Prevalence of prehypertension and hypertension among the adults in South Asia: A multinomial logit model

Childhood triglyceride-glucose index and pre-hypertension in adulthood: a prospective cohort study

Background

The triglyceride-glucose (TyG) index serves as a surrogate marker for insulin resistance. Multiple studies have demonstrated a positive correlation between the TyG index and blood pressure, indicating that a high TyG index is related to a greater risk of developing pre-hypertension (pre-HTN) and hypertension (HTN). However, the relationship between changes in the TyG index during childhood and pre-HTN in adulthood requires further clarification.

Methods

The present prospective study utilized data from the Bogalusa Heart Study, a long-term follow-up study. Data on triglycerides (TG), fasting glucose (Fg), and low-density lipoprotein cholesterol (LDL-C) were collected from cross-sectional examinations of participants during childhood. Blood pressure (BP) in early adulthood was categorized into normotensive and pre-HTN groups. Logistic regression was employed to evaluate the relationship between the TyG index in childhood and pre-HTN in adulthood.

Results

A total of 1,222 participants were included in the study, of whom 258 presented with pre-HTN in adulthood. Significant differences were observed in baseline TyG index, body mass index (BMI), and high-density lipoprotein cholesterol (HDL-C) between the two groups. In both unadjusted logistic regression (Odds Ratio (OR):1.8, 95% CI: 1.4, 2.5, P < 0.001) and simple adjustment (OR: 1.7, 95% CI: 1.2, 2.3, P = 0.003), childhood TyG index were significantly associated with pre-HTN in adulthood. However, this significant relationship disappeared after full adjustment (OR: 1.2, 95% CI: 0.8, 1.9, P = 0.373) which extended Model 1 by including adjustments for baseline BMI, baseline HDL-C, baseline LDL-C, smoking status, drinking status, use of antihypertensive medication and family history of HTN.Stratified analysis in Model 2 showed that gender and race significantly affected the relationship between TyG index and BP. In the male population, elevated TyG index levels increased the probability of pre-HTN, whereas no such relationship was found in female (Male: OR: 1.9, 95% CI: 1.1, 3.5, P = 0.029; Female: OR: 0.8, 95% CI: 0.4, 1.4, P = 0.447; P for interaction = 0.037). Similarly, in American Caucasians, TyG was positively associated with the risk of pre-HTN, but this relationship was not observed in African American (American Caucasian: OR: 1.7, 95% CI: 1.0, 2.9, P = 0.035; African American: OR: 0.5, 95% CI: 0.2, 1.1, P = 0.087; P for interaction = 0.007).

Conclusions

In males and Caucasians, elevated TyG index during childhood can increase the risk of pre-HTN in adulthood. Monitoring the TyG index may help in screening individuals at higher risk of pre-HTN.

Prevalence of prehypertension and high normal blood pressure in Latin America: A systematic review with meta-analysis

INTRODUCTION

Prehypertension and high normal blood pressure (HNBP) are important risk factors for the development of hypertension and cardiovascular diseases. However, their prevalence in Latin America has not been systematically evaluated.

OBJECTIVES

To determine the prevalence of prehypertension and HNBP in Latin America through a systematic review and meta-analysis.

METHODS

A systematic search was conducted in electronic databases until September 24, 2024. Observational studies with probabilistic sampling that reported the prevalence of prehypertension or HNBP in adult Latin American populations were included. Random-effects models were used for the meta-analysis, and subgroup analyses and meta-regression were performed.

RESULTS

A total of 17 studies (n=227,741) from 7 countries were included. The pooled prevalence of prehypertension was 27.98% (95% CI: 21.17-35.34%), with significant heterogeneity (I2=100%, p<0.01). The prevalence of HNBP was 19.23% (95% CI: 11.43-28.49%). Considerable variations were observed between countries, with prehypertension prevalence ranging from 3.55% in Cuba to 46.10% in Puerto Rico. Meta-regression analyses identified a slight decreasing trend in prehypertension prevalence over time and with increasing sample size.

CONCLUSION

This study reveals a high prevalence of prehypertension and HNBP in Latin America, with significant variations between countries. These findings underscore the need for tailored public health strategies to prevent and manage these prehypertensive states early in the region.

Improving urban health through primary health care in south Asia

South Asia is rapidly urbanising. The strains of rapid urbanisation have profound implications for the health and equity of urban populations. This Series paper examines primary health care (PHC) in south Asian cities. Health and its social determinants vary considerably across south Asian cities and substantial socioeconomic inequities are present. Although cities offer easy geographical access to PHC services, financial hardship associated with health care use and low quality of care are a concern, particularly for low-income residents. Providing better PHC in south Asia requires a multi-sectoral response, with effective and resourced urban local bodies; increased public financing for health care; and new service delivery models aimed at low-income urban communities that involve strengthening public sector services, strengthening government engagement with private providers where necessary, and engaging with low-income communities and the PHC providers that serve them.

Rural health dynamics: Exploring the prevalence of prediabetes and prehypertension among the rural population of Puducherry district

Introduction

Noncommunicable diseases are a leading cause of death worldwide, claiming 41 million lives annually. Notably, type 2 diabetes not only presents well-known complications but also increases the risk of cardiovascular disease silently. Furthermore, concerningly high rates of undiagnosed diabetes and hypertension emphasize the need for improved diagnostic capabilities and enhanced awareness. The growing prevalence of prediabetes, a precursor to diabetes, further underscores the urgency for proactive action. Therefore, addressing the silent killers through early detection and comprehensive management strategies is crucial to combat this global health crisis.

Objective

The objective of the study was to assess the prevalence of prediabetes and prehypertension and the factors associated with them among the rural population of Puducherry district.

Methodology

A community-based cross-sectional study was conducted among 203 adults more than 30 years of age residing in rural field practice areas of a private medical college in the Puducherry district over 8 months (January 2023 to August 2023). Multistage sampling was employed. After obtaining written informed consent, data collection included a pretested questionnaire, and anthropometric measurements (weight, height, waist circumference, hip circumference) and blood pressure measurements were recorded; on subsequent days, fasting capillary blood sugar levels were checked. The data were analyzed using SPSS v21.

Results

On categorization based on the Indian Diabetes Risk Score, the results showed that 14.4% of participants were high-risk for diabetes, with 74% and 11.5% falling into medium- and low-risk categories, respectively. Also, the prevalence of hypertension was 31.3%, with an additional 13% prehypertensive and 55.8% normotensive. Notably, 64.6% of hypertensive individuals had Stage I and 35.4% had Stage II. Family history, self-reported diet, physical activity, and body mass index were significantly associated with prediabetes/diabetes (P value < 0.05). In addition to this, there has been a significant association between the risk of developing diabetes and systolic blood pressure (P value = 0.011).

Conclusion

Family history emerged as a significant risk factor for both diabetes and hypertension, highlighting the importance of genetic predisposition and the potential benefit of targeted family-based interventions. These findings raise concerns regarding the high prevalence of diabetes and hypertension risk factors within this population.

Prevalence and determinants of hypertension in South-Asian Urban Communities: findings from Demographic and Health Surveys (DHS) data of South Asian countries

Hypertension increases risk of stroke and other cardiovascular diseases, however, its prevalence and determinants in South Asian urban communities using country representative community-based datasets is lacking. This study evaluated prevalence of hypertension and it's determinants among urban residents of three South Asian countries. Urban population data from demographic and health surveys in Bangladesh, India, and Nepal were extracted. Hypertension prevalence was defined as systolic/diastolic blood pressure ≥ 140/ 90 mmHg. Age, education, wealth, physical activity, alcohol, BMI were considered as risk factors associated with the increased risk of hypertension. We performed binary logistic regression and calculated adjusted Odds Ratios (AOR) with 95% confidence interval (CI) to assess factors related to hypertension. Hypertension prevalence was 37.4% in India, 25.1% in Bangladesh and 18.4% in Nepal. Prevalence increased with age in all settings. Females had reduced odds of hypertension in Bangladesh (AOR 0.75; CI: 0.69, 0.81) and Nepal (AOR 0.62; CI: 0.54, 0.71), but higher risk in India (AOR 2.54; CI: 2.45, 2.63). Low education, caffeine consumption, obesity was associated with higher prevalence of hypertension in all three countries. Smokers had increased odds of hypertension in India (AOR 1.11; CI: 1.06, 1.15) and Nepal (AOR 1.23; 1.02, 1.47). Overall, hypertension prevalence is high in all three countries. Modifiable socioeconomic and lifestyle factors (education, wealth index, smoking status, caffeine consumption and BMI) associated with hypertension. Comprehensive hypertension pacific and sensitive interventions (including behavioral modification treatments and timely screening and access to health care) are urgently needed to prevent and control hypertension among urban populations in South Asia.

Examining the influence of wealth status on prehypertension risk in women aged 30-49: evidence from the 2018 Benin demographic and health survey

BACKGROUND

There is an interest in the extent to which the wealth status of women predicts their risk of being pre-hypertensive. This understanding is lacking in the current body of empirical literature, particularly within the context of Benin. Thus, indicating a knowledge gap that must be filled. To this end, the present study aimed to assess the association between wealth status and the risk of prehypertension among women aged 30-49 years in Benin.

METHODS

This study used a secondary data from the recent (2018) Demographic and Health Survey of Benin. Bivariate and multivariate logistic regression models were computed to examine the association between wealth index and the risks of prehypertension using Stata version 14. Findings were presented in adjusted odds ratio at 95% confidence level.

RESULTS

Women in the richest wealth index were significantly more likely to have prehypertension than those in the poorest wealth index [AOR = 1.4; 95%CI: 1.26-2.26]. Women aged 45-49 years were more likely to have prehypertension [AOR = 1.5; 95%CI: 1.15-1.98] compared to younger women. Women who used unclean cooking fuel were less likely to have prehypertension compared to those using clean cooking fuel [AOR = 0.6; 95%CI: 0.37,0.87].

CONCLUSION

The study concludes that wealth status is a significant predictor of prehypertension among women in Benin. Therefore, the Ministry of Health in Benin should prioritize health education and prehypertension awareness campaigns specifically targeting women in affluent communities and households. These campaigns should focus on promoting healthy dietary choices and encouraging physical activity to mitigate the elevated risk associated with wealth status. Recognizing the influence of age on prehypertension risk, it is imperative for older-middle aged women to be targeted as primary beneficiaries of health education programs and prehypertension screening programs.