaction between ACE (I/D) gene and risk factors for EH in a genetically homogenous Mongolia rural population of China. Methods Individuals (n=1099) were recruited from general population of Kezuohouqi Banner in Inner Mongolian Autonomous Region. Results The association was found between ACE genotype DD plus ID and EH, with an interaction between ACE genotype DD plus ID and cigarette smoking in an additive model. Cigarette smoking index and ACE gene showed a low exposure-gene (LEG) effect on EH, with interaction indices from 7.10 to 1.16. Interaction between ACE genotype DD plus ID and alcohol drinking on EH appeared an additive model. Alcohol drinking index and ACE gene showed a low exposure-gene (LEG) effect on EH, with interaction indices from 1.66 to 1.09. BMI and ACE gene showed a low exposure-gene (LEG) effect on EH, with interaction indices from 6.15 to 2.49. Interactions between ACE genotype and WHR on EH showed a multiplicative model. In a short, there was an interaction between ACE gene and cigarette smoking, alcohol drinking and BMI on EH, especially in a low dose-exposure effect Conclusion It is important for individuals who carry ACE D allele gene to prevent EH, and furthermore, to prevent and control coronary heart disease, in a view of population-based prevention.展开更多
Objective To evaluate whether the clustering of risk factors, both environmental and genetic, increases the risk of essential hypertension (EH) and the accumulation of risk factors influences the blood pressure leve...Objective To evaluate whether the clustering of risk factors, both environmental and genetic, increases the risk of essential hypertension (EH) and the accumulation of risk factors influences the blood pressure level in normotensives. Methods On the basis of a prevalence survey, 501 subjects of Mongolian ethnicity (243 hypertensives and 258 normotensives) who were not related to each other were selected to conduct a case-control study. All subjects were interviewed with questionnaires and their blood specimens were collected. Renin gene insertion/deletion (I/D) polymorphism, a new genetic marker, was genotyped with PCR and polyacrylamide gel electrophoresis. Results Overweight, alcohol consumption, and renin gene I/D polymorphism were significant risk factors of EH (P〈0.05). The odds ratios (OR) for the number of risk factors were 2.39 (95%CI: 0.98-6.74) for one risk factor, 5.03 (95%CI: 2.06-14.18) for two, and 6.09 (95%CI: 1.85-22.38) for three respectively after adjusting for age and sex. In normotensives, age- and sex-adjusted mean blood pressures increased with more accumulation of risk factors. However, there were no significant differences among the different blood pressure levels according to the number of risk factors (P〉0.05). Conclusion Overweight, alcohol consumption, and renin gene I/D polymorphism are risk factors of EH in the Mongolian ethnic population of China. The accumulation of the risk factors causes a sharp increase of the risk of EH.展开更多
文摘Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of the adults with hypertension are unaware of their hypertensive status due to factors that bother on poor management and poor screening approaches. The implication is that people who have poor access to healthcare especially those in the rural communities are at increased risk of cardiovascular complications and all-cause mortality. Unfortunately, not much has been done to ascertain the burden of undiagnosed hypertension and associated risk factors in rural communities in Nigeria. Methods: We conducted a community-based cross-sectional study in a rural community in Imo State, Nigeria, on burden of undiagnosed hypertension with participants recruited via a multi-stage sampling method. An interviewer-administered questionnaire was used, and standardized instruments were applied to obtain, process and analyze the data. Tests of association between the independent variables and outcome were conducted using logistic regression. P-value of Results: A total of 380 adults participated in the study. The mean age was 44.2 years. The prevalence of undiagnosed hypertension was 35.8%. Logistic regression revealed that age, with the respondents in the age groups 26 - 35 years (OR = 10.647, 1.910 - 59.345, p-value = 0.007), 36 - 45 (OR = 3.680, 1.263 - 10.723, p-value = 0.017), 46 - 55 years (OR = 2.737, 1.114 - 6.727, p-value = 0.039), 56 - 65 years old (OR = 3.384, 1.610 - 7.115, p-value = 0.001);and being married (OR = 3.846, 1.118 - 13.233, p-value = 0.033), were independent risk factors for undiagnosed hypertension. Conclusion: The prevalence of undiagnosed hypertension in the rural population of South-East Nigeria is high. Younger age (26 - 35 years) had the highest odds of risk for occurrence of hypertension. Also being married was identified as a risk factor for undiagnosed hypertension.
文摘Introduction: Obesity, excessive alcohol use, cigarette smoking, a lack of physical activity, stress, and an unhealthy diet are modifiable risk factors linked to hypertension. Non-modifiable risk factors for hypertension include older age and a family history of hypertension. The purpose of this study was to assess university students’ knowledge of hypertension risk factors. Methods: This was a cross-sectional study conducted at St. Augustine University of Tanzania. A pre-tested, semi-structured questionnaire was used to collect data. Out of a total score of eight, a score of four or more was considered good knowledge, and a score of less than four was considered poor. All sociodemographic characteristics were included in logistic regression to calculate the adjusted odds ratio. Results: A total of 390 undergraduate students participated in this study. Most of the participants 266 (68.2%) identified stress as a risk factor for hypertension. The median (IQR) knowledge score was 2 (2 - 3). Overall, only 43 (11.0%) of the participants had good knowledge of risk factors for hypertension. However, none of the sociodemographic factors were associated with a good level of knowledge of risk factors for hypertension. Conclusion: Our findings highlight poor knowledge of modifiable and non-modifiable risk factors for hypertension among university students in northwestern Tanzania. Only stress and older age were known by more than half of the students as risk factors for hypertension. To reduce the burden of hypertension, it is crucial for prevention and control programs to target improving university students’ knowledge of risk factors for hypertension.
基金the Service of Cardiology, Erasme Hospital, Brussels Free University
文摘Objective: To assess the prevalence of prehypertension and hypertension, their determinants and associated cardiovascular risk factors in Congolese urban dwellers. Methods: From July 2007 to March 2008, we collected information on lifestyle habits, medical history and anthropometric data in 1292 household members of Adoula Quarter, Kinshasa, aged 20 years or more, 731 women (56.6%). We obtained measurements of BP, blood glucose, serum lipids and qualitative proteinuria. We defined blood pressure categories according to JNC7 classification and used logistic regression analyses to assess their independent determinants. We obtained age adjustment of continuous and categorical variables using GLM and Genmod procedures, respectively. Results: Prehypertension was observed in 30.3% of subjects, 34.9% of men and 26.7% of women (P = 0.0045). The prevalence of hypertension amounted to 30.9% with no difference between genders. Participants with prehypertension had average age, BMI and waist circumference intermediate between those with normal BP and hypertensive subjects. Their glucose and lipids levels were similar to those of normotensives. The prevalence of prehypertension amounted to 33% at age 20 - 29 years and decreased to 16.7% at ≥60 years whereas the prevalence of hypertension increased from 11.2% to 71.4%. The rates of diabetes mellitus were similar accross blood pressure catogo- ries whilst prevalences of overweight/obesity, abdominal adiposity, dyslipidemia and metabolic syndrome significatively increased (P = 0.05 or less). Among participants with prehypertension, 73% had two or more additional cardiovascular risk factors. In the logistic model the probability of prehypertension was higher in men (OR: 1.429;95% CI: 1.099 - 1.857) and participants with overweight/obesity (OR: 1.666;1.146 - 2.422), lower in participants aged ≥ 55 years (0.427;0.267 - 0.683) and those with high fruit intake (0.691;0.488 - 0.977). The probability of hypertension was higher in participants aged ≥ 55 years (OR: 6.988;4.561 - 10.706), overweight/obesity (2.263;1.704 - 3.004), those with high vegetables consumption (1.152;1.003 - 1.324) and faster pulse rate (1.013;1.002 - 1.025). Conclusion: Our results suggest that fruit consumption and control of over-weight are important issues for prevention of cardiovascular disease in sub-Saharan Africa where high blood pressure is the main driver of the current epidemic.
文摘Background: Hypertension is one of the signficant risk factors for further severe cardiovascular diseases. Furthermore, the insidence of hypertension in adult age population has increased gradually. Thus, assessment of hypertension insidence and their risk factors in adult age people has given the beneficience for treating dan preventing program earlier. Aim: To analyze hypertension insidence in adult age and their risk factors that dominanly effect the occurance of hypertension. Method: This study was correlational with survey method. Accidental sampling was conducted to 120 respondents who live around Malioboro district. Hypertension was detected from systole and diastole value, while the risk factors of hypertension were age, gender, family disease history, type of activity, the number of cigarette each day, the length of smoking, random blood glucose, and body mass index. Analyzing the data used Pearson correlation if data were normal, or used Spearman correlation if data were not normal. Findings: From 120 participants, mean of systolic pressure was 120.7 mmHg and mean of diastolic pressure was 78.5 mmHg. Age mean was 39 years old, dominantly was woman amount 83 (69.2%), and without family disease history as 66 (55%). Mostly they had moderate physical activity amount 71 (59%). Mean of cigarette consumtion was 11 pieces/day, for 23 years. Random blood glucose mean was 131 mg/dL and mean of body mass index was 26 kg/m2. Correlation analysis mentioned that body mass index had correlate with systolic and diastolic value significantly (p 〈 0.05). Conclusion: Systolic and diastolic pressure value in adult age were still normal. Risk factor that correlated significantly with adult age blood pressure was body mass index. Another risk factors such as cholesterol level, blood glucose in fasting condition and two hour post meal, also food consumtion were considered that should be included in next study.
文摘The Systemic Arterial Hypertension (SAH) stands out among the chronic non-transmissible pathologies that impact the cause and/or aggravation of cardiovascular diseases (CVD) on a global level, as the disease is an underestimated disorder due to non-perceptive symptoms and associated with factors and risk markers of another CVD. Therefore, establishing the risk of progression and aggravation of the SAH, according the Framingham Risk Score (FRS), allows to reducing morbidity and improving preventative measures for DCVs. This observational and transversal study approaches the data collection of patient records at the Health Family Strategy of Senhor do Bonfim, BA, which established differences by descriptive and inferential statistical analysis (correlation and regression). The aspects of hypertension associated with risk factors for atherosclerosis were analyzed, determining the risk of developing cardiovascular events in 10 years by FRS. From 432 families, 746 patients were selected, of which 340 are hypertensive individuals (SAH = 45.57%) and 406 (NSAH = 54.42%) non-hypertensives. Among the SAH the majority (31.17%) was in the age range of 63 - 77, but, in both groups, women were in stronger number. There was greater prevalence in SAH for all the characteristics analyzed, smoking (13.20%), sedentary (29.41%) and cardiovascular accident (22.60%). The SAH group is more susceptive to the CVD progress in 10 years by FRS (P < 0.0001 ANOVA). In the NSAH group, there were significant associations among all the variables analyzed as was expected, without differences between the linear correlation and regression, indicating the physio-metabolic equilibrium of the factors and markers evaluated by FRS. Already in SAH group, despite the correlations have been significant too, the regression analysis revealed that only Total Cholesterol (P = 0.0086);LDL (P < 0.0001), Glucose (P < 0.0006) and Age (P < 0.0001) have significative association with FRS. So, these factors and markers deserve more attention upon the health staff of Health Family Strategy, in the SAH course at studied population, attempt the highest cardiovascular risk by FRS (2.5 to 2.8 times) to SAH. The monitoring of high-risk patients should prioritize the lifestyle changes, employing preventive measures to SAH and CVD and atherosclerosis.
基金supported by the National Natural Science Foundation of China[81670706&81800736]Natural Science Foundation of Shandong Province[ZR2019PH078].
文摘In 2017,American College of Cardiology(ACC)/American Heart Association(AHA)et al.jointly released the latest guidelines for adult hypertension,exactly including prevention,diagnosis,assess and treatment,in which blood pressure levels greater than 130/80 mm Hg were defined as hypertension[1].Based on these modified guidelines,the morbidity of hypertension in US increased from 32%to 46%.
文摘Aim: To establish the prevalence and risk factors for hypertension, diabetes and obesity among teaching and non-teaching staff of Bishop Stuart University, Mbarara-Uganda. Background: None communicable diseases (NCDs) are projected to exceed communicable diseases as the most common causes of death by 2030 in Africa. Most sub-Saharan African countries however lack detailed countrywide data on hypertension and other NCDs risk factors. Cognizant of Uganda’s recent inclusion of Hypertension and diabetes in the health policy agenda, this study was conducted among the university staff in a rural setting to provide benchmark information for design of appropriate interventions. Study Design: This was a descriptive cross-sectional, institutional based survey design. Place and duration of the study: This study was conducted among the teaching and none teaching staff of Bishop Stuart University Mbarara, Uganda from 18th April-6th June 2017. Methodology: A structured questionnaire was used to gather social demographic and risk factors data from the university workers at their work stations. Blood pressure of each participant was measured and Hypertension was defined as systolic BP > 140 and/or diastolic (BP) > 90 mmHg. Anthropometric measurements: Body Mass index (BMI) was done by weight in (Kg) and Height in (M2) to establish weight levels. Obesity was considered at BMI > 40. A random Blood Sugar (RBS) > 200 mg/dl was considered as diabetic. Epi-info version 7 was used to enter data, analyzed using SPSS version 19. Results: A total of 156 University staff aged 25 - 75 years of both sexes, mean age 42 ± 8 were interviewed of whom 51% were males. About 15% were administrative staff, 55% teaching staff, 3% senior lecturers and professors and 25% non-teaching staff. The prevalences of Hypertension, Diabetes, and obesity were 7.7%, 16%, and 28% respectively. But also majority (60.2%) were found at risk of developing both hypertension and diabetes. Less than 20% of the participants were knowledgeable on causes, signs and symptoms and preventive measures for Hypertension but had moderate knowledgeable of the risk factors, the most frequently mentioned risk by 71% was lack of exercise. Despite the awareness of risk factors, majority (61.3%) had not done any form of exercise and 64.1% had not had regular Blood pressure check ups. The study also demonstrated a statistically significant relationship between those aged more than 40 years and having hypertension (X2 = 5.82, P = 0.015, OR = 4.2). Likewise the risk of Diabetes increased with increasing age. Lecturers aged 40 years and above were 5.6 times likely to have diabetes compared to those aged less than 40 years (OR = 5.6, X2 = 16 , P = 0.0005). A significant number of respondents 57/156 (36.5%) reported history of HPT among their family members. Prevalence of obesity and overweight was observed higher in senior administrative staff and lecturers than in lower cadre staff 49% and 34% (p 0.01). Conclusion: Hypertension, Diabetes and obesity are conditions prevalent among the teaching and none teaching staff of BSU, but knowledge on risk factors, clinical presentation and preventive strategies is limited. Routine physical exercises...
文摘BACKGROUND Sessile serrated lesions(SSLs)are considered precancerous colorectal lesions that should be detected and removed to prevent colorectal cancer.Previous studies in Vietnam mainly investigated the adenoma pathway,with limited data on the serrated pathway.AIM To evaluate the prevalence,risk factors,and BRAF mutations of SSLs in the Vietnamese population.METHODS This is a cross-sectional study conducted on patients with lower gastrointestinal symptoms who underwent colonoscopy at a tertiary hospital in Vietnam.SSLs were diagnosed on histopathology according to the 2019 World Health Organi-zation classification.BRAF mutation analysis was performed using the Sanger DNA sequencing method.The multivariate logistic regression model was used to determine SSL-associated factors.RESULTS There were 2489 patients,with a mean age of 52.1±13.1 and a female-to-male ratio of 1:1.1.The prevalence of SSLs was 4.2%[95%confidence interval(CI):3.5-5.1].In the multivariate analysis,factors significantly associated with SSLs were age≥40[odds ratio(OR):3.303;95%CI:1.607-6.790],male sex(OR:2.032;95%CI:1.204-3.429),diabetes mellitus(OR:2.721;95%CI:1.551-4.772),and hypertension(OR:1.650,95%CI:1.045-2.605).The rate of BRAF mutations in SSLs was 35.5%.CONCLUSION The prevalence of SSLs was 4.2%.BRAF mutations were present in one-third of SSLs.Significant risk factors for SSLs included age≥40,male sex,diabetes mellitus,and hypertension.
文摘Background: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are serious diseases with similar pathophysiologic aspects. The prognosis of patients with these conditions is highly uncertain, particularly incident cases. Methods: A Cox proportional hazards model was applied to a group of 85 patients (81% women, mean age 52 (18 - 82) years) with PAH (80%) and non-surgical CTEPH (20%) to evaluate risk factors for mortality. The following variables were included in the model: age, etiology, baseline 6-minute walk test (6 mWT), cardiac index, and improvement in the 6 mWT following initiation of first medical treatment. Results: In the multivariate analysis, the response to treatment, assessed by an improvement on the 6 mWT, was the most relevant prognostic factor in these patients (RR, 4.832 (95% CI, 1.888 - 12.364);p = 0.001). The remaining variables studied in this model had less influence on the prognosis: age > 50 years (RR, 0.744 (95% CI, 0.26 - 2.133);p = 0.582);etiology of connective tissue disease-associated PAH (RR, 3.145 (95% CI, 0.995-9.946);p = 0.051) or CTEPH (RR, 0.654 (95% CI, 0.179 - 2.387);p = 0.521) with respect to idiopathic PAH;baseline 6 mWT (RR, 1.173 (95% CI, 0.599 - 4.895);p = 0.315);or cardiac index (RR, 2.295 (95% CI, 0.793 - 6.642);p = 0.125). Conclusions: There is a high degree of uncer-tainty regarding the prognosis of PAH and CTEPH at the start of appropriate treatment. Our results support the idea that the initial treatment response is of paramount importance as prognostic factor in these patients.
文摘The fight against cardiovascular diseases requires the knowledge of their modifiable risk factors. This study aimed to assess the level of modifiable cardiovascular risk factors in a rural area in order to develop a prevention program. Methods: This is an analytical and cross-sectional study on data collected during a fairground medical consultation of adults from 20 to 25 May 2013, in both border districts of the municipality of Djidja (Agouna and Houto). The studied parameters were the capillary blood glucose profile, blood pressure profile, waist circumference (WC) and Body Mass Index (BMI). Diabetes is defined by a fasting blood glucose ≥ 1.26 g/L two times. Hypertension is defined according to the criteria of JNC VII and obesity by BMI ≥ 30 kg/m2;abdominal obesity is defined by a WC above 102 cm in men and 88 cm in women. Data were analyzed using SPSS software version 18.0. Results: A total of 926 people were included among whom 57.8% were women. The average age was 38.43 ± 15.84 years. The prevalence of diabetes mellitus was 2.9%. The prevalence of obesity (BMI ≥ 30 kg/m2) was 8.4%;10.8% of studied population had abdominal obesity and 19.2% had hypertension. Age above 35 years and obesity were significantly associated with hypertension. Risk factors of obesity (IMC ≥ 30 kg/m2) were the place of residence (Agouna), the female gender, age between 35 and 64 and abdominal obesity. Conclusion: The frequency of cardiovascular risk factors, although small compared to the national level, remains a concern in the investigated rural communities. This must lead to undertake a survey on the lifestyle and dietary habits of the inhabitants of these areas.
文摘Objective:The aim of this study was to evaluate the effects of traditional Chinese exercises (TCEs) on stroke risk factors in patients with pre-hypertension or mild-to-moderate essential hypertension.Methods:We performed searches of seven electronic databases for studies published from their inception until July 2017.We included randomized controlled trials (RCTs) of the effects of TCEs with or without health education on stroke risk factors in patients with prehypertension or mild-to-moderate essential hypertension.Outcomes were independently extracted from each study by two authors and were pooled to determine risk ratios and standardized mean differences.materials-methodsResults:We included 15 RCTs,involving 1272 hypertensive participants.Compared with no intervention,TCEs were associated with a clinically meaningful amelioration of stroke risk factors,including reductions in systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting blood glucose,blood lipids,and waist-to-hip ratio,and improved quality of life.Compared with health education,TCEs reduced SBP but had no effect on DBP.Compared with health education alone,TCEs plus health education resulted in an amelioration of stroke risk factors.No serious adverse events were reported.resultsConclusion:TCEs may be effective alongside health education in ameliorating stroke risk factors in individuals with pre-hypertension or mild-to-moderate essential hypertension.However,the current evidence is insufficient due to poor methodology and lack of adequate safety data.Further rigorously-designed RCTs are warranted.conclusion.
文摘Introduction: Non-communicable diseases constitute a major public health problem, due to their morbi-mortality. The aim was to study knowledge of cardiovascular risk factors among residents of Dakar. Patients and Methods: This was a descriptive cross-sectional study. Our investigations were recruited over a six-month period (October 17, 2021 to March 21, 2022). Results: Two hundred and twenty-six (226) patients were enrolled. The mean age was 45.9 years. The under-40 age group was the most represented with 37.2%. There were 129 men (57.1%), giving a male/female sex ratio of 1.33. The highest level was represented by 159 people (70.4%). Those who responded (heart disease) were in the majority (38.1%). Hypertension was the most common CVD for 101 people (44.7%). One hundred and ninety (190) people (84%) knew the risk factors for CVD. Good knowledge of risk factors concerned 103 people (54.2%). Obesity was the best-known risk factor in 156 cases (69%). The media was the most important source of information for 121 people (53.5%). Hypertensives were the most represented with 8.4%. One hundred and thirty (130) people (57.5%) had previously paid attention to these FDRCVs. Awareness campaigns were the most effective means of communication for 170 cases (75.2%). Sixteen (16) people (35.6%) were taking antihypertensive medication. Walking was the most popular physical activity for 102 people (45%). People with a balanced diet were in the majority, with 174 respondents (77.0%). Conclusion: NCDs are a major cause of morbidity and mortality. It is essential to develop and implement a prevention and management program.
文摘BACKGROUND Postpartum hypertension poses a considerable health risk.Despite research on gestational hypertension,comprehensive studies focusing on postpartum hypertension in communities are limited.Understanding its prevalence and associated risk factors is crucial for effective prevention and management.AIM To provide insights for postpartum hypertension’s prevention and management.METHODS In total,3297 women who gave birth between June 2021 and December 2022 in Xuhui District,Shanghai were selected.Blood pressure was measured thrice within one month post-delivery during home visits.Eighty-six women with hypertension were followed up for four months to analyze hypertension persistence and its related risk factors.A predictive model for persistent postpartum hypertension was established and verified using the Nomo diagram model.RESULTS Hypertension prevalence 1 month post-delivery was 2.61%(86/3297).Among the 86 pregnant women,32(37.21%)had persistent hypertension at four months post-delivery.Multivariate logistic regression analysis revealed that older age[odds ratio(OR)=1.212;95%confidence interval(CI):1.065–1.380]and higher pre-pregnancy body mass index(BMI)(OR=1.188;95%CI:1.006–1.404)were associated with hypertension(OR=10.781;95%CI:1.006–1.404)during pregnancy.A 95%CI of 1.243–93.480 is a risk factor for persistent postpartum hypertension.The Nomograph model accurately predicted the risk of persistent postpartum hypertension,demonstrating high precision.CONCLUSION In Xuhui,older age,higher pre-pregnancy BMI,and gestational hypertension are risk factors for persistent postpartum hypertension.Our prediction model can identify high-risk individuals,thereby improving patient quality of life.
文摘Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The purpose of this study was to establish and validate a nomogram prediction model for assessing the risk of HDP in pregnant women based on laboratory indicators and HDP risk factors. Method: A total of 307 pregnant women who were hospitalized in the obstetrics and gynecology department of our hospital were included in this study, and were randomly divided into a training cohort and validation cohort at a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for the development of HDP on laboratory indicators as well as risk factors for HDP in the training cohort of patients. The results of the multivariate regression model were visualized by forest plots. A nomogram was constructed based on the results of multivariate logistic regression to predict the risk of HDP in pregnant women. The validity of the risk prediction model was evaluated by the area under the receiver operating characteristic curve (AUC), the consistency index (C-index), the calibration curve and the decision curve analysis (DCA). Results: BMI ≥ 25 Kg/m2, total cholesterol in early pregnancy, uric acid and proteinuria in late pregnancy were independent risk factors for HDP. The AUC and C-index of the nomogram constructed by the above four factors were both 0.848. The calibration curve is closely fitted with the ideal diagonal, showing a good consistency between the nomogram prediction and the actual observation of HDP. The DCA has demonstrated the great clinical utility of nomogram. Internal verification proves the reliability of the predicted nomograms. Conclusion: The BTUP nomogram model based on laboratory indicators and risk factors proposed in this study showed good predictive value for the risk assessment of HDP. It is expected to provide evidence for clinical prediction of the risk of HDP in pregnant women.
文摘Background: Kidney failure, cardiovascular disease, and early mortality are just a few of the major negative effects of chronic renal disease, a serious global health issue. The considerable financial and public health burden associated with chronic kidney disease can be lessened by raising awareness and adopting better practices for its impact, prevention, and early identification. Objective: In this study, individuals with hypertension and diabetes were evaluated for their knowledge of chronic kidney disease, its prevalence, and its risk factors. Method: It was a hospital-based cross-sectional study conducted on adult (>18 years) patients with diabetes mellitus and hypertension. Each participant provided written informed consent before having their data collected through interviews, medical information, and blood samples for CKD screening. The CKD epidemiology collaboration (CKD-EPI) equation was used to calculate the glomerular filtration rate (GFR) from serum creatinine, and CKD was determined using the estimated GFR (e-GFR). To find independent CKD factors, multivariate logistic regression was employed, with a p-value of 0.05 being regarded as statistically significant. This was accomplished using SPSS (Statistical Program for Social Sciences) version 22.0, IBM Corp., Armonk, NY. Result: A total of 156 participants took part in the study among which 95 (60.9%) were male, most of the participants 82 (52.6%) were aged between 51 - 70 years (mean 59.42 ± 11.007), 76 (48.7%) were unemployed and 97 (62.2%) were single. Overall, the knowledge score of participants on CKD was 65.4% for good knowledge and 34.6% for poor or inadequate knowledge of CKD. More than half of the participants (60%) had chronic kidney disease. Among these, the greatest proportion of CKD patients were those who were hypertensive (88.2%) followed by those who were both hypertensive and diabetic (70.7%). Conclusion: There is poor management of CKD in the South West Region of Cameroon which has contributed greatly to the progression of CKD and increases in the mortality rate.
基金supported in part by research grants from the National Key Research and Development Program of China(Grant Number:2017YFC0907200 and 2017YFC0907201).
文摘Objective:This study compared the prevalence,awareness,treatment and control of hypertension and associated factors in China and the United States(US).Methods:Adult data from nationally representative samples were derived from the Chronic Disease and Risk Factors Surveillance in 2010 and 2013 in China and the National Health and Nutrition Examination Survey in 2010 and 2013 in the US.Multivariable logistic and Poisson regression analysis were conducted to assess associations of the four outcomes with body weight status and behavioral factors.Results:Age-standardized prevalence rates of hypertension was 35.7%(95%confidence interval[CI]:35.4%to 36.1%)in 2010 and 29.8%(95%CI:29.4%to 30.2%)in 2013 in China,and 35.3%(95%CI:33.6%to 37.1%)in 2010 and 37.9%(95%CI:36.0%to 39.7%)in 2013 in the US.Among hypertensive participants,the age-standardized rates of treatment were 18.4%(95%CI:17.9%to 1&9%)in 2010 and 23.8%(95%CI:23.1%to 24.6%)in 2013 in China and 54.5%(95%CI:50.3%to 5&7%)in 2010 and 50.9%(95%CI:46.5%to 55.3%)in 2013 in the US;the age-standardized hypertension control rates were 3.2%(95%CI:3.0%to 3.5%)and 5.7%(95%CI:5.3%to 6.0%)in 2010 and 2013 in China and 50.6%(95%CI:46.2%to 55.0%)and 55.3%(95%CI:50.3%to 60.3%)in the US.Obesity was significantly associated with prevalence,awareness and control rates in both countries.Different from the US,obesity was negatively associated with hypertension control in China.Conclusion:Hypertension prevalence in China is similar to that in the US,but the control rate in China was significantly lower.Obesity was a critical risk factor for poor hypertension control in China.
基金The National Natural Science Foundation of China(No.71673169).
文摘Objective:To have a basic and comprehensive understanding about the prevalence,risk factors and disease management situation of hypertension among floating population in China.Method:We used“(hypertension or hypertensive or chronic disease)and(floating population or migrant worker)”as the key words,to search in the China academic literature database(CNKI),Wan Fang database,PubMed and Web of Science for relevant literature and extracted the data about the prevalence of hypertension,relevant risk factors and disease management of floating population in China from 1990 to 2016.Result:The 23 related studies that entered into final analysis were all articles in Chinese.The prevalence of hypertension in floating population is lower than that in both general population and local residents.The prevalence of hypertension in male floating population is higher than that in females.In addition,the prevalence of hypertension also increases with age growing.As for the risk factors of hypertension,the rate of drinking in floating population is higher than that in general population and local residents,while the rates of overweight and obesity in floating population are lower than that in general population in China.Finally,the rates of awareness,treatment and control of hypertension are also lower in floating population.Conclusion:The major problem of floating population is focused on their unhealthy lifestyle(drinking)and deficient disease management.Therefore,we should increase the fund and facility support for public health service system so as to improve their service delivery ability,and enforce the education and unhealthy lifestyle intervention to improve their health awareness and compliance to disease management.
基金The study was reviewed and approved by the Institutional Review Board at Rabin Medical Center,approval No.0075-17-RMC.
文摘BACKGROUND Type 1 diabetes(T1D)contributes to altered lipid profiles and increases the risk of cardiovascular disease(CVD).Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.AIM To examine risk factors for dyslipidemia in young subjects with T1D.METHODS Longitudinal and cross-sectional retrospective study of 170 young subjects with T1D(86 males;baseline mean age 12.2±5.6 years and hemoglobin A1c 8.4%±1.4%)were followed in a single tertiary diabetes center for a median duration of 15 years.Predictors for outcomes of lipid profiles at last visit(total cholesterol[TC],triglycerides[TGs],low-density lipoprotein-cholesterol[LDL-c],and highdensity lipoprotein-cholesterol[HDL-c])were analyzed by stepwise linear regression models.RESULTS At baseline,79.5%of the patients had at least one additional CVD risk factor(borderline dyslipidemia/dyslipidemia[37.5%],pre-hypertension/hypertension[27.6%],and overweight/obesity[16.5%])and 41.6%had multiple(≥2)CVD risk factors.A positive family history of at least one CVD risk factor in a first-degree relative was reported in 54.1%of the cohort.Predictors of elevated TC:family history of CVD(β[SE]=23.1[8.3],P=0.006);of elevated LDL-c:baseline diastolic blood pressure(DBP)(β[SE]=11.4[4.7],P=0.003)and family history of CVD(β[SE]=20.7[6.8],P=0.017);of elevated TGs:baseline DBP(β[SE]=23.8[9.1],P=0.010)and family history of CVD(β[SE]=31.0[13.1],P=0.020);and of low HDL-c levels:baseline DBP(β[SE]=4.8[2.1],P=0.022]).CONCLUSION Our findings suggest that elevated lipid profiles are associated with DBP and a positive family history of CVD.It is of utmost importance to prevent and control modifiable risk factors such as these,as early as childhood,given that inadequate glycemic control and elevation in blood pressure intensify the risk of dyslipidemia.
基金This study was supported by Beijing Municipal Natural Sciences Foundation (Grant No. 7001004) Research Fund for the Doctoral Training Program from the Ministry of Education (Grant No. 20020023009) China Medical Board in New York (Grant No. 96-657).
文摘Objective To investigate the association of specific functional gene ACE (I/D) variants of the renin-angiotensin system with essential hypertension (EH) and interaction between ACE (I/D) gene and risk factors for EH in a genetically homogenous Mongolia rural population of China. Methods Individuals (n=1099) were recruited from general population of Kezuohouqi Banner in Inner Mongolian Autonomous Region. Results The association was found between ACE genotype DD plus ID and EH, with an interaction between ACE genotype DD plus ID and cigarette smoking in an additive model. Cigarette smoking index and ACE gene showed a low exposure-gene (LEG) effect on EH, with interaction indices from 7.10 to 1.16. Interaction between ACE genotype DD plus ID and alcohol drinking on EH appeared an additive model. Alcohol drinking index and ACE gene showed a low exposure-gene (LEG) effect on EH, with interaction indices from 1.66 to 1.09. BMI and ACE gene showed a low exposure-gene (LEG) effect on EH, with interaction indices from 6.15 to 2.49. Interactions between ACE genotype and WHR on EH showed a multiplicative model. In a short, there was an interaction between ACE gene and cigarette smoking, alcohol drinking and BMI on EH, especially in a low dose-exposure effect Conclusion It is important for individuals who carry ACE D allele gene to prevent EH, and furthermore, to prevent and control coronary heart disease, in a view of population-based prevention.
基金This study was supported by the National Natural Sciences Foundation of China (Grant No. 30271149)Beijing Municipal NaturalSciences Foundation (No. 7001004)China Medical Board in New York (No. 96-657).
文摘Objective To evaluate whether the clustering of risk factors, both environmental and genetic, increases the risk of essential hypertension (EH) and the accumulation of risk factors influences the blood pressure level in normotensives. Methods On the basis of a prevalence survey, 501 subjects of Mongolian ethnicity (243 hypertensives and 258 normotensives) who were not related to each other were selected to conduct a case-control study. All subjects were interviewed with questionnaires and their blood specimens were collected. Renin gene insertion/deletion (I/D) polymorphism, a new genetic marker, was genotyped with PCR and polyacrylamide gel electrophoresis. Results Overweight, alcohol consumption, and renin gene I/D polymorphism were significant risk factors of EH (P〈0.05). The odds ratios (OR) for the number of risk factors were 2.39 (95%CI: 0.98-6.74) for one risk factor, 5.03 (95%CI: 2.06-14.18) for two, and 6.09 (95%CI: 1.85-22.38) for three respectively after adjusting for age and sex. In normotensives, age- and sex-adjusted mean blood pressures increased with more accumulation of risk factors. However, there were no significant differences among the different blood pressure levels according to the number of risk factors (P〉0.05). Conclusion Overweight, alcohol consumption, and renin gene I/D polymorphism are risk factors of EH in the Mongolian ethnic population of China. The accumulation of the risk factors causes a sharp increase of the risk of EH.