Prevalence and Associated Factors of Hypertension among Adults in Rural Uttarakhand: A Community Based Cross Sectional Study

"Behavioural and metabolic risk factors of cardiovascular diseases among post-menopausal women: A cross-sectional study in Itahari sub-metropolitan city of Nepal"

BACKGROUND AND OBJECTIVES

Cardiovascular diseases (CVDs) are main cause of mortality and morbidity among women globally. Menopause, aging and different factors in collaboration leads to increased risk for CVDs among postmenopausal women but study on risk factors of CVDs among postmenopausal women is limited in Nepal. Therefore, we aimed to assess prevalence of behavioural and metabolic risk factors of cardiovascular disease among post-menopausal women.

MATERIALS & METHODS

Community based cross-sectional study was carried among 390 post-menopausal women of the Itahari sub-metropolitan city. Multistage simple random sampling technique was used to collect data. Modified semi structured questionnaire STEP I, STEP II and STEP III was used as data collection tool. SPSS version 11.5 used for data analysis. Chi-square test and logistic regressions were performed at 95% confidence interval to find predictors of raised blood pressure and overweight/obesity.

RESULTS

The mean age of respondents was 63.37 years. The prevalence of current smokers, current alcohol use, less than 5 servings of fruits and vegetables per day, low level of physical activity, overweight/obesity and raised blood pressure was 9.2%, 18.2%, 86.4%, 52.3%, 56.2% and 44.4% respectively. On multivariate analysis strong predictors of overweight obesity were age ≤59 years (AOR: 3.21, CI 1.49-6.89), poor economic status (AOR: 1.764, CI: 1.120-2.779) and low physical activity (AOR: 2.132, CI: 1.350-3.370). Predictors of raised blood pressure were age ≥75 years (AOR: 2.04, CI: 1.01-4.11), unmarried and widow (AOR: 1.815, CI: 1.108-2.971), higher economic status (AOR: 1.752, CI: 1.119-2.740) and smoking (AOR: 4.109, CI: 1.737-9.718).

CONCLUSION

Prevalence of behavioural and metabolic risk factors among postmenopausal women in Itahari sub-metropolitan city were alarmingly high. This calls for an early need of intervention and policies at local, provincial and institutional level to address risk factors of CVDs.

Prevalence of multimorbidity and its associated risk factors among population of Mechinagar municipality of Nepal

Background

Multimorbidity is a group of conditions, it has significant impact on the population as a whole, resulting in lower quality of life, higher mortality, frequent use of medical services, and consequently higher healthcare costs. The objective of this study is to document the prevalence of common multimorbidity and its associated risk factors among population of Mechinagar Municipality.

Methods

Community-based cross-sectional study was conducted where selected multimorbidity were assessed in selected areas of Mechinagar municipality of Jhapa District . Systematic random sampling technique was used to select 590 adult participants from three pre-defined pocket areas. Pre-designed semi-structured multimorbidity assessment questionnaire for primary care (MAQ-PC)was used to assess prevalence of multimorbidity. Multiple logistic regression was conducted to identify the strongest determinants of multimorbidity.

Results

The prevalence of multimorbidity was 22.4%.Hypertension, Diabetes mellitus and COPD was seen in 39.2%, 7.8.% and 4.4% of the participants respectively . Participants with advancing age i. e. 40-49yrs were 12.62 times (AOR) more likely to have multimorbidity compared to their counterparts who were 20-29yrs old( p=<0.01,CI3.01-15.28) after adjusting for occupation, physical activity and family history of kidney disease. Working individuals, Physical inactivity and positive family history of kidney disease were the strongest determinates of multimorbidity.

Conclusions

The study revealed that participants with increasing age, working individuals, physical inactivity and family history of kidney disease were more vulnerable of having multimorbidity. The findings of our study indicate need of intervention strategies and community-based health promotion programs in reducing burden of chronic disease among adult population.

Participants' Views on Lifestyle Intervention Program Enhancing Long-Term Health-Related Behaviors Improvement among Prehypertension and/or Prediabetes Mellitus Older Adults: A Qualitative Study Examined in Thailand at Health Promoting Hospitals

This study aimed to investigate the view of prediabetes and prehypertension elderly patients living around temple on long-term self-management in proficient way underneath the lifestyle intervention program based on both focus-group discussion and In-depth interview methods to fill the gap in partially successful intervention. 62 participants were selected from 220 participants of the quantitative published study by 2 researchers. The triangulation method was used to put great emphasis on the consistency and the credibility of the results. Almost all of the participants had benefited from the program regarding proper foods, suitable exercise and an inspiration of lifestyle modification. They made changes of eating behavior and exercise behavior during program attendance, however, after the program had finished, they had minimal concern to take care of themselves. Nonetheless, more than half of them demonstrated some health-related behaviors changes due to they gave the value of the suggestion in different aspects. Moreover, high-frequency program attendance was not related to blood results improvement. The knowledge obtained from program intervention together with adequate contact between the patient and the program staff, personal problems solving, personal attitude, practice and acceptable played a key role for long-term lifestyle modification and completely successful intervention.

Central obesity and hypertension among rural adults of Paschim Medinipur, West Bengal, India

Obesity is generally classified into generalized obesity (BMI ≥30 kg/m2) and abdominal or central obesity (WC ≥90 cm for men and WC ≥80 cm for women) based on World Health Organization recommendation for Asians. Hypertension is one of the most common obesity-related complications, and about 30% of hypertensive individuals can be classified as being obese. The present study aimed to investigate the effect of different age groups (years) on the anthropometric and derived variables. It determined the correlation between anthropometric and derived variables and also estimated the frequency of central obesity and hypertension. Finally, it investigated the relationship between central obesity and blood pressure among rural Bengalee adults of Dirghagram village of Ghatal Block, Paschim Medinipur, West Bengal, India. The present cross-sectional study was undertaken among 310 rural adults (154 males; 156 females) aged over 18 years. Our study was carried out during March, 2017. Height (cm), weight (kg), waist circumference (cm), hip circumference (cm) and blood pressure (systolic and diastolic) were measured using standard procedures. One way ANOVA analysis on most of the anthropometric and derived variables showed a statistically significant increase from younger to older age group in both sexes (p<0.001;p<0.01; p<0.05). In addition to that, more females had central obesity using waist circumference (55.8% vs. 19.5%), waist hip ratio (87.2% vs. 35.7%), waist height ratio (73.7% vs. 44.2%), and conicity index (87.2% vs. 57.8%) criteria, and hypertension (52.5% vs. 27.3%). The prevalence of central obesity was much higher in case of hypertensive individuals. Therefore, the present study showed a high prevalence of central obesity among the rural adults of Dirghagram village. Furthermore, central obesity contributed in increasing hypertension among the villagers.