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Sewberath Misser VH, Shankar A, Hindori-Mohangoo A, Wickliffe J, Lichtveld M, Mans DRA. The distribution of disease in the Republic of Suriname - A pharmacoepidemiological analysis using the claims database of the State Health Foundation of the year 2017. JOURNAL OF PUBLIC HEALTH AND EPIDEMIOLOGY 2021; 13:272-281. [PMID: 34925950 PMCID: PMC8682966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The patterns of prescription drug use in Suriname in the year 2017 have been determined with the purpose of obtaining indications about the distribution of disease in the country. The claims database of the State Health Foundation (Staatsziekenfonds, SZF) of Suriname was used for calculations of prescription rates of the fifty most prescribed drugs overall and after stratification according to gender, age, and residence of the insured persons. Information in the database had been de-identified, and the prescribed medicines had been coded according to the Anatomic Therapeutic Chemical Classification System. Statistically significant differences among the prescription rates were assessed with the two samples test of proportions using normal theory method and χ2 Goodness of Fit tests (p < 0.05). Additionally, the Bonferroni adjustment was used to adjust for type 1 error inflation resulting from multiple comparisons. Overall, drugs for the cardiovascular, respiratory, and musculo-skeletal systems had the highest prescription rates (p < 0.001). Furthermore, rates were generally higher in females than in males, in the older age groups than in younger individuals, and in the coastal regions compared to the country's interior (p < 0.001). These findings are largely in line with data found in the literature and support the use of this pharmacoepidemiological approach to assess the distribution of disease in Suriname.
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Affiliation(s)
- Vinoj H Sewberath Misser
- Department of Pharmacology, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - Arti Shankar
- Tulane University School of Public Health and Tropical Medicine, New Orleans (LA), USA
| | - Ashna Hindori-Mohangoo
- Tulane University School of Public Health and Tropical Medicine, New Orleans (LA), USA
- Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
| | - Jeffrey Wickliffe
- Tulane University School of Public Health and Tropical Medicine, New Orleans (LA), USA
- Department of Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham, Alabama (AL), USA
| | - Maureen Lichtveld
- Tulane University School of Public Health and Tropical Medicine, New Orleans (LA), USA
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh (PA), USA
| | - Dennis R A Mans
- Department of Pharmacology, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
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Sairras S, Baldew SS, van der Hilst K, Shankar A, Zijlmans W, Lichtveld M, Ferdinand K. Heart Failure Hospitalizations and Risk Factors among the Multi-Ethnic Population from a Middle Income Country: The Suriname Heart Failure Studies. J Natl Med Assoc 2021; 113:177-186. [PMID: 32928542 PMCID: PMC7486052 DOI: 10.1016/j.jnma.2020.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/09/2020] [Accepted: 08/18/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Heart failure (HF) is an emerging epidemic with poor disease outcomes and differences in its prevalence, etiology and management between and within world regions. Hypertension (HT) and ischemic heart disease (IHD) are the leading causes of HF. In Suriname, South-America, data on HF burden are lacking. The aim of this Suriname Heart Failure I (SUHF-I) study, is to assess baseline characteristics of HF admitted patients in order to set up the prospective interventional SUHF-II study to longitudinally determine the effectiveness of a comprehensive HF management program in HF patients. METHODS A cross-sectional analysis was conducted of Thorax Center Paramaribo (TCP) discharge data from January 2013-December 2015. The analysis included all admissions with primary or secondary discharge of HF ICD-10 codes I50-I50.9 and I11.0 and the following variables: patient demographics (age, sex, and ethnicity), # of readmissions, risk factors (RF) for HF: HT, diabetes mellitus (DM), smoking, and left ventricle (LV) function. T-tests were used to analyze continuous variables and Chi-square test for categorical variables. Differences were considered statistically significant when a p-value <0.05 is obtained. RESULTS 895 patients (1:1 sex ratio) with either a primary (80%) or secondary HF diagnosis were admitted. Female patients were significantly older (66.2 ± 14.8 years, p < 0.01) at first admission compared to male patients (63.5 ± 13.7 years) and the majority of admissions were of Hindustani and Creole descent. HT, DM and smoking were highly prevalent respectively 62.6%, 38.9 and 17.3%. There were 379 readmissions (29.1%) and 7% of all admissions were readmissions within 30 days and 16% were readmissions for 31-365 day. IHD is more prevalent in patients from Asian descendant (52.2%) compared to African descendant (11.7%). Whereas, HT (39.3%) is more prevalent in African descendants compared to Asian descendants (12.7%). There were no statistically significant differences in age, sex, ethnicity, LV function and RFs between single admitted and readmitted patients. CONCLUSION RF prevalence, ethnic differences and readmission rates in Surinamese HF patients are in line with reports from other Caribbean and Latin American countries. These results are the basis for the SUHF-II study which will aid in identifying the country specific and clinical factors for the successful development of a multidisciplinary HF management program.
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Affiliation(s)
- Shellice Sairras
- Scientific Research Center Suriname (SRCS), Academic Hospital Paramaribo (AZP), Suriname.
| | - Se-Sergio Baldew
- Physical Therapy Department, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - Kwame van der Hilst
- Thorax Center Paramaribo, Academic Hospital Paramaribo, Suriname; Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - Arti Shankar
- Department of Biostatistics, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Wilco Zijlmans
- Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname; Department of Global Environmental Health Sciences, Tulane University, New Orleans, LA, USA
| | - Maureen Lichtveld
- Department of Global Environmental Health Sciences, Tulane University, New Orleans, LA, USA
| | - Keith Ferdinand
- John W. Deming Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
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Diemer FS, Snijder MB, Agyemang C, Haan YC, Karamat FA, van Montfrans GA, Oehlers GP, Peters RJG, Brewster LM, Stronks K. Hypertension prevalence, awareness, treatment, and control in Surinamese living in Suriname and The Netherlands: the HELISUR and HELIUS studies. Intern Emerg Med 2020; 15:1041-1049. [PMID: 31950398 DOI: 10.1007/s11739-019-02269-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 12/21/2019] [Indexed: 01/14/2023]
Abstract
We studied hypertension prevalence, awareness, treatment, and control among persons living in a middle-income country compared with those of similar ethnicity living in a high-income country. Data from the cross-sectional HELISUR and HELIUS studies were used among 1000 Surinamese and 6971 Surinamese migrants living in The Netherlands (18-70 years), respectively. Groups were formed based on country and self-defined ethnicity, and stratified by sex. Age-adjusted odds ratios (OR) with 95% confidence intervals (CI) were calculated for hypertension prevalence, awareness, treatment, and control. Subsequently, we focused on hypertension prevalence and adjusted for risk factors for hypertension: BMI and waist circumference (model 2), educational level, physical activity, and smoking (model 3). After adjustment for age, no significant differences in hypertension prevalence, awareness, treatment, and control between countries were seen in men. However, women in Suriname were more often hypertensive with lower levels of awareness and control than those in The Netherlands (African: OR 1.54 [95% CI 1.19, 2.00]; South-Asian: 1.90 [1.35, 2.67]; awareness: 0.62 [0.43, 0.88] in African women; control: 0.48 [0.28, 0.84] in South-Asian women). Higher hypertension prevalence was explained by differences in BMI and waist circumference in African women (adjusted OR 1.26 [0.96, 1.65]) and by education, physical activity, and smoking in South-Asian women (adjusted OR 1.29 [0.87, 1.89]). Particularly, women in Suriname bear a relatively high hypertension burden with lower levels of awareness and control. As the higher hypertension prevalence was mainly explained by lifestyle-related risk factors, health promotion interventions may reduce the hypertension burden in Suriname.
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Affiliation(s)
- Frederieke Sophie Diemer
- Department of Cardiology, Academic Hospital Paramaribo, Paramaribo, Suriname
- Department of Cardiology, Amsterdam UMC, Univ of Amsterdam, Amsterdam, The Netherlands
| | - Marieke Brigitte Snijder
- Department of Public Health, Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Charles Agyemang
- Department of Public Health, Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Yentl Christina Haan
- Department of Vascular Medicine, Amsterdam UMC, Univ of Amsterdam, Amsterdam, The Netherlands
| | - Fares Aziz Karamat
- Department of Vascular Medicine, Amsterdam UMC, Univ of Amsterdam, Amsterdam, The Netherlands
| | | | - Glenn Paul Oehlers
- Department of Cardiology, Academic Hospital Paramaribo, Paramaribo, Suriname
| | | | - Lizzy Maritza Brewster
- The Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, The Netherlands
- Creatine Kinase Foundation, Amsterdam, The Netherlands
- Department of Public Health, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - Karien Stronks
- Department of Public Health, Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
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Liang H, Luo S, Chen X, Lu Y, Liu Z, Wei L. Effects of Tai Chi exercise on cardiovascular disease risk factors and quality of life in adults with essential hypertension: A meta-analysis. Heart Lung 2020; 49:353-363. [PMID: 32171586 DOI: 10.1016/j.hrtlng.2020.02.041] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 02/02/2020] [Accepted: 02/07/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Hypertension is the major attributable risk factor for cardiovascular disease. The effect of Tai Chi on essential hypertension (EH) is contentious. OBJECTIVES In this study, we investigated the effects of Tai Chi on the risk factors for cardiovascular disease and quality of life in adults with EH. METHODS Using data collected from 15 databases up to December 2018, we meta-analyzed randomized controlled trials of the effect of Tai Chi on EH. RESULTS Tai Chi exercise was associated with lower systolic blood pressure (SBP) (WMD -12.47, 95%CI -16.00 to -8.94, P < 0.001) and diastolic blood pressure (DBP) (WMD -6.46, 95%CI -8.28 to -4.64, P < 0.001); better quality of life (SMD 0.62, 95% CI 0.35 to 0.90, P < 0.001); lower lipid profiles, including total cholesterol (WMD -0.49, 95% CI -0.62 to -0.37, P < 0.001), triglycerides (WMD -0.49, 95% CI -0.92 to -0.07, P = 0.02), and low-density lipoprotein-cholesterol (LDL-C) (WMD -0.86, 95% CI -1.30 to -0.43, P < 0.001); and lower blood glucose (WMD -0.91, 95% CI -1.59 to -0.23, P = 0.009). Tai Chi had no significant effect on high-density lipoprotein-cholesterol (WMD -0.92, 95% CI -2.21 to -0.37, P = 0.16). CONCLUSIONS Tai Chi lowers blood pressure, total cholesterol, triglycerides, LDL-C, and blood glucose and significantly increases the quality of life in adults with EH. There is strong evidence for the short-term efficacy of Tai Chi exercises. Larger well-designed RCTs focused on the long-term effect of Tai Chi exercises and patient adherence are needed.
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Affiliation(s)
- Hao Liang
- School of Nursing, Guangzhou University of Chinese Medicine, No.232 Waihuan East Road, Higher Education Mega Center, Panyu District, Guangzhou 510006, Guangdong, China
| | - Shangpeng Luo
- Department of Joint Surgery, The First People's Hospital of Chenzhou, University of South China, Nanta Road 102, Beihu District, Chenzhou 423000, Hunan, China
| | - Xiaoyun Chen
- School of Nursing, Guangzhou University of Chinese Medicine, No.232 Waihuan East Road, Higher Education Mega Center, Panyu District, Guangzhou 510006, Guangdong, China
| | - Yongmei Lu
- School of Nursing, Guangzhou University of Chinese Medicine, No.232 Waihuan East Road, Higher Education Mega Center, Panyu District, Guangzhou 510006, Guangdong, China
| | - Zhuyun Liu
- Department of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Dade Road 111, Yuexiu District, Guangzhou 510120, Guangdong, China
| | - Lin Wei
- Department of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Dade Road 111, Yuexiu District, Guangzhou 510120, Guangdong, China.
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Wei Z, Yang Y, Li Q, Yin Y, Wei Z, Zhang W, Mu D, Ni J, Sun X, Xu B. The transcriptome of circulating cells indicates potential biomarkers and therapeutic targets in the course of hypertension-related myocardial infarction. Genes Dis 2020; 8:555-568. [PMID: 34179317 PMCID: PMC8209311 DOI: 10.1016/j.gendis.2020.01.007] [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: 10/09/2019] [Revised: 01/06/2020] [Accepted: 01/08/2020] [Indexed: 12/12/2022] Open
Abstract
Hypertension (HT) is the most common public-health challenge and shows a high incidence around the world. Cardiovascular diseases are the leading cause of mortality and morbidity among the elderly (age > 65 years) in the United States. Now, there is widespread acceptance of the causal link between HT and acute myocardial infarction (MI). This is the first data-mining study to identify co-expressed differentially expressed genes (co-DEGs) between HT and MI (relative to normal control) and to uncover potential biomarkers and therapeutic targets of HT-related MI. In this manuscript, HT-specific DEGs and MI-specific DEGs and differentially expressed microRNAs (DE-miRNAs) were identified in Gene Expression Omnibus (GEO) datasets GSE24752, GSE60993, GSE62646, and GSE24548 after data consolidation and batch correction. Subsequently, enrichment in Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways as well as protein–protein interaction networks were identified, and single-gene gene set enrichment analysis was performed to determine the affected biological categories and networks. Cross-matching of the results on co-DE-miRNAs and predicted miRNAs targeting the co-DEGs was conducted and discussed as well. We found that MYC and HIST1H2BO may be associated with HT, whereas FCGR1A, FYN, KLRD1, KLRB1, and FOLR3 may be implicated in MI. Moreover, co-DEGs FOLR3 and NFE2 with predicted miRNAs and DE-miRNAs, especially miR-7 and miR-548, may be significantly associated and show huge potential as a new set of novel biomarkers and important molecular targets in the course of HT-related MI.
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Affiliation(s)
- Zilun Wei
- Department of Cardiology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu Province, 210008, PR China
| | - Yining Yang
- Department of Cardiology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu Province, 210008, PR China
| | - Qiaoling Li
- Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu Province, 210008, PR China
| | - Yong Yin
- Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu Province, 210008, PR China
| | - Zhonghai Wei
- Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu Province, 210008, PR China
| | - Wenfeng Zhang
- Department of Cardiology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu Province, 210008, PR China
| | - Dan Mu
- Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu Province, 210008, PR China
| | - Jie Ni
- Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu Province, 210008, PR China
| | - Xuan Sun
- Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu Province, 210008, PR China
- Corresponding author. Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Biao Xu
- Department of Cardiology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu Province, 210008, PR China
- Corresponding author. Department of Cardiology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing 210008, China
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Bersaoui M, Baldew SSM, Cornelis N, Toelsie J, Cornelissen VA. The effect of exercise training on blood pressure in African and Asian populations: A systematic review and meta-analysis of randomized controlled trials. Eur J Prev Cardiol 2019; 27:457-472. [PMID: 31450966 DOI: 10.1177/2047487319871233] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Exercise is key in the primary prevention and management of hypertension. Yet, current exercise recommendations are predominantly based on meta-analyses involving populations of European descent. Since blood pressure (BP) responses to pharmaceutical interventions are known to differ among ethnic groups, we aimed to investigate the BP responses to exercise training in non-European descendants. PURPOSE The aim of this study was to systematically summarize the available literature on the efficacy of exercise on BP in healthy adults (age ≥18 years) of African or Asian origin. METHODS We searched the MEDLINE database for randomized controlled trials that evaluated the effect of exercise training on BP in healthy African and Asian adults with optimal BP, elevated BP or hypertension and published in a peer-reviewed journal up to May 2019. Random effect models were fitted to estimate the effect sizes. RESULTS We identified 22 trials involving individuals of Asian origin (n = 931; mean age: 44 years; 41% male) and four trials involving individuals of African origin (n = 510; mean age: 56.7 years; 80% male). Aerobic exercise training significantly (p < 0.001) reduced systolic and diastolic BP in each ethnic group. Resistance training did not affect the BP of Asian participants with optimal BP. The effect of resistance training in Asians with elevated BP or hypertension and Africans could not be determined due to lack of data. Sub-analyses suggested somewhat larger reductions in systolic BP following aerobic training in hypertensive Africans compared with hypertensive Asians. CONCLUSIONS We found favorable effects of aerobic exercise training on BP in the African and the Asian populations. However, the overall low number of studies and especially the lack of data on resistance training and combined training in African and Asian populations warrant more research to improve the quality of evidence.
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Affiliation(s)
- Marina Bersaoui
- Department of Physical Therapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - Se-Sergio M Baldew
- Department of Physical Therapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - Nils Cornelis
- Department of Rehabilitation Sciences, KU Leuven, Belgium
| | - Jerry Toelsie
- Department of Physiology, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
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Nannan Panday R, Haan Y, Diemer F, Punwasi A, Rommy C, Heerenveen I, van Montfrans GA, Brewster LM. Chronic kidney disease and kidney health care status: the healthy life in Suriname (HeliSur) study. Intern Emerg Med 2019; 14:249-258. [PMID: 30361850 PMCID: PMC6394460 DOI: 10.1007/s11739-018-1962-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 09/26/2018] [Indexed: 01/13/2023]
Abstract
The high cardiovascular risk burden in low- and middle-income countries is expected to lead to an explosive increase in chronic kidney disease (CKD). However, population data on CKD from these countries are scarce. Therefore, we assessed kidney health in Suriname. In the Healthy Life in Suriname (HeliSur) study, a random sample of the adult population, we collected data with standardized questionnaires, physical examination, and blood and urine samples analysed in a central laboratory. Prevalent CKD was graded with KDIGO guidelines. In addition, we assessed national data on prevalent renal replacement therapy (RRT), estimated the future need for RRT, and evaluated national kidney health work force and policies. We include 1117 participants (2.0‰ of the population), 63% women, 40% of African ancestry and 43% of Asian ancestry, with a mean age of 42.2 (SE 0.4) years. Blood pressure is elevated in 72% of the participants, 26% have diabetes or prediabetes, and 78% are obese or overweight. The prevalence of CKD is 5.4%, and around 0.3% have kidney failure, translating to approximately 1500 patients nationally (2690 per million population, pmp), with currently 516 patients (920 pmp) on dialysis. Based on the participants from the random population sample in CKD stage G3 or G4, we estimate that 6750-10,750 pmp may develop kidney failure within the next 10 years. However, specialized kidney health workforce is currently very limited, and specific national or local policies for CKD management are lacking. Since the large majority of the general population has one or more risk factors for CKD including elevated blood pressure, urgent action is needed to strengthen kidney health care and prevent a catastrophic rise in need for RRT in the coming years.
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Affiliation(s)
- Rani Nannan Panday
- Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Yentl Haan
- Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Frederieke Diemer
- Department of Cardiology, Academic Hospital of Paramaribo, Paramaribo, Suriname
| | - Amar Punwasi
- Department of Internal Medicine, Academic Hospital of Paramaribo, Paramaribo, Suriname
- Surrenal Dialysis Center, Paramaribo, Suriname
| | - Chantal Rommy
- Faculty of Medicine, Anton de Kom University, Paramaribo, Suriname
| | | | - Gert A van Montfrans
- Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Lizzy M Brewster
- Amsterdam Institute for Global Health and Development, AHTC, Tower C4, Paasheuvelweg 25, BP 1105, Amsterdam, The Netherlands.
- Creatine Kinase Foundation, Amsterdam, The Netherlands.
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Diemer FS, Baldew SSM, Haan YC, Karamat FA, Oehlers GP, van Montfrans GA, van den Born BJH, Peters RJG, Nahar-Van Venrooij LMW, Brewster LM. Aortic pulse wave velocity in individuals of Asian and African ancestry: the HELISUR study. J Hum Hypertens 2018; 34:108-116. [DOI: 10.1038/s41371-018-0144-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/12/2018] [Accepted: 11/20/2018] [Indexed: 12/22/2022]
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Haan YC, Diemer FS, Van Der Woude L, Van Montfrans GA, Oehlers GP, Brewster LM. The risk of hypertension and cardiovascular disease in women with uterine fibroids. J Clin Hypertens (Greenwich) 2018; 20:718-726. [PMID: 29569360 DOI: 10.1111/jch.13253] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 12/28/2017] [Accepted: 01/01/2018] [Indexed: 11/28/2022]
Abstract
Women with fibroids have a notably high hypertension risk. However, adjusted data regarding other cardiovascular disease (CVD) risk factors are scarce. In this cross-sectional study, CVD risk factors, hemodynamic parameters, and asymptomatic organ damage were analyzed between women with uterine fibroids and controls in a multi-ethnic population. In total, 104 women with self-reported fibroids and 624 controls were included. Women with fibroids had significantly higher odds to have hypertension (OR 3.4; 95% CI 2.2-5.2), diabetes (1.7; 1.0-2.9), and hypercholesterolemia (1.8; 1.1-3.2). After adjustment for confounders, only the odds ratio for hypertension was significant (1.8; 1.1-3.1). Asymptomatic organ damage occurred significantly more often in women with fibroids (66.7%; 95% CI 55.8%-77.6% vs 42.9%; 38.0-47.8 in controls), especially in the younger age group (respectively 48.5%; 31.1%-65.9% vs 22.1%; 17.0-27.2). In this study, women with fibroids had a remarkably high hypertension risk compared to controls, with more asymptomatic organ damage, in particular young women.
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Affiliation(s)
- Yentl C Haan
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Frederieke S Diemer
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands.,Department of Cardiology, Academic Hospital Paramaribo, Paramaribo, Suriname
| | - Lisa Van Der Woude
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Gert A Van Montfrans
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands.,Department of Internal Medicine, Academic Medical Center, Amsterdam, the Netherlands
| | - Glenn P Oehlers
- Department of Cardiology, Academic Hospital Paramaribo, Paramaribo, Suriname
| | - Lizzy M Brewster
- Department of Internal Medicine, Academic Medical Center, Amsterdam, the Netherlands.,Department of Public Health, Anton de Kom University of Suriname, Paramaribo, Suriname
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