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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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Rossios K, Antza C, Kachtsidis V, Kotsis V. The Modern Environment: The New Secondary Cause of Hypertension? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2095. [PMID: 38138198 PMCID: PMC10744418 DOI: 10.3390/medicina59122095] [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: 08/31/2023] [Revised: 10/15/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
The most important risk factor for cardiovascular disease, the leading cause of death worldwide, is hypertension. Although most cases of hypertension are thought to be essential, the multifactorial associations of the environmental influence on blood pressure seem to play an important role and should be more closely investigated. This review attempts to focus on the recent literature that examines the environmental effects on arterial blood pressure and its management. Seasonal variability and the role of ambient temperature, either occupational or recreational noise pollution, as well as obesity due to environment-caused dietary habits, are recognized as important risk factors, affecting the onset as well as the regulation of hypertension. Furthermore, the effects of seasonal fluctuations in blood pressure, noise pollution, and obesity seem to share a similar pathogenesis, and as such to all further react together, leading to increased blood pressure. The activation of the autonomous nervous system plays a key role and causes an increase in stress hormones that generates oxidative stress on the vascular system and, thus, vasoconstriction. In this review, by focusing on the association of the environmental impact with arterial blood pressure, we come to the question of whether most cases of hypertension-if not all-should, indeed, be considered primary or secondary.
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Affiliation(s)
- Konstantinos Rossios
- Cardiology Clinic, Papageorgiou Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Christina Antza
- Hypertension Center, 3rd Department of Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (C.A.); (V.K.)
| | - Vasileios Kachtsidis
- Hypertension Center, 3rd Department of Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (C.A.); (V.K.)
| | - Vasilios Kotsis
- Hypertension Center, 3rd Department of Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (C.A.); (V.K.)
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3
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Qi H, Wen FY, Xie YY, Liu XH, Li BX, Peng WJ, Cao H, Zhang L. Associations between depressive, anxiety, stress symptoms and elevated blood pressure: Findings from the CHCN-BTH cohort study and a two-sample Mendelian randomization analysis. J Affect Disord 2023; 341:176-184. [PMID: 37598715 DOI: 10.1016/j.jad.2023.08.086] [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: 03/05/2023] [Revised: 08/08/2023] [Accepted: 08/14/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND We aimed to determine whether depressive, anxiety, stress symptoms were associated with the risk of elevated blood pressure by performing longitudinal cohort and Mendelian Randomization (MR) analyses. METHODS We used data from the Cohort Study on Chronic Disease of Community Natural Population in the Beijing-Tianjin-Hebei region (CHCN-BTH) from 2017 to 2021. The Depression-Anxiety-Stress Scale was used to evaluate the depressive, anxiety, stress symptoms. The longitudinal associations between depressive, anxiety, stress symptoms and elevated blood pressure were estimated using Cox proportional regression models. Two-sample MR analysis was performed using the Inverse-variance weighted (IVW), weighted median, and MR-Egger to explore the causal relationships between depressive, anxiety, stress symptoms and elevated blood pressure. RESULTS In total, 5624 participants were included. The risk of SBP ≥ 140 mmHg or DBP ≥ 90 mmHg was significantly higher in participants with baseline anxiety symptoms (HR = 1.48, 95 % CI: 1.03 to 2.12, P = 0.033; HR = 1.56, 95 % CI: 1.05 to 2.32, P = 0.028), especially in men and individuals with higher educational levels, independent of baseline depression and anxiety at the two-year follow-up. The two-sample MR analysis showed positive associations between depressive, anxiety, stress symptoms and elevated blood pressure. LIMITATION Self-reported mental health symptoms, relatively shorter follow-up duration and the European-derived genome-wide association study data for MR analysis. CONCLUSIONS Anxiety symptoms were positively associated with elevated blood pressures in the longitudinal analysis independent of depression, stress, and other confounders. The results were verified in MR analysis, providing evidence for causal effects of anxiety symptoms on the risk of elevated blood pressure.
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Affiliation(s)
- Han Qi
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China; Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Fu-Yuan Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Yun-Yi Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Xiao-Hui Liu
- Center for Evidence-Based Medicine, Beijing Luhe Hospital Affiliate to Capital Medical University, Beijing 101199, China
| | - Bing-Xiao Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Wen-Juan Peng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Han Cao
- Department of Biostatistics, Peking University First Hospital, Beijing 100034, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
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Predicting the onset of hypertension for workers: does including work characteristics improve risk predictive accuracy? J Hum Hypertens 2023; 37:220-226. [PMID: 35277589 PMCID: PMC8914447 DOI: 10.1038/s41371-022-00666-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 02/08/2022] [Accepted: 02/22/2022] [Indexed: 01/07/2023]
Abstract
Despite extensive evidence of work as a key social determinant of hypertension, risk prediction equations incorporating this information are lacking. Such limitations hinder clinicians' ability to tailor patient care and comprehensively address hypertension risk factors. This study examined whether including work characteristics in hypertension risk equations improves their predictive accuracy. Using occupation ratings from the Occupational Information Network database, we measured job demand, job control, and supportiveness of supervisors and coworkers for occupations in the United States economy. We linked these occupation-based measures with the employment status and health data of participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study. We fit logistic regression equations to estimate the probability of hypertension onset in five years among CARDIA participants with and without variables reflecting work characteristics. Based on the Harrell's c- and Hosmer-Lemeshow's goodness-of-fit statistics, we found that our logistic regression models that include work characteristics predict hypertension onset more accurately than those that do not incorporate these variables. We also found that the models that rely on occupation-based measures predict hypertension onset more accurately for White than Black participants, even after accounting for a sample size difference. Including other aspects of work, such as workers' experience in the workplace, and other social determinants of health in risk equations may eliminate this discrepancy. Overall, our study showed that clinicians should examine workers' work-related characteristics to tailor hypertension care plans appropriately.
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McCarrick D, Prestwich A, O'Connor DB. The role of perseverative cognition in the job strain-health outcome relationship. Psychol Health 2023:1-23. [PMID: 36628608 DOI: 10.1080/08870446.2022.2154353] [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: 10/19/2021] [Revised: 10/19/2022] [Accepted: 11/23/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Job strain has been implicated in a variety of adverse health outcomes, particularly cardiometabolic and inflammatory diseases. However, the mechanisms underlying these effects remain largely unknown. One possibility is that the maladaptive coping response to stress, (perseverative cognition (PC); the cognitive representation of past stressful events (rumination) or feared future events (worry)), either in work or more generally, mediates the relationship between job strain and physical disease. The aim of this study was thus to test the potential role of both general, and work- related PC as a mediating, or potentially moderating, mechanism between job strain and ill- health outcomes.Design & Measures:Using an online cross- sectional design, 650 full- time employees completed measures of job strain, general and work- related PC (rumination & worry) and health outcomes (burnout, somatization, health behaviours & sleep quality). RESULTS General and work- related worry and rumination significantly mediated, often independently, the relationship between job strain and burnout, somatization, and sleep quality. No significant mediation effects were observed for health behaviours and no type of PC (general or work- related) moderated job strain- health outcome relations. CONCLUSION Both general and work- related worry and rumination are likely to play important, and partly independent, roles in understanding the adverse relationships between job strain and various health outcomes.
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Muñoz Medina F, López Bohle S, Ugarte SM, Chambel MJ, Wall E. Employees Perceptions of Job Insecurity and Performance: A Qualitative Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16665. [PMID: 36554546 PMCID: PMC9779114 DOI: 10.3390/ijerph192416665] [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: 10/16/2022] [Revised: 12/01/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
The purpose of this article is to understand the experience of workers' perceptions of job insecurity and its relation to performance. To this end, we conducted semi-structured interviews with 38 workers in the retail, services, education, financial, construction, and pharmaceutical industries in Chile. Using content analysis based on workers' accounts of their own experience, we identified two main categories: (a) the experience of job insecurity viewed in relation to the context of the COVID-19 pandemic and emotional aspects of job insecurity, and (b) the relation between job insecurity and performance. The possibility of job loss expresses itself in experiences and emotions that are related to the performance of workers in different ways. These findings are discussed in terms of stress theory and the motivation to preserve jobs.
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Affiliation(s)
- Felipe Muñoz Medina
- Departamento de Tecnologías de Gestión, Facultad Tecnológica, Universidad de Santiago de Chile, Santiago 9170022, Chile
| | - Sergio López Bohle
- Departamento de Administración, Facultad de Administración y Economía, Universidad de Santiago de Chile, Santiago 9170020, Chile
| | - Sebastian M. Ugarte
- Faculty of Economics and Business, University of Chile, Santiago 8330015, Chile
| | - Maria José Chambel
- Faculdade de Psicologia, Universidade de Lisboa, 1649-013 Lisboa, Portugal
| | - Erika Wall
- Department of Health Sciences, Mid Sweden University, 831 25 Ostersund, Sweden
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Azoulay R, Gilboa-Schechtman E. Social Construction and Evolutionary Perspectives on Gender Differences in Post-traumatic Distress: The Case of Status Loss Events. Front Psychiatry 2022; 13:858304. [PMID: 35651822 PMCID: PMC9148972 DOI: 10.3389/fpsyt.2022.858304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Women report greater post-traumatic distress (PTD) than men following physically threatening events. However, gender differences in PTD following social stressors such as status losses are understudied. Whereas the social construction account points to a general sensitivity in women following any type of stressor, the evolutionary account suggests enhanced sensitivity to status losses in men, especially following inter-males aggressions. These propositions were examined in two studies (Study 1, N = 211; Study 2, N = 436). Participants were asked to recall a status loss and to fill out measures assessing PTD and depression severity. In line with the evolutionary account, men, as compared to women, displayed enhanced PTD following status loss. Status losses conducted by men against men were associated with greater PTD than were instances involving other target-aggressor pairings. Finally, age was negatively associated with PTD in men but not in women. The examination of evolutionary challenges modifies the standard view linking the female gender to enhanced sensitivity to trauma. Thus, the pattern of enhanced sensitivity to stressful events appears to be affected by gender- and development-specific adaptive challenges.
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Affiliation(s)
- Roy Azoulay
- Department of Psychology and Gonda Multidisciplinary Brain Center, Bar-Ilan University, Ramat Gan, Israel
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Pop VJM, Boekhorst MGBM, Deneer R, Oei G, Endendijk JJ, Kop WJ. Psychological Distress During Pregnancy and the Development of Pregnancy-Induced Hypertension: A Prospective Study. Psychosom Med 2022; 84:446-456. [PMID: 35067651 DOI: 10.1097/psy.0000000000001050] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Pregnancy-induced hypertension (PIH) is associated with serious complications in both the mother and the unborn child. We examined the possible association between trajectories of maternal psychological distress symptoms and PIH separately in primiparous and multiparous women. METHODS Pregnancy-specific negative affect (P-NA) and depressive symptoms were assessed prospectively at each trimester using the Tilburg Pregnancy Distress Scale pregnancy negative affect subscale (P-NA) and the Edinburgh Depression Scale (EDS). Data on PIH were collected from medical records. Growth mixture modeling analysis was used to identify trajectories of P-NA and EDS. The independent role of P-NA and EDS symptom trajectories on developing PIH was examined using multivariate logistic regression models. RESULTS One hundred (7.6%) women developed PIH and were compared with 1219 women without hypertension or other complications during pregnancy. Three P-NA trajectories were identified: low stable (reference group; 90%), decreasing (5.2%), and increasing (4.8%). The latter two classes showed persistently and significantly higher P-NA symptoms during pregnancy compared with the reference group. In multiparous women, high P-NA scores (belonging to classes 2 and 3) were related to PIH (odds ratio [OR] = 6.91, 95% confidence interval [CI] = 2.26-21.2), independent of body mass index (OR = 1.17, 95% CI = 1.06-1.27) and previous PIH (OR = 14.82, 95% CI = 6.01-32.7). No associations between P-NA and PIH were found in primiparous women. EDS trajectories were not related to PIH in both primiparous and multiparous women. CONCLUSIONS In multiparous women, persistently high levels of P-NA symptoms but not depressive symptoms were independently associated with development of PIH.
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Affiliation(s)
- Victor J M Pop
- From the Department of Medical and Clinical Psychology (Pop, Boekhorst, Deneer, Kop), Tilburg University, Tilburg; Department of Obstetrics and Gynecology (Oei), Máxima Medical Centre Veldhoven, Veldhoven; and Child and Adolescent Studies (Endendijk), Utrecht University, Utrecht, the Netherlands
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Yu X, Langa KM, Cho TC, Kobayashi LC. Association of Perceived Job Insecurity With Subsequent Memory Function and Decline Among Adults 55 Years or Older in England and the US, 2006 to 2016. JAMA Netw Open 2022; 5:e227060. [PMID: 35416992 PMCID: PMC9008497 DOI: 10.1001/jamanetworkopen.2022.7060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/23/2022] [Indexed: 12/02/2022] Open
Abstract
Importance Intensified global economic competition and recent financial crises, including those associated with the COVID-19 pandemic, have contributed to uncertainty about job security. However, little is known about the association of perceived job insecurity with memory function and decline among older adults. Objectives To investigate the association between perceived job insecurity and subsequent memory function and rate of memory decline among older adults in the US and England. Design, Setting, and Participants This 10-year prospective population-based cohort study used data from the US Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA) collected from 2006 to 2016. Participants included 9538 adults 55 years or older. Data were analyzed from August 1 to 31, 2021. Exposures Perceived job insecurity (yes vs no) at baseline. Main Outcomes and Measures Episodic memory z scores at baseline and rate of decline during the follow-up. Results Among the 9538 study participants, the mean (SD) age at baseline was 60.97 (6.06) years, and 4981 (52.22%) were women. A total of 2320 participants (24.32%) reported job insecurity at baseline (1088 of 3949 [27.55%] in England and 1232 of 5589 [22.04%] in the US). Perceived job insecurity after 55 years of age was associated with lower baseline memory z scores in the fully adjusted model (β = -0.04 [95% CI, -0.08 to -0.01]) but not with rate of memory decline (β = 0.01 [95% CI, -0.01 to 0.01]). The association appeared to be stronger in the US than in England (job insecurity × US, β = -0.05 [95% CI, -0.11 to 0.02]), but the estimate was imprecise, potentially owing to low statistical power. Conclusions and Relevance The findings of this cohort study suggest that exposure to job insecurity in middle to late life was associated with worse memory function among older adults in the US and England. This association may vary across socioeconomic and social welfare contexts, although future studies with large samples from diverse socioeconomic settings are warranted.
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Affiliation(s)
- Xuexin Yu
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Kenneth M. Langa
- Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
- Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor
| | - Tsai-Chin Cho
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Lindsay C. Kobayashi
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
- MRC (Medical Research Council)/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Chantarat T, Enns EA, Hardeman RR, McGovern PM, Myers SL, Dill J. Occupational Segregation And Hypertension Inequity: The Implication Of The Inverse Hazard Law Among Healthcare Workers. JOURNAL OF ECONOMICS, RACE, AND POLICY 2022; 5:267-282. [PMID: 35341024 PMCID: PMC8938730 DOI: 10.1007/s41996-022-00098-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 01/07/2023]
Abstract
In the United States (US), Black-particularly Black female-healthcare workers are more likely to hold occupations with high job demand, low job control with limited support from supervisors or coworkers and are more vulnerable to job loss than their white counterparts. These work-related factors increase the risk of hypertension. This study examines the extent to which occupational segregation explains the persistent racial inequity in hypertension in the healthcare workforce and the potential health impact of workforce desegregation policies. We simulated a US healthcare workforce with four occupational classes: health diagnosing professionals (i.e., highest status), health treating professionals, healthcare technicians, and healthcare aides (i.e., lowest status). We simulated occupational segregation by allocating 25-year-old workers to occupational classes with the race- and gender-specific probabilities estimated from the American Community Survey data. Our model used occupational class attributes and workers' health behaviors to predict hypertension over a 40-year career. We tracked the hypertension prevalence and the Black-white prevalence gap among the simulated workers under the staus quo condition (occupational segregation) and the experimental conditions in which occupational segregation was eliminated. We found that the Black-white hypertension prevalence gap became approximately one percentage point smaller in the experimental than in the status quo conditions. These findings suggest that policies designed to desegregate the healthcare workforce may reduce racial health inequities in this population. Our microsimulation may be used in future research to compare various desegregation policies as they may affect workers' health differently. Supplementary Information The online version contains supplementary material available at 10.1007/s41996-022-00098-5.
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Affiliation(s)
- Tongtan Chantarat
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
- Center for Antiracism Research for Health Equity, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
| | - Eva A. Enns
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
| | - Rachel R. Hardeman
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
- Center for Antiracism Research for Health Equity, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
| | - Patricia M. McGovern
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
| | - Samuel L. Myers
- Hubert H. Humphrey School of Public Affairs, University of Minnesota, Minneapolis, MN 55455 USA
| | - Janette Dill
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN 55455 USA
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Ab Majid NL, Rodzlan Hasani WS, Mat Rifin H, Robert Lourdes TG, Jane Ling MY, Saminanthan TA, Ismail H, Ahmad A, Mohd Yusoff MF. Self-reported diabetes, hypertension and hypercholesterolemia among older persons in Malaysia. Geriatr Gerontol Int 2021; 20 Suppl 2:79-84. [PMID: 33370854 DOI: 10.1111/ggi.13968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/30/2020] [Accepted: 05/25/2020] [Indexed: 12/16/2022]
Abstract
AIM The objective of this study is to determine the prevalence of self-reported diabetes, hypertension and hypercholesterolemia among older persons in Malaysia and their associated factors. METHODS The study used data from the National Health and Morbidity Survey in 2018. It was a cross-sectional study with two-staged stratified cluster sampling design. In total, 3977 adults aged ≥60 years were selected for this study. Respondents were interviewed face to face using a structured questionnaire. Self-reported diabetes, hypertension or hypercholesterolemia was defined as having ever been told they have these diseases by a medical doctor or paramedic. Data were analyzed using SPSS version 25. The multiple logistic regression model was used to examine the factors associated with the prevalence of self-reporting. RESULTS The prevalence of self-reported diabetes, hypertension and hypercholesterolemia among older persons in Malaysia were 27.7%, 51.1% and 41.8% respectively. Presence of other comorbidities and being obese showed higher odds for all three diseases. Indians, unemployed, inactive had higher odds for diabetes. Other Bumiputras, unemployed, non-smoker, obese and inactive had higher odds for hypertension. Non-smoker had higher odds for hypercholesterolemia. CONCLUSIONS Health promotion, vigilance, attention and services targeting on the associated factors should be strengthened for older persons in Malaysia to ensure healthy aging. Geriatr Gerontol Int 2020; 20: 79-84.
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Affiliation(s)
- Nur Liana Ab Majid
- Institute for Public Health Malaysia, National Institutes of Health Malaysia, Ministry of Health, Selangor, Malaysia
| | - Wan Shakira Rodzlan Hasani
- Institute for Public Health Malaysia, National Institutes of Health Malaysia, Ministry of Health, Selangor, Malaysia
| | - Halizah Mat Rifin
- Institute for Public Health Malaysia, National Institutes of Health Malaysia, Ministry of Health, Selangor, Malaysia
| | - Tania Gayle Robert Lourdes
- Institute for Public Health Malaysia, National Institutes of Health Malaysia, Ministry of Health, Selangor, Malaysia
| | - Miaw Yn Jane Ling
- Institute for Public Health Malaysia, National Institutes of Health Malaysia, Ministry of Health, Selangor, Malaysia
| | - Thamil Arasu Saminanthan
- Institute for Public Health Malaysia, National Institutes of Health Malaysia, Ministry of Health, Selangor, Malaysia
| | - Hasimah Ismail
- Institute for Public Health Malaysia, National Institutes of Health Malaysia, Ministry of Health, Selangor, Malaysia
| | - Ahzairin Ahmad
- Institute for Public Health Malaysia, National Institutes of Health Malaysia, Ministry of Health, Selangor, Malaysia
| | - Muhammad Fadhli Mohd Yusoff
- Institute for Public Health Malaysia, National Institutes of Health Malaysia, Ministry of Health, Selangor, Malaysia
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12
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Raina J, El-Messidi A, Badeghiesh A, Tulandi T, Nguyen TV, Suarthana E. Pregnancy hypertension and its association with maternal anxiety and mood disorders: A population-based study of 9 million pregnancies. J Affect Disord 2021; 281:533-538. [PMID: 33388464 DOI: 10.1016/j.jad.2020.10.058] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/24/2020] [Accepted: 10/27/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Evidence on whether anxiety or mood disorders increases the risk of hypertensive disorders of pregnancy (HDP) has been conflicting. We aimed to evaluate the prevalence of maternal mental disorders over time and their associations with HDP. METHODS This was a population-based retrospective study involving 9,097,355 pregnant women using Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) data from 2004 through 2014. We calculated the prevalence of maternal anxiety, depression, bipolar disorder and mood disorder and trends of gestational hypertension, preeclampsia and eclampsia during the study period. Multivariate logistic regression was used to examine the association between each mental disorder and HDP. RESULTS Mental disorders showed increasing trends among pregnant women, with anxiety showing the greatest increase in rates. Unadjusted associations suggest all mental disorders increase the likelihood of HDP. When adjusted for sociodemographic characteristics and comorbidities, only anxiety showed consistently increased risk of gestational hypertension (adjusted odds ratio (aOR) 1.324, 95% CI 1.255-1.397), preeclampsia (aOR 1.522, 95% CI 1.444-1.604), with the strongest association with eclampsia (aOR 1.813, 95% CI 1.260-2.610). LIMITATIONS Information on medication use is not available in the HCUP-NIS database and might have been contributory to our findings. CONCLUSIONS Rates of maternal psychopathology are rising in the United States. Our study suggests that pregnant women with anxiety are at increased risk of HDP. Targeted screening for mental disorders as possible clinical risk markers may allow for timely prophylaxis and surveillance for the development of HDP.
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Affiliation(s)
- Jason Raina
- Department of Obstetrics and Gynecology, McGill University, Montréal, Québec, Canada
| | - Amira El-Messidi
- Department of Obstetrics and Gynecology, McGill University, Montréal, Québec, Canada
| | - Ahmad Badeghiesh
- Department of Obstetrics and Gynecology, McGill University, Montréal, Québec, Canada
| | - Togas Tulandi
- Department of Obstetrics and Gynecology, McGill University, Montréal, Québec, Canada
| | - Tuong-Vi Nguyen
- Department of Obstetrics and Gynecology, McGill University, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Eva Suarthana
- Department of Obstetrics and Gynecology, McGill University, Montréal, Québec, Canada.
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Implications of the COVID-19 Pandemic for Cardiovascular Disease and Risk-Factor Management. Can J Cardiol 2020; 37:722-732. [PMID: 33212203 PMCID: PMC7667463 DOI: 10.1016/j.cjca.2020.11.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/31/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023] Open
Abstract
COVID-19 and our public health responses to the pandemic may have far-reaching implications for cardiovascular (CV) risk, affecting the general population and not only survivors of COVID-19. In this narrative review, we discuss how the pandemic may affect general CV risk for years to come and explore the mitigating potential of telehealth interventions. From a health care perspective, the shift away from in-person office visits may have led many to defer routine risk- factor management and may have had unforeseen effects on continuity of care and adherence. Fear of COVID-19 has led some patients to forego care for acute CV events. Curtailment of routine outpatient laboratory testing has likely delayed intensification of risk-factor–modifying medical therapy, and drug shortages and misinformation may have negative impacts on adherence to antihypertensive, glucose-lowering, and lipid-lowering agents. From a societal perspective, the unprecedented curtailment of social and economic activities has led to loss of income, unemployment, social isolation, decreased physical activity, and increased frequency of depression and anxiety, all of which are known to be associated with worse CV risk-factor control and outcomes. We must embrace and evaluate measures to mitigate these potential harms to avoid an epidemic of CV morbidity and mortality in the coming years that could dwarf the initial health effects of COVID-19.
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14
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Takeuchi M, Ogita M, Wada H, Takahashi D, Nozaki Y, Nishio R, Yasuda K, Takahashi N, Sonoda T, Yatsu S, Shitara J, Tsuboi S, Dohi T, Suwa S, Miyauchi K, Daida H. Comparison of long-term mortality between living alone patients vs. living together patients with acute coronary syndrome treated with percutaneous coronary intervention. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2020; 6:332-337. [PMID: 32044997 DOI: 10.1093/ehjqcco/qcaa011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/24/2020] [Accepted: 02/01/2020] [Indexed: 02/06/2023]
Abstract
AIMS Living alone is reported as an independent risk factor for cardiovascular disease. However, little is known about the association between clinical outcomes and living alone in patients with acute coronary syndrome (ACS). The aim of this study was to determine whether living alone is an independent prognostic risk factor for long-term mortality stratified by age in patients with ACS who were treated with primary percutaneous coronary intervention (PCI). METHODS AND RESULTS We conducted an observational cohort study of ACS patients who underwent PCI between January 1999 and May 2015 at Juntendo University Shizuoka Hospital, Japan. The primary endpoint was all-cause death. Among 2547 ACS patients, 381 (15.0%) patients were living alone at the onset of ACS. The cumulative incidence of all-cause death was comparable between living alone and living together (34.8% vs. 34.4%, log-rank P = 0.63). However, among younger population (aged <65 years), the incidence of all-cause death was significantly higher in the living alone group (log-rank P = 0.01). Multivariate Cox hazard analysis revealed a significant association between living alone and all-cause death, even after adjusting for other risk factors (hazard ratio 2.30, 95% confidence interval 1.38-3.84, P = 0.001). CONCLUSION Although living alone was not significantly associated with long-term clinical outcomes in patients with ACS, it was a predictive risk factor among younger ACS patients. Careful attention should be paid to patients' lifestyle, especially younger patients with ACS.
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Affiliation(s)
- Mitsuhiro Takeuchi
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Manabu Ogita
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Hideki Wada
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Daigo Takahashi
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Yui Nozaki
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Ryota Nishio
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Kentaro Yasuda
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Norihito Takahashi
- Department of Cardiovascular Medicine, Juntendo University, Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku Tokyo 113-8421, Japan
| | - Taketo Sonoda
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Shoichiro Yatsu
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Jun Shitara
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Shuta Tsuboi
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Tomotaka Dohi
- Department of Cardiovascular Medicine, Juntendo University, Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku Tokyo 113-8421, Japan
| | - Satoru Suwa
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan
| | - Katsumi Miyauchi
- Department of Cardiovascular Medicine, Juntendo University, Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku Tokyo 113-8421, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University, Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku Tokyo 113-8421, Japan
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Moody DLB, Chang YF, Pantesco EJ, Darden TM, Lewis TT, Brown C, Bromberger JT, Matthews KA. Everyday Discrimination Prospectively Predicts Blood Pressure Across 10 Years in Racially/Ethnically Diverse Midlife Women: Study of Women's Health Across the Nation. Ann Behav Med 2020; 53:608-620. [PMID: 30247506 DOI: 10.1093/abm/kay069] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Interpersonal discrimination is linked to greater risk for cardiovascular disease (CVD) and this association varies by race/ethnicity. PURPOSE To examine whether exposure to everyday discrimination prospectively predicts elevated blood pressure (BP), whether this association differs by race/ethnicity, and is mediated by adiposity indices. METHODS Using data for 2,180 self-identified White, Black, Chinese, Japanese, and Hispanic participants from the Study of Women's Health Across the Nation, we examined associations among exposure to (higher vs. lower) everyday discrimination at baseline and BP and hypertension (HTN; systolic blood pressure [SBP] ≥ 140 mmHg; diastolic blood pressure [DBP] ≥ 90 mmHg; or self-reported HTN medication use) risk over a 10 year period. Additionally, we used the bootstrap method to assess repeated, time-varying markers of central and overall adiposity (waist circumference and body mass index [BMI] (kg/m2), respectively) as potential mediators. RESULTS Exposure to everyday discrimination predicted increases in SBP and DBP over time, even after adjusting for known demographic, behavioral, or medical risk factors. However, greater waist circumference or BMI (examined separately) mediated these observations. Notably, there were no racial/ethnic differences in the observed association and HTN risk was not predicted. CONCLUSIONS The current findings suggest that everyday discrimination may contribute to elevated BP over time in U.S. women, in part, through increased adiposity. These findings demonstrate the complexity of the linkage of discrimination to CVD risk and raise the need to closely examine biobehavioral pathways that may serve as potential mediators.
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Affiliation(s)
| | - Yue-Fang Chang
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, PA
| | - Elizabeth J Pantesco
- Department of Psychological and Brain Sciences, Villanova University, Villanova, PA
| | - Taylor M Darden
- Department of Psychology, University of Maryland, Baltimore County, MD
| | - Tené T Lewis
- Department of Epidemiology, Emory University, Atlanta, GA
| | - Charlotte Brown
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Joyce T Bromberger
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA.,Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA.,Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
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Awuah RB, de-Graft Aikins A, Dodoo FNA, Meeks KA, Beune EJ, Klipstein-Grobusch K, Addo J, Smeeth L, Bahendeka SK, Agyemang C. Psychosocial factors and hypertension prevalence among Ghanaians in Ghana and Ghanaian migrants in Europe: The RODAM study. Health Psychol Open 2019; 6:2055102919885752. [PMID: 31763049 PMCID: PMC6851611 DOI: 10.1177/2055102919885752] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Despite progress made to prevent and control hypertension, its prevalence has
persisted in many countries. This study examined the associations between
psychosocial factors and hypertension among Ghanaian non-migrants and migrants.
Data were drawn from the Research on Obesity and Diabetes among African Migrants
(RODAM) project. Findings show that among migrant women, those who experienced
periods of stress at home/work had higher odds of hypertension. Among
non-migrants, women with depression symptoms were more likely to be
hypertensive. Furthermore, there was a positive association between negative
life events and hypertension among non-migrant men. The findings highlight the
importance of psychosocial factors in addressing hypertension prevalence in
Ghanaian populations.
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Affiliation(s)
| | | | | | | | | | | | - Juliet Addo
- London School of Hygiene & Tropical Medicine, UK
| | - Liam Smeeth
- London School of Hygiene & Tropical Medicine, UK
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Spatz ES, Martinez-Brockman JL, Tessier-Sherman B, Mortazavi B, Roy B, Schwartz JI, Nazario CM, Maharaj R, Nunez M, Adams OP, Burg M, Nunez-Smith M. Phenotypes of Hypertensive Ambulatory Blood Pressure Patterns: Design and Rationale of the ECHORN Hypertension Study. Ethn Dis 2019; 29:535-544. [PMID: 31641320 PMCID: PMC6802166 DOI: 10.18865/ed.29.4.535] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Objective To describe the rationale and design of a prospective study of ambulatory blood pressure measurement (ABPM) combined with measurement of contextual factors to identify hypertensive phenotypes in a Caribbean population with high rates of HTN and cardiovascular disease. Design Prospective, multi-center sub-study. Setting Eastern Caribbean Health Outcomes Research Network Cohort (ECHORN) Study, with study sites in Puerto Rico, the US Virgin Islands, Trinidad and Tobago, and Barbados. Participants Community-residing adults without a diagnosis of HTN and not taking antihypertensive medication. Intervention Ambulatory BP patterns are assessed using 24-hour ABPM. Contextual factors are assessed with: ecological momentary assessment (7-item survey of experiences, exposures and responses associated with daytime BP measurements); actigraphy (capturing physical activity and sleep quality); and self-report surveys (assessing physical and social health, environmental and social stressors and supports). Main Outcome Measures Phenotypes of contextual factors associated with hypertensive BP patterns (sustained HTN, masked HTN, and nocturnal non-dipping). Methods and Results This study will enroll 500 participants; assessments of blood pressure and contextual factors will be conducted during Waves 2 and 3 of the ECHORN parent study, occurring 2 years apart. In Wave 2, we will assess the association between contextual factors and ABPM patterns. Using advanced analytic clustering methods, we will identify phenotypes of contextual factors associated with hypertensive ABPM patterns. We will then test the stability of these phenotypes and their ability to predict change in ABPM patterns between Waves 2 and 3. Conclusions Assessment of ABPM, and the contextual factors influencing ABPM, can identify unique phenotypes of HTN, which can then be used to develop more precision-based approaches to the prevention, detection and treatment of HTN in high-risk populations.
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Affiliation(s)
- Erica S. Spatz
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine; New Haven, CT
- Yale/Yale New Haven Health System Corporation Center for Outcomes Research and Evaluation; New Haven, CT
| | | | | | - Bobak Mortazavi
- Department of Computer Science and Engineering, Texas A & M University College of Engineering; College Station, TX
| | - Brita Roy
- Section of General Internal Medicine, Department of Medicine, Yale School of Medicine; New Haven, CT
| | - Jeremy I. Schwartz
- Equity Research and Innovation Center, Yale School of Medicine; New Haven, CT
- Section of General Internal Medicine, Department of Medicine, Yale School of Medicine; New Haven, CT
| | - Cruz M. Nazario
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico; San Juan, PR
| | - Rohan Maharaj
- Department of Paraclinical Sciences, University of the West Indies; Saint Augustine, Trinidad
| | - Maxine Nunez
- School of Nursing, University of the Virgin Islands; US Virgin Islands
| | - O. Peter Adams
- Department of Family Medicine, Faculty of Medical Sciences, University of the West Indies; Cave Hill, Barbados
| | - Matthew Burg
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine; New Haven, CT
- Department of Anesthesiology, Yale School of Medicine; New Haven, CT
| | - Marcella Nunez-Smith
- Equity Research and Innovation Center, Yale School of Medicine; New Haven, CT
- Section of General Internal Medicine, Department of Medicine, Yale School of Medicine; New Haven, CT
| | - ECHORN Writing Group
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine; New Haven, CT
- Yale/Yale New Haven Health System Corporation Center for Outcomes Research and Evaluation; New Haven, CT
- Equity Research and Innovation Center, Yale School of Medicine; New Haven, CT
- Department of Computer Science and Engineering, Texas A & M University College of Engineering; College Station, TX
- Section of General Internal Medicine, Department of Medicine, Yale School of Medicine; New Haven, CT
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico; San Juan, PR
- Department of Paraclinical Sciences, University of the West Indies; Saint Augustine, Trinidad
- School of Nursing, University of the Virgin Islands; US Virgin Islands
- Department of Family Medicine, Faculty of Medical Sciences, University of the West Indies; Cave Hill, Barbados
- Department of Anesthesiology, Yale School of Medicine; New Haven, CT
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18
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Wekesah FM, Kyobutungi C, Grobbee DE, Klipstein-Grobusch K. Understanding of and perceptions towards cardiovascular diseases and their risk factors: a qualitative study among residents of urban informal settings in Nairobi. BMJ Open 2019; 9:e026852. [PMID: 31209088 PMCID: PMC6588962 DOI: 10.1136/bmjopen-2018-026852] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The study explored the understanding of and perception towards cardiovascular disease (CVD) and risk factors, and how they influence prevention and development of the conditions, care-seeking and adhering to treatment. SETTING Informal settlements of Nairobi. PARTICIPANTS Nine focus group discussions consisting of between six and eight purposively sampled participants were conducted among healthy individuals aged 20 years or older. A total of 65 participants (41 female) were involved. RESULTS Poverty, ignorance and illiteracy promoted behaviours like smoking, (harmful) alcohol consumption, physical inactivity and unhealthy diet, implicated in the development of obesity, diabetes and hypertension. Some respondents could not see the link between behavioural risk factors with diabetes, hypertension and stroke and heart attacks. Contaminated food items consumed by the residents and familial inheritance were factors that caused CVD, whereas emotional stress from constant worry was linked to hypertension, stroke and heart attacks. Few and inadequately equipped public health facilities were hindrances to treatment seeking and adherence to treatment for CVD conditions. Lack of medication in public health facilities was considered to be the single most important barrier to adherence to treatment next to lack of family support among older patients. CONCLUSION Interventions to prevent and manage CVD in low-resource and urban poor settings should consider perceptions and understanding of risk factors for CVD, and the interrelationships among them while accounting for cultural and contextual issues for example, stigma and disregard for conventional medicine. Programmes should be informed by locally generated evidence on awareness and opportunities for CVD care, coupled with effective risk communication through healthcare providers. Screening for and treatment of CVD must address perceptions such as prohibitive cost of healthcare. Finally, social determinants of disease and health, mainly poverty and illiteracy, which are implicated in addressing CVD in low-resource settings, should be addressed.
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Affiliation(s)
- Frederick Murunga Wekesah
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Health and Systems for Health, African Population and Health Research Center, Nairobi, Kenya
| | - Catherine Kyobutungi
- Health and Systems for Health, African Population and Health Research Center, Nairobi, Kenya
| | - Diederick E Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of theWitwatersrand, Johannesburg, South Africa
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Shiju R, Thomas D, Al Arouj M, Sharma P, Tuomilehto J, Bennakhi A. Effect of Sudarshan Kriya Yoga on anxiety, depression, and quality of life in people with type 2 diabetes: A pilot study in Kuwait. Diabetes Metab Syndr 2019; 13:1995-1999. [PMID: 31235126 DOI: 10.1016/j.dsx.2019.04.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 04/22/2019] [Indexed: 11/25/2022]
Abstract
AIM This pilot study in Kuwait was aimed to assess the effect of Sudarshan kriya yoga (SKY) on anxiety, depression and total quality of life in people with type 2 diabetes mellitus (T2DM). METHODS 26 T2DM patients aged greater than 30, male and female visiting the outpatient clinic of Dasman Diabetes Institute were enrolled for the study. Pre and post 5 day SKY intervention responses of participants on psychosocial problems were evaluated using four questionnaires (Hamilton anxiety, patient health questionnaire (PHQ-9), Hospital anxiety depression and WHO total quality of life (QOL). Biochemical parameters; such as lipid profile, glycated hemoglobin (HbA1c) were measured at baseline and after 15 weeks of SKY practice. RESULTS The mean age of the participants was 56.7 (±11.4 SD) years, and mean duration of diabetes 15.0 (±9.3 SD) years. Comparison of responses before and after intervention indicated a significant improvement in the QOL, depression, anxiety and insomnia. But no significant improvement in glycemic control. CONCLUSION Results indicate that SKY can be potentially beneficial for treating anxiety, insomnia, and depression associated in people with T2DM and in improving the quality of life in people with T2DM.
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Affiliation(s)
| | | | | | | | - Jaakko Tuomilehto
- National Institute of Health and Welfare, Helsinki, Finland; Department of Public Health, University of Helsinki, Finland
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20
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Thombre Kulkarni M, Holzman C, Wasilevich E, Luo Z, Scheid J, Allswede M. Pregnancy hypertension and its associations with pre-pregnancy depression, anxiety, antidepressants, and anxiolytics. Pregnancy Hypertens 2019; 16:67-74. [DOI: 10.1016/j.preghy.2019.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 03/07/2019] [Accepted: 03/11/2019] [Indexed: 11/28/2022]
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Angier H, Huguet N, Marino M, Green B, Holderness H, Gold R, Hoopes M, DeVoe J. Observational study protocol for evaluating control of hypertension and the effects of social determinants. BMJ Open 2019; 9:e025975. [PMID: 30878987 PMCID: PMC6429873 DOI: 10.1136/bmjopen-2018-025975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Hypertension is a common chronic health condition. Having health insurance reduces hypertension risk; health insurance coverage could improve hypertension screening, treatment and management. The Medicaid eligibility expansion of the Affordable Care Act was ruled not to be required by the US Supreme Court. Subsequently, a 'natural experiment' was produced with some states expanding Medicaid eligibility while others did not. This presents a unique opportunity to learn whether and to what extent Medicaid expansion can affect healthcare access and services for patients at risk for and diagnosed with hypertension, and patients with undiagnosed hypertension. Additionally, social determinants of health (SDH), at both the individual- and community-level, influence diagnosis and care for hypertension and it is important to understand how they interact with health insurance coverage changes. METHODS/DESIGN We will use electronic health record (EHR) data from the Accelerating Data Value Across a National Community Health Center Network clinical data research network, which has data from community health centres in 22 states, some that did and some that did not expand Medicaid. Data include information on changes in health insurance, service receipt and health outcomes from 2012 through the most recent data available. We will include patients between the ages of 19 and 64 years (n=1 524 241) with ≥1 ambulatory visit to a community health centre. We will estimate differences in outcomes using difference-in-difference and difference-in-difference-in-difference approaches. We will test three-way interactions with insurance group, time and social determinants of health factors to compare the potential effect of gaining insurance on our proposed outcomes. ETHICS AND DISSEMINATION This study uses secondary data analysis and therefore approval for consent to participate was waived. The Institutional Review Board for OHSU approved this study. Approval reference number is: IRB00011858. We plan to disseminate our findings at relevant conferences, meetings and through peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03545763.
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Affiliation(s)
- Heather Angier
- Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Nathalie Huguet
- Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Miguel Marino
- Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Beverly Green
- Research, Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Heather Holderness
- Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | | | | | - Jennifer DeVoe
- Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
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22
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Lane G, Farag M, White J, Nisbet C, Vatanparast H. Chronic health disparities among refugee and immigrant children in Canada. Appl Physiol Nutr Metab 2019; 43:1043-1058. [PMID: 29726691 DOI: 10.1139/apnm-2017-0407] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
There are knowledge gaps in our understanding of the development of chronic disease risks in children, especially with regard to the risk differentials experienced by immigrants and refugees. The Healthy Immigrant Children study employed a mixed-methods cross-sectional study design to characterize the health and nutritional status of 300 immigrant and refugee children aged 3-13 years who had been in Canada for less than 5 years. Quantitative data regarding socioeconomic status, food security, physical activity, diet, and bone and body composition and anthropometric measurements were collected. Qualitative data regarding their experiences with accessing health care and their family lifestyle habits were gathered through in-depth interviews with the parents of newcomer children. Many newcomers spoke about their struggles to attain their desired standard of living. Regarding health outcomes, significantly more refugees (23%) had stunted growth when compared with immigrants (5%). Older children, those with better-educated parents, and those who consumed a poorer-quality diet were at a higher risk of being overweight or obese. Sixty percent of refugees and 42% of immigrants had high blood cholesterol. Significant health concerns for refugee children include stunting and high blood cholesterol levels, and emerging trends indicate that older immigrant children from privileged backgrounds in low-income countries may be more at risk of overweight and obesity. A variety of pathways related to their families' conceptualization of life in Canada and the social structures that limit progress to meeting their goals likely influence the development of health inequity among refugee and immigrant children. Public health initiatives should address these health inequities among newcomer families.
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Affiliation(s)
- Ginny Lane
- a Government of Saskatchewan, Community Care Branch, Ministry of Health, Regina, SK S4S 6X6, Canada
| | - Marwa Farag
- b School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada
| | - Judy White
- c Faculty of Social Work, University of Regina, Saskatoon, SK S7N 3R3, Canada
| | - Christine Nisbet
- d College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada
| | - Hassan Vatanparast
- e College of Pharmacy and Nutrition, School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada
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Taylor JL, Makarem N, Shimbo D, Aggarwal B. Gender Differences in Associations Between Stress and Cardiovascular Risk Factors and Outcomes. GENDER AND THE GENOME 2018; 2:111-122. [PMID: 34136738 PMCID: PMC8204799 DOI: 10.1177/2470289718820845] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Psychological stress, a subjective perception of an adverse environmental change, is a hallmark of modern society. Although psychological stress has previously been established as a risk factor for cardiovascular disease (CVD), it is unclear whether stress influences cardiovascular risk differently in men versus women. Gender disparities exist in the prevalence of stress as well as in the prevalence and prognosis of CVD; therefore, associations between stress and CVD risk and mortality may vary by sex. The purpose of this review was to summarize the evidence from recent and landmark studies on gender differences in the associations of stress with CVD risk factors and end points and to highlight clinical and public health implications as well as future research directions in this field. Taken together, research to date indicates that while stress is associated with poorer cardiovascular health metrics in both men and women, the influence of stress on measures of glucose regulation and dyslipidemia and on overall CVD risk may be stronger among women. However, men may be more susceptible to the influence of stress on body adiposity, blood pressure, and CVD mortality. In terms of behavioral risk factors for CVD, associations between stress and diet quantity and quality appear to be stronger among women, but the influence of stress on sedentary behaviors and sleep may be stronger among men. Given that gender disparities exist in the prevalence of overall and different types of stress (eg, financial stress, caregiving stress, and occupational stress), future studies should decipher the potential differential associations between types of stress and cardiovascular risk among men and women to identify vulnerable populations and develop targeted interventions.
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Affiliation(s)
| | - Nour Makarem
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Daichi Shimbo
- Center for Behavioral Cardiovascular Health, Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Brooke Aggarwal
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
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Clemow LP, Pickering TG, Davidson KW, Schwartz JE, Williams VP, Shaffer JA, Williams RB, Gerin W. Stress management in the workplace for employees with hypertension: a randomized controlled trial. Transl Behav Med 2018; 8:761-770. [PMID: 30202927 PMCID: PMC6128963 DOI: 10.1093/tbm/iby018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
While behavioral interventions can improve blood pressure (BP) in individuals with hypertension, getting such services to people who could benefit remains difficult. Workplace programs have potential as dissemination vehicles. The objective is to evaluate the effectiveness of a standardized stress management program delivered in groups at the workplace for reducing BP compared with enhanced usual care. This randomized controlled trial studied 92 urban medical center employees with hypertension randomized into two groups. The intervention was a 10-week group workshop on cognitive-behavioral coping skills. Enhanced usual care included self-help materials for BP reduction and physician referral. Intervention group participants' systolic BP (SBP) decreased 7.5 mm Hg over controls between baseline and follow-up, from 149.1 (95% CI: 146.0-152.1) to 140.0 (95% CI: 134.7-145.2), p < .001. The differential change between intervention and enhanced usual care groups (Group × Time interaction) was 7.5 mm Hg (t = -2.05; p = .04). Diastolic BP reductions were not significantly different. Scores on measures of emotional exhaustion and depressive rumination showed significant improvements and correlated with reductions in SBP. There was no significant change in the usual care group. A standardized worksite group intervention produced clinically meaningful reductions in SBP in participants with hypertension.
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Affiliation(s)
- Lynn P Clemow
- Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY, USA
- Department of Family and Community Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Thomas G Pickering
- Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY, USA
| | - Karina W Davidson
- Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY, USA
| | - Joseph E Schwartz
- Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY, USA
| | | | - Jonathan A Shaffer
- Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY, USA
| | - Redford B Williams
- Psychiatry and Behavioral Science, Duke University Medical Center, Durham, NC, USA
| | - William Gerin
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA, USA
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Thomas SJ, Booth JN, Dai C, Li X, Allen N, Calhoun D, Carson AP, Gidding S, Lewis CE, Shikany JM, Shimbo D, Sidney S, Muntner P. Cumulative Incidence of Hypertension by 55 Years of Age in Blacks and Whites: The CARDIA Study. J Am Heart Assoc 2018; 7:e007988. [PMID: 29997132 PMCID: PMC6064834 DOI: 10.1161/jaha.117.007988] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/23/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Blacks have higher blood pressure levels compared with whites beginning in childhood. Few data are available on racial differences in the incidence of hypertension from young adulthood through middle age. METHODS AND RESULTS We calculated the cumulative incidence of hypertension from age 18 to 55 years among participants in the CARDIA (Coronary Artery Risk Development in Young Adults) study. Incident hypertension was defined by the first visit with mean systolic blood pressure ≥130 mm Hg, mean diastolic blood pressure ≥80 mm Hg, or self-reported use of antihypertensive medication. Among 3890 participants without hypertension at baseline (aged 18-30 years), cumulative incidence of hypertension by age 55 years was 75.5%, 75.7%, 54.5%, and 40.0% in black men, black women, white men, and white women, respectively. Among participants with systolic blood pressure/diastolic blood pressure <110 and 70, 110 to 119/70 to 74, and 120 to 129/75 to 79 mm Hg at baseline, blacks were more likely than whites to develop hypertension: multivariable-adjusted hazard ratios 1.97 (95% confidence interval, 1.65, 2.35), 1.80 (95% confidence interval, 1.52, 2.14), and 1.59 (95% confidence interval, 1.31, 1.93), respectively. Parental history of hypertension and higher body mass index, serum uric acid, and systolic blood pressure/diastolic blood pressure categories were associated with a higher risk for hypertension among blacks and whites. A higher Dietary Approaches to Stop Hypertension diet adherence score was associated with a lower risk for hypertension in blacks and whites. CONCLUSIONS Regardless of blood pressure level in young adulthood, blacks have a substantially higher risk for hypertension compared with whites through 55 years of age.
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Affiliation(s)
- S Justin Thomas
- Department of Psychiatry, University of Alabama at Birmingham, AL
| | - John N Booth
- Department of Epidemiology, University of Alabama at Birmingham, AL
| | - Chen Dai
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, AL
| | - Xuelin Li
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, AL
| | - Norrina Allen
- Department of Preventive Medicine, Northwestern University, Chicago, IL
| | - David Calhoun
- Department of Medicine, University of Alabama at Birmingham, AL
| | - April P Carson
- Department of Epidemiology, University of Alabama at Birmingham, AL
| | - Samuel Gidding
- Nemours Cardiac Center, DuPont Hospital for Children, Wilmington, DE
| | - Cora E Lewis
- Department of Epidemiology, University of Alabama at Birmingham, AL
| | - James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, AL
| | - Daichi Shimbo
- Department of Medicine, Columbia University, New York, NY
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, AL
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Jayedi A, Rashidy-Pour A, Khorshidi M, Shab-Bidar S. Body mass index, abdominal adiposity, weight gain and risk of developing hypertension: a systematic review and dose-response meta-analysis of more than 2.3 million participants. Obes Rev 2018; 19:654-667. [PMID: 29334692 DOI: 10.1111/obr.12656] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 11/13/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This study aimed to test the association between anthropometric measures and risk of developing hypertension. METHODS We did a systematic search using PubMed and Scopus, from inception up to January 2017. Prospective cohort studies reporting the risk estimates of hypertension for three or more quantitative categories of indices of general and abdominal adiposity were included. Summary relative risks were calculated using random-effects models. RESULTS Fifty-seven prospective cohort studies were included. Summary relative risks were 1.49 (95% confidence interval [CI]: 1.41, 1.58; I2 = 97.4%, n = 50) for a five-unit increment in body mass index, 1.27 (95%CI: 1.15, 1.39; I2 = 95.0%, n = 14) for a 10-cm increment in waist circumference, 1.16 (95%CI: 1.09, 1.23; I2 = 77.8%, n = 5) for weight gain equal to a one-unit increment in BMI, and 1.37 (95%CI: 1.24, 1.51; I2 = 76.4%, n = 8) and 1.74 (95%CI: 1.35, 2.13; I2 = 58.9%, n = 4) for a 0.1-unit increment in waist-to-hip ratio and waist-to-height ratio, respectively. The risk of hypertension increased continuously with increasing all anthropometric measures, and also along with weight gain. CONCLUSION Being as lean as possible within the normal body mass index range may be the best suggestion in relation to primary prevention of hypertension.
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Affiliation(s)
- A Jayedi
- Food (salt) Safety Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - A Rashidy-Pour
- Laboratory of Learning and Memory, Research Center and Department of Physiology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - M Khorshidi
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - S Shab-Bidar
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Medina C, Janssen I, Barquera S, Bautista-Arredondo S, González ME, González C. Occupational and leisure time physical inactivity and the risk of type II diabetes and hypertension among Mexican adults: A prospective cohort study. Sci Rep 2018; 8:5399. [PMID: 29599426 PMCID: PMC5876361 DOI: 10.1038/s41598-018-23553-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 03/14/2018] [Indexed: 01/09/2023] Open
Abstract
There is a lack of longitudinal data linking physical inactivity and chronic diseases among Mexicans. Objective. To examine the relationship between total, leisure and occupational moderate-to-vigorous physical activity (MVPA) and incidence of type II diabetes (T2D) and hypertension in the Mexico City Diabetes Study. Study design and population. A prospective cohort study was conducted from 1989 to 2009 among 2282 men and non-pregnant women residing in six low-income neighborhoods in Mexico City. Main outcome. Incidence of T2D and hypertension. Results. After controlling for confounders, <1 MET/min/week of MVPA during leisure time was associated with higher risk of hypertension (HR 1.29, CI 95% 1.01, 1.66) and T2D (HR 1.31 CI 95% 1.00, 1.74). In addition, accumulating <1 MET/min/week of occupational MVPA was associated with higher risk of hypertension (HR 1.47, CI 95% 1.13, 1.90). Conclusion. The absence of leisure and occupational MVPA was associated with an increased risk of hypertension. However, no associations were found between occupational MVPA and T2D.
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Affiliation(s)
- C Medina
- Mexican National Institute of Public Health, Health and Nutrition Research Center, Cuernavaca, Mexico.,Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - I Janssen
- Queen's University, School of Kinesiology and Health Studies, Kingston, Canada
| | - S Barquera
- Mexican National Institute of Public Health, Health and Nutrition Research Center, Cuernavaca, Mexico
| | - S Bautista-Arredondo
- Mexican National Institute of Public Health, Division of Health Economics, Cuernavaca, Mexico
| | - M E González
- Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - C González
- Mexican National Institute of Public Health, Unit for Research in Diabetes and Cardiovascular Risk, Cuernavaca, Mexico. .,Centro de Estudios en Diabetes, Mexico City, Mexico.
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McIntosh RC, Ironson G, Krause N. Do religious and spiritual identity confer risk for hypertension via psychosocial and lifestyle factors? J Health Psychol 2018; 25:1082-1097. [PMID: 29292660 DOI: 10.1177/1359105317748733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The total and indirect effect of hostility on systolic and diastolic blood pressure was compared as a function of religious and spirituality identity in a nationally representative sample of 2971 adults aged 46.44 years. Structural equation modeling uncovered an indirect path from hostility to diastolic blood pressure via unhealthy behaviors and hostility to unhealthy behaviors via social isolation. Compared to a non-religious/non-spiritual reference group, the effect for unhealthy behaviors on diastolic blood pressure was greater for those endorsing some form of religious identity. However, the direction of the effect for hostility on social isolation and social isolation on unhealthy behaviors was reversed in those endorsing spiritual and religious identity.
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29
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Depression and cardiovascular disease in elderly: Current understanding. J Clin Neurosci 2018; 47:1-5. [DOI: 10.1016/j.jocn.2017.09.022] [Citation(s) in RCA: 164] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 09/25/2017] [Accepted: 09/29/2017] [Indexed: 12/18/2022]
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30
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African Americans, African Immigrants, and Afro-Caribbeans Differ in Social Determinants of Hypertension and Diabetes: Evidence from the National Health Interview Survey. J Racial Ethn Health Disparities 2017; 5:995-1002. [PMID: 29234990 DOI: 10.1007/s40615-017-0446-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/28/2017] [Accepted: 10/30/2017] [Indexed: 01/11/2023]
Abstract
In the United States (U.S.), Blacks have higher morbidity and mortality from cardiovascular disease (CVD) than other racial groups. The Black racial group includes African Americans (AAs), African immigrants (AIs), and Afro-Caribbeans (ACs); however, little research examines how social determinants differentially influence CVD risk factors in each ethnic subgroup. We analyzed the 2010-2014 National Health Interview Survey, a cross-sectional, nationally representative survey of non-institutionalized civilians. We included 40,838 Blacks: 36,881 AAs, 1660 AIs, and 2297 ACs. Age- and sex-adjusted hypertension prevalence was 37, 22, and 21% in AAs, ACs, and AIs, respectively. Age- and sex-adjusted diabetes prevalence was 12, 10, and 7% in AAs, ACs, and AIs, respectively. In the multivariable logistic regression analyses, social determinants of hypertension and diabetes differed by ethnicity. Higher income was associated with lower odds of hypertension in AAs (aOR 0.86, 95% CI 0.77-0.96) and ACs (aOR 0.55, 95% CI 0.37-0.83). In AAs, those with some college education (aOR 0.79, 95% CI 0.68-0.92) and college graduates (aOR 0.62, 95% CI 0.53-0.73) had lower odds of hypertension than those with < high school education. In AIs, having health insurance was associated with higher odds of hypertension (aOR 1.59, 95% CI 1.04-2.42) and diabetes (aOR 3.22, 95% CI 1.29-8.04) diagnoses. We observed that the social determinants associated with hypertension and diabetes differed by ethnicity. Socioeconomic factors of health insurance and income were associated with a disparate prevalence of hypertension by ethnic group. Future research among Blacks should stratify by ethnicity to adequately address the contributors to health disparities.
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31
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Effect of oxidative stress on racial differences in vascular function at rest and during hand grip exercise. J Hypertens 2017; 35:2006-2015. [DOI: 10.1097/hjh.0000000000001433] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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32
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Liu MY, Li N, Li WA, Khan H. Association between psychosocial stress and hypertension: a systematic review and meta-analysis. Neurol Res 2017; 39:573-580. [PMID: 28415916 DOI: 10.1080/01616412.2017.1317904] [Citation(s) in RCA: 202] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Mei-Yan Liu
- Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China
| | - Na Li
- Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China
| | - William A. Li
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Hajra Khan
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
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33
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Wickrama KKAS, O'Neal CW, Lorenz FO. The decade-long effect of work insecurity on husbands' and wives' midlife health mediated by anxiety: A dyadic analysis. J Occup Health Psychol 2017; 23:350-360. [PMID: 28358574 DOI: 10.1037/ocp0000084] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although the detrimental physical health effects of work insecurity have been noted in previous research, less is known about the mediating processes, such as anxiety symptoms, that link work insecurity to physical health. Even less research has explored these effects at specific life stages and how these effects may impact significant others, even though the impact of this stress may vary across the life course and the mutual influences between married partners may cause dyadic effects stemming from partners' work insecurity. To fill these gaps, the current study incorporates theories that emphasize the stress-work connection, such as stress appraisal theory (Lazarus, 1999) and resource conservation theory (Hobfoll, 1989), into a neurobiological stress-health perspective. This study uses a sample of 330 consistently married, dual-earner husbands and wives who provided data at multiple time points over a 10-year period from 1991 to 2001. Results from a model including growth curves of work insecurity and anxiety symptoms when respondents were in their early middle years and reports of physical illness in their later middle years generally supported the hypothesized model. Both the level and rate of change in work insecurity were related to the change in anxiety symptoms over time. Similarly, the level and rate of change in anxiety symptoms from 1991 to 1994 were linked to subsequent illness years later in 2001. There was only partial support for the existence of partner effects. Findings are discussed as they relate to previous research as well as policy and clinical implications. (PsycINFO Database Record
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Affiliation(s)
| | | | - Frederick O Lorenz
- Department of Statistics and Department of Psychology, Iowa State University
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34
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Roane SJ, Pössel P, Mitchell AM, Eaton WW. Associations of depression status and hopelessness with blood pressure: a 24-year follow-up study. PSYCHOL HEALTH MED 2017; 22:761-771. [DOI: 10.1080/13548506.2017.1281977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sarah J. Roane
- Department of Counseling and Human Development, University of Louisville, Louisville, KY, USA
| | - Patrick Pössel
- Department of Counseling and Human Development, University of Louisville, Louisville, KY, USA
| | - Amanda M. Mitchell
- Department of Counseling and Human Development, University of Louisville, Louisville, KY, USA
| | - William W. Eaton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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35
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Tenkorang EY, Kuuire VZ. Noncommunicable Diseases in Ghana: Does the Theory of Social Gradient in Health Hold? HEALTH EDUCATION & BEHAVIOR 2017; 43:25S-36S. [PMID: 27037145 DOI: 10.1177/1090198115602675] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The theory of social gradient in health posits that individuals with lower socioeconomic status (SES) have poorer health outcomes, compared with those in higher socioeconomic brackets. Applied to noncommunicable diseases (NCDs), this theory has largely been corroborated by studies from the West. However, evidence from sub-Saharan Africa are mixed, with those from Ghana conspicuously missing in the literature. Using data from the Study on Global Ageing and Adult Health, and applying random-effects C log-log models, this study examined the relationship between SES and the risks of living with NCDs in Ghana. Results confirmed a negative social gradient, as Ghanaians with higher SES were more likely to live with NCDs compared with those with low SES. The addition of lifestyle factors attenuated the risks of living with NCDs among Ghanaian men and women with higher SES. This study underscores the need for policies targeted at specific socioeconomic and demographic groups, such as the emerging middle and upper class Ghanaians. It is similarly important for interventions to move beyond biomedical solutions that put more emphasis on epidemiological risk factors to strategies that embrace psychosocial factors as important correlates of cardiovascular health.
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Affiliation(s)
- Eric Y Tenkorang
- Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
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36
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Schmitz LL. Do working conditions at older ages shape the health gradient? JOURNAL OF HEALTH ECONOMICS 2016; 50:183-197. [PMID: 27814483 PMCID: PMC5127717 DOI: 10.1016/j.jhealeco.2016.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 10/12/2016] [Accepted: 10/14/2016] [Indexed: 06/04/2023]
Abstract
This study examines whether working conditions at the end of workers' careers impact health and contribute to health disparities across occupations. A dynamic panel correlated random effects model is used in conjunction with a rich data set that combines information from the Health and Retirement Study (HRS), expert ratings of job demands from the Occupational Information Network (O*NET), and mid-career earnings records from the Social Security Administration's (SSA) Master Earnings File (MEF). Results reveal a strong relationship between positive aspects of the psychosocial work environment and improved self-reported health status, blood pressure, and cognitive function. However, there is little evidence to suggest that working conditions shape observed health disparities between occupations in the years leading up to retirement.
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Affiliation(s)
- Lauren L Schmitz
- Population Studies Center, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104, USA.
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37
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Tenkorang EY, Kuuire V, Luginaah I, Banchani E. Examining risk factors for hypertension in Ghana: evidence from the Study on Global Ageing and Adult Health. Glob Health Promot 2016. [PMID: 26205104 DOI: 10.1177/1757975915583636] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Like most countries in sub-Saharan Africa, hypertension contributes substantially to morbidity and mortality in Ghana, yet nationally representative studies that examine the odds of becoming hypertensive among Ghanaians are conspicuously missing. We aimed to fill this void in the literature. The data used for analysis came from the first wave of the Study on Global Ageing and Adult Health (SAGE), collected in Ghana from January 2007 to December 2008 by the World Health Organization (WHO). A total of 5573 respondents were sampled for the study. Random-effects C-log-log models were employed in examining socio-economic, lifestyle and psychosocial factors on the odds of becoming hypertensive in Ghana. Separate models were run for male and females. Results indicated there were strong significant associations between socio-economic, lifestyle and psychosocial factors on the likelihood of becoming hypertensive, among Ghanaian men and women. Compared with the poorest, Ghanaians from wealthy households were significantly more likely to be hypertensive. Educated women, as compared with the uneducated, were also more likely to be hypertensive. Ghanaians who engaged in vigorous or intensive activities continuously, for at least 10 minutes, were significantly less likely to be hypertensive, compared to those who did not. Happier men had lower odds of becoming hypertensive, and depressed women had increased odds of reporting they were hypertensive.
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Affiliation(s)
- Eric Y Tenkorang
- 1. Department of Sociology, Memorial University, St. John's, Canada
| | - Vincent Kuuire
- 2. Department of Geography, Western University, London, Ontario, Canada
| | - Isaac Luginaah
- 2. Department of Geography, Western University, London, Ontario, Canada
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38
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Gender differences in the relationships between psychosocial factors and hypertension. Maturitas 2016; 93:58-64. [PMID: 27338977 DOI: 10.1016/j.maturitas.2016.06.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 05/25/2016] [Accepted: 06/01/2016] [Indexed: 12/19/2022]
Abstract
Gender differences in the epidemiology, pathophysiology, clinical manifestations and outcomes of cardiovascular disease are well established but there is still a lack of awareness of this both in the general population and among healthcare providers. In addition to the traditionally recognized cardiovascular risk factors, more recently psychosocial risk factors such as stress, mood disorders, low socioeconomic status and sleep disorders have been linked to cardiovascular diseases and hypertension. Psychosocial factors may have different cardiovascular consequences in men and women; thus further efforts are required to explore pathophysiological mechanisms, to obtain gender-specific data from clinical trials and to translate this knowledge into everyday clinical practice.
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39
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Ware LJ, Rennie KL, Gafane LF, Nell TM, Thompson JES, Van Rooyen JM, Schutte R, Schutte AE. Masked Hypertension in Low-Income South African Adults. J Clin Hypertens (Greenwich) 2016; 18:396-404. [PMID: 26762489 DOI: 10.1111/jch.12768] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 10/07/2015] [Accepted: 10/11/2015] [Indexed: 11/30/2022]
Abstract
While South Africa has one of the highest hypertension rates globally, there are few data on masked hypertension (MHT) and white-coat hypertension (WCHT). This study measured the frequency of MHT and WCHT in low-income (<$500 US per month) South African adults, evaluating cardiovascular risk by arterial stiffness. Participants (n=101, 50% male; mean age 39.4±9.7 years) were recruited from a large North-West Province employer. Clinic and 24-hour blood pressure (BP) and pulse wave analysis were recorded. Clinic BP identified 18% of patients as hypertensive, while 24-hour BP showed that 63% of patients were hypertensive. The frequency of MHT was high (33 of 81, 41%) with only one case of WCHT. In comparison to those with normal clinic and 24-hour BP, augmentation index and pulse wave velocity were significantly higher in those with hypertensive 24-hour BP irrespective of clinic BP, indicating that, in this group, masked and sustained hypertension carry a similar elevated cardiovascular risk.
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Affiliation(s)
- Lisa J Ware
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Kirsten L Rennie
- Centre for Lifespan and Chronic Illness Research, University of Hertfordshire, Hertfordshire, UK
| | - Lebo F Gafane
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Tarryn M Nell
- HIV Coordinator, North-West University, Potchefstroom, South Africa
| | - Jane E S Thompson
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Johannes M Van Rooyen
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Rudolph Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Aletta E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
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White CN, VanderDrift LE, Heffernan KS. Social isolation, cognitive decline, and cardiovascular disease risk. Curr Opin Psychol 2015. [DOI: 10.1016/j.copsyc.2015.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Kim TJ, von dem Knesebeck O. Is an insecure job better for health than having no job at all? A systematic review of studies investigating the health-related risks of both job insecurity and unemployment. BMC Public Health 2015; 15:985. [PMID: 26419739 PMCID: PMC4589035 DOI: 10.1186/s12889-015-2313-1] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 09/22/2015] [Indexed: 11/19/2022] Open
Abstract
Background Though previous research repeatedly found that being employed is better for health than having no job at all, evidence suggests that employment is not always beneficial for health. With especially job insecurity reflecting a contemporary health risk for the employed, a systematic review was performed to assess if insecure employment can be as detrimental for health as unemployment, and to determine whether these associations vary according to different health measures and among men and women. Methods The literature search was conducted in the databases Medline, Embase and PsychInfo. In order to allow a more accurate comparison between the two risk factors, studies were included if the data for job insecurity and unemployment was ascertained from the same sample, and contained a quantitative analysis for both exposures towards one (or more) health outcome(s). Results Out of 375 articles, in total, 13 studies were included in the systematic review. In 24 analyses contrasting the health-related associations between job insecurity and unemployment, 16 statistically significant associations were found for each exposure. According to the different health outcomes used, job insecurity and unemployment were strongly related to mental health, whereas job insecurity was more strongly associated with somatic symptoms. Unemployment showed stronger relations with worse general health and mortality. In 4 out of 16 gender-stratified analyses, significant associations between job insecurity/unemployment and health were found for men but not for women. Beyond that, associations were significant or insignificant in both gender groups. Conclusions Though there were moderate differences across the health outcomes, overall, it was found that job insecurity can pose a comparable threat to health than unemployment. Policy interventions should therefore not only consider health risks posed by unemployment, but should also aim at the reduction of insecure employment. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2313-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tae Jun Kim
- Department of Medical Sociology, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Olaf von dem Knesebeck
- Department of Medical Sociology, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
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Laditka JN, Laditka SB. Unemployment, disability and life expectancy in the United States: A life course study. Disabil Health J 2015; 9:46-53. [PMID: 26385529 DOI: 10.1016/j.dhjo.2015.08.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 07/18/2015] [Accepted: 08/09/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Unemployment may be associated with health through factors including stress, depression, unhealthy behaviors, reduced health care, and loss of social networks. Little is known about associations of total lifetime unemployment with disability and life expectancy. HYPOTHESIS People with high unemployment (≥the median) will live shorter lives with more disability than those with less unemployment. METHODS Data were nationally representative of African Americans and non-Hispanic whites, from the Panel Study of Income Dynamics (37 waves 1968-2011, n = 7,970, mean work years = 24.7). Seven waves (1999-2011, 58,268 person-years) measured disability in activities of daily living. We estimated monthly probabilities of disability and death associated with unemployment using multinomial logistic Markov models adjusted for age, sex, race/ethnicity, education, health status at baseline and throughout work life, and social support. We used the probabilities to create large populations with microsimulation, each individual having known monthly disability status, age 40 to death. We analyzed the populations to measure outcomes. RESULTS Respectively for African American and white women and African American and white men, life expectancies (with 95% confidence intervals) from age 40 with low unemployment were ages: 77.1 (75.0-78.3), 80.6 (78.4-81.4), 71.4 (69.6-72.5), and 76.9 (74.9-77.9). Corresponding high unemployment results were: 73.7 (71.7-75.0), 77.5 (75.1-78.0), 68.4 (66.8-69.0), and 73.7 (71.5-74.3). The percentage of life disabled from age 40 was greater with high unemployment for the same groups, by 23.9%, 21.0%, 21.3%, and 21.1% (all p < 0.01). CONCLUSIONS High lifetime unemployment may be associated with a larger proportion of later life with disability and lower life expectancy.
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Affiliation(s)
- James N Laditka
- Department of Public Health Sciences, Public Policy, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA
| | - Sarah B Laditka
- Department of Public Health Sciences, Public Policy, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA.
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Undiagnosed hypertension in a rural district in Bangladesh: The Bangladesh Population-based Diabetes and Eye Study (BPDES). J Hum Hypertens 2015; 30:252-9. [PMID: 26108363 DOI: 10.1038/jhh.2015.65] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 04/21/2015] [Accepted: 05/22/2015] [Indexed: 01/16/2023]
Abstract
Hypertension is mainly asymptomatic and remains undiagnosed until the disease progresses. The objective of the study was to determine the prevalence of and risk factors for hypertension in rural Bangladesh. Using a population-based cluster random sampling strategy, 3096 adults aged ⩾30 years were recruited from a rural district in Bangladesh. Data collected included two blood pressure (BP) measurements, fasting blood glucose, socio-demographic and anthropometric measurements. Hypertension was defined as systolic BP (SBP) ⩾140 mm Hg or diastolic BP (DBP) ⩾90 mm Hg or self-reported diagnosed hypertension. Logistic regression techniques were used for data analyses. The crude prevalence of hypertension was 40% (95% confidence interval (CI) 38-42%) of which 82% were previously undiagnosed. People from lower socio-economic status (SES) had a significantly higher percentage of undiagnosed hypertension compared with people with higher SES (P<0.001). There was no significant gender difference in severity of hypertension. Males with higher education level compared with no education had a higher prevalence of hypertension (odds ratio 2.34, 95% CI 1.49-3.69). Older age and waist circumference in both genders, and diabetes, lack of physical activity in females were found to be associated with higher prevalence of hypertension. Our research suggests the prevalence of undiagnosed hypertension was higher in the rural area in Bangladesh than that reported from the rural area in neighbouring India and China. Lower SES was associated with a higher risk of undiagnosed hypertension. Public health programs at the grass-roots level must emphasise the provision of primary care and preventive services in managing this non-communicable disease.
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Work-Related Psychological Injury Is Associated with Metabolic Syndrome Components in Apparently Healthy Workers. PLoS One 2015; 10:e0130944. [PMID: 26086387 PMCID: PMC4473100 DOI: 10.1371/journal.pone.0130944] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 05/27/2015] [Indexed: 11/26/2022] Open
Abstract
Objective The aim of this study was to evaluate the association between psychological damage caused by common occupational trauma and metabolic syndrome (MES). Method 571 workers from 20 small Italian companies were invited to fill in the Psychological Injury Risk Indicator (PIRI) during their routine medical examination at the workplace. Results Compared to workers with no psychological injury, workers with a high PIRI score had a significantly increased risk of having at least one metabolic syndrome component (adjusted hazards ratio, 1.8; 95% confidence interval, 1.2 to 2.6). There was a significant increase in the risk of hypertriglyceridemia in male workers (OR 2.53 CI95% 1.03-6.22), and of hypertension in female workers (OR 2.45 CI95% 1.29-4.66). Conclusion Psychological injury related to common occupational trauma may be a modifiable risk factor for metabolic syndrome.
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Hu B, Liu X, Yin S, Fan H, Feng F, Yuan J. Effects of psychological stress on hypertension in middle-aged Chinese: a cross-sectional study. PLoS One 2015; 10:e0129163. [PMID: 26043027 PMCID: PMC4456410 DOI: 10.1371/journal.pone.0129163] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 05/05/2015] [Indexed: 12/22/2022] Open
Abstract
We examined the effect and relative contributions of different types of stress on the risk of hypertension. Using cluster sampling, 5,976 community-dwelling individuals aged 40-60 were selected. Hypertension was defined according to the Seventh Report of the Joint National Committee, and general psychological stress was defined as experiencing stress at work or home. Information on known risk factors of hypertension (e.g., physical activity levels, food intake, smoking behavior) was collected from participants. Logistic regression analysis was used to determine the associations between psychological stress and hypertension, calculating population-attributable risks and 95% confidence intervals (CIs). General stress was significantly related to hypertension (odds ratio [OR] = 1.247, 95% CI [1.076, 1.446]). Additionally, after adjustment for all other risk factors, women showed a greater risk of hypertension if they had either stress at work or at home: OR = 1.285, 95% CI (1.027, 1.609) and OR = 1.231, 95% CI (1.001, 1.514), respectively. However, this increased risk for hypertension by stress was not found in men. General stress contributed approximately 9.1% (95% CI [3.1, 15.0]) to the risk for hypertension. Thus, psychological stress was associated with an increased risk for hypertension, although this increased risk was not consistent across gender.
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Affiliation(s)
- Bo Hu
- School of Public Health and the Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, Hebei United University, Tangshan, Hebei Province, China
- * E-mail:
| | - Xiaoyu Liu
- Department of Respiratory Medicine, Kailuan General Hospital, Hebei United University, Tangshan, Hebei Province, China
| | - Sufeng Yin
- School of Public Health and the Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, Hebei United University, Tangshan, Hebei Province, China
| | - Hongmin Fan
- School of Public Health and the Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, Hebei United University, Tangshan, Hebei Province, China
| | - Fumin Feng
- School of Public Health and the Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, Hebei United University, Tangshan, Hebei Province, China
| | - Juxiang Yuan
- School of Public Health and the Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, Hebei United University, Tangshan, Hebei Province, China
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The effects of unemployment and perceived job insecurity: a comparison of their association with psychological and somatic complaints, self-rated health and life satisfaction. Int Arch Occup Environ Health 2015; 89:147-62. [PMID: 25981312 DOI: 10.1007/s00420-015-1059-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 05/07/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Research has provided convincing evidence for the adverse effects of both short- and long-term unemployment, and perceived job insecurity on individuals' health and well-being. This study aims to go one critical step further by comparing the association between short- and long-term unemployment, and perceived job insecurity with a diverse set of health and well-being indicators. METHODS We compare four groups: (1) secure permanent employees (N = 2257), (2) insecure permanent employees (N = 713), (3) short-term unemployed (N = 662), and (4) long-term unemployed (N = 345) using cross-sectional data from the nationally representative Living Conditions Survey in Finland. RESULTS Covariance analyses adjusted for background variables support findings from earlier studies that long-term unemployment and perceived job insecurity are detrimental: short-term unemployed and secure permanent employees experienced fewer psychological complaints and lower subjective complaints load, reported a higher self-rated health, and were more satisfied with their life compared to long-term unemployed and insecure permanent employees. Second, whereas unemployment was found to be more detrimental than insecure employment in terms of life satisfaction, insecure employment was found to be more detrimental than unemployment in terms of psychological complaints. No differences were found regarding subjective complaints load and self-rated health. CONCLUSIONS Our findings suggest that (1) insecure employment relates to more psychological complaints than short-term unemployment and secure permanent employment, (2) insecure employment and long-term unemployment relate to more subjective complaints load and poorer health when compared to secure permanent employment, and (3) insecure employment relates to higher life satisfaction than both short- and long-term unemployment.
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Association of perceived job insecurity with ischemic heart disease and antihypertensive medication in the Danish Work Environment Cohort Study 1990-2010. Int Arch Occup Environ Health 2015; 88:1087-97. [PMID: 25731852 PMCID: PMC4608994 DOI: 10.1007/s00420-015-1030-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 02/04/2015] [Indexed: 11/08/2022]
Abstract
Purpose To determine the effect of job insecurity based on repeated measurements on ischemic heart disease (IHD) and on antihypertensive medication. Methods The study population consists of 12,559 employees aged 18–59 years of the Danish Work Environment Cohort Study. With an open cohort design, data from up to four representative waves were linked to four registers. Poisson regression with time-dependent covariates was used to estimate the rate ratio (RR) with confidence interval (CI) of perceived job insecurity associated with first-time IHD hospitalization or mortality 1991–2010 (n = 561 cases) and incident dispensing of prescribed antihypertensive medications 1996–2010 (n = 2,402 cases). Results Participants with perceived job insecurity filled more antihypertensive prescriptions (age-, gender-, and calendar year-adjusted RR 1.23, 95 % CI 1.12–1.33) and had a borderline significant higher IHD incidence (RR 1.23, 95 % CI 0.98–1.55). In a subanalysis, the risk of antihypertensive medication dispensed was only significant among employees with worries about both unemployment and poor reemployment opportunities. After explorative stratifications by age, gender, and occupational status, perceived job insecurity was associated with more dispensing of antihypertensive medications to participants less than 50 years of age. Conclusions In a country with high social security and active labor market policy, employees with the feeling of an insecure job have a modestly increased risk to fill an antihypertensive prescription. Further studies on health risks of job insecurity should consider improved exposure assessment, earlier outcomes such as medication in order to increase statistical power, and identification of vulnerable population groups.
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Thombre MK, Talge NM, Holzman C. Association between pre-pregnancy depression/anxiety symptoms and hypertensive disorders of pregnancy. J Womens Health (Larchmt) 2015; 24:228-36. [PMID: 25588112 DOI: 10.1089/jwh.2014.4902] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Depression and anxiety symptoms have been linked with hypertensive disorders during pregnancy, but these associations have not been fully elucidated. Our objective was to consider hypertension in pregnancy and its subtypes (chronic hypertension, gestational hypertension, preeclampsia) and evaluate whether the proximity of psychological symptoms to pregnancy informs any associations observed. METHODS Pregnancy Outcomes and Community Health Study participants who provided interview data at enrollment (16-27 weeks' gestation) and whose hypertensive disorder status was abstracted from medical records were eligible for inclusion (n=1371). Maternal history of depression/anxiety symptoms at four time points in the life course were ascertained via self-report at enrollment (i.e., lifetime history, 1 year prior to pregnancy, since last menstrual period, and past week). Weighted logistic regression models were used to examine depression/anxiety symptom measures in relation to hypertensive disorders (overall) and subtype. RESULTS Following adjustment for maternal sociodemographic factors, smoking, and prepregnancy body mass index, prepregnancy depression or anxiety symptoms (i.e., lifetime history and 1 year prior to pregnancy) were associated with hypertensive disorders during pregnancy. Subtype analyses revealed that these associations were driven primarily by chronic hypertension (adjusted odds ratios=2.7-3.5). Preeclampsia accompanied by preterm delivery was also linked to women's lifetime history of depression symptoms (odds ratio=2.3, 95% confidence interval 1.0-5.2). CONCLUSION Our results suggest that the link between maternal chronic hypertension and depression/anxiety symptoms precedes pregnancy. In addition, prepregnancy history of depression/anxiety symptoms may be considered part of a risk profile for preterm preeclampsia.
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Affiliation(s)
- Madhavi K Thombre
- Department of Epidemiology & Biostatistics, Michigan State University , East Lansing, Michigan
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Kaur H, Luckhaupt SE, Li J, Alterman T, Calvert GM. Workplace psychosocial factors associated with hypertension in the U.S. workforce: a cross-sectional study based on the 2010 national health interview survey. Am J Ind Med 2014; 57:1011-21. [PMID: 25137617 DOI: 10.1002/ajim.22345] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To explore associations between self-reported hypertension and workplace psychosocial factors that are common among U.S. workers and to identify industries and occupations (I&Os) that are associated with a high prevalence of hypertension, even after adjustment for common known risk factors. METHODS Data from the 2010 National Health Interview Survey were used to examine relationships between the prevalence of self-reported hypertension and job insecurity, hostile work environment, work- family imbalance, work hours and I&O. RESULTS Job insecurity (adjusted prevalence ratio (aPR): 1.11; 95% confidence interval (CI): 1.04-1.19)) and hostile work environment (aPR: 1.15; 95% CI: 1.03-1.29) were significantly associated with hypertension. Hypertension prevalence was significantly elevated among those employed in Healthcare Support occupations and Public Administration industries. CONCLUSION Addressing hostile work environments and the stress associated with job insecurity may improve workers' health. Other occupational factors that contribute to the variation in prevalence of hypertension by I&O should be sought.
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Affiliation(s)
- Harpriya Kaur
- University of Nebraska Medical Center; Omaha Nebraska
| | - Sara E. Luckhaupt
- Division of Surveillance; Hazard Evaluations and Field Studies; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Jia Li
- Division of Surveillance; Hazard Evaluations and Field Studies; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Toni Alterman
- Division of Surveillance; Hazard Evaluations and Field Studies; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Geoffrey M. Calvert
- Division of Surveillance; Hazard Evaluations and Field Studies; National Institute for Occupational Safety and Health; Centers for Disease Control and Prevention; Cincinnati Ohio
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Sneed RS, Cohen S. Negative social interactions and incident hypertension among older adults. Health Psychol 2014; 33:554-65. [PMID: 24884909 DOI: 10.1037/hea0000057] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To determine if negative social interactions are prospectively associated with hypertension among older adults. METHOD This is a secondary analysis of data from the 2006 and 2010 waves of the Health and Retirement Study, a survey of community-dwelling older adults (age > 50 years). Total average negative social interactions were assessed at baseline by averaging the frequency of negative interactions across 4 domains (partner, children, other family, friends). Blood pressure was measured at both waves. Individuals were considered to have hypertension if they reported use of antihypertensive medications, had measured average resting systolic blood pressure of 140 mmHg or higher, or measured average resting diastolic blood pressure of 90 mmHg or higher. Analyses excluded those who were hypertensive at baseline and controlled for demographics, personality, positive social interactions, and baseline health. RESULTS Twenty-nine percent of participants developed hypertension over the 4-year follow-up. Each 1-unit increase in the total average negative social interaction score was associated with a 38% increased odds of developing hypertension. Sex moderated the association between total average negative social interactions and hypertension, with effects observed among women but not men. The association of total average negative interactions and hypertension in women was attributable primarily to interactions with friends, but also to negative interactions with family and partners. Age also moderated the association between total average negative social interactions and hypertension, with effects observed among those ages 51-64 years, but not those ages 65 or older. CONCLUSION In this sample of older adults, negative social interactions were associated with increased hypertension risk in women and the youngest older adults.
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Affiliation(s)
| | - Sheldon Cohen
- Department of Psychology, Carnegie Mellon University
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