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Cebrino J, Portero de la Cruz S. Factors related to depression in adults with oral health problems in Spain (2017 to 2020). Front Public Health 2024; 12:1364119. [PMID: 38476497 PMCID: PMC10927730 DOI: 10.3389/fpubh.2024.1364119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
Background The need to study the link between gender, depression, and oral health is becoming increasingly evident. This study therefore aimed to determine the prevalence and evolution over time of depression among women and men with oral health problems and to evaluate the association between depression status, lifestyle-related variables health-related variables and use of dental health services in those people. Methods We performed a nationwide cross-sectional study on 25,631 adults with oral health problems residing in Spain from the Spanish National Health Survey 2017 and the European Health Survey of Spain 2020, including as the main variable self-reported diagnosis of depression. We analysed independent variables such as lifestyle-related variables, health-related variables, and variables related to dental health services. Sociodemographic characteristics were considered as control variables. Results The prevalence of depression among adults with oral health problems in Spain was 7.81% (10.14% for women, 5.39% for men), with a notable decrease from 2017 to 2020 in women. Depressed women had a slightly higher percentage of filled or capped teeth, and had more covers (crowns), bridges or other types of prostheses or dentures, while men had more caries. Women also made more frequent, regular dental visits for check-ups and mouth cleaning, whereas men often needed extractions. Unfavourable associated factors in both genders were: perceiving their health as good, average, poor, or very poor, and having 1-2 and ≥ 3 comorbidities. Conversely, not being a current smoker was related to less likelihood of depression. In women only, not engaging in leisure-time physical activity produced more unfavourable associated factors. Conclusion The prevalence of depression among adults with oral health problems in Spain from 2017 to 2020 was 7.81%, but this figure has been steadily decreasing over time. In addition, the favourable and unfavourable associated factors could help us inform health professionals and authorities in order to prevent depression and enhance the care of this population according to gender.
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Affiliation(s)
- Jesús Cebrino
- Department of Preventive Medicine and Public Health, University of Seville, Seville, Spain
| | - Silvia Portero de la Cruz
- Department of Nursing, Pharmacology and Physiotherapy, University of Córdoba, Córdoba, Spain
- Research Group GE10 Clinical and Epidemiological Research in Primary Care, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Córdoba, Spain
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National Trends in Prevalence of Depression in Men and Women with Chronic Obstructive Pulmonary Disease Hospitalized in Spain, 2016–2020. J Clin Med 2022; 11:jcm11216337. [PMID: 36362570 PMCID: PMC9655616 DOI: 10.3390/jcm11216337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/23/2022] Open
Abstract
(1) Background: To describe trends in the prevalence of depression in men and women with COPD hospitalized in Spain (2016–2020). (2) Methods: We used a nationwide discharge database to select all patients ≥35 years with COPD. (3) Results: The prevalence of depression was 3.54-times higher in women with COPD than in men (OR 3.54; 95%CI 3.48–3.6). It decreased significantly between 2016 and 2020, although the reduction was only significant in women (12.27% in 2016 vs. 10.56% in 2020). Older age, comorbidity and the most recent years of hospital admission were associated with lower prevalence of depression in both men and women, while obesity, obstructive sleep apnea (OSA) and use of oxygen prior to admission were risk factors. In-hospital mortality (IHM) increased significantly over time. Older age, comorbidity, the use of oxygen prior to admission and having been hospitalized in 2020 increased the risk of IHM. Female sex was associated with a lower IHM in patients with depression and COPD. (4) Conclusions: The prevalence of depression has decreased over time in women with COPD while it has not changed significantly in men with this disease. IHM increased over time both in men and women with COPD and depression, with higher prevalence in the former.
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Herbst K, Juvekar S, Jasseh M, Berhane Y, Chuc NTK, Seeley J, Sankoh O, Clark SJ, Collinson MA. Health and demographic surveillance systems in low- and middle-income countries: history, state of the art and future prospects. Glob Health Action 2021; 14:1974676. [PMID: 35377288 PMCID: PMC8986235 DOI: 10.1080/16549716.2021.1974676] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/25/2021] [Indexed: 11/09/2022] Open
Abstract
Health and Demographic Surveillance Systems (HDSS) have been developed in several low- and middle-income countries (LMICs) in Africa and Asia. This paper reviews their history, state of the art and future potential and highlights substantial areas of contribution by the late Professor Peter Byass.Historically, HDSS appeared in the second half of the twentieth century, responding to a dearth of accurate population data in poorly resourced settings to contextualise the study of interventions to improve health and well-being. The progress of the development of this network is described starting with Pholela, and progressing through Gwembe, Balabgarh, Niakhar, Matlab, Navrongo, Agincourt, Farafenni, and Butajira, and the emergence of the INDEPTH Network in the early 1990'sThe paper describes the HDSS methodology, data, strengths, and limitations. The strengths are particularly their temporal coverage, detail, dense linkage, and the fact that they exist in chronically under-documented populations in LMICs where HDSS sites operate. The main limitations are generalisability to a national population and a potential Hawthorne effect, whereby the project itself may have changed characteristics of the population.The future will include advances in HDSS data harmonisation, accessibility, and protection. Key applications of the data are to validate and assess bias in other datasets. A strong collaboration between a national HDSS network and the national statistics office is modelled in South Africa and Sierra Leone, and it is possible that other low- to middle-income countries will see the benefit and take this approach.
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Affiliation(s)
- Kobus Herbst
- DSI-MRC South African Population Infrastructure Network, Durban, South Africa
- Population Science, Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
| | - Sanjay Juvekar
- KEM Hospital Research Centre, Vadu Rural Health Program, Pune, India
| | - Momodou Jasseh
- Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | | | - Janet Seeley
- Population Science, Africa Health Research Institute, Durban, KwaZulu-Natal, South Africa
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Osman Sankoh
- Statistics Sierra Leone, Tower Hill, Freetown, Sierra Leone
- Njala University, University Secretariat, Njala, Sierra Leone
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Heidelberg Institute of Global Health, University of Heidelberg Medical School, Heidelberg, Germany
| | - Samuel J. Clark
- Department of Sociology, The Ohio State University, Columbus, Ohio, USA
| | - Mark A. Collinson
- DSI-MRC South African Population Infrastructure Network, Durban, South Africa
- SAMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa
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Sharafi M, Bahramali E, Farjam M, Rezaeian S, Afrashteh S, Amiri Z. Socioeconomic inequality in noncommunicable diseases: Results from a baseline Persian cohort study. Med J Islam Repub Iran 2021; 35:78. [PMID: 34291002 PMCID: PMC8285560 DOI: 10.47176/mjiri.35.78] [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: 12/11/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Contrary to health indices advancement during recent years, health inequalities are still a global challenge. This study aimed to determine socioeconomic factors for noncommunicable diseases using concentration indices (CI).
Methods: This cross-sectional study was conducted on the baseline data from a cohort study in Fasa (southern Iran). Principle component analysis was used to measure asset index. Moreover, socioeconomic inequalities were calculated by CI. Analysis was done at 95% confidence level using STATA software.
Results: A total of 7990 individuals were included in the study. The highest negative CIs were significantly found for epilepsy (-0.334), paramnesia (-0.255), and learning disabilities (-0.063), respectively, and the lowest were significantly found for chronic headaches (-0.046), recurrent headaches (-0.03), infertility (-0.028) and hypertension (-0.057). This index was positive for breast cancer (0.298). Furthermore, it was not Significant for diabetes, thyroid disorders, depression, and chronic lung diseases.
Conclusion: The findings showed a significant inequality in the most of the noncommunicable diseases in the region, which are more concentrated among the poorest population. Policymakers in the health system and city planners should consider these results to decrease the burden of noncommunicable diseases in the society by identifying vulnerable subcategories.
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Affiliation(s)
- Mehdi Sharafi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ehsan Bahramali
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Mojtaba Farjam
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Shahab Rezaeian
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sima Afrashteh
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Amiri
- Hormozgan University of Medical Sciences, Hormozgan, Iran
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Eldeeb HM, Elgharabawy RM, Abd Elmoniem AE, Ahmed AA. Alpha-2 beta-adrenergic receptor (301-303 I/D) gene polymorphism in hypertension and type 2 diabetes mellitus diseases among Saudi cases in the Qassim region. Sci Prog 2021; 104:368504211012162. [PMID: 33900865 PMCID: PMC10454788 DOI: 10.1177/00368504211012162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The hypertension (HTN) and type 2 diabetes mellitus (T2DM) are a common multifactorial disease due to genetics and environmental factors. The alpha 2B adrenergic receptor (α2B-AR) has relationship with secretion of insulin and mediates the vasoconstriction that elevate blood pressure. This study aimed to determine the association between α2B-AR gene polymorphism with HTN and T2DM in Saudi cases. 200 cases and 100 healthy controls from Saudi population were recruited from the Internal Medicine clinic, Qassim University. The patients were grouped into: 72 HTN without T2DM; 62 HTN with T2DM and 66 T2DM only. Full medical history, examination and biochemical assays were performed for all participants. Genomic DNA was isolated from blood lymphocytes of all subjects for detection of α2B-AR gene polymorphism by using polymerase chain reaction (PCR). The results found a significant association between D carriers genotype and HTN with T2DM cases (p < 0.05) as well as with T2DM-only cases, (p < 0.05) compared to control. Regardless of HTN status, only cases with HTN and T2DM as well as those with T2DM were significantly associated with the recessive model DD versus II+ID (p < 0.05). So, D carriers genotype was significantly associated with total cases of HTN and T2DM (p < 0.05) compared to controls. Our results suggested that there is a relationship between the α2B-AR I/D gene polymorphism and the risk for T2DM with or without HTN, but no such comparable relationship is evident with HTN-only cases among Saudi population in Qassim region.
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Affiliation(s)
- Hussein Mohammad Eldeeb
- Department of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraydah, Kingdom of Saudi Arabia
- Department of Biochemistry, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Rehab M. Elgharabawy
- Department of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraydah, Kingdom of Saudi Arabia
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Alaa E Abd Elmoniem
- Internal Medicine and Cardiology, College of Medicine, Qassim University, Kingdom of Saudi Arabia
- Internal Medicine and Cardiology, College of Medicine, Assiut University, Egypt
| | - Ahmed Ali Ahmed
- Research Center of Biotechnology, College of Medicine, Qassim University, Kingdom of Saudi Arabia
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Ha DA, Tran OT, Nguyen HL, Chiriboga G, Goldberg RJ, Phan VH, Nguyen CT, Nguyen GH, Pham HV, Nguyen TT, Le TT, Allison JJ. Conquering hypertension in Vietnam-solutions at grassroots level: study protocol of a cluster randomized controlled trial. Trials 2020; 21:985. [PMID: 33246495 PMCID: PMC7694904 DOI: 10.1186/s13063-020-04917-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 11/18/2020] [Indexed: 12/30/2022] Open
Abstract
Background Vietnam has been experiencing an epidemiologic transition to that of a lower-middle income country with an increasing prevalence of non-communicable diseases. The key risk factors for cardiovascular disease (CVD) are either on the rise or at alarming levels in Vietnam, particularly hypertension (HTN). Inasmuch, the burden of CVD will continue to increase in the Vietnamese population unless effective prevention and control measures are put in place. The objectives of the proposed project are to evaluate the implementation and effectiveness of two multi-faceted community and clinic-based strategies on the control of elevated blood pressure (BP) among adults in Vietnam via a cluster randomized trial design. Methods Sixteen communities will be randomized to either an intervention (8 communities) or a comparison group (8 communities). Eligible and consenting adult study participants with HTN (n = 680) will be assigned to intervention/comparison status based on the community in which they reside. Both comparison and intervention groups will receive a multi-level intervention modeled after the Vietnam National Hypertension Program including education and practice change modules for health care providers, accessible reading materials for patients, and a multi-media community awareness program. In addition, the intervention group only will receive three carefully selected enhancements integrated into routine clinical care: (1) expanded community health worker services, (2) home BP self-monitoring, and (3) a “storytelling intervention,” which consists of interactive, literacy-appropriate, and culturally sensitive multi-media storytelling modules for motivating behavior change through the power of patients speaking in their own voices. The storytelling intervention will be delivered by DVDs with serial installments at baseline and at 3, 6, and 9 months after trial enrollment. Changes in BP will be assessed in both groups at several follow-up time points. Implementation outcomes will be assessed as well. Discussion Results from this full-scale trial will provide health policymakers with practical evidence on how to combat a key risk factor for CVD using a feasible, sustainable, and cost-effective intervention that could be used as a national program for controlling HTN in Vietnam. Trial registration ClinicalTrials.gov NCT03590691. Registered on July 17, 2018. Protocol version: 6. Date: August 15, 2019.
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Affiliation(s)
- Duc A Ha
- Ministry of Health, Hanoi, Vietnam.,Health Strategy and Policy Institute, Hanoi, Vietnam
| | - Oanh T Tran
- Health Strategy and Policy Institute, Hanoi, Vietnam
| | - Hoa L Nguyen
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, MA, 01655, USA.
| | - Germán Chiriboga
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, MA, 01655, USA
| | - Robert J Goldberg
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, MA, 01655, USA
| | - Van H Phan
- Health Strategy and Policy Institute, Hanoi, Vietnam
| | - Cuc T Nguyen
- Health Strategy and Policy Institute, Hanoi, Vietnam
| | | | - Hien V Pham
- Health Strategy and Policy Institute, Hanoi, Vietnam
| | | | - Thanh T Le
- National Heart Institute, Hanoi, Vietnam.,Vinmec Healthcare System, Hanoi, Vietnam
| | - Jeroan J Allison
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, MA, 01655, USA
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Korinek K, Young Y, Teerawichitchainan B, Kim Chuc NT, Kovnick M, Zimmer Z. Is war hard on the heart? Gender, wartime stress and late life cardiovascular conditions in a population of Vietnamese older adults. Soc Sci Med 2020; 265:113380. [PMID: 33096339 PMCID: PMC8114945 DOI: 10.1016/j.socscimed.2020.113380] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/01/2020] [Accepted: 09/15/2020] [Indexed: 12/19/2022]
Abstract
Populations in the global south are disproportionately exposed to the stressors of development, disaster and armed conflict, all of which heighten cardiovascular disease (CVD) risk. We consider how war-related stressors exert a lasting influence upon population health, in particular the cardiovascular health of war survivors now entering older adulthood. Data come from the 2018 Vietnam Health and Aging Study conducted among 2447 northern Vietnamese adults age 60 and older. We conduct survey-adjusted logistic regression analyses to examine the associations among respondents' wartime exposure to combat and physical threat, malevolent environment conditions, and four CVD conditions (hypertension, dyslipidemia, heart disease, and stroke). We examine posttraumatic stress disorder (PTSD) as it mediates the association between wartime stress exposures and late life CVD, and gender as it moderates the relationship between wartime stressors and CVD. We find that exposure to wartime combat and violence, as well as malevolent living conditions, exhibit significant, positive associations with cardiovascular conditions. These associations are mediated by the severity of recent PTSD symptoms. For certain CVD conditions, particularly hypertension, the associations between wartime stressors and late life cardiovascular conditions diverge across gender with women experiencing a greater penalty for their exposure to war-related stressors than their male counterparts. We conclude that the stressors of war and resultant PTSD, widespread in this cohort of Vietnamese older adults who endured myriad forms of war exposure during their young adulthood, exhibit modest, yet significant associations with late-life cardiovascular conditions. Women, especially those exposed to wartime violence and combat, bear this CVD burden alongside men.
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Affiliation(s)
- Kim Korinek
- Department of Sociology, University of Utah, Salt Lake City, UT, USA.
| | - Yvette Young
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
| | | | | | - Miles Kovnick
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
| | - Zachary Zimmer
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
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Wachamo D, Geleta D, Woldesemayat EM. Undiagnosed Hypertension and Associated Factors Among Adults in Hawela Tula Sub-City, Hawassa, Southern Ethiopia: A Community-Based Cross-Sectional Study. Risk Manag Healthc Policy 2020; 13:2169-2177. [PMID: 33116995 PMCID: PMC7573300 DOI: 10.2147/rmhp.s276955] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 09/15/2020] [Indexed: 01/12/2023] Open
Abstract
Background Hypertension (HTN) is a major public health problem and often it is unnoticed. Undiagnosed HTN may lead to a high burden of cardiovascular diseases and complications such as stroke and heart attack. In this study, we aimed to assess the prevalence and associated factors of undiagnosed HTN. Methods From February to June 2019, a community-based cross-sectional study was conducted on 383 randomly selected adults in Hawela Tulla Sub-city, Hawassa, southern Ethiopia. Data were collected by pretested questionnaires, and physical measurements of weight, height and blood pressure were collected through standardized procedures adapted from WHO STEPS survey tools. Data entry and analysis were carried out using SPSS version 23 statistical software. Descriptive analysis and logistic regression models were used to describe the results. Logistic regression analysis results were declared statistically significant if the P-value was below 0.05 and the 95% CI did not cross the null value. Results The prevalence of undiagnosed HTN among the respondents was 12.3%. Only 152 (39.7%) of the study population knew the symptoms of HTN. Males (adjusted odds ratio [AOR] =2.5, 95% CI: 1.2, 5.2; P=0.016), people with a family history of HTN (AOR=2.7, 95% CI: 1.0, 7.0; P= 0.044), people who chewed khat (AOR=4.6, 95% CI: 2.0, 10.2; P<0.001), overweight or obese individuals (AOR=3.5, 95% CI: 1.7, 7.3; P=0.001) and people with diabetes mellitus (AOR=3.2, 95% CI: 1.1, 9.3; P=0.036) had a higher risk of undiagnosed HTN than their counterparts. Conclusion Identification of people with the risk factors of undiagnosed HTN and delivering health education to reduce the risky behaviors could reduce the burden and consequences of HTN. Integrating interventions at the community level may be important.
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Affiliation(s)
- Demelash Wachamo
- Hawassa College of Health Sciences, Department of Public Health, Hawassa, Ethiopia
| | - Dereje Geleta
- Hawassa University, College of Medicine and Health Sciences, School of Public Health, Hawassa, Ethiopia
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Gender differences in the association between socioeconomic status and hypertension in France: A cross-sectional analysis of the CONSTANCES cohort. PLoS One 2020; 15:e0231878. [PMID: 32311000 PMCID: PMC7170232 DOI: 10.1371/journal.pone.0231878] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 04/02/2020] [Indexed: 12/12/2022] Open
Abstract
Background Hypertension prevalence increases when socioeconomic status decreases but gender differences in the relationship between socioeconomic status and hypertension have been less studied. This work aimed to explore the pattern of associations between three indicators of socioeconomic status at individual, household, and municipal levels with hypertension across genders in a large sample of French adults from the CONSTANCES cohort. Methods Using data at inclusion from 59 805 participants (52% women) aged 25–69 years and recruited between 2012 and 2015, multilevel log-Poisson regressions with robust variance estimates were used to assess the associations of Relative Index of Inequality in education, monthly income per consumption unit and residential deprivation with hypertension. Modifying effects of gender and age in those associations were tested. Results Hypertension prevalence was higher in men than in women. Steep socioeconomic gradients of hypertension were observed for the three socioeconomic indicators in both genders and from the youngest to the oldest age class. Socioeconomic inequalities, especially educational inequalities, were larger among women than men: Relative Index of Inequality for highest versus lowest education among the 25–34 years were 0.43 [95%-confidence interval = 0.28–0.67] in women and 0.70 [95%-confidence interval = 0.53–0.92] in men. With increasing age, socioeconomic gradients of hypertension eased in men and even more in women so that gender differences decreased. Conclusions In this cross-sectional analysis of a large sample of adults, prevalence of hypertension was higher in men than in women. Moreover, socioeconomic status and especially education displayed a stronger association with hypertension prevalence in women compared to men. Reducing inequalities in hypertension may require gender-specific approaches.
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Assessing the true association between hypertension status and stature of individuals in Bangladesh: propensity score analysis. J Hum Hypertens 2020; 35:250-256. [PMID: 32203075 DOI: 10.1038/s41371-020-0328-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 11/09/2022]
Abstract
Inconsistent evidence is found in the literature regarding the association between individuals' stature and hypertension status. In this study, an attempt has been made to investigate the true association between height and occurrence of hypertension. For analysis purpose, this study considers Bangladesh Demographic and Health Survey (BDHS) 2011 data obtained from an observational study. By dividing height (tall/normal/short) based on 25th and 75th percentile points separately for females and males, a binary logistic regression model was fitted to the weighted data, where weights were calculated from propensity scores (PS). From the PS-based weighted data, we did not find any significant association between height and hypertension (p > 0.05). Besides the respondent's height, logistic regression analyses of a balanced data set have revolved around some well-known factors that are associated with the occurrence of hypertension: gender of the respondent, higher wealth index status, as well as overweight. This study also found higher odds of occurring hypertension among the residents of Khulna and Rangpur divisions, whereas lower likelihood of hypertension is reported for the individual living in Chittagong and Sylhet districts. The findings of this paper indicate that human stature is not a risk factor for hypertension. Apart from height, this study uncovers some important risk factors for developing hypertension. By considering these factors, awareness should be raised among male, wealthier, and overweighted individuals in Bangladesh. However, why the prevalence of hypertension is higher in Khulna and Rangpur, as well as lower in Chittagong and Sylhet, demands further research.
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Rana J, Ahmmad Z, Sen KK, Bista S, Islam RM. Socioeconomic differentials in hypertension based on JNC7 and ACC/AHA 2017 guidelines mediated by body mass index: Evidence from Nepal demographic and health survey. PLoS One 2020; 15:e0218767. [PMID: 31986173 PMCID: PMC6984730 DOI: 10.1371/journal.pone.0218767] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 01/02/2020] [Indexed: 01/30/2023] Open
Abstract
Background Unlike developed countries, higher socioeconomic status (SES-education, and wealth) is associated with hypertension in low and middle-income countries (LMICs) with limited evidence. We examined the associations between SES and hypertension in Nepal and the extent to which these associations vary by sex and urbanity. The body mass index (BMI) was examined as a secondary outcome and assessed as a potential mediator. Materials and methods We analyzed the latest Nepal Demographic and Health Survey data (N = 13,436) collected between June 2016 and January 2017, using a multistage stratified sampling technique. Participants aged 15 years or older from selected households were interviewed with an overall response rate of 97%. Primary outcomes were hypertension and normal blood pressure defined by the widely used Seventh Report of the Joint National Committee (JNC7) and the American College of Cardiology/American Heart Association (ACC/AHA) 2017. Results The prevalence of hypertension was higher in Nepalese men than women. The likelihood of being hypertensive was significantly higher in the higher education group compared with the lowest or no education group for men (OR 1.89 95% CI: 1.36, 2.61) and for women (OR 1.20 95% CI: 0.79, 1.83). People in the richest group were more likely to be hypertensive compared with people in the poorest group for men (OR 1.66 95% CI: 1.26, 2.19) and for women (OR 1.60 95% CI: 1.20, 2.12). The associations between SES (education) and hypertension were partially modified by sex and fully modified by urbanity. BMI mediated these associations. Conclusions The higher SES was positively associated with the higher likelihood of having hypertension in Nepal according to both JNC7 and ACC/AHA 2017 guidelines. These associations were mediated by BMI, which may help to explain broader socioeconomic differentials in cardiovascular disease (CVD) and related risk factors, particularly in terms of education and wealth. Our study suggests that the mediating factor of BMI should be tackled to diminish the risk of CVD in people with higher SES in LMICs.
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Affiliation(s)
- Juwel Rana
- Research and Innovation Department, South Asia Institute for Social Transformation (SAIST), Dhaka, Bangladesh
- Department of Public Health, North South University, Dhaka, Bangladesh
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, Massachusetts, United States of America
- * E-mail:
| | - Zobayer Ahmmad
- Department of Sociology, University of Utah, Salt Lake City, Utah, United States of America
| | | | - Sanjeev Bista
- Advanced Biostatistics and Epidemiology, Ecole des Hautes Etudes en Sante Publique, Rennes, France
| | - Rakibul M. Islam
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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Jahan Y, Moriyama M, Rahman MM, Kazawa K, Mizukawa M, Rahman A, Bin Shahid ASMS, Das SK, Faruque ASG, Chisti MJ. Disease perception and experiences among rural Bangladeshi hypertensive women: A qualitative approach. Health Promot Perspect 2020; 10:66-73. [PMID: 32104659 PMCID: PMC7036212 DOI: 10.15171/hpp.2020.11] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 01/08/2020] [Indexed: 11/09/2022] Open
Abstract
Background: Hypertension (HTN) is well established as a leading cause of common serious illnesses worldwide. We carried out this qualitative research to understand perception of and experiences related to HTN among rural Bangladeshi hypertensive women. Methods: A total of 74 female hypertensive participants who were diagnosed as HTN were purposively recruited in a rural community in Mirzapur, Bangladesh. A focus group discussion(FGD) was applied to share their perception and experiences. Transcripts were read in an iterative process, and a thematic analysis was performed. This paper is reported followed by COREQ checklist. Results: Three main themes were generated; (i) Perception of HTN based on experiences, (ii)Knowledge of management of HTN, and (iii) Barriers of management of HTN. Under the themes, seven subthemes were identified. The participants only knew about their high blood pressure(HBP) when they had symptoms, and they applied traditional remedies in the rural context to deal with those symptoms. Even though more than half of participants had relevant knowledge of how to manage HTN, but still there were social-cultural and economic barriers and lack of social infrastructure to access healthcare, existed to practice them. Conclusion: Based on our study reports, health education programs at the household and community level could be a potential starting point for any preventive and containment strategy in rural communities of Bangladesh.
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Affiliation(s)
- Yasmin Jahan
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Michiko Moriyama
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Md Moshiur Rahman
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kana Kazawa
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mariko Mizukawa
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Atiqur Rahman
- Division Ageing and Social Change (ASC), ISV, Linköping University, Linköping, Sweden
| | | | - Sumon Kumar Das
- Child Health Division, Menzies School of health Research, Northern Territory, Australia
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Brummett BH, Babyak MA, Jiang R, Huffman KM, Kraus WE, Singh A, Hauser ER, Siegler IC, Williams RB. Systolic Blood Pressure and Socioeconomic Status in a large multi-study population. SSM Popul Health 2019; 9:100498. [PMID: 31650001 PMCID: PMC6804683 DOI: 10.1016/j.ssmph.2019.100498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/07/2019] [Accepted: 10/09/2019] [Indexed: 02/07/2023] Open
Abstract
The present study used harmonized data from eight studies (N = 28,891) to examine the association between socioeconomic status (SES) and resting systolic blood pressure (SBP). The study replicates and extends our prior work on this topic by examining potential moderation of this association by race and gender. We also examined the extent to which body mass index (BMI), waist circumference (WC), and smoking might explain the association between SES and SBP. Data were available from six race/gender groups: 9200 Black women; 2337 Black men; 7248 White women; 6519 White men; 2950 Hispanic women; and 637 Hispanic men. Multivariable regression models showed that greater annual household income was associated with lower SBP in all groups except Hispanic men. The magnitude and form of this negative association differed across groups, with White women showing the strongest linear negative association. Among Black men and Hispanic women, the association was curvilinear: relatively flat among lower income levels, but then negative among higher income ranges. Education also was independently, negatively related to SBP, though evidence was weaker for race and gender differences in the strength of the association. Higher BMI and WC were associated with higher SBP, and current smoking with lower SBP. Inclusion of these risk factors resulted in only a modest change in the magnitude of the SBP and SES relation, accounting on average about 0.4 mmHg of the effect of income and 0.2 mmHg of the effect of education—effects unlikely to be clinically significant. Further understanding of mechanisms underlying the association between SBP and SES may improve risk stratification in clinical settings and potentially inform interventions aimed at reductions in social disparities in health. Harmonized data (n = 28,291) examined association between blood pressure and socioeconomic status. Replication and extension of prior work by examining potential moderation of this association by race and gender. Further understanding of this association inform interventions aimed at reductions in social disparities in health.
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Affiliation(s)
- Beverly H Brummett
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, N.C, 27710, USA
| | - Michael A Babyak
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, N.C, 27710, USA
| | - Rong Jiang
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, N.C, 27710, USA
| | - Kim M Huffman
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - William E Kraus
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA.,Division of Cardiology, Duke University School of Medicine, Durham, NC, USA
| | - Abanish Singh
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, N.C, 27710, USA.,Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - Elizabeth R Hauser
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA.,Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA.,Cooperative Studies Program Epidemiology Center, Durham Veterans Affairs Medical Center, Durham, NC, USA
| | - Ilene C Siegler
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, N.C, 27710, USA
| | - Redford B Williams
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, N.C, 27710, USA
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Prevalence and Risk Factors of Hypertension in the Vietnamese Elderly. High Blood Press Cardiovasc Prev 2019; 26:239-246. [PMID: 31020550 DOI: 10.1007/s40292-019-00314-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 04/02/2019] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Hypertension (HT) is considered as a major determinant of cardiovascular complications. However, few studies have addressed HT prevalence among adults aged 60 years and older in the northern mountainous region of Vietnam. AIM To determine the prevalence of HT and its risk factors in the elderly in that area. METHODS A cross-sectional study was conducted in a study area in the northern of Vietnam. We interviewed 354 adults aged 60 years or over who were randomly selected, and then measured their blood pressure. RESULTS The overall HT prevalence was 62.15%. The isolated systolic hypertension (ISH) prevalence was 22.88%. There was a slight decrease in the proportion of HT by stage 1, stage 2 and stage 3 respectively. The univariate and multivariate logistic regression analysis indicated some risk factors for HT including age groups, body mass index (BMI) and waist-hip ratio (WHR) (p < 0.05). Furthermore, we also found that the risk factors of ISH was obesity status classified by BMI category and WHR (p < 0.05). In particularly, the ethnicity was statistically significantly associated with ISH. CONCLUSION Our data showed a high prevalence of hypertension in the elderly in studied area. The risk factors for HT and ISH among studied subjects included age groups, ethnic groups, BMI and WHR. Hence, these findings are important for policy-making related to launch public health prevention and control campaigns for hypertension among older adults in the northern mountainous region of Vietnam.
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Meiqari L, Essink D, Wright P, Scheele F. Prevalence of Hypertension in Vietnam: A Systematic Review and Meta-Analysis. Asia Pac J Public Health 2019; 31:101-112. [PMID: 30678477 PMCID: PMC6463272 DOI: 10.1177/1010539518824810] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Studies on the prevalence of hypertension in Vietnam have reported various estimates. There is no up-to-date assessment of the evidence on the magnitude of hypertension in Vietnam. Search engines for scientific and gray literature were used to identify relevant records for eligibility screening and quality assessment. Data from selected articles were extracted using standardized spreadsheets. Statistical analysis included estimating pooled prevalence and odds ratio, heterogeneity evaluation, meta-regression, and subgroup analysis, in addition to sensitivity analysis and publication bias evaluation. The pooled prevalence of measured hypertension in Vietnam was 21.1% (95% confidence interval = 18.5-23.7) based on 10 studies, and 18.4% (95% confidence interval = 15.2-21.8) based on 3 national surveys. Lower pooled prevalence was estimated for hypertension awareness (9.3%) and hypertension treatment (4.7%). The pooled prevalence of measured hypertension is significantly higher among men. The pooled prevalence of measured hypertension and hypertension awareness and treatment were significantly lower in rural settings. There is a need to strengthen efforts for primary and secondary prevention and disease management to reduce morbidity and mortality, especially in rural residence settings.
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Affiliation(s)
- Lana Meiqari
- Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Dirk Essink
- Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pamela Wright
- Guelph International Health Consulting, Amsterdam, Netherlands
| | - Fedde Scheele
- Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Sex Differences in Quality of Life and Health Services Utilization among Elderly People in Rural Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:ijerph16010069. [PMID: 30597825 PMCID: PMC6338901 DOI: 10.3390/ijerph16010069] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/17/2018] [Accepted: 12/18/2018] [Indexed: 11/19/2022]
Abstract
As in much of the world, the elderly population in Vietnam is growing rapidly with two-thirds of them currently living in rural areas. Besides limited access to quality healthcare services, they also have unique health profiles and needs due to various factors, including the highly skewed sex ratio of more women residing in rural areas. However, the relationship between gender, health-seeking behaviors, and health outcomes in this under-served population has not been well characterized. This study sought to explore the associations of gender with health-related quality of life and health-seeking behavior among the elderly in Soc Son, a rural district of Hanoi, Vietnam. A cross-sectional design was used; elderly individuals were surveyed across the domains of socioeconomic information, health status, and healthcare service utilization. We found that overall, women had poorer health and quality of life even though gender difference did not appear to significantly influence their levels of health services utilization. A greater understanding of the systemic, sociocultural, and psychological factors underlying such differences may help better inform future healthcare service delivery strategies targeting this growing population in rural areas.
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Prevalence and Risk Factors of Hypertension in Two Communes in the Vietnam Northern Mountainous, 2017. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7814195. [PMID: 30402492 PMCID: PMC6198548 DOI: 10.1155/2018/7814195] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 09/05/2018] [Indexed: 01/19/2023]
Abstract
Background The aims were to characterize the prevalence of hypertension (HTN) and explore its associations in the northern mountainous. Methods We carried out a cross-sectional study in two communes in Chiem Hoa district, Tuyen Quang province, between June and November 2017. All subjects at the age of 18 years and over currently living in two communes. The usage of the descriptive statistics was to characterize the HTN prevalence. We used the univariate and multivariate models of logistic regression to determine the prevalence and related factors of HTN. Results There were 319 people with overall HTN in the total of 675 participants. Among people with HTN, there were 101 ones with isolated systolic hypertension (ISH). The proportion of HTN among the Tay ethnic group was 47.6%. The factors related to HTN included group, body mass index (BMI), low physical fitness, and waist-hip ratio (WHR). These factors as well as the ethnicity were significantly associated with ISH. Conclusions Two communes of Chiem Hoa district in Tuyen Quang province had a high prevalence of HTN. Age, BMI, WHR, and physical activity were the risk factors of overall HTN and ISH. In particular, ISH was affected by ethnicity.
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18
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Niessen LW, Mohan D, Akuoku JK, Mirelman AJ, Ahmed S, Koehlmoos TP, Trujillo A, Khan J, Peters DH. Tackling socioeconomic inequalities and non-communicable diseases in low-income and middle-income countries under the Sustainable Development agenda. Lancet 2018; 391:2036-2046. [PMID: 29627160 DOI: 10.1016/s0140-6736(18)30482-3] [Citation(s) in RCA: 174] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 07/24/2017] [Accepted: 01/17/2018] [Indexed: 12/01/2022]
Abstract
Five Sustainable Development Goals (SDGs) set targets that relate to the reduction of health inequalities nationally and worldwide. These targets are poverty reduction, health and wellbeing for all, equitable education, gender equality, and reduction of inequalities within and between countries. The interaction between inequalities and health is complex: better economic and educational outcomes for households enhance health, low socioeconomic status leads to chronic ill health, and non-communicable diseases (NCDs) reduce income status of households. NCDs account for most causes of early death and disability worldwide, so it is alarming that strong scientific evidence suggests an increase in the clustering of non-communicable conditions with low socioeconomic status in low-income and middle-income countries since 2000, as previously seen in high-income settings. These conditions include tobacco use, obesity, hypertension, cancer, and diabetes. Strong evidence from 283 studies overwhelmingly supports a positive association between low-income, low socioeconomic status, or low educational status and NCDs. The associations have been differentiated by sex in only four studies. Health is a key driver in the SDGs, and reduction of health inequalities and NCDs should become key in the promotion of the overall SDG agenda. A sustained reduction of general inequalities in income status, education, and gender within and between countries would enhance worldwide equality in health. To end poverty through elimination of its causes, NCD programmes should be included in the development agenda. National programmes should mitigate social and health shocks to protect the poor from events that worsen their frail socioeconomic condition and health status. Programmes related to universal health coverage of NCDs should specifically target susceptible populations, such as elderly people, who are most at risk. Growing inequalities in access to resources for prevention and treatment need to be addressed through improved international regulations across jurisdictions that eliminate the legal and practical barriers in the implementation of non-communicable disease control.
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Affiliation(s)
- Louis W Niessen
- Department of International Public Health and Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Diwakar Mohan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jonathan K Akuoku
- Department of Health, Nutrition and Population Global Practice, The World Bank, Washington, DC, USA
| | | | - Sayem Ahmed
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh; Health Economics and Policy Research Group, Department of Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Tracey P Koehlmoos
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh; Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Antonio Trujillo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jahangir Khan
- Department of International Public Health and Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK; Health Economics and Policy Research Group, Department of Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - David H Peters
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Prevalence, Awareness, Treatment, and Control of Hypertension and Its Risk Factors in (Central) Vietnam. Int J Hypertens 2018; 2018:6326984. [PMID: 29887994 PMCID: PMC5977008 DOI: 10.1155/2018/6326984] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/30/2018] [Accepted: 04/10/2018] [Indexed: 02/07/2023] Open
Abstract
Introduction The objective of this study is to describe the prevalence, awareness, treatment, and control of hypertension and its associated risk factors in (Central) Vietnam. Methods In this cross-sectional study, a multistage sampling was used to select 969 participants from the general population aged from 40 to 69 years. The cardiovascular risk factors were collected throughout the interviews with a standardized questionnaire. Multivariate logistic regression analysis was conducted to test the relationship between the prevalence, awareness, treatment, and control of hypertension and the prevalence of risk factors. Results The prevalence of hypertension was 44.8%. It was higher in men than in women (51.3% versus 39.7%, p < 0.001). In total 67.3% (74.5% in women, 60.1% in men; p = 0.001) of the participants were aware of their hypertension, 33.2% (37.5% in women, 28.9% in men; p = 0.01) of the participants were treated, and 12.2% (16.7% in women, 7.8% in men; p < 0.001) of the hypertensive participants' hypertension was controlled. Age, gender, place of residence, body mass index, and diabetes were found to be independent risk factors for hypertension. Conclusion The prevalence of hypertension in Vietnam is high, and the proportion of treated and controlled patients is rather low.
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Liu Y, Liu G, Wu H, Jian W, Wild SH, Gasevic D. Sex differences in non-communicable disease prevalence in China: a cross-sectional analysis of the China Health and Retirement Longitudinal Study in 2011. BMJ Open 2017; 7:e017450. [PMID: 29247088 PMCID: PMC5736028 DOI: 10.1136/bmjopen-2017-017450] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To describe the sex differences in the prevalence of non-communicable diseases (NCDs) in adults aged 45 years or older in China. DESIGN Cross-sectional study. SETTING Nationally representative sample of the Chinese population 2011. PARTICIPANTS 8401 men and 8928 women over 45 years of age who participated in the first wave of the China Health and Retirement Longitudinal Study (CHARLS). OUTCOME MEASURES Self-reported data on overall health and diagnosis of hypertension, dyslipidaemia, diabetes, heart disease, stroke, chronic lung disease, cancer or arthritis. Sex differences in NCDs were described using logistic regression to generate odds ratios (OR) with adjustment for sociodemographic factors and health-related behaviours. All analyses were stratified by age group for 45-64-year-old and ≥65-year-old participants. RESULTS In both age groups, men reported better overall health than women. The crude prevalence of heart disease, cancer and arthritis was higher while that of stroke and chronic lung disease was lower in women than in men. After adjustment, ORs (95% CI) for the 45-64 and ≥65 year age groups were 0.70 (0.58 to 0.84) and 0.66 (0.54 to 0.80), respectively, for arthritis for men compared with women. In contrast, ORs were 1.66 (1.09 to 2.52) and 2.12 (1.36 to 3.30) for stroke and 1.51 (1.21 to 1.89) and 1.43 (1.09 to 1.88) for chronic lung disease for men compared with women. ORs for heart disease (0.65 (0.52 to 0.80)) were lower in men than in women only in the 45-64 year age group. CONCLUSIONS Odds of arthritis were lower while those of stroke and chronic lung disease were higher in men than in women in both age groups. However, odds of heart disease were lower in men than in women, but only in the group of individuals aged 45-64 years.
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Affiliation(s)
- Yan Liu
- School of Public Health, Peking University, Beijing, China
| | - Guofeng Liu
- School of Public Health, Peking University, Beijing, China
| | - Hongjiang Wu
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Weiyan Jian
- School of Public Health, Peking University, Beijing, China
| | - Sarah H Wild
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Danijela Gasevic
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
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Prevalence and correlates of hypertension in a semi-rural population of Southern India. J Hum Hypertens 2017; 32:66-74. [PMID: 29180803 PMCID: PMC5842939 DOI: 10.1038/s41371-017-0010-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 09/06/2017] [Accepted: 09/07/2017] [Indexed: 12/17/2022]
Abstract
While elevated blood pressure is a recognized risk factor for cardiovascular disease, the prevalence of hypertension still remains unclear for most populations. A door-to-door survey was conducted using modified WHO STEPS questionnaire in a group of villages under the Thavanampalle Mandal of Chittoor District in the state of Andhra Pradesh of South India. Data were collated and analyzed for 16,636 individuals (62.3% females and 37.7% males) above 15 years of age. Overall, prevalence of hypertension (as per JNC-7 classification) was found to be 27.0% (95% CI, 26.3, 27.7) in the surveyed community with 56.7% of the total hypertensives being diagnosed for the first time during the survey. An additional 39.1% had their blood pressure readings in the prehypertensive range. Among the known Hypertensives on treatment only 46.2% had a blood pressure recording within acceptable limits, with 31.2% in the prehypertensive range and only 15.0% in the normal range. Systolic blood pressure (SBP) of the surveyed population showed a continuous linear increase with age, but diastolic blood pressure (DBP) peaked and started reducing in early fifth decade in males. Male gender, increasing age, higher body mass index (BMI), increased waist-hip ratio, increased body weight, family history of hypertension, death of spouse, and diabetes were found to be positively correlated with hypertension. Risk factors of alcohol intake, use of ground nut/palm oil, and family history of diabetes lost their independent predictive ability for hypertension on multivariate logistic regression analysis. The level of physical activity was also not found to be a significant predictor of hypertension in the study population.
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Singsalasang A, Laohasiriwong W, Puttanapong N, Phajan T, Boonyaleephan S. Socioeconomic disparities in income, education and geographic location for hypertension among Thai adults: Results from the National Socioeconomic Survey. F1000Res 2017; 6:1836. [PMID: 30135711 PMCID: PMC6080422 DOI: 10.12688/f1000research.12709.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2017] [Indexed: 11/24/2022] Open
Abstract
Background: Hypertension (HT) has been one of the leading global risk factors for health and the leading cause of death in Thailand for decades. The influence of socioeconomic factors on HT has been varied and inconclusive. The aim of this study was to determine the association between socioeconomic determinants and HT in Thailand. Methods: This study used data from the National Socioeconomic Survey, a cross-sectional study that was conducted by the National Statistical Office of Thailand in the years 2005, 2006 and 2007. In our analysis, data were collected on gender, age, marital status, smoking status, education, status of work, occupation, current liability (short-term debt), household monthly income, residential area, region and previously diagnosed HT by a physician. Results: The odds of having HT were significantly higher among those who had household monthly income, education, residential area and region. The participants who had monthly income of <10001 baht (2005: AOR = 3.19, 95%CI:1.47 - 6.92; 2006: AOR 2.53, 95%CI:1.37 - 4.69; 2007: AOR = 3.35, 95%CI: 1.97 - 7.00), were living in Bangkok compared with the Northeast region (2005: AOR = 1.72, 95%CI:1.37 - 2.17; 2006: AOR = 2.44, 95%CI: 1.89 - 3.13; 2007: AOR = 2.63, 95%CI 2.08 - 3.45), lived as an urban resident (2005: AOR= 1.32, 95%CI: 1.12 - 1.56; 2006: AOR= 1.21, 95%CI: 1.02 - 1.43; 2007: AOR= 1.47, 95%CI: 1.18 - 1.62), and finished primary education (2005: AOR =1.21, 95%CI: 1.03 - 1.43; 2006: AOR= 1.23, 95%CI: 1.04 - 1.46; 2007: AOR= 1.18, 95%CI: 1.01 - 1.38) when controlling for other covariates. Conclusion: This study indicated that socioeconomic disparity has an influence on HT. Those with low educational attainment, low income, lived in urban regions, and were metropolitan residents (Bangkok) were vulnerable to HT.
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Affiliation(s)
| | - Wongsa Laohasiriwong
- Faculty of Public Health and Research and Training Center for Enhancing Quality of Life for Working Age People, Khon Kaen University, Khon Kaen, 40002, Thailand
| | | | - Teerasak Phajan
- Sirindhorn College of Public Health Khon Kaen, Khon Kaen, 40000, Thailand
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Ali N, Mahmood S, Manirujjaman M, Perveen R, Al Nahid A, Ahmed S, Khanum FA, Rahman M. Hypertension prevalence and influence of basal metabolic rate on blood pressure among adult students in Bangladesh. BMC Public Health 2017; 18:58. [PMID: 28743284 PMCID: PMC5526296 DOI: 10.1186/s12889-017-4617-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 07/20/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Hypertension is a global health issue and is currently increasing at rapid pace in South Asian countries including Bangladesh. Although, some studies on hypertension have been conducted in Bangladesh, there is a lack of scientific evidence in the adult student population that was missing from the previous and recent national cross-sectional studies. Moreover, the specific risk factors of hypertension in the Bangladeshi adults still need to be investigated. This study was conducted to estimate hypertension prevalence among adult students in Bangladesh and to test the hypothesis of Luke et al. (Hypertension 43:555-560, 2004) that basal metabolic rate (BMR) and blood pressure are positively associated independent of body size. METHOD The data was collected on 184 adult university students (118 female and 66 male) in Dhaka, Bangladesh. Anthropometric, BMR details and an average of at least two blood pressure measurements were obtained. Hypertension was defined by a systolic blood pressure (SBP) ≥ 140 mmHg and/or, diastolic blood pressure (DBP) ≥ 90 mmHg. RESULTS Overall, 6.5% of participants had hypertension with significantly (p < 0.001) higher prevalence in male (12.1%) than in the female (3.4%) students. Age and BMI showed positive and significant correlation with hypertension among the students. When adjusted for body mass index (BMI), as well as other potentially confounding variables such as age, sex, smoking status and degree of urbanization, BMR was positively correlated with SBP and DBP (p < 0.001). Thus, higher BMR is associated with SBP and DBP; this is opposite the well documented inverse relationship between physical activity and blood pressure. If the influence of BMR on blood pressure is confirmed, the systematically elevated BMR might be an important predictor that can explain relatively high blood pressure and hypertension in humans. CONCLUSION This study reports the prevalence and associated risk factors of hypertension in the Bangladeshi adult students. The study also showed a positive association between BMR and blood pressure among the participants. A large scale longitudinal study across the country is needed to find out the underlying causes of hypertension in the Bangladeshi adults. In addition, comprehensive and integrated intervention programs focusing on modifiable risk factors are recommended to make awareness and prevent hypertension.
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Affiliation(s)
- Nurshad Ali
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114 Bangladesh
| | - Shakil Mahmood
- Department of Biochemistry and Molecular Biology, Gonoshasthaya Samaj Vittik Medical College, Gono University, Savar, Dhaka, -1344 Bangladesh
| | - M. Manirujjaman
- Department of Biochemistry and Molecular Biology, Gonoshasthaya Samaj Vittik Medical College, Gono University, Savar, Dhaka, -1344 Bangladesh
| | - Rasheda Perveen
- Department of Biochemistry and Molecular Biology, Gonoshasthaya Samaj Vittik Medical College, Gono University, Savar, Dhaka, -1344 Bangladesh
| | - Abdullah Al Nahid
- Department of Physiology, Gonoshasthaya Samaj Vittik Medical College, Gono University, Savar, Dhaka, -1344 Bangladesh
| | - Shamim Ahmed
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, 3114 Bangladesh
| | - Farida Adib Khanum
- Department of Biochemistry and Molecular Biology, Gonoshasthaya Samaj Vittik Medical College, Gono University, Savar, Dhaka, -1344 Bangladesh
| | - Mustafizur Rahman
- Department of Biochemistry and Molecular Biology, Gonoshasthaya Samaj Vittik Medical College, Gono University, Savar, Dhaka, -1344 Bangladesh
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Nguyen HL, Allison JJ, Ha DA, Chiriboga G, Ly HN, Tran HT, Nguyen CK, Dang DM, Phan NT, Vu NC, Nguyen QP, Goldberg RJ. Culturally adaptive storytelling intervention versus didactic intervention to improve hypertension control in Vietnam: a cluster-randomized controlled feasibility trial. Pilot Feasibility Stud 2017; 3:22. [PMID: 28473924 PMCID: PMC5414312 DOI: 10.1186/s40814-017-0136-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 04/13/2017] [Indexed: 11/25/2022] Open
Abstract
Background Vietnam is experiencing an epidemiologic transition with an increased prevalence of non-communicable diseases. Novel, large-scale, effective, and sustainable interventions to control hypertension in Vietnam are needed. We report the results of a cluster-randomized feasibility trial at 3 months follow-up conducted in Hung Yen province, Vietnam, designed to evaluate the feasibility and acceptability of two community-based interventions to improve hypertension control: a “storytelling” intervention, “We Talk about Our Hypertension,” and a didactic intervention. Methods The storytelling intervention included stories about strategies for coping with hypertension, with patients speaking in their own words, and didactic content about the importance of healthy lifestyle behaviors including salt reduction and exercise. The didactic intervention included only didactic content. The storytelling intervention was delivered by two DVDs at 3-month intervals; the didactic intervention included only one installment. The trial was conducted in four communes, equally randomized to the two interventions. Results The mean age of the 160 study patients was 66 years, and 54% were men. Most participants described both interventions as understandable, informative, and motivational. Between baseline and 3 months, mean systolic blood pressure declined by 8.2 mmHg (95% CI 4.1–12.2) in the storytelling group and by 5.5 mmHg (95% CI 1.4–9.5) in the didactic group. The storytelling group also reported a significant increase in hypertension medication adherence. Conclusions Both interventions were well accepted in several rural communities and were shown to be potentially effective in lowering blood pressure. A large-scale randomized trial is needed to compare the effectiveness of the two interventions in controlling hypertension. Trial registration ClinicalTrials.gov, NCT02483780
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Affiliation(s)
- Hoa L Nguyen
- Institute of Population, Health and Development, 18 Alley 132, Hoa Bang Street, Cau giay District, Hanoi, Vietnam.,Department of Quantitative Sciences, Baylor Scott &White Health, Dallas, Texas USA
| | - Jeroan J Allison
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA USA
| | - Duc A Ha
- Ministry of Health, Hanoi, Vietnam
| | - Germán Chiriboga
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA USA
| | - Ha N Ly
- Institute of Population, Health and Development, 18 Alley 132, Hoa Bang Street, Cau giay District, Hanoi, Vietnam
| | - Hanh T Tran
- Department of Pathophysiology-Immunology, Hanoi School of Public Health, Hanoi, Vietnam
| | - Cuong K Nguyen
- Institute of Population, Health and Development, 18 Alley 132, Hoa Bang Street, Cau giay District, Hanoi, Vietnam
| | - Diem M Dang
- Department of Pathophysiology-Immunology, Hanoi School of Public Health, Hanoi, Vietnam
| | - Ngoc T Phan
- Institute of Population, Health and Development, 18 Alley 132, Hoa Bang Street, Cau giay District, Hanoi, Vietnam
| | - Nguyen C Vu
- Institute of Population, Health and Development, 18 Alley 132, Hoa Bang Street, Cau giay District, Hanoi, Vietnam
| | | | - Robert J Goldberg
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA USA
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25
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Caswell JM. Prevalence of reported high blood pressure in Canada: investigation of demographic and spatial trends. J Public Health (Oxf) 2017. [DOI: 10.1007/s10389-016-0761-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Park CS, Ha KH, Kim HC, Park S, Ihm SH, Lee HY. The Association between Parameters of Socioeconomic Status and Hypertension in Korea: the Korean Genome and Epidemiology Study. J Korean Med Sci 2016; 31:1922-1928. [PMID: 27822930 PMCID: PMC5102855 DOI: 10.3346/jkms.2016.31.12.1922] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 08/14/2016] [Indexed: 12/25/2022] Open
Abstract
We investigated the association between socioeconomic status and hypertension in Korea, a country that has experienced a dynamic socioeconomic transition. We analyzed participants of a prospective cohort study-the Korean Genome and Epidemiology Study-enrolled between 2001 and 2003. We recruited 7,089 subjects who underwent a 4-year follow up till 2007. Education and income levels, which are important parameters for socioeconomic status, were stratified into 4 groups. Education level was defined as short (≤ 6 years), mid-short (7-9 years), mid-long (10-12 years), and long (≥ 12 years). Monthly income level was stratified as low (< 500,000 KRW), mid-low (500,000-1,499,999 KRW), mid-high (1,500,000-2,999,999 KRW) or high (≥ 3,000,000 KRW). At baseline, 2,805 subjects (39.5%) were diagnosed with hypertension. Education and income levels were inversely associated with the prevalence and incidence of hypertension (P < 0.001). In multivariate analysis, a shorter duration of education was significantly associated with a higher prevalence of hypertension (P < 0.001), but income level was not (P = 0.305). During the follow-up, 605 subjects (14.2%) were newly diagnosed with hypertension. In multivariate adjusted analysis, the hazard ratios (95% confidence interval) for incident hypertension across the longer education groups were 0.749 (0.544-1.032), 0.639 (0.462-0.884), and 0.583 (0.387-0.879), compared with the shortest education group. There was no significant association between incident hypertension and income across higher income groups: 0.988 (0.714-1.366), 0.780 (0.542-1.121), and 0.693 (0.454-1.056), compared with the lowest income group. In conclusion, education and income levels are associated with the prevalence and incidence of hypertension, but only education is an independent prognostic factor in Korea.
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Affiliation(s)
- Chan Soon Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung Hwa Ha
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sungha Park
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hyun Ihm
- Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Korea
| | - Hae Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
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Yamanashi H, Ngoc MQ, Huy TV, Suzuki M, Tsujino A, Toizumi M, Takahashi K, Thiem VD, Anh DD, Anh NTH, Tho LH, Maeda T, Cox SE, Yoshida LM, Ariyoshi K. Population-Based Incidence Rates of First-Ever Stroke in Central Vietnam. PLoS One 2016; 11:e0160665. [PMID: 27513471 PMCID: PMC4981455 DOI: 10.1371/journal.pone.0160665] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 07/22/2016] [Indexed: 11/28/2022] Open
Abstract
Introduction Stroke incidence data with methodologically acceptable design in Southeast Asia countries is limited. This study aimed to determine incidence of age-, sex- and subtype-specific first-ever stroke (FES) in Vietnam. Methods We conducted a hospital-based retrospective study, targeting all stroke cases hospitalized at a solo-provider hospital in our study site of Nha Trang from January 2009 to December 2011 with International Classification of Diseases, 10th revision (ICD-10) codes I60-69. We calculated positive predictive values (PPVs) of each ICD-10-coded stroke by conducting a detailed case review of 190 randomly selected admissions with ICD-10 codes of I60-I69. These PPVs were then used to estimate annual incident stroke cases from the computerized database. National census data in 2009 was used as a denominator. Results 2,693 eligible admissions were recorded during the study period. The crude annual incidence rate of total FES was 90.2 per 100,000 population (95% CI 81.1–100.2). The age-adjusted incidence of FES was 115.7 (95% CI 95.9–139.1) when adjusted to the WHO world populations. Importantly, age-adjusted intracerebral hemorrhage was as much as one third of total FES: 36.9 (95% CI 26.1–51.0). Conclusions We found a considerable proportion of FES in Vietnam to be attributable to intracerebral hemorrhage, which is as high or exceeding levels seen in high-income countries. A high prevalence of improperly treated hypertension in Vietnam may underlie the high prevalence of intracerebral hemorrhagic stroke in this population.
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Affiliation(s)
- Hirotomo Yamanashi
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki, Japan
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Goto, Nagasaki, Japan
| | - Mai Quang Ngoc
- Department of Geriatrics, Khanh Hoa Gerenral Hospital, Nha Trang, Khanh Hoa, Vietnam
| | - Tran Van Huy
- Department of Geriatrics, Khanh Hoa Gerenral Hospital, Nha Trang, Khanh Hoa, Vietnam
| | - Motoi Suzuki
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki, Japan
| | - Akira Tsujino
- Department of Neurology and Strokology, University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki, Japan
| | - Michiko Toizumi
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Kensuke Takahashi
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki, Japan
| | - Vu Dinh Thiem
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Le Huu Tho
- Khanh Hoa Health Service, Nha Trang, Khanh Hoa, Vietnam
| | - Takahiro Maeda
- Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Goto, Nagasaki, Japan
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki, Japan
| | - Sharon E. Cox
- Nagasaki University School of Tropical Medicine and Global Health, Sakamoto, Nagasaki, Japan
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Lay-Myint Yoshida
- Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Koya Ariyoshi
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki, Japan
- * E-mail:
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Dalal J, Sethi KK, Kerkar PG, Ray S, Guha S, Hiremath MS. Vascular Disease in Young Indians (20-40 years): Role of Hypertension. J Clin Diagn Res 2016; 10:OE01-6. [PMID: 27656492 PMCID: PMC5028527 DOI: 10.7860/jcdr/2016/20204.8258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 05/02/2016] [Indexed: 11/24/2022]
Abstract
Hypertension (HTN) being one of the important risk factors for cardiovascular disease (CVD) is a significant health concern, especially in India. With age, prevalence of HTN, especially systolic HTN increases. Special attention needs to be directed to HTN in young ages (20-40 years) due to lower awareness, need for early treatment and better control of HTN. HTN in the age group of 20-40 years needs critical reappraisal. Given the high prevalence of HTN in the general population in India, in this review we attempt to provide current evidence and expert opinion on epidemiology, aetiopathogenesis and treatment of HTN in young (20-40 years) Indians.
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Affiliation(s)
- Jamshed Dalal
- Director, Centre for Cardiac Sciences, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
| | - Kamal Kumar Sethi
- Head, Department of Cardiology, Delhi Heart and Lung Institute, New Delhi, India
| | | | - Saumitra Ray
- Professor, Department of Cardiology, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, India
| | - Santanu Guha
- Professor and Head, Department of Cardiology, Calcutta Medical College, Kolkata, West Bengal, India
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Abstract
OBJECTIVE To assess the socioeconomic and behavioural risk factors associated with hypertension among a sample male and female population in India. SETTING Cross-sectional survey data from a Health and Demographic Surveillance System (HDSS) of rural West Bengal, India was used. PARTICIPANTS 27 589 adult individuals (13 994 males and 13 595 females), aged ≥18 years, were included in the study. PRIMARY AND SECONDARY OUTCOME MEASURES Hypertension was defined as mean systolic blood pressure (SBP) ≥140 mm Hg or diastolic blood pressure (DBP) ≥90 mm Hg, or if the subject was undergoing regular antihypertensive therapy. Prehypertension was defined as SBP 120-139 mm Hg and DBP 80-89 mm Hg. Individuals were categorised as non-normotensives, which includes both the prehypertensives and hypertensives. Generalised ordered logit model (GOLM) was deployed to fulfil the study objective. RESULTS Over 39% of the men and 25% of the women were prehypertensives. Almost 12.5% of the men and 11.3% of the women were diagnosed as hypertensives. Women were less likely to be non-normotensive compared to males. Odds ratios estimated from GOLM indicate that women were less likely to be hypertensive or prehypertensive, and age (OR 1.04, 95% CI 1.03 to 1.05; and OR 1.08, 95% CI 1.07 to 1.09 for males and females, respectively) and body mass index (OR 1.64, 95% CI 1.38 to 1.97 for males; and OR 1.32, 95% CI 1.08 to 1.60 for females) are associated with hypertension. CONCLUSIONS An elevated level of hypertension exists among a select group of the rural Indian population. Focusing on men, an intervention could be designed for lifestyle modification to curb the prevalence of hypertension.
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Affiliation(s)
- Saswata Ghosh
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
- Institute of Development Studies Kolkata, Kolkata, West Bengal, India
| | | | - Anamitra Barik
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
- Niramay TB Sanatorium and Chest Clinic, District Hospital, Suri, Birbhum, West Bengal, India
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Bui TV, Blizzard CL, Luong KN, Truong NLV, Tran BQ, Otahal P, Gall S, Nelson MR, Au TB, Ha ST, Phung HN, Tran MH, Callisaya M, Srikanth V. National survey of risk factors for non-communicable disease in Vietnam: prevalence estimates and an assessment of their validity. BMC Public Health 2016; 16:498. [PMID: 27286818 PMCID: PMC4902939 DOI: 10.1186/s12889-016-3160-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 05/13/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To estimate the prevalence of non-communicable disease (NCD) risk factors at a provincial level in Vietnam, and to assess whether the summary estimates allow reliable inferences to be drawn regarding regional differences in risk factors and associations between them. METHODS Participants (n = 14706, 53.5 % females) aged 25-64 years were selected by multi-stage stratified cluster sampling from eight provinces each representing one of the eight geographical regions of Vietnam. Measurements were made using the World Health Organization STEPS protocols. Data were analysed using complex survey methods. RESULTS Differences by sex in mean years of schooling (males 8.26 ± 0.20, females 7.00 ± 0.18), proportions of current smokers (males 57.70 %, females 1.73 %), and binge-drinkers (males 25.11 %, females 0.63 %), and regional differences in diet, reflected the geographical and socio-cultural characteristics of the country. Provinces with a higher proportion of urban population had greater mean levels of BMI (r = 0.82), and lesser proportions of active people (r = -0.89). The associations between the summary estimates were generally plausible (e.g. physical activity and BMI, r = -0.80) but overstated, and with some anomalous findings due to characterisation of smoking and hypertension by STEPS protocols. CONCLUSIONS This report provides an extensive description of the sex-specific and regional distribution of NCD risk factors in Vietnam and an account of some health-related consequences of industrialisation in its early stages. The STEPS protocols can be utilized to provide aggregate data for valid between-population comparisons, but with important caveats identified.
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Affiliation(s)
- Tan Van Bui
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
- Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Christopher Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.
| | - Khue Ngoc Luong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Ngoc Le Van Truong
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Bao Quoc Tran
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Thuy Bich Au
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Son Thai Ha
- Medical Services Administration, Ministry of Health of the Socialist Republic of Vietnam, Ha Noi, Vietnam
| | - Hai Ngoc Phung
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Mai Hoang Tran
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
- Department of Medicine, Southern Clinical School, Monash Medical Centre, Monash University, Clayton, VIC, Australia
| | - Velandai Srikanth
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
- Department of Medicine, Southern Clinical School, Monash Medical Centre, Monash University, Clayton, VIC, Australia
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Abstract
BACKGROUND The relationship between socioeconomic status (SES) and hypertension has been studied in a number of reviews. However, the impact of SES on hypertension has been reported in several studies with conflicting results. METHODS A systematic search was performed in PubMed, Proquest and Cochrane databases for observational studies on hypertension prevalence and SES, published in English, until March 2014. Hypertension was defined as a mean SBP of at least 140 mmHg or a DBP of at least 90 mmHg, or use of antihypertensive medication. The inverse variance method with a random-effects model was used to pool the risk estimates from the individual studies. Data abstraction was conducted independently by two authors. RESULTS Among the 2404 references, 51 studies fulfilled the inclusion criteria. An overall increased risk of hypertension among the lowest SES was found for all three indicators: income [pooled odds ratio (OR) 1.19, 95% confidence interval (CI) 0.96-1.48], occupation (pooled OR 1.31, 95% CI 1.04-1.64) and education (pooled OR 2.02, 95% CI 1.55-2.63). The associations were significant in high-income countries, and the increased risk of hypertension for the lowest categories of all SES indicators was most evident for women, whereas men revealed less consistent associations. CONCLUSION Low SES is associated with higher blood pressure, and this association is particularly evident in the level of education. It is important to identify and monitor hypertension to reduce the risk of this disease among the most vulnerable groups in different countries and among different societies.
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Chowdhury MAB, Uddin MJ, Haque MR, Ibrahimou B. Hypertension among adults in Bangladesh: evidence from a national cross-sectional survey. BMC Cardiovasc Disord 2016; 16:22. [PMID: 26809175 PMCID: PMC4727356 DOI: 10.1186/s12872-016-0197-3] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 01/15/2016] [Indexed: 12/23/2022] Open
Abstract
Background Hypertension is an increasing problem in Southeast Asia, particularly in Bangladesh. Although some epidemiological studies on hypertension have been conducted in Bangladesh, the factors associated with hypertension in this nation remain unclear. We aimed to determine the factors associated with hypertension among the adults in Bangladesh. Methods We conducted a cross-sectional study using data from the nationally representative 2011 Bangladesh Demographic and Health Survey (BDHS). A total of 7,839 (3,964 women and 3,875 men) adults aged 35 years and older who participated in the survey was included. Hypertension was defined by a systolic blood pressure ≥ 140 mmHg and/or, diastolic blood pressure ≥ 90 mmHg and/or, receipt of an anti-hypertensive medication at time of the survey. The degree of association between the risk factors and the outcome was assessed by the odd ratio (OR) obtained from the bivariate and multivariable logistic regression models. Results The overall prevalence of hypertension was 26.4 %, and the prevalence was higher in women (32.4 %) than men (20.3 %). Study participants with the age group of 60–69 years had higher odds of having hypertension (AOR: 3.77, 95 % CI: 3.01–4.72) than the age group 35–39 years. Moreover, individuals who had higher educational attainment (AOR: 1.63, 95 % C.I: 1.25–2.14) and higher wealth status (AOR = 1.91, 95 % CI: 1.54–2.38) had higher odds of having hypertension than the individuals with no education and lower social status, respectively. The analysis also showed that high BMI (AOR: 2.19, 95 % C.I: 1.87–2.57) and having diabetes (AOR: 1.54, 95 % C.I: 1.31–1.83) were associated with the increasing risk of hypertension. Conclusions Our study shows that the risk of hypertension was significantly associated with older age, sex, education, place of residence, working status, wealth index, BMI, and diabetes. Moreover, hypertension is largely untreated, especially in rural settings. The health system needs to develop appropriate strategies including early diagnosis, awareness via mass media, and health education programs for changing lifestyles should be initiated for older age, wealthy, and/or higher educated individuals in Bangladesh. Moreover, area-specific longitudinal research is necessary to find out the underlying causes of regional variations.
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Affiliation(s)
- Muhammad Abdul Baker Chowdhury
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA.
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh.
| | - Md Rabiul Haque
- Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh.
| | - Boubakari Ibrahimou
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA.
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Allison JJ, Nguyen HL, Ha DA, Chiriboga G, Ly HN, Tran HT, Phan NT, Vu NC, Kim M, Goldberg RJ. Culturally adaptive storytelling method to improve hypertension control in Vietnam - "We talk about our hypertension": study protocol for a feasibility cluster-randomized controlled trial. Trials 2016; 17:26. [PMID: 26762128 PMCID: PMC4712480 DOI: 10.1186/s13063-015-1147-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 12/29/2015] [Indexed: 01/29/2023] Open
Abstract
Background Vietnam is experiencing an epidemiologic transition with an increased prevalence of non-communicable diseases. At present, the major risk factors for cardiovascular disease (CVD) are either on the rise or at alarming levels in Vietnam; inasmuch, the burden of CVD will continue to increase in this country unless effective prevention and control measures are put in place. A national survey in 2008 found that the prevalence of hypertension (HTN) was approximately 25 % among Vietnamese adults and it increased with advancing age. Therefore, novel, large-scale, and sustainable interventions for public health education to promote engagement in the process of detecting and treating HTN in Vietnam are urgently needed. Methods A feasibility randomized trial will be conducted in Hung Yen province, Vietnam to evaluate the feasibility and acceptability of a novel community-based intervention using the “storytelling” method to enhance the control of HTN in adults residing in four rural communities. The intervention will center on stories about living with HTN, with patients speaking in their own words. The stories will be obtained from particularly eloquent patients, or “video stars,” identified during Story Development Groups. The study will involve two phases: (i) developing a HTN intervention using the storytelling method, which is designed to empower patients to facilitate changes in their lifestyle practices, and (ii) conducting a feasibility cluster-randomized trial to investigate the feasibility, acceptability, and potential efficacy of the intervention compared with usual care in HTN control among rural residents. The trial will be conducted at four communes, and within each commune, 25 individuals 50 years or older with HTN will be enrolled in the trial resulting in a total sample size of 100 patients. Discussion This feasibility trial will provide the necessary groundwork for a subsequent large-scale, fully powered, cluster-randomized controlled trial to test the efficacy of our novel community-based intervention. Results from the full-scale trial will provide health policy makers with practical evidence on how to combat a key risk factor for CVD using a feasible, sustainable, and cost-effective intervention that could be used as a national program for controlling HTN in Vietnam and other developing countries. Trial registration ClinicalTrials.gov. Registration number: https://clinicaltrials.gov/ct2/show/NCT02483780(registration date June 22, 2015).
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Affiliation(s)
- Jeroan J Allison
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.
| | - Hoa L Nguyen
- Institute of Population, Health and Development, 18 Alley 132, Hoa Bang Street, Cau Giay District, Hanoi, Vietnam. .,Department of Epidemiology, Baylor Scott &White Health, 8080 N Central Expy, Dallas, TX, 75206, USA.
| | - Duc A Ha
- Ministry of Health, 138a Giang Vo, Ba Dinh District, Hanoi, Vietnam.
| | - Germán Chiriboga
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.
| | - Ha N Ly
- Institute of Population, Health and Development, 18 Alley 132, Hoa Bang Street, Cau Giay District, Hanoi, Vietnam.
| | - Hanh T Tran
- Department of Pathophysiology - Immunology, Hanoi School of Public Health, 138 Giang Vo, Ba Dinh District, Hanoi, Vietnam.
| | - Ngoc T Phan
- Institute of Population, Health and Development, 18 Alley 132, Hoa Bang Street, Cau Giay District, Hanoi, Vietnam.
| | - Nguyen C Vu
- Institute of Population, Health and Development, 18 Alley 132, Hoa Bang Street, Cau Giay District, Hanoi, Vietnam.
| | - Minjin Kim
- College of Nursing and Health Sciences, University of Massachusetts, 100 Morrissey Boulevard, Boston, MA, 02125, USA.
| | - Robert J Goldberg
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.
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Kien VD, Van Minh H, Giang KB, Dao A, Weinehall L, Eriksson M, Ng N. Socioeconomic inequalities in self-reported chronic non-communicable diseases in urban Hanoi, Vietnam. Glob Public Health 2016; 12:1522-1537. [PMID: 26727691 DOI: 10.1080/17441692.2015.1123282] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study measures and decomposes socioeconomic inequalities in the prevalence of self-reported chronic non-communicable diseases (NCDs) in urban Hanoi, Vietnam. A cross-sectional survey of 1211 selected households was carried out in four urban districts in both slum and non-slum areas of Hanoi city in 2013. The respondents were asked if a doctor or health worker had diagnosed any household members with an NCD, such as cardiovascular diseases, chronic respiratory, diabetes or cancer, during last 12 months. Information from 3736 individuals, aged 15 years and over, was used for the analysis. The concentration index (CI) was used to measure inequalities in self-reported NCD prevalence, and it was also decomposed into contributing factors. The prevalence of chronic NCDs in the slum and non-slum areas was 7.9% and 11.6%, respectively. The CIs show gradients disadvantageous to both the slum (CI = -0.103) and non-slum (CI = -0.165) areas. Lower socioeconomic status and aging significantly contributed to inequalities in the self-reported NCDs, particularly for those living in the slum areas. The findings confirm the existence of substantial socioeconomic inequalities linked to NCDs in urban Vietnam. Future policies should target these vulnerable areas.
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Affiliation(s)
- Vu Duy Kien
- a Center for Population Health Sciences , Hanoi School of Public Health , Hanoi , Vietnam.,b Center for Health System Research , Hanoi Medical University , Hanoi , Vietnam.,c Unit of Epidemiology and Global Health , Department of Public Health and Clinical Medicine , Umeå , Sweden
| | - Hoang Van Minh
- a Center for Population Health Sciences , Hanoi School of Public Health , Hanoi , Vietnam.,b Center for Health System Research , Hanoi Medical University , Hanoi , Vietnam
| | - Kim Bao Giang
- b Center for Health System Research , Hanoi Medical University , Hanoi , Vietnam.,d Institute for Preventive Medicine and Public Health , Hanoi Medical University , Hanoi , Vietnam
| | - Amy Dao
- e Department of Sociomedical Sciences, Mailman School of Public Health , Columbia University , New York , NY , USA
| | - Lars Weinehall
- c Unit of Epidemiology and Global Health , Department of Public Health and Clinical Medicine , Umeå , Sweden
| | - Malin Eriksson
- c Unit of Epidemiology and Global Health , Department of Public Health and Clinical Medicine , Umeå , Sweden
| | - Nawi Ng
- c Unit of Epidemiology and Global Health , Department of Public Health and Clinical Medicine , Umeå , Sweden
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Seow LSE, Subramaniam M, Abdin E, Vaingankar JA, Chong SA. Hypertension and its associated risks among Singapore elderly residential population. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.jcgg.2015.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Sarki AM, Nduka CU, Stranges S, Kandala NB, Uthman OA. Prevalence of Hypertension in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis. Medicine (Baltimore) 2015; 94:e1959. [PMID: 26683910 PMCID: PMC5058882 DOI: 10.1097/md.0000000000001959] [Citation(s) in RCA: 206] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/09/2015] [Accepted: 10/13/2015] [Indexed: 11/26/2022] Open
Abstract
We aimed to obtain overall and regional estimates of hypertension prevalence, and to examine the pattern of this disease condition across different socio-demographic characteristics in low-and middle-income countries. We searched electronic databases from inception to August 2015. We included population-based studies that reported hypertension prevalence using the current definition of blood pressure ≥140/90 mm Hg or self-reported use of antihypertensive medication. We used random-effects meta-analyses to pool prevalence estimates of hypertension, overall, by World Bank region and country income group. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. A total of 242 studies, comprising data on 1,494,609 adults from 45 countries, met our inclusion criteria. The overall prevalence of hypertension was 32.3% (95% confidence interval [CI] 29.4-35.3), with the Latin America and Caribbean region reporting the highest estimates (39.1%, 95% CI 33.1-45.2). Pooled prevalence estimate was also highest across upper middle income countries (37.8%, 95% CI 35.0-40.6) and lowest across low-income countries (23.1%, 95% CI 20.1-26.2). Prevalence estimates were significantly higher in the elderly (≥65 years) compared with younger adults (<65 years) overall and across the geographical regions; however, there was no significant sex-difference in hypertension prevalence (31.9% vs 30.8%, P = 0.6). Persons without formal education (49.0% vs 24.9%, P < 0.00001), overweight/obese (46.4% vs 26.3%, P < 0.00001), and urban settlers (32.7% vs 25.2%, P = 0.0005) were also more likely to be hypertensive, compared with those who were educated, normal weight, and rural settlers respectively. This study provides contemporary and up-to-date estimates that reflect the significant burden of hypertension in low- and middle-income countries, as well as evidence that hypertension remains a major public health issue across the various socio-demographic subgroups. On average, about 1 in 3 adults in the developing world is hypertensive. The findings of this study will be useful for the design of hypertension screening and treatment programmes in low- and middle-income countries.
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Affiliation(s)
- Ahmed M Sarki
- From the Division of Health Sciences, University of Warwick Medical School, Coventry, UK (AMS, CUN); Family and Youth Health Initiative (FAYOHI), Nigeria (AMS); Department of Population Health, Luxembourg Institute of Health, Luxembourg (SS, N-BK); Warwick-Centre for Applied Health Research and Delivery (WCAHRD), Division of health Sciences, University of Warwick Medical School, Coventry, UK (OAU); and Centre for Applied Health Research and Delivery (CAHRD), Liverpool School of Tropical Medicine, International Health Group, Liverpool, UK (OAU); Department of Mathematics and Information sciences, Faculty of Engineering and Environment, Northumbria University, Newcastle upon Tyne, UK (N-BK)
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Adeoye AM, Adebiyi A, Owolabi MO, Lackland DT, Ogedegbe G, Tayo BO. Sex Disparity in Blood Pressure Levels Among Nigerian Health Workers. J Clin Hypertens (Greenwich) 2015; 18:685-9. [PMID: 26582436 DOI: 10.1111/jch.12735] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 09/25/2015] [Accepted: 09/28/2015] [Indexed: 12/31/2022]
Abstract
Sex disparity in hypertension prevalence is well established in developed nations; however, there is paucity of data on the distribution of hypertension prevalence between the sexes in developing countries. Therefore, the authors examined sex differences in hypertension prevalence and cardiovascular risk factors in a sample of 352 healthy hospital workers in Nigeria. The mean ages of the men and women were 37.2±7.9 and 44.7±9.1 years, respectively. Thirty-five percent of participants were hypertensive, with 54% on treatment and 70% with controlled blood pressure. Men had a higher prevalence of hypertension (38.4% vs 33.0%) and prehypertension (37.6% vs 29.7%). Women had significantly higher odds of developing hypertension and of being on treatment. Mean blood pressure and fasting plasma glucose values were higher in men, while women were more often older, obese, and dyslipidemic and had a lower mean estimated glomerular filtration rate (P<.0001). These findings indicate sex disparity in blood pressure among hospital employees. Sex-focused management of hypertension is therefore advocated for hospital employees.
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Affiliation(s)
- Abiodun M Adeoye
- Department of Medicine, University of Ibadan, Ibadan, Nigeria.,Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Adewole Adebiyi
- Department of Medicine, University of Ibadan, Ibadan, Nigeria.,Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Mayowa O Owolabi
- Department of Medicine, University of Ibadan, Ibadan, Nigeria.,Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Daniel T Lackland
- Department of Neurology, Medical University of South Carolina, Charleston, SC
| | - Gbenga Ogedegbe
- Department of Population Science, Centers for Healthful Behavior Change, New York University School of Medicine, New York, NY
| | - Bamidele O Tayo
- Department of Public Health Sciences, Loyola University Chicago Stritch School of Medicine, Maywood, IL
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Mwangi J, Kulane A, Van Hoi L. Chronic diseases among the elderly in a rural Vietnam: prevalence, associated socio-demographic factors and healthcare expenditures. Int J Equity Health 2015; 14:134. [PMID: 26578189 PMCID: PMC4650337 DOI: 10.1186/s12939-015-0266-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 11/08/2015] [Indexed: 12/03/2022] Open
Abstract
Background Globally, the population of elderly persons is increasing as well as the prevalence of chronic diseases. This change is causing increased healthcare costs to health care systems threatening to push many households into poverty. Low and middle income countries are projected to experience the greatest impact from this change. This study aims to describe the prevalence of common chronic diseases (CCDs) among the elderly in Vietnam, the associated socio-demographic factors and healthcare expenditures. Methods This is a cross-sectional study in the FilaBavi demographic surveillance site in Vietnam. 2873 persons over 60 years were randomly sampled. Prevalence of CCDs was reported from study subjects who previously were informed by physicians. Healthcare expenditures were determined from recall of expenses during the last hospital visit. Binomial logistic regression was done to determine the socio demographic predictors of having a CCD or multiple CCDs. Mean healthcare expenditures for the elderly with CCDs and those without CCDs were summarised and compared. Results Forty two percent of the elderly were found to have at least one CCD. Joint problems were the most common CCD at 35 %, followed by hypertension at 15 % and chronic bronchitis at 11 %. Being female (OR = 1.51, 95 % CI = 1.03–2.21, p-value = 0.036), higher education (OR = 2.54, 95 % CI = 1.13–5.74, p-value = 0.025) and having advanced age (OR = 1.92, 95 % CI = 1.22–3.00, p-value = 0.005), were associated with common chronic diseases in the elderly. Outpatient healthcare expenditures were found to be significantly higher for the elderly with CCDs than those without CCDs. Conclusions Higher education and being female are important key predictors of having a CCD, while wealth quintile is a predictor of multimorbidity, in the elderly. Healthcare expenditures for outpatient health services are higher for elderly persons with CCDs and these costs should be targeted when planning for financial protection.
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Affiliation(s)
- Jonathan Mwangi
- Global Health, Department of Public Health Sciences, Karolinska Institute, Widerströmska Huset, Tomtebodavägen 18A, Stockholm, Sweden.
| | - Asli Kulane
- Global Health, Department of Public Health Sciences, Karolinska Institute, Widerströmska Huset, Tomtebodavägen 18A, Stockholm, Sweden.
| | - Le Van Hoi
- National Lung Hospital, EVIPNet Vietnam, 463, Hoang Hoa Tham, Ba Dinh, Hanoi, Vietnam.
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Baek TH, Lee HY, Lim NK, Park HY. Gender differences in the association between socioeconomic status and hypertension incidence: the Korean Genome and Epidemiology Study (KoGES). BMC Public Health 2015; 15:852. [PMID: 26336067 PMCID: PMC4558783 DOI: 10.1186/s12889-015-2175-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 08/21/2015] [Indexed: 12/05/2022] Open
Abstract
Background Hypertension is a leading cause of cardiovascular events. We examined whether there was a gender difference in the association between SES, measured by education and income, and hypertension incidence. Methods Data for 2596 men and 2686 women aged 40–69 years without hypertension at baseline from the Korean Genome and Epidemiology Study (KoGES) were analyzed. Participants had two follow-up examinations during 4 years, and were classified into three categories by self-reported educational attainment: ≥ 10 years, 7–9 years, and 0–6 years, and monthly household income (×10,000 Korean Won): ≥ 200, 100–199, and <100. The association between SES and incidence hypertension was examined by Cox’s proportional hazard regression analyses. Results Adjusting for conventional risk factors, compared with the high education group (reference), the hazard ratios (95 % confidence interval) for incident hypertension across the education categories were 1.54 (1.16–2.06) and 1.80 (1.36–2.38) in women and 1.15 (0.92–1.43), and 1.08 (0.84–1.38) in men. Women with the low household income were more likely to have hypertension than those with the high household income and incident hypertension had an inverse association with household income level in women: multivariate adjusted hazard ratios were 1.00 (reference), 1.10 (0.83–1.45), and 1.63 (0.75–2.16). Men with medium income were less likely to have hypertension compared with those with high income (0.76, 0.61–0.90). Conclusions Educational level and economic status had stronger impacts on hypertension in Korean women than men. Thus, a stratified approach for women of low socioeconomic status, especially those with low educational attainment, is needed for the prevention of hypertension.
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Affiliation(s)
- Tae-Hwa Baek
- Division of Cardiovascular and Rare Disease, Center for Biomedical Science, Korea National Institute of Health, Cheongju, 187 OsongSaengmyeong2-Ro, Osong-Eup, Cheongju, Chungcheongbuk-Do, 361-951, Republic of Korea.
| | - Hae-Young Lee
- Department Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Nam-Kyoo Lim
- Division of Cardiovascular and Rare Disease, Center for Biomedical Science, Korea National Institute of Health, Cheongju, 187 OsongSaengmyeong2-Ro, Osong-Eup, Cheongju, Chungcheongbuk-Do, 361-951, Republic of Korea.
| | - Hyun-Young Park
- Division of Cardiovascular and Rare Disease, Center for Biomedical Science, Korea National Institute of Health, Cheongju, 187 OsongSaengmyeong2-Ro, Osong-Eup, Cheongju, Chungcheongbuk-Do, 361-951, Republic of Korea.
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Poor sleep quality associated with high risk of hypertension and elevated blood pressure in China: results from a large population-based study. Hypertens Res 2015; 39:54-9. [PMID: 26333359 DOI: 10.1038/hr.2015.98] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 06/17/2015] [Accepted: 07/12/2015] [Indexed: 01/10/2023]
Abstract
Little information is available concerning the association between sleep quality and blood pressure (BP) in Chinese individuals. This study evaluated the association between sleep quality, as determined by the Pittsburgh sleep quality index (PSQI), and hypertension in a rural Chinese population. Using a multistage cluster and random sampling method, a representative sample of 9404 adults aged 20-93 years in northeastern China was selected from 2012 to 2013. Sleep quality was assessed by PSQI, and trained observers measured BP. A sleep disorder (SD) was diagnosed for any participant with a score of 6 or greater. Overall, 1218 male participants (25.53%) and 1261 female participants (27.22%) were defined as having SDs. Compared with the normal subjects, participants with hypertension had higher global PSQI scores and subscores in all elements. The odds ratios (ORs) of hypertension, systolic hypertension and diastolic hypertension among participants with SDs were 2.38 (95% confidence interval (CI): 2.13-2.65), 2.52 (95% CI: 2.26-2.80) and 1.93 (95% CI: 1.74-2.14) in contrast to the reference group, respectively. The risk for hypertension in poor sleepers with subscores over 0 in all of the elements was significantly increased, with ORs ranging from 1.16 (95% CI: 1.04-2.30) to 3.88 (95% CI: 1.24-12.16). The global PSQI score and its components were associated with hypertension and high BP.
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Lin MC, Guo HR, Lu MC, Livneh H, Lai NS, Tsai TY. Increased risk of depression in patients with rheumatoid arthritis: a seven-year population-based cohort study. Clinics (Sao Paulo) 2015; 70:91-6. [PMID: 25789516 PMCID: PMC4351304 DOI: 10.6061/clinics/2015(02)04] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 12/05/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Rheumatoid arthritis (RA) is a costly and crippling autoimmune disease that can lead to the development of depression, contributing to suboptimal clinical outcomes. However, no longitudinal studies have identified an association between rheumatoid arthritis and subsequent depression. This study aimed to investigate the incidence and risk factors of depression among RA patients in Taiwan. METHODS Using Taiwan's National Health Insurance Research Database, we identified 3,698 newly diagnosed RA patients aged 18 years or older, together with 7,396 subjects without RA matched by sex, age and index date, between 2000 and 2004. The incidence of depression and the risk factors among RA cases were evaluated using Cox proportional-hazard regression. RESULTS The incidence of depression was 1.74-fold greater in the RA cohort than in the non-RA cohort (11.80 versus 6.89 per 1,000 person-years; p<0.01). Multivariate analysis showed that RA subjects who were female, were older, or had comorbidities such as stroke, chronic kidney disease, or cancer had a significantly greater risk of depression compared with those without these conditions. CONCLUSION This population-based cohort study showed a strong relationship between RA and a subsequent risk of depression. The findings could be beneficial to healthcare providers for identifying individuals with a higher predisposition for depression, thereby possibly facilitating the provision of an appropriate rehabilitation intervention after RA onset to support the patient's adaptation.
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Affiliation(s)
- Miao-Chiu Lin
- Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - How-Ran Guo
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ming-Chi Lu
- Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Hanoch Livneh
- Rehabilitation Counseling Program, Portland State University, Portland, OR, USA
| | - Ning-Sheng Lai
- Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Tzung-Yi Tsai
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Ke L, Ho J, Feng J, Mpofu E, Dibley MJ, Li Y, Feng X, Van F, Lau W, Brock KE. Prevalence, awareness, treatment and control of hypertension in Macau: results from a cross-sectional epidemiological study in Macau, China. Am J Hypertens 2015; 28:159-65. [PMID: 25063734 DOI: 10.1093/ajh/hpu121] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Awareness of hypertension, as well as its prevalence, treatment, and control status, has not been comprehensively investigated in Macau Special Administrative Region (SAR), China. METHODS A survey was conducted on a randomly sampled population of 1,410 participants (n = 638 men) aged 18-93 years in 2012. Blood pressure was individually measured twice. Awareness, treatment, and control of hypertension were assessed by interview-administered questionnaire. RESULTS Prevalence of hypertension was 34% in Macau, similar to the United States (30%) and United Kingdom (31%). Among hypertensives, 69% were aware of their condition, 59% were treated, and 30% were adequately controlled. Older age (≥50 years; odds ratio (OR) = 5.3; 95% confidence interval (CI) = 4.6-6.1), being of the male sex (OR = 2.2; 95% CI = 1.9-2.5), having retired (OR = 2.0; 95% CI = 1.8-2.3), being married (OR = 1.5; 95% CI = 1.3-1.9), having a low level of education in women (OR = 1.5; 95% CI = 1.1-2.1), Pinteraction = 0.01), and lack of salt awareness (OR = 1.1; 95% CI = 1.0-1.3) were associated with hypertension. Older age, having retired, and being married were also associated with higher awareness and treatment rates. Those who were older and married were better controlled. These demographic factors differed by sex. Those who had some knowledge of salt intake were more likely to have higher hypertension awareness, treatment, and control rates. CONCLUSIONS The prevalence of hypertension in Macau in 2012 has increased compared with 2006 (28%) and is comparable with prevalence rates in developed countries. Specific health promotion campaigns related to knowledge of risk factors such as salt intake and smoking may be useful for hypertension prevention and to improve hypertension awareness, treatment, and control rates.
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Affiliation(s)
- Liang Ke
- Macau Hypertension Alliance, Macau SAR, China; Discipline of Behavioural and Social Sciences in Health Faculty of Health Science, University of Sydney, Sydney, Australia
| | - Jacky Ho
- Macau Hypertension Alliance, Macau SAR, China
| | | | - Elias Mpofu
- Discipline of Rehabilitation Counselling, Faculty of Health Science, University of Sydney, Sydney, Australia
| | - Michael J Dibley
- School of Public Health, Faculty of Medicine, University of Sydney, Sydney, Australia
| | - Yan Li
- Department of the Joint Program in Survey Methodology, University of Maryland, College Park, Maryland
| | - Xiuhua Feng
- Macau Hypertension Alliance, Macau SAR, China
| | - Florance Van
- Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Winne Lau
- Macau and the Union General of Community Association, Macau SAR, China
| | - Kaye E Brock
- Discipline of Behavioural and Social Sciences in Health Faculty of Health Science, University of Sydney, Sydney, Australia;
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Do HTP, Geleijnse JM, Le MB, Kok FJ, Feskens EJM. National prevalence and associated risk factors of hypertension and prehypertension among Vietnamese adults. Am J Hypertens 2015; 28:89-97. [PMID: 24862960 DOI: 10.1093/ajh/hpu092] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Hypertension has recently been identified as the leading risk factor for global mortality. This study aims to present the national prevalence of hypertension and prehypertension and, their determinants in Vietnamese adults. METHODS Nationally representative data were obtained from the National Adult Overweight Survey 2005. This one visit survey included 17,199 subjects aged 25-64 years, with a mean body mass index (BMI) of 20.7 kg/m(2). RESULTS The overall census-weighted JNC7 (the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure) defined prevalence of hypertension was 20.7% (95% confidence interval (CI) = 19.4-22.1); the prevalence of prehypertension was 41.8% (95% CI = 40.4-43.1). Hypertension and prehypertension were more prevalent in men. Higher age, overweight, alcohol use (among men), and living in rural areas (among women) were independently associated with a higher prevalence of hypertension, whereas higher physical activity and education level were inversely associated. Age, BMI, and living in rural areas were independently associated with an increased prevalence of prehypertension. Among the hypertensives, 25.9% were aware of their hypertension, 12.2% were being treated, and 2.8% had their blood pressure under control; among the treated hypertensives, 32.4% had their blood pressure controlled. CONCLUSIONS Hypertension and prehypertension are prevalent in Vietnam, but awareness, treatment, and control are low. The findings suggest that lifestyle modifications, including the prevention of overweight, the promotion of physical activity particularly in urban areas, and the reduction of high alcohol consumption, may help to prevent hypertension in Vietnam. Furthermore, increased efforts regarding education, detection, and treatment could be important in management of hypertension and cardiovascular disease risk prevention.
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Affiliation(s)
- Ha T P Do
- Department of Community Nutrition, National Institute of Nutrition, Hanoi, Vietnam; Division of Human Nutrition; Wageningen University, Wageningen, The Netherlands.
| | - Johanna M Geleijnse
- Division of Human Nutrition; Wageningen University, Wageningen, The Netherlands
| | - Mai B Le
- Department of Community Nutrition, National Institute of Nutrition, Hanoi, Vietnam
| | - Frans J Kok
- Division of Human Nutrition; Wageningen University, Wageningen, The Netherlands
| | - Edith J M Feskens
- Division of Human Nutrition; Wageningen University, Wageningen, The Netherlands
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Busingye D, Arabshahi S, Subasinghe AK, Evans RG, Riddell MA, Thrift AG. Do the socioeconomic and hypertension gradients in rural populations of low- and middle-income countries differ by geographical region? A systematic review and meta-analysis. Int J Epidemiol 2014; 43:1563-77. [PMID: 24867304 DOI: 10.1093/ije/dyu112] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Of the 1 billion people with hypertension globally, two-thirds reside in low- and middle-income countries (LMICs). The risk of hypertension in LMICs is thought to be positively associated with socioeconomic status (SES). However, recent studies have provided data inconsistent with this concept. Thus, we assessed the association between SES and hypertension in rural populations of LMICs. Further, we explored whether this association differs according to geographical region. METHODS Through a search of databases we identified population-based studies that presented risk estimates for the association between SES, or any of its proxies, and hypertension. Meta-analyses were conducted using a random effects model. RESULTS Overall, no association was detected between educational status and hypertension, whereas a positive association was observed with income. Interestingly, educational status was inversely associated with hypertension in East Asia {effect size [ES] 0.82 [95% confidence interval (CI) 0.78, 0.87]} but positively associated in South Asia [ES 1.28 (95% CI 1.14, 1.43)]. Higher income, household assets or social class were positively associated with hypertension in South Asia whereas no association was detected in East Asia and Africa. Compared with other occupations, farmers or manual labourers were associated with a lower risk for hypertension. Further, in regions such as Latin America, few studies were identified that fulfilled our inclusion criteria. CONCLUSIONS We provide evidence that the association between hypertension and SES in rural populations of LMICs in Asia varies according to geographical region. This has important implications for targeting intervention strategies aimed at high-risk populations in different geographical regions.
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Affiliation(s)
- Doreen Busingye
- Department of Medicine and Department of Physiology, Monash University, Melbourne, Australia and Florey Neuroscience Institutes, Heidelberg, Victoria, Australia
| | - Simin Arabshahi
- Department of Medicine and Department of Physiology, Monash University, Melbourne, Australia and Florey Neuroscience Institutes, Heidelberg, Victoria, Australia
| | - Asvini K Subasinghe
- Department of Medicine and Department of Physiology, Monash University, Melbourne, Australia and Florey Neuroscience Institutes, Heidelberg, Victoria, Australia
| | - Roger G Evans
- Department of Medicine and Department of Physiology, Monash University, Melbourne, Australia and Florey Neuroscience Institutes, Heidelberg, Victoria, Australia
| | - Michaela A Riddell
- Department of Medicine and Department of Physiology, Monash University, Melbourne, Australia and Florey Neuroscience Institutes, Heidelberg, Victoria, Australia
| | - Amanda G Thrift
- Department of Medicine and Department of Physiology, Monash University, Melbourne, Australia and Florey Neuroscience Institutes, Heidelberg, Victoria, Australia Department of Medicine and Department of Physiology, Monash University, Melbourne, Australia and Florey Neuroscience Institutes, Heidelberg, Victoria, Australia
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Lloyd-Sherlock P, Beard J, Minicuci N, Ebrahim S, Chatterji S. Hypertension among older adults in low- and middle-income countries: prevalence, awareness and control. Int J Epidemiol 2014; 43:116-28. [PMID: 24505082 PMCID: PMC3937973 DOI: 10.1093/ije/dyt215] [Citation(s) in RCA: 312] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This study uses data from the World Health Organization's Study on Global Ageing and Adult Health (SAGE) to examine patterns of hypertension prevalence, awareness, treatment and control for people aged 50 years and over in China, Ghana, India, Mexico, the Russian Federation and South Africa. METHODS The SAGE sample comprises of 35 125 people aged 50 years and older, selected randomly. Hypertension was defined as ≥140 mmHg (systolic blood pressure) or ≥90 mmHg (diastolic blood pressure) or by currently taking antihypertensives. Control of hypertension was defined as blood pressure below 140/90 mmHg on treatment. A person was defined as aware if he/she was hypertensive and self-reported the condition. RESULTS Prevalence rates in all countries are broadly comparable to those of developed countries (52.9%; range 32.3% in India to 77.9% in South Africa). Hypertension was associated with overweight/obesity and was more common in women, those in the lowest wealth quintile and in heavy alcohol consumers. Awareness was found to be low for all countries, albeit with substantial national variations (48.3%; range 23.3% in Ghana to 72.1% in the Russian Federation). This was also the case for control (10.2%; range 4.1% in Ghana to 14.1% India) and treatment efficacy (26.3%; range 17.4% in the Russian Federation to 55.2% in India). Awareness was associated with increasing age, being female and being overweight or obese. Effective control of hypertension was more likely in older people, women and in the richest quintile. Obesity was associated with poorer control. CONCLUSIONS The high rates of hypertension in low- and middle-income countries are striking. Levels of treatment and control are inadequate despite half those sampled being aware of their condition. Since cardiovascular disease is by far the largest cause of years of life lost in these settings, these findings emphasize the need for new approaches towards control of this major risk factor.
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Affiliation(s)
- Peter Lloyd-Sherlock
- School of International Development, University of East Anglia, Norwich, UK, Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland National Research Council, Institute of Neuroscience, Padova, Italy, London School of Hygiene and Tropical Medicine, London, UK and Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland
| | - John Beard
- School of International Development, University of East Anglia, Norwich, UK, Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland National Research Council, Institute of Neuroscience, Padova, Italy, London School of Hygiene and Tropical Medicine, London, UK and Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland
| | - Nadia Minicuci
- School of International Development, University of East Anglia, Norwich, UK, Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland National Research Council, Institute of Neuroscience, Padova, Italy, London School of Hygiene and Tropical Medicine, London, UK and Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland
| | - Shah Ebrahim
- School of International Development, University of East Anglia, Norwich, UK, Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland National Research Council, Institute of Neuroscience, Padova, Italy, London School of Hygiene and Tropical Medicine, London, UK and Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland
| | - Somnath Chatterji
- School of International Development, University of East Anglia, Norwich, UK, Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland National Research Council, Institute of Neuroscience, Padova, Italy, London School of Hygiene and Tropical Medicine, London, UK and Department of Health Statistics and Informatics, World Health Organization, Geneva, Switzerland
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Tsai TY, Livneh H, Lu MC, Tsai PY, Chen PC, Sung FC. Increased risk and related factors of depression among patients with COPD: a population-based cohort study. BMC Public Health 2013; 13:976. [PMID: 24138872 PMCID: PMC4016549 DOI: 10.1186/1471-2458-13-976] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 10/15/2013] [Indexed: 11/10/2022] Open
Abstract
Background Depression is a common and mostly undertreated problem in patients with chronic diseases. However, population-based studies on the association between chronic obstructive pulmonary disease (COPD) and subsequent depression are limited in Asian populations. This study evaluated the incidence and risk factors of depression for patients with COPD in Taiwan. Methods Using the claims data from the National Health Insurance of Taiwan, we identified 38,010 COPD patients newly diagnosed in 2000–2004 and 38,010 subjects without COPD frequency, matched by sex, age and index date. The incidence rate and hazard ratio for depression were estimated by the end of 2008. Results The incidence rate of depression was 1.88 folds higher in the COPD cohort than in the non-COPD cohort (12.2 versus 6.47 per 1,000 person-years, p < 0.0001). The depression risk was the greatest within the first year following COPD diagnosis and tended to decline with follow-up time. Among COPD patients, multivariate analysis showed that younger women and low-income patients were at higher risk of depression. Hospitalization and comorbidities such as hypertension, arthritis, cancer, and heart disease were also significant predictors for depression risk. Conclusion This population-based cohort study demonstrated a strong relationship between COPD and subsequent depression. These findings could assist healthcare providers to pinpoint individuals with a higher predisposition to having depression, which could then facilitate the provision of culturally appropriate rehabilitation within the first year after the diagnosis of COPD.
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Affiliation(s)
| | | | | | | | | | - Fung-Chang Sung
- Department of Public Health, China Medical University, Taichung, Taiwan.
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Prevalence, awareness, treatment and control of hypertension in the Palestinian population. J Hum Hypertens 2013; 27:623-8. [PMID: 23575447 DOI: 10.1038/jhh.2013.26] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 02/05/2013] [Accepted: 02/22/2013] [Indexed: 01/13/2023]
Abstract
We determined the prevalence of hypertension and the level of awareness, treatment and control of hypertension among Palestinian adults in a population-based cross-sectional survey. Two-stage stratified sampling method was used to select 2077 participants from the general population aged 25 years and over. Trained observers obtained two blood pressure (BP) measurements from each individual by the use of a standardized mercury sphygmomanometer after a 5-min sitting rest. Information on sociogeographical factors and antihypertensive medications was obtained using a standard questionnaire. Hypertension was defined as a mean systolic BP (SBP) 140 mm Hg, diastolic BP (DBP) 90 mm Hg, and/or use of antihypertensive medications. The overall prevalence of hypertension was 27.6%, with a higher percentage among men (29.2 vs 26.4%; P=0.04). Hypertension increased with age in both men and women. Among hypertensive patients, 51.0% were aware of their elevated BP, 40.2% had treatment and only 9.5% achieved targeted BP control (<140/90 mm Hg). Patients under antihypertensive treatment showed SBP and DBP that were only 3.1 mm Hg and 2.5 mm Hg lower than individuals without antihypertensive treatment, respectively. The data show that hypertension prevalence among Palestinian adults is high, whereas the proportions of awareness treatment and control of hypertension were low. Concerted public health effort is urgently required to improve the detection, treatment and control of hypertension in Palestine.
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Islam MR, Khan I, Attia J, Hassan SMN, McEvoy M, D’Este C, Azim S, Akhter A, Akter S, Shahidullah SM, Milton AH. Association between hypertension and chronic arsenic exposure in drinking water: a cross-sectional study in Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:4522-36. [PMID: 23222207 PMCID: PMC3546776 DOI: 10.3390/ijerph9124522] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 11/27/2012] [Accepted: 11/29/2012] [Indexed: 12/12/2022]
Abstract
Chronic arsenic exposure and its association with hypertension in adults are inconclusive and this cross-sectional study investigated the association. The study was conducted between January and July 2009 among 1,004 participants from 1,682 eligible women and men aged ≥30 years living in rural Bangladesh who had continuously consumed arsenic-contaminated drinking water for at least 6 months. Hypertension was defined as systolic blood pressure ≥140 mmHg (systolic hypertension) and diastolic blood pressure ≥90 mmHg (diastolic hypertension). Pulse pressure was calculated by deducting diastolic from systolic pressure and considered to be increased when the difference was ≥55 mmHg. The prevalence of hypertension was 6.6% (95% CI: 5.1-8.3%). After adjustment for other factors, no excess risk of hypertension was observed for arsenic exposure >50 μg/L or to that of arsenic exposure as quartiles or as duration. Arsenic concentration as quartiles and >50 μg/L did show a strong relationship with increased pulse pressure (adjusted OR: 3.54, 95% CI: 1.46-8.57), as did arsenic exposure for ≥10 years (adjusted OR: 5.25, 95% CI: 1.41-19.51). Arsenic as quartiles showed a dose response relationship with increased pulse pressure. Our study suggests an association between higher drinking water arsenic or duration and pulse pressure, but not hypertension.
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Affiliation(s)
- Mohammad Rafiqul Islam
- Centre for Clinical Epidemiology & Biostatistics (CCEB), The University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; E-Mails: (M.R.I.); (J.A.); (M.M.); (C.D.)
| | - Ismail Khan
- Department of Pharmacology, Dhaka Medical College, Dhaka 1000, Bangladesh; E-Mail:
| | - John Attia
- Centre for Clinical Epidemiology & Biostatistics (CCEB), The University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; E-Mails: (M.R.I.); (J.A.); (M.M.); (C.D.)
| | | | - Mark McEvoy
- Centre for Clinical Epidemiology & Biostatistics (CCEB), The University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; E-Mails: (M.R.I.); (J.A.); (M.M.); (C.D.)
| | - Catherine D’Este
- Centre for Clinical Epidemiology & Biostatistics (CCEB), The University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; E-Mails: (M.R.I.); (J.A.); (M.M.); (C.D.)
| | - Syed Azim
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia; E-Mail:
| | - Ayesha Akhter
- Department of Obstetrics and Gynaecology, Tairunnessa Memorial Medical College, Targas, Kunia, Gazipur, Dhaka, Gazipur 1701, Bangladesh; E-Mail:
| | - Shahnaz Akter
- Department of Paediatrics, Institute of Child and Mother Health (ICMH), Matuail, Demra, Dhaka 1362, Bangladesh; E-Mail:
| | | | - Abul Hasnat Milton
- Centre for Clinical Epidemiology & Biostatistics (CCEB), The University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; E-Mails: (M.R.I.); (J.A.); (M.M.); (C.D.)
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Awoke A, Awoke T, Alemu S, Megabiaw B. Prevalence and associated factors of hypertension among adults in Gondar, Northwest Ethiopia: a community based cross-sectional study. BMC Cardiovasc Disord 2012. [PMID: 23186560 PMCID: PMC3519757 DOI: 10.1186/1471-2261-12-113] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Hypertension is a growing public health problem in many developing countries including Ethiopia. However, its prevention and control has not yet received due attention. This study aimed to determine the prevalence and associated factors of hypertension among adults in Gondar city, North-West Ethiopia. Methods A community based cross-sectional study was conducted in April 2012 in Gondar city. Participants aged 35 years and older were recruited using multi-stage random sampling technique. Data were collected by face-to-face interview technique after verbal informed consent. Additionally, weight, height and Blood Pressure (BP) of participants were measured following standard procedures. Hypertension was defined as having Systolic BP ≥140 mmHG or Diastolic BP≥ 90mmHG or reported use of regular anti-hypertensive medications prescribed by professionals for raised BP. Data were collected by clinical nurses and then entered into a computer using Epi Info version 3.5.3 and exported to SPSS version 20 for analysis. Multiple logistic regressions were fitted and Odds ratios with 95% confidence intervals were calculated to identify associated factors. Results A total of 679 participants were included in this study. About one in –five participants (21.0%) were aged 65 years or older. Obesity among all participants was 5.6%. Hundred ninety two (28.3%) were hypertensive of whom more than a third (37.0%) did not know they had hypertension. Family history of hypertension (AOR = 2.71, 95%CI; 1.37-5.36), obesity (AOR = 5.50, 95%CI; 2.07-14.62), self reported diabetes (AOR = 4.15, 95%CI; 1.77-9.72), age ≥ 55 years (AOR=3.33, 95%CI; 1.88-5.90) and not continuously walking for 10 minutes per day (AOR = 2.86, 95%CI; 1.15-7.12) were factors associated with hypertension. Conclusion There was a high prevalence of hypertension probably indicating a hidden epidemic in this community. Age ≥ 55 years, obesity, family history of hypertension, physical inactivity and self reported diabetes were associated with hypertension. Hence, we recommend the design and implementation of community based screening programs.
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Affiliation(s)
- Akilew Awoke
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Long-term effects of socioeconomic status on incident hypertension and progression of blood pressure. J Hypertens 2012; 30:1347-53. [DOI: 10.1097/hjh.0b013e32835465ca] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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