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Understanding factors influencing uptake of healthy lifestyle practices among adults following a community cardiovascular disease prevention programme in Mukono and Buikwe districts in Uganda: A qualitative study. PLoS One 2022; 17:e0263867. [PMID: 35176069 PMCID: PMC8853581 DOI: 10.1371/journal.pone.0263867] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 01/31/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Healthy lifestyle practices including physical activity, healthy diets, non-smoking, reduced alcohol consumption and stress reduction are important in the prevention of metabollic CVD risk factors such as hypertension, overweight and obesity, diabetes and hyperlipidaemia. Owing to current lifestyle changes, the increasing burden of CVD and importance of healthy behaviours, the need for strategies to increase uptake of healthy lifestyles among sub-Saharan African populations are apparent. This study explored the factors influencing uptake of healthy lifestyle practices among adults following implementation of a community CVD prevention programme. Methods This was a descriptive qualitative study conducted among purposively selected adults who had engaged in a community CVD prevention programme. Data were collected using in-depth interviews, which were audio recorded and transcribed verbatim. Study transcripts were read into NVIVO 12.6 software for coding and analysis guided by thematic analysis following the semantic approach. Results This study found variations in uptake of healthy lifestyle practices for CVD prevention with most changes reported for dietary behaviour especially in vegetable and fruit intake, reduction of salt intake and fats and oils consumption. Changes in physical activity were also notable. On the other hand, participants were slow in making changes in alcohol consumption, smoking behaviours and stress reduction. The barriers to uptake of healthy lifestyle practices were individual such as limited capability or skills, structural such as limited physical activity facilities, and social such as cultural and peer influence. Relatedly, the facilitators of practices uptake were individual including knowledge and personal determination to change, and social including social support from family and the community. Conclusions Insights from understanding the uptake of lifestyle practices should guide planning and design of community programmes with an emphasis on removing barriers and strengthening facilitators building on the intermediate motivating factors and considering individual needs and expectations.
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Rahman MM, Taniguchi H, Nsashiyi RS, Islam R, Mahmud SR, Rahman S, Jung J, Khan S. Trend and projection of skilled birth attendants and institutional delivery coverage for adolescents in 54 low- and middle-income countries, 2000-2030. BMC Med 2022; 20:46. [PMID: 35115000 PMCID: PMC8813474 DOI: 10.1186/s12916-022-02255-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/12/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Limitations to accessing delivery care services increase the risks of adverse outcomes during pregnancy and delivery for all pregnant women, particularly among adolescents in LMICs. In order to inform adolescent-specific delivery care initiatives and coverage, we conducted a comprehensive analysis of trends, projections and inequalities in coverage of delivery care services among adolescents at national, urban-rural and socio-economic levels in LMICs. METHODS Using 224 nationally representative cross-sectional survey data between 2000 and 2019, we estimated the coverage of institutional delivery (INSD) and skilled birth attendants (SBA). Bayesian hierarchical regression models were used to estimate trends, projections and determinants of INSD and SBA. RESULTS Coverage of delivery care services among adolescents increased substantially at the national level, as well as in both urban and rural areas in most countries between 2000 and 2018. Of the 54 LMICs, 24 countries reached 80% coverage of both INSD and SBA in 2018, and predictions for 40 countries are set to exceed 80% by 2030. The trends in coverage of INSD and SBA of adult mothers mostly align with those for adolescent mothers. Our findings show that urban-rural and wealth-based inequalities to delivery care remain persistent by 2030. In 2018, urban settings across 54 countries had higher rates of coverage exceeding 80% compared to rural for both INSD (45 urban, 16 rural) and SBA (50 urban, 19 rural). Several factors such as household head age ≥ 46 years, household head being female, access to mass media, lower parity, higher education, higher ANC visits and higher socio-economic status could increase the coverage of INSD and SBA among adolescents and adult women. CONCLUSIONS More than three-quarters of the LMICs are predicted to achieve 80% coverage of INSD and SBA among adolescent mothers in 2030, although with sustained inequalities.
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Affiliation(s)
- Md Mizanur Rahman
- Hitotsubashi Institute for Advanced Study, University of Hitotsubashi, 2-1 Naka, Kunitachi Tokyo, 186-8601, Japan.
| | - Hiroko Taniguchi
- Department of Global Health Policy, School of International Health, The University of Tokyo, Tokyo, Japan
| | - Raïssa Shiyghan Nsashiyi
- Department of Global Health Policy, School of International Health, The University of Tokyo, Tokyo, Japan
- Institute for Nature, Health, and Agricultural Research (INHAR), Yaoundé, Cameroon
| | - Rashedul Islam
- Department of Global Health Policy, School of International Health, The University of Tokyo, Tokyo, Japan
| | | | - Shafiur Rahman
- Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Jenny Jung
- Global Public Health Research Foundation, Dhaka, Bangladesh
| | - Shahjahan Khan
- School of Sciences, Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
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Shaheen RS, Alqadhibi AF, Bin Qrba AM, Alqublan YE, Neyaz AA. Dental Professional's Knowledge Regarding Updated Protocols in Periodontics, Diabetes Mellitus, and Hypertension in Saudi Arabia. ANNALS OF DENTAL SPECIALTY 2022. [DOI: 10.51847/vwpbgljna2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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OUP accepted manuscript. Eur Heart J 2022; 43:3312-3322. [DOI: 10.1093/eurheartj/ehab899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 12/01/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
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Chen X, Liu C, Yang S, Yang Y, Chen Y, Zhao X, Zhu W, Zhao Q, Ni C, Huang X, Yan W, Shen C, Gu HF. Gender Specificity and Local Socioeconomic Influence on Association of GHR fl/d3 Polymorphism With Growth and Metabolism in Children and Adolescents. Front Pediatr 2022; 10:546080. [PMID: 35402349 PMCID: PMC8984194 DOI: 10.3389/fped.2022.546080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Growth hormone receptor (GHR) mediates most GH biological actions. This study is aimed to evaluate whether GHR fl/d3 polymorphism contributes to the inter-individual variability of growth and metabolism in healthy children and adolescents. METHODS A total of 4,730 students aged 6-16 years from Yixing and Suqian City in China were included in this cross-sectional study. Height and body mass index (BMI) were transformed into the form of z-score corresponding to age and gender. Logistic regression was used to evaluate the associations of GHR fl/d3 polymorphism with height, BMI, metabolic traits, and hypertension by estimating the odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS GHR d3 allele was inversely associated with overweight, total cholesterol (TC) and triglyceride (TG) levels (OR [95% CI] for overweight: 0.754 [0.593-0.959], P = 0.021; OR [95% CI] for TC: 0.744 [0.614-0.902], P = 0.003; OR [95% CI] for TG: 0.812 [0.654-0.998], P = 0.047). GHR d3 allele was associated with decreased odds of pre-hypertension in boys (OR [95% CI]: 0.791 [0.645-0.971], P = 0.025), but associated with increased odds of pre-hypertension and hypertension in girls (ORs [95% CIs]: 1.379 [1.106-1.719], P = 0.004; OR [95% CI]: 1.240 [1.013-1.519], P = 0.037). Interaction of GHR fl/d3 polymorphism with gender contributed to increased odds of pre-hypertension and hypertension (interactive ORs [95% CIs]: 1.735 [1.214-2.481], P = 0.003; OR [95% CI]: 1.509 [1.092-2.086], P = 0.013). Stratification analysis showed that the correlation tendencies of GHR fl/d3 polymorphism and BMI with age were different between two cities with discrepant economic development levels. CONCLUSION GHR fl/d3 polymorphism is associated with growth, metabolism, and hypertension in children and adolescents with the gender specificity, and the genetic effect of GHR fl/d3 may be modified by the local socioeconomic levels.
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Affiliation(s)
- Xiaotian Chen
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
| | - Chunlan Liu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Song Yang
- Department of Cardiology, People's Hospital of Yixing City, Affiliated Yixing People's Hospital of Jiangsu University, Yixing, China
| | - Yaming Yang
- Center for Disease Control and Prevention of Yixing City, Yixing, China
| | - Yanchun Chen
- Department of Cardiology, People's Hospital of Yixing City, Affiliated Yixing People's Hospital of Jiangsu University, Yixing, China
| | - Xianghai Zhao
- Department of Cardiology, People's Hospital of Yixing City, Affiliated Yixing People's Hospital of Jiangsu University, Yixing, China
| | - Weiguang Zhu
- Center for Disease Control and Prevention of Suqian City, Suqian, China
| | - Qihui Zhao
- Center for Disease Control and Prevention of Suqian City, Suqian, China
| | - Chuan Ni
- Center for Disease Control and Prevention of Suqian City, Suqian, China
| | - Xiangyuan Huang
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
| | - Weili Yan
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
| | - Chong Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Harvest F Gu
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
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Krishnamurthi RV, Feigin VL. Global Burden of Stroke. Stroke 2022. [DOI: 10.1016/b978-0-323-69424-7.00014-4] [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]
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Ali MK, Pearson-Stuttard J, Selvin E, Gregg EW. Interpreting global trends in type 2 diabetes complications and mortality. Diabetologia 2022; 65:3-13. [PMID: 34837505 PMCID: PMC8660730 DOI: 10.1007/s00125-021-05585-2] [Citation(s) in RCA: 126] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/03/2021] [Indexed: 12/16/2022]
Abstract
International trends in traditional diabetes complications (cardiovascular, renal, peripheral vascular, ophthalmic, hepatic or neurological diseases) and mortality rates are poorly characterised. An earlier review of studies published up to 2015 demonstrated that most data come from a dozen high-income countries (HICs) in North America, Europe or the Asia-Pacific region and that, in these countries at least, rates of acute glycaemic fluctuations needing medical attention and amputations, myocardial infarction and mortality were all declining over the period. Here, we provide an updated review of published literature on trends in type 2 diabetes complications and mortality in adults since 2015. We also discuss issues related to data collection, analysis and reporting that have influenced global trends in type 2 diabetes and its complications. We found that most data on trends in type 2 diabetes, its complications and mortality come from a small number of HICs with comprehensive surveillance systems, though at least some low- and middle-income countries (LMICs) from Africa and Latin America are represented in this review. The published data suggest that HICs have experienced declines in cardiovascular complication rates and all-cause mortality in people with diabetes. In parallel, cardiovascular complications and mortality rates in people with diabetes have increased over time in LMICs. However, caution is warranted in interpreting trends from LMICs due to extremely sparse data or data that are not comparable across countries. We noted that approaches to case ascertainment and definitions of complications and mortality (numerators) and type 2 diabetes (the denominator) vary widely and influence the interpretation of international data. We offer four key recommendations to more rigorously document trends in rates of type 2 diabetes complications and mortality, over time and worldwide: (1) increasing investments in data collection systems; (2) standardising case definitions and approaches to ascertainment; (3) strengthening analytical capacity; and (4) developing and implementing structured guidelines for reporting of data.
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Affiliation(s)
- Mohammed K Ali
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, USA.
| | - Jonathan Pearson-Stuttard
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
- Health Analytics, Lane Clark & Peacock LLP, London, UK
| | - Elizabeth Selvin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Edward W Gregg
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK.
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The 10-year incidence of hypertension across blood pressure categories in a population-based cohort in southwestern Sweden. BMC Cardiovasc Disord 2021; 21:523. [PMID: 34715783 PMCID: PMC8556935 DOI: 10.1186/s12872-021-02334-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 10/19/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND To explore the determinants of incident hypertension, and especially the impact of baseline blood pressure categories, in a representative Swedish population. METHODS A 10-year longitudinal study of residents aged 30-74. Blood pressures were measured and categorized according to ESH guidelines with optimal blood pressure < 120/80 mmHg, normal 120-129/80-84 mmHg, and high normal 130-139/85-89 mmHg. Incident hypertension was defined as ongoing treatment or three consecutive blood pressure readings ≥ 140/ ≥ 90 mmHg (one or both) at follow-up, while those with ≥ 140 and/or ≥ 90 mmHg at only one or two visits were labelled as unstable. After excluding subjects with hypertension, ongoing blood pressure lowering medication or a previous CVD event at baseline, 1099 remained for further analyses. RESULTS Sixteen (2.6%) subjects with optimal baseline blood pressure had hypertension at follow up. Corresponding numbers for subjects with normal, high normal and unstable blood pressure were 55 (19.4%), 50 (39.1%) and 46 (74.2%), respectively. Compared with subjects in optimal group those in normal, high normal and unstable blood pressure categories had significantly higher risk to develop manifest hypertension with odds ratios OR and (95% CI) of 7.04 (3.89-12.7), 17.1 (8.88-33.0) and 84.2 (37.4-190), respectively, with adjustment for age, BMI and family history for hypertension. The progression to hypertension was also independently predicted by BMI (p < 0.001), however, not by age. CONCLUSIONS Subjects with high normal or unstable blood pressure should be identified in clinical practice, evaluated for global hypertension risk and offered personalized advice on lifestyle modification for early prevention of manifest hypertension and cardiovascular disease.
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Menon J, Numpeli M, Kunjan SP, Karimbuvayilil BV, Sreedevi A, Panniyamakkal J, Suseela RP, Thachathodiyil R, Banerjee A. A Sustainable Community-Based Model of Noncommunicable Disease Risk Factor Surveillance (Shraddha-Jagrithi Project): Protocol for a Cohort Study. JMIR Res Protoc 2021; 10:e27299. [PMID: 34677141 PMCID: PMC8571687 DOI: 10.2196/27299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/28/2021] [Accepted: 04/12/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND India has a massive noncommunicable disease (NCD) burden, at an enormous cost to the individual, family, society, and health system at large, despite which prevention and surveillance are relatively neglected. If diagnosed early and treated adequately, risk factors for atherosclerotic cardiovascular disease would help decrease the mortality and morbidity burden. Surveillance for NCDs, creating awareness, positive lifestyle changes, and treatment are the proven measures known to prevent the progression of the disease. India is in a stage of rapid epidemiological transition, with the state of Kerala being at the forefront, pointing us towards likely disease burden and outcomes for the rest of the country in the future. A previous study done by the same investigators in a population of >100,000 revealed poor awareness, treatment of NCDs, and poor adherence to medicines in individuals with CVD. OBJECTIVE This study aimed at assessing a sustainable, community-based surveillance model for NCDs with corporate support fully embedded in the public health system. METHODS Frontline health workers will check all individuals in the target group (≥age 30 years) with further follow-up and treatment planned in a "spoke and hub" model using the public health system of primary health centers as spokes to the hubs of taluk or district hospitals. All data entry done by frontline health workers will be on a tablet PC, ensuring rapid acquisition and transfer of participant health details to primary health centers for further follow-up and treatment. RESULTS The model will be evaluated based on the utilization rate of various services offered at all tier levels. The proportions of the target population screened, eligible individuals who reached the spoke or hub centers for risk stratification and care, and community-level control for hypertension and diabetes in annual surveys will be used as indicator variables. The model ensures diagnosis and follow-up treatment at no cost to the individual entirely through the tiered public health system of the state and country. CONCLUSIONS Surveillance for NCDs is an essential facet of health care presently lacking in India. Atherosclerotic cardiovascular disease has a long gestation period in progression to the symptomatic phase of the disease, during which timely preventive and lifestyle measures would help prevent disease progression if implemented. Unfortunately, several asymptomatic individuals have never tested their plasma glucose, serum lipid levels, or blood pressure and are unaware of their disease status. Our model, implemented through the public health system using frontline health workers, would ensure individuals aged≥30 years at risk of disease are identified, and necessary lifestyle modifications and treatments are given. In addition, the surveillance at the community level would help create a general awareness of NCDs and lead to healthier lifestyle habits. TRIAL REGISTRATION Clinical Trial Registry India CTRI/2018/07/014856; https://tinyurl.com/4saydnxf. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/27299.
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Affiliation(s)
- Jaideep Menon
- Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, India
| | | | | | | | | | - Jeemon Panniyamakkal
- Sree Chitra Thirunal Institute of Medical Sciences and Technology, Thiruvananthapuram, India
| | - Rakesh P Suseela
- Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Rajesh Thachathodiyil
- Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, United Kingdom
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Global and Regional Patterns in Noncommunicable Diseases and Dietary Factors across National Income Levels. Nutrients 2021; 13:nu13103595. [PMID: 34684595 PMCID: PMC8537506 DOI: 10.3390/nu13103595] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/04/2021] [Accepted: 10/11/2021] [Indexed: 01/03/2023] Open
Abstract
Background: Noncommunicable diseases (NCDs) are the leading global cause of death and share common risk factors. Little quantitative data are available on the patterns of each NCDs death and dietary factors by national income level and region. We aimed to identify the trend of NCDs deaths and dietary factors with other health-related behaviors across national income levels and geographical regions. Methods: Three databases were collected, including the World Health Organization, Food and Agriculture Organization, and World Bank in 2014. These were analyzed to describe the trend for NCDs deaths and dietary factors with health-related behaviors across national income levels (high income, upper-middle income, lower-middle income, and low income) from 151 countries using variance-weighted least-squares linear regression. Results: Lower-middle-income and low-income countries in Africa and Asia had higher death rates of NCDs. More than 30% of the population had raised blood pressure with higher carbohydrate intake and lower protein and fat intake compared to high-income European countries in 2014. High-income countries had the highest prevalence of raised total cholesterol, overweight, and obesity, the highest total energy, fat, and protein intake, and the highest supplies of animal fat, stimulants, sugar and sweetener, vegetable oil, and milk, as well as insufficient activity with an increasing trend (p for trend < 0.001). Conclusion: There were differences in NCDs risk factors and dietary factors by national income and region. Accordingly, measures should be taken to suit the situation in each country. Our findings have significance for health workers and health policies preventing and controlling the rise of NCDs.
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Matshazi DM, Weale CJ, Erasmus RT, Kengne AP, Davids SFG, Raghubeer S, Davison GM, Matsha TE. Circulating Levels of MicroRNAs Associated With Hypertension: A Cross-Sectional Study in Male and Female South African Participants. Front Genet 2021; 12:710438. [PMID: 34594360 PMCID: PMC8476992 DOI: 10.3389/fgene.2021.710438] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/13/2021] [Indexed: 11/19/2022] Open
Abstract
MicroRNAs are non-coding, post-transcriptional regulators of gene expression and their dysregulation has been associated with development of various diseases, including hypertension. Consequently, understanding their role in the pathogenesis and progression of disease is essential. Prior research focusing on microRNAs in disease has provided a basis for understanding disease prognosis and offered possible channels for therapeutic interventions. Herein, we aimed to investigate possible differences in the expression profiles of five microRNAs in the blood of participants grouped on the basis of their hypertension status. This was done to elucidate the possible roles played by these microRNAs in the development of hypertension. Using quantitative reverse transcription polymerase chain reaction, we evaluated the expression levels of miR-126-3p, 30a-5p, 182-5p, 30e-3p, and 1299 in the whole blood of 1456 participants, normotensive (n = 573), screen-detected hypertensive (n = 304) and known hypertensive (n = 579). The expression of miR-126-3p and 182-5p was significantly higher in known hypertensives relative to both screen-detected hypertensives and normotensives, and also in screen-detected hypertensives vs normotensives. A significant association between the expression of miR-126-3p, 182-5p, and 30a-5p and known hypertension was also evident. This study demonstrated dysregulated miR-126-3p, 182-5p, and 30a-5p expression in hypertension, highlighting the possible efficacy of these microRNAs as targets for the diagnosis of hypertension as well as the development of microRNA-based therapies.
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Affiliation(s)
- Don M Matshazi
- SAMRC/CPUT/Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness Science, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Cecil J Weale
- SAMRC/CPUT/Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness Science, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Rajiv T Erasmus
- Division of Chemical Pathology, Faculty of Health Sciences, National Health Laboratory Service (NHLS) and Stellenbosch University, Cape Town, South Africa
| | - Andre P Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.,Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Saarah F G Davids
- SAMRC/CPUT/Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness Science, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Shanel Raghubeer
- SAMRC/CPUT/Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness Science, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Glenda M Davison
- SAMRC/CPUT/Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness Science, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Tandi E Matsha
- SAMRC/CPUT/Cardiometabolic Health Research Unit, Department of Biomedical Sciences, Faculty of Health and Wellness Science, Cape Peninsula University of Technology, Cape Town, South Africa
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Alcohol and tobacco influencing prevalence of hypertension among 15–54 years old Indian men: An application of discriminant analysis using National Family Health Survey (NFHS), 2015–16. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Ayoub N, Mantash H, Dhaini HR, Mourad A, Hneino M, Daher Z. Serum Cadmium Levels and Risk of Metabolic Syndrome: A Cross-Sectional Study. Biol Trace Elem Res 2021; 199:3625-3633. [PMID: 33405080 DOI: 10.1007/s12011-020-02502-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/17/2020] [Indexed: 12/15/2022]
Abstract
The increase in the prevalence of metabolic disorders globally is becoming a public health concern. Previous studies have reported an association between environmental exposures to hazardous substances, including various heavy metals, and the risk for metabolic syndrome. However, reports on the contributions of cadmium (Cd) to the risk for obesity and diabetes remain inconsistent. This study aims to investigate an association between serum Cd levels (SCL) and diabesity and dyslipidemia risk scores. A total of 140 subjects were identified from a public academic institution in Lebanon. Socio-demographic information, diabesity, and obesity risk scores were determined using an interview-based adapted FINDRISC questionnaire and analysis of an acquired blood sample. SCL was quantified using inductively coupled plasma mass spectrometry (ICP-MS). The statistical analysis relied on a chi-squared test and multivariate logistic regression models, along with checks for confounders and effect modifiers. Our results showed a Cd geometric mean of 4.04 μg/L (± 2.5). High SCL was significantly associated with higher dyslipidemia risk (OR: 3.05 [95% CI: 1.19-7.86], P = 0.02), even after adjusting for confounders. However, SCL did not show a statistically significant association with diabetes and obesity outcomes. Elevated SCL increases the risk of dyslipidemia and alters the blood lipid profile. In addition, our findings do not support a role for Cd in diabesity.
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Affiliation(s)
- Nour Ayoub
- Faculty of Public Health I, Lebanese University, Rafic Hariri University Campus, Hadath, Beirut, Lebanon
| | - Hiba Mantash
- Faculty of Public Health I, Lebanese University, Rafic Hariri University Campus, Hadath, Beirut, Lebanon
| | - Hassan R Dhaini
- Department of Environmental Health, American University of Beirut, Beirut, Lebanon
| | - Abbas Mourad
- Faculty of Sciences I, Lebanese University, Rafic Hariri University Campus, Hadath, Beirut, Lebanon
| | - Mohammad Hneino
- Faculty of Public Health I, Lebanese University, Rafic Hariri University Campus, Hadath, Beirut, Lebanon
| | - Zeina Daher
- Faculty of Public Health I, Lebanese University, Rafic Hariri University Campus, Hadath, Beirut, Lebanon.
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Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet 2021; 398:957-980. [PMID: 34450083 PMCID: PMC8446938 DOI: 10.1016/s0140-6736(21)01330-1] [Citation(s) in RCA: 1076] [Impact Index Per Article: 358.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. FINDINGS The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. INTERPRETATION Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. FUNDING WHO.
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Cui C, Higashiyama A, Lopresti BJ, Ihara M, Aizenstein HJ, Watanabe M, Chang Y, Kakuta C, Yu Z, Mathis CA, Kokubo Y, Fukuda T, Villemagne VL, Klunk WE, Lopez OL, Kuller LH, Miyamoto Y, Sekikawa A. Comparing Pathological Risk Factors for Dementia between Cognitively Normal Japanese and Americans. Brain Sci 2021; 11:1180. [PMID: 34573201 PMCID: PMC8469296 DOI: 10.3390/brainsci11091180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/28/2021] [Accepted: 08/30/2021] [Indexed: 11/16/2022] Open
Abstract
The Alzheimer's Disease Neuroimaging Initiative showed that Japanese had significantly lower brain Aβ burden than Americans among a cognitively normal population. This cross-sectional study aimed to compare vascular disease burden, Aβ burden, and neurodegeneration between cognitively normal elderly Japanese and Americans. Japanese and American participants were matched for age (±4-year-old), sex, and Apolipoprotein E (APOE) genotype. Brain vascular disease burden and brain Aβ burden were measured using white matter lesions (WMLs) and 11C-labeled Pittsburgh Compound B (PiB) retention, respectively. Neurodegeneration was measured using hippocampal volumes and cortical thickness. A total of 95 Japanese and 95 Americans were recruited (50.5% men, mean age = 82). Compared to Americans, Japanese participants had larger WMLs, and a similar global Aβ standardized uptake value ratio (SUVR), cortical thickness and hippocampal volumes. Japanese had significantly lower regional Aβ SUVR in the anterior ventral striatum, posterior cingulate cortex, and precuneus. Cognitively normal elderly Japanese and Americans had different profiles regarding vascular disease and Aβ burden. This suggests that multiple risk factors are likely to be involved in the development of dementia. Additionally, Japanese might have a lower risk of dementia due to lower Aβ burden than Americans. Longitudinal follow-up of these cohorts is warranted to ascertain the predictive accuracy of these findings.
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Affiliation(s)
- Chendi Cui
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; (C.C.); (L.H.K.)
| | - Aya Higashiyama
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan; (A.H.); (M.W.); (Y.K.); (Y.M.)
- Department of Hygiene, Wakayama Medical University, Wakayama 641-0011, Japan
| | - Brian J. Lopresti
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213, USA; (B.J.L.); (Z.Y.); (C.A.M.)
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan; (M.I.); (C.K.)
| | - Howard J. Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA; (H.J.A.); (V.L.V.); (W.E.K.)
| | - Makoto Watanabe
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan; (A.H.); (M.W.); (Y.K.); (Y.M.)
| | - Yuefang Chang
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA;
| | - Chikage Kakuta
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan; (M.I.); (C.K.)
| | - Zheming Yu
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213, USA; (B.J.L.); (Z.Y.); (C.A.M.)
| | - Chester A. Mathis
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213, USA; (B.J.L.); (Z.Y.); (C.A.M.)
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan; (A.H.); (M.W.); (Y.K.); (Y.M.)
| | - Tetsuya Fukuda
- Department of Radiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan;
| | - Victor L. Villemagne
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA; (H.J.A.); (V.L.V.); (W.E.K.)
| | - William E. Klunk
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA; (H.J.A.); (V.L.V.); (W.E.K.)
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA 15213, USA;
| | - Oscar L. Lopez
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA 15213, USA;
| | - Lewis H. Kuller
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; (C.C.); (L.H.K.)
| | - Yoshihiro Miyamoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan; (A.H.); (M.W.); (Y.K.); (Y.M.)
- Open Innovation Center, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
| | - Akira Sekikawa
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; (C.C.); (L.H.K.)
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Stöckl H, Sardinha L, Maheu-Giroux M, Meyer SR, García-Moreno C. Physical, sexual and psychological intimate partner violence and non-partner sexual violence against women and girls: a systematic review protocol for producing global, regional and country estimates. BMJ Open 2021; 11:e045574. [PMID: 34413098 PMCID: PMC8378393 DOI: 10.1136/bmjopen-2020-045574] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION In 2013, the WHO published the first global and regional estimates on physical and sexual intimate partner violence (IPV) and non-partner sexual violence (NPSV) based on a systematic review of population-based prevalence studies. In this protocol, we describe a new systematic review for the production of updated estimates for IPV and NPSV for global monitoring of violence against women, including providing the baseline for measuring Sustainable Development Goal to eliminate all forms of violence against women and girls. METHODS AND ANALYSIS The systematic review will update and extend the previous search for population-based surveys (either nationally or subnationally representative) conducted among women aged 15+ years that measured the prevalence of physical, sexual, psychological and physical and/or sexual IPV, NPSV or sexual violence by any perpetrator up to December 2019. Data will be extracted separately for all age groups, setting (urban/rural), partnership status (currently partnered/ever partnered/all women) and recall period (lifetime prevalence/past 12 months). Studies will be identified from electronic searches of online databases of EMBASE, MEDLINE, Global Health and PsycInfo. A search of national statistics office homepages will be conducted for each country to identify reports on population-based, national or subnational studies that include data on IPV or NPSV published outside academic journals. Two reviewers will be involved in quality assessment and data extraction of the review. The review is planned to be updated on a continuous basis. All findings will undergo a country consultation process. ETHICS AND DISSEMINATION Formal ethical approval is not required, as primary data will not be collected. This systematic review will provide a basis and a follow-up tool for global monitoring of the Sustainable Development Goal Target 5.2 on the elimination of all forms of violence against women and girls. PROSPERO REGISTRATION NUMBER CRD42017054100.
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Affiliation(s)
- Heidi Stöckl
- Gender, Violence and Health Centre, Global Health and Development, LSHTM, London, UK
| | - Lynnmarie Sardinha
- The UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | | | - Sarah R Meyer
- The UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Claudia García-Moreno
- The UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Miliku K, Moraes TJ, Becker AB, Mandhane PJ, Sears MR, Turvey SE, Subbarao P, Azad MB. Breastfeeding in the First Days of Life Is Associated With Lower Blood Pressure at 3 Years of Age. J Am Heart Assoc 2021; 10:e019067. [PMID: 34284597 PMCID: PMC8475685 DOI: 10.1161/jaha.120.019067] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Breastfeeding in infancy is associated with lower cardiovascular disease risk in adulthood; however, the amount of breastfeeding required to achieve this benefit is unknown. Methods and Results In the CHILD (Canadian Healthy Infant Longitudinal Development) Cohort Study, we analyzed 2382 children with complete data on early life feeding and blood pressure. Infant feeding was documented from hospital records in the first few days of life and reported by mothers throughout infancy. Blood pressure was measured at 3 years of age. Analyses controlled for birth weight, gestational age, socioeconomic status, maternal body mass index, and other potential confounders. We found that nearly all children (2333/2382; 97.9%) were ever breastfed, of whom 98 (4.2%) only briefly received breast milk during their birth hospitalization (“early limited breastfeeding”). At 3 years of age, blood pressure was higher in children who were never breastfed (mean systolic/diastolic 103/60 mm Hg) compared with those who were ever breastfed (99/58 mm Hg), including those who received only early limited breastfeeding (99/57 mm Hg). These differences in systolic blood pressure persisted in adjusted models (ever breastfed: −3.47 mm Hg, 95% CI, −6.14 to −0.80; early limited breastfeeding: −4.24 mm Hg, 95% CI, −7.45 to −1.04). Among breastfed children, there was no significant dose‐response association according to the duration or exclusivity of breastfeeding. Associations were not mediated by child body mass index. Conclusions Although the benefits of sustained and exclusive breastfeeding are indisputable, this study indicates any breastfeeding, regardless of duration or exclusivity, is associated with lower blood pressure at 3 years of age. Further research examining the bioactive components of early breast milk, underlying mechanisms, and long‐term associations is warranted.
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Affiliation(s)
- Kozeta Miliku
- Department of Medicine McMaster University Hamilton Canada.,Department of Pediatrics and Child Health University of Manitoba Winnipeg Canada.,Manitoba Interdisciplinary Lactation Centre (MILC) Children's Hospital Research Institute of Manitoba Winnipeg Canada
| | - Theo J Moraes
- Departments of Pediatrics Hospital for Sick Children University of Toronto Toronto Canada
| | - Allan B Becker
- Department of Pediatrics and Child Health University of Manitoba Winnipeg Canada
| | | | | | - Stuart E Turvey
- Department of Pediatrics University of British Columbia Vancouver Canada
| | - Padmaja Subbarao
- Departments of Pediatrics Hospital for Sick Children University of Toronto Toronto Canada
| | - Meghan B Azad
- Department of Pediatrics and Child Health University of Manitoba Winnipeg Canada.,Manitoba Interdisciplinary Lactation Centre (MILC) Children's Hospital Research Institute of Manitoba Winnipeg Canada
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Teufel F, Geldsetzer P, Sudharsanan N, Subramanyam M, Yapa HM, De Neve JW, Vollmer S, Bärnighausen T. The effect of bearing and rearing a child on blood pressure: a nationally representative instrumental variable analysis of 444611 mothers in India. Int J Epidemiol 2021; 50:1671-1683. [PMID: 34293139 PMCID: PMC8580275 DOI: 10.1093/ije/dyab058] [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] [Accepted: 03/04/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND At the individual level, it is well known that pregnancies have a short-term effect on a woman's cardiovascular system and blood pressure. The long-term effect of having children on maternal blood pressure, however, is unknown. We thus estimated the causal effect of having children on blood pressure among mothers in India, a country with a history of high fertility rates. METHODS We used nationally representative cross-sectional data from the 2015-16 India National Family and Health Survey (NFHS-4). The study population comprised 444 611 mothers aged 15-49 years. We used the sex of the first-born child as an instrumental variable (IV) for the total number of a woman's children. We estimated the effect of an additional child on systolic and diastolic blood pressure in IV (two-stage least squares) regressions. In additional analyses, we stratified the IV regressions by time since a mother last gave birth. Furthermore, we repeated our analyses using mothers' husbands and partners as the regression sample. RESULTS On average, mothers had 2.7 children [standard deviation (SD): 1.5], a systolic blood pressure of 116.4 mmHg (SD: 14.4) and diastolic blood pressure of 78.5 mmHg (SD: 9.4). One in seven mothers was hypertensive. In conventional ordinary least squares regression, each child was associated with 0.42 mmHg lower systolic [95% confidence interval (CI): -0.46 to -0.39, P < 0.001] and 0.13 mmHg lower diastolic (95% CI: -0.15 to -0.11, P < 0.001) blood pressure. In the IV regressions, each child decreased a mother's systolic blood pressure by an average of 1.00 mmHg (95% CI: -1.26 to -0.74, P < 0.001) and diastolic blood pressure by an average of 0.35 mmHg (95% CI: -0.52 to -0.17, P < 0.001). These decreases were sustained over more than a decade after childbirth, with effect sizes slightly declining as the time since last birth increased. Having children did not influence blood pressure in men. CONCLUSIONS Bearing and rearing a child decreases blood pressure among mothers in India.
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Affiliation(s)
- Felix Teufel
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Pascal Geldsetzer
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.,Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Nikkil Sudharsanan
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | | | - H Manisha Yapa
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Jan-Walter De Neve
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Sebastian Vollmer
- Department of Economics, University of Goettingen, Goettingen, Germany.,Centre for Modern Indian Studies, University of Goettingen, Goettingen, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.,Africa Health Research Institute (AHRI), Somkhele and Durban, South Africa.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Lantelme P, Moulayat C, Courand PY, Mouly-Bertin C, Debouzy-Berge C, Rial MO, Iwaz J, Harbaoui B, Riche B, Rabilloud M. Gain in net survival from hypertension control over the last half-century. Eur J Prev Cardiol 2021; 29:169-177. [PMID: 34269383 DOI: 10.1093/eurjpc/zwab094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/28/2021] [Accepted: 05/12/2021] [Indexed: 11/12/2022]
Abstract
AIMS This study determined whether the improvements in hypertension management over the last five decades have influenced subjects' prognosis. METHODS AND RESULTS The study considered 5693 eligible subjects seen January 1969 to February 1991 (follow-up until December 2003) or January 1995 to October 2014 (follow-up until July 2016) in an all-grade hypertension reference centre. Missing data or incomplete follow-ups led to exclude 1036 subjects (18%). The outcome was all-cause death. An adjusted modelling of the excess mortality rate assessed subjects' net survival over five inclusion periods to allow for the increase in life expectancy of the general population during the same periods. The analysis of 4657 records (mean age: 47 years; 43.2% women) showed that the proportion of subjects with grade 3 hypertension decreased significantly from 43.3% (1142) to only 6.3% (22) over the five periods and that the net survival improved in men and women regardless of the hypertension grade; i.e. the gain in net survival at 15 years was estimated at 12.3% (95% confidence interval: 8.1-22.3). The 15-year restricted mean survival was estimated at 13 years over the first period and 14.8 years over the last period, which is nearly a 2-year gain in life expectancy at 15 years. CONCLUSION Since the 70s and the advent of modern management, the excess mortality of hypertensive subjects (vs. the general population) was markedly reduced. Within a context of trivialization of blood pressure measurement and reluctance to long-term treatments, physicians should consider this advantage and use it to promote blood pressure control.
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Affiliation(s)
- Pierre Lantelme
- Université de Lyon, Lyon, France.,Service de Cardiologie, Hôpital de la Croix-Rousse and Hôpital Lyon Sud, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France.,CREATIS (CNRS UMR 5220, INSERM U1044, Université Lyon 1, INSA Lyon), Lyon, France
| | - Chahinaz Moulayat
- Université de Lyon, Lyon, France.,Service de Cardiologie, Hôpital de la Croix-Rousse and Hôpital Lyon Sud, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France.,CREATIS (CNRS UMR 5220, INSERM U1044, Université Lyon 1, INSA Lyon), Lyon, France
| | - Pierre-Yves Courand
- Université de Lyon, Lyon, France.,Service de Cardiologie, Hôpital de la Croix-Rousse and Hôpital Lyon Sud, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France.,CREATIS (CNRS UMR 5220, INSERM U1044, Université Lyon 1, INSA Lyon), Lyon, France
| | - Carine Mouly-Bertin
- Université de Lyon, Lyon, France.,Service de Cardiologie, Hôpital de la Croix-Rousse and Hôpital Lyon Sud, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France.,CREATIS (CNRS UMR 5220, INSERM U1044, Université Lyon 1, INSA Lyon), Lyon, France
| | - Constance Debouzy-Berge
- Université de Lyon, Lyon, France.,Service de Cardiologie, Hôpital de la Croix-Rousse and Hôpital Lyon Sud, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France.,CREATIS (CNRS UMR 5220, INSERM U1044, Université Lyon 1, INSA Lyon), Lyon, France
| | - Marie-Odile Rial
- Université de Lyon, Lyon, France.,Service de Cardiologie, Hôpital de la Croix-Rousse and Hôpital Lyon Sud, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France.,CREATIS (CNRS UMR 5220, INSERM U1044, Université Lyon 1, INSA Lyon), Lyon, France
| | - Jean Iwaz
- Université de Lyon, Lyon, France.,Université Lyon 1, Villeurbanne, France.,Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR5558, Villeurbanne, France
| | - Brahim Harbaoui
- Université de Lyon, Lyon, France.,Service de Cardiologie, Hôpital de la Croix-Rousse and Hôpital Lyon Sud, Hospices Civils de Lyon, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France.,CREATIS (CNRS UMR 5220, INSERM U1044, Université Lyon 1, INSA Lyon), Lyon, France
| | - Benjamin Riche
- Université de Lyon, Lyon, France.,Université Lyon 1, Villeurbanne, France.,Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR5558, Villeurbanne, France
| | - Muriel Rabilloud
- Université de Lyon, Lyon, France.,Université Lyon 1, Villeurbanne, France.,Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.,Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR5558, Villeurbanne, France
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Impact of Adrenalectomy on Morbidity in Patients with Non-Functioning Adrenal Cortical Tumours, Mild Hypercortisolism and Cushing's Syndrome as Assessed by National and Quality Registries. World J Surg 2021; 45:3099-3107. [PMID: 34180008 PMCID: PMC8408086 DOI: 10.1007/s00268-021-06214-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 01/06/2023]
Abstract
Background The impact of adrenalectomy on morbidity in patients with mild hypercortisolism and non-functioning adrenocortical adenoma is unclear. The present study evaluated morbidity before and after adrenalectomy in patients with benign adrenocortical tumour with Cushing´s syndrome (CS), autonomous cortisol secretion (ACS) and non-functioning adrenocortical adenoma as assessed by national and quality registries. Methods Patients registered in the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery (SQRTPA) 2009–2017 with CS, ACS or non-functioning adrenocortical adenoma, were included in this retrospective study and analysed with age- and sex-matched controls, 1:3. Morbidity associated with CS was assessed pre- and postoperatively by analysing data from the Swedish National Patient Register and the Swedish Prescribed Drug Register. Results Some 271 patients were included, CS (127), ACS (45) and non-functioning adrenocortical adenoma (99), with 813 matched controls. The frequency of hypertension was almost 50% in all tumour groups. Antihypertensive medication preoperatively was more frequent in all tumour groups compared with controls. No preoperative differences in medication were detected between patients with CS and ACS. A decrease in the use of hypertensive drugs was noticed annually for all patient groups after adrenalectomy. Conclusions Hypertension is common in patients with benign adrenocortical tumours regardless of cortisol hypersecretion. The use of antihypertensive drugs in patients with CS, ACS and non-functioning adrenocortical adenoma was reduced after adrenalectomy. These findings highlight the need for a randomized controlled trial to investigate the impact of adrenalectomy on morbidity in patients with mild hypercortisolism. Supplementary Information The online version contains supplementary material available at 10.1007/s00268-021-06214-0.
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Gohardehi F, Seyedin H, Moslehi S. Prevalence Rate of Diabetes and Hypertension in Disaster-Exposed Populations: A Systematic Review and Meta-Analysis. Ethiop J Health Sci 2021; 30:439-448. [PMID: 32874087 PMCID: PMC7445951 DOI: 10.4314/ejhs.v30i3.15] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Non-communicable diseases (NCD) such as hypertension (HTN) and diabetes mellitus (DM) have been one of the major health problems in the world. The aim of this study was to evaluate the prevalence rate of DM and HTN following natural and man-made disasters that impose significant economic and psychological burdens on human communities. Methods In this systematic and meta-analysis review, all cross-sectional studies that at least one of their objectives was to measure the prevalence of HTN or DM in individuals affected by natural and man-made disasters were included. Literature review was done in international databases including PubMed, Scopus and Web of Science, from database inception to February 17, 2019. The extracted data included the bibliographic characteristics of the article, the age of the participants, number of participants, gender, sample size, outcome, duration of the follow-up, and prevalence of DM and HTN. Data were analyzed by STATA software (version 11) and random effect method and the I2 index were used to investigate heterogeneity between the articles. Results A total of 16 articles met the inclusion criteria. Based on the quality assessment, 11 papers were categorized as moderate and 5 paper were categorized as high quality. The prevalence of HTN and DM in disaster-exposed populations were 47.35 (CI 95%: 38.53–56.17) and 13.56 (CI 95%: 10.12–17.01), respectively. Conclusion The results of this study show a high prevalence of HTN and DM in survivors of major disasters, which is higher in comparison to the general population
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Affiliation(s)
- Farzad Gohardehi
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hesam Seyedin
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shandiz Moslehi
- Department of Health in Disasters and Emergencies, Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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Time trends in the relation between blood pressure and dementia in 85-year-olds. J Hypertens 2021; 39:1964-1971. [PMID: 34102663 DOI: 10.1097/hjh.0000000000002902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Blood pressure has decreased in the general population. We aimed to examine whether this is true also among the very old, and among persons with and without dementia. Further, we aimed to investigate how common undetected and untreated hypertension is in the very old, both among people with and without dementia. METHOD Blood pressure was measured in representative population samples of 85-year-olds living in Gothenburg, Sweden, examined 1986-1987 (n = 484) and 2008-2010 (n = 571). Dementia was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, edition 3 revised, by the same medical doctor at both examinations. RESULTS Both systolic and diastolic blood pressure were lower in 85-year-olds examined 2008-2010 than in those examined 1986-1987, both among those with and without dementia. Participants with dementia had lower systolic blood pressure than those without dementia in both cohorts, and blood pressure levels related to dementia severity. Despite this, hypertension (≥140/90 mmHg) was found in almost half (46.5%) of those with dementia in 2008-2010. CONCLUSION Our findings show that time-trends of lower blood pressure in western populations also applies to the very old, and that individuals with dementia continue to have lower blood pressure compared to the rest of the population. The latter finding suggests that the pathophysiological processes in dementia affect blood pressure regulating regions in the brain independent of time trends. Still, hypertension is common in dementia and needs to be detected and treated.
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Zhang M, Liu T, Wang G, Buckley JP, Guallar E, Hong X, Wang MC, Wills-Karp M, Wang X, Mueller NT. In Utero Exposure to Heavy Metals and Trace Elements and Childhood Blood Pressure in a U.S. Urban, Low-Income, Minority Birth Cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:67005. [PMID: 34160246 PMCID: PMC8221032 DOI: 10.1289/ehp8325] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND In utero exposure to heavy metals lead (Pb), mercury (Hg), and cadmium (Cd) may be associated with higher childhood blood pressure (BP), whereas trace elements selenium (Se) and manganese (Mn) may have protective antioxidant effects that modify metal-BP associations. OBJECTIVES We examined the individual and joint effects of in utero exposure to Pb, Hg, Cd, Se, and Mn on childhood BP. METHODS We used data from the Boston Birth Cohort (enrolled 2002-2013). We measured heavy metals and trace elements in maternal red blood cells collected 24-72 h after delivery. We calculated child BP percentile per the 2017 American Academy of Pediatrics Clinical Practice Guideline. We used linear regression models to estimate the association of each metal, and Bayesian kernel machine regression (BKMR) to examine metal coexposures, with child BP between 3 to 15 years of age. RESULTS Our analytic sample comprised 1,194 mother-infant pairs (61% non-Hispanic Black, 20% Hispanic). Hg and Pb were not associated with child systolic BP (SBP). Se and Mn were inversely associated with child SBP percentiles, which, on average, were 6.23 points lower with a doubling of Se (95% CI: -11.51, -0.96) and 2.62 points lower with a doubling of Mn (95% CI: -5.20, -0.04). BKMR models showed similar results. Although Cd was not associated with child SBP overall, the inverse association between Mn and child SBP was stronger at higher levels of Cd (p-interaction=0.04). Consistent with this finding, in utero exposure to cigarette smoke modified the Mn-child SBP association. Among children whose mothers smoked during pregnancy, a doubling of Mn was associated with a 10.09-point reduction in SBP percentile (95% CI: -18.03, -2.15), compared with a 1.49-point reduction (95% CI: -4.21, 1.24) in children whose mothers did not smoke during pregnancy (p-interaction=0.08). CONCLUSION Se and Mn concentrations in maternal red blood cells collected 24-72 h after delivery were associated with lower child SBP at 3 to 15 years of age. There was an interaction between Mn and Cd on child SBP, whereby the protective association of Mn on child SBP was stronger among mothers who had higher Cd. The association of Mn and child SBP was also modified by maternal cigarette smoking-a source of Cd-during pregnancy. Optimizing in utero Se levels, as well as Mn levels in women who had high Cd or smoked during pregnancy, may protect offspring from developing high BP during childhood. https://doi.org/10.1289/EHP8325.
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Affiliation(s)
- Mingyu Zhang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tiange Liu
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Guoying Wang
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jessie P. Buckley
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Eliseo Guallar
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Xiumei Hong
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Mei-Cheng Wang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Marsha Wills-Karp
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Xiaobin Wang
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Noel T. Mueller
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
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Trump S, Lukassen S, Anker MS, Chua RL, Liebig J, Thürmann L, Corman VM, Binder M, Loske J, Klasa C, Krieger T, Hennig BP, Messingschlager M, Pott F, Kazmierski J, Twardziok S, Albrecht JP, Eils J, Hadzibegovic S, Lena A, Heidecker B, Bürgel T, Steinfeldt J, Goffinet C, Kurth F, Witzenrath M, Völker MT, Müller SD, Liebert UG, Ishaque N, Kaderali L, Sander LE, Drosten C, Laudi S, Eils R, Conrad C, Landmesser U, Lehmann I. Hypertension delays viral clearance and exacerbates airway hyperinflammation in patients with COVID-19. Nat Biotechnol 2021; 39:705-716. [PMID: 33361824 DOI: 10.1038/s41587-020-00796-1] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/11/2020] [Indexed: 01/29/2023]
Abstract
In coronavirus disease 2019 (COVID-19), hypertension and cardiovascular diseases are major risk factors for critical disease progression. However, the underlying causes and the effects of the main anti-hypertensive therapies-angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs)-remain unclear. Combining clinical data (n = 144) and single-cell sequencing data of airway samples (n = 48) with in vitro experiments, we observed a distinct inflammatory predisposition of immune cells in patients with hypertension that correlated with critical COVID-19 progression. ACEI treatment was associated with dampened COVID-19-related hyperinflammation and with increased cell intrinsic antiviral responses, whereas ARB treatment related to enhanced epithelial-immune cell interactions. Macrophages and neutrophils of patients with hypertension, in particular under ARB treatment, exhibited higher expression of the pro-inflammatory cytokines CCL3 and CCL4 and the chemokine receptor CCR1. Although the limited size of our cohort does not allow us to establish clinical efficacy, our data suggest that the clinical benefits of ACEI treatment in patients with COVID-19 who have hypertension warrant further investigation.
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Affiliation(s)
- Saskia Trump
- Molecular Epidemiology Unit, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Soeren Lukassen
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Markus S Anker
- Department of Cardiology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.,Division of Cardiology and Metabolism, Department of Cardiology Campus Virchow, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.,Centre for Cardiovascular Research (DZHK), Berlin, Germany.,Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany
| | - Robert Lorenz Chua
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Johannes Liebig
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Loreen Thürmann
- Molecular Epidemiology Unit, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Victor Max Corman
- Institute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Marco Binder
- Research group 'Dynamics of early viral infection and the innate antiviral response' (division F170), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jennifer Loske
- Molecular Epidemiology Unit, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Christina Klasa
- Institute for Bioinformatics, University Medicine Greifswald, Greifswald, Germany
| | - Teresa Krieger
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Bianca P Hennig
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Marey Messingschlager
- Molecular Epidemiology Unit, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Fabian Pott
- Institute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Julia Kazmierski
- Institute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Sven Twardziok
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jan Philipp Albrecht
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jürgen Eils
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sara Hadzibegovic
- Department of Cardiology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.,Division of Cardiology and Metabolism, Department of Cardiology Campus Virchow, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.,Centre for Cardiovascular Research (DZHK), Berlin, Germany.,Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany
| | - Alessia Lena
- Department of Cardiology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.,Division of Cardiology and Metabolism, Department of Cardiology Campus Virchow, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.,Centre for Cardiovascular Research (DZHK), Berlin, Germany.,Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Germany
| | - Bettina Heidecker
- Department of Cardiology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Thore Bürgel
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jakob Steinfeldt
- Department of Cardiology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Christine Goffinet
- Institute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Florian Kurth
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.,Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Witzenrath
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Maria Theresa Völker
- Department of Anesthesiology and Intensive Care, University Hospital Leipzig, Leipzig, Germany
| | - Sarah Dorothea Müller
- Department of Anesthesiology and Intensive Care, University Hospital Leipzig, Leipzig, Germany
| | - Uwe Gerd Liebert
- Institute of Virology, University Hospital Leipzig, Leipzig, Germany
| | - Naveed Ishaque
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Lars Kaderali
- Institute for Bioinformatics, University Medicine Greifswald, Greifswald, Germany
| | - Leif-Erik Sander
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Christian Drosten
- Institute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Sven Laudi
- Department of Anesthesiology and Intensive Care, University Hospital Leipzig, Leipzig, Germany.
| | - Roland Eils
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany. .,German Center for Lung Research (DZL), Berlin, Germany. .,Health Data Science Unit, Medical Faculty and BioQuant, University of Heidelberg, Heidelberg, Germany.
| | - Christian Conrad
- Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Ulf Landmesser
- Department of Cardiology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.
| | - Irina Lehmann
- Molecular Epidemiology Unit, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany. .,German Center for Lung Research (DZL), Berlin, Germany.
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Oridupa OA, Oyagbemi AA, Adejumobi O, Falade FB, Obisesan AD, Abegunde BA, Ekwem PC, Adegboye VO, Omobowale TO. Compensatory depression of arterial pressure and reversal of ECG abnormalities by Annona muricata and Curcuma longa in hypertensive Wistar rats. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 19:375-382. [PMID: 34018384 DOI: 10.1515/jcim-2020-0280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 02/15/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Increasing hypertension incidence in Sub-Sahara Africa and the current cost of management of the metabolic disorder has necessitated research on medicinal plants employed in African Traditional Medicine for hypertension. Thus, this study evaluated antihypertensive effect of Annona muricata leaves or Curcuma longa rhizomes in experimentally-induced hypertensive male Wistar rats (n=70) which were unilaterally nephrectomized and daily loaded with 1% salt. Cardiovascular and haematological changes, as well as urinalysis were determined. METHODS Rats were uninephrectomized and NaCl (1%) included in drinking water for 42 days. Extract-treated hypertensive rats were compared to normotensive, untreated hypertensive and hypertensive rats treated with lisinopril (5 mg/70 kg) or hydrochlorothiazide (12.5 mg/70 kg). A. muricata extract or C. longa extract were administered at 100, 200 or 400 mg/kg. Blood pressure (systolic, diastolic and mean arterial) and electrocardiogram was measured on day 41. Twenty-four-hour urine samples were collected from day 42. Blood samples were collected on day 43 for haematology (PCV, red cell indices, WBC and its differentials, and platelets). RESULTS AND CONCULSIONS A. muricata or C. longa extracts caused a decline in elevated blood pressure of hypertensive rats. Heart rate and QT segment reduction coupled with prolonged QRS duration were reversed in extract-treated rats, with significant increases in hemogram parameters indicating increased blood viscosity. Also, leukocyturia, proteinuria and ketonuria with increased urine alkalinity, urobilinogen and specific gravity which are classical indicators of poor prognostic outcomes in hypertension were reversed in extract-treated rats. In conclusion, A. muricata and C. longa have cardioprotective effect with reversal of derangements in haemogram and urinalysis associated with hypertension.
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Affiliation(s)
| | | | | | | | | | | | - Precious Chima Ekwem
- Department of Veterinary Pharmacology and Toxicology, University of Ibadan, Ibadan, Nigeria
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76
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Ruiz-Castell M, Samouda H, Bocquet V, Fagherazzi G, Stranges S, Huiart L. Estimated visceral adiposity is associated with risk of cardiometabolic conditions in a population based study. Sci Rep 2021; 11:9121. [PMID: 33907272 PMCID: PMC8079669 DOI: 10.1038/s41598-021-88587-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/13/2021] [Indexed: 12/14/2022] Open
Abstract
Visceral adiposity is a major risk factor of cardiometabolic diseases. Visceral adipose tissue (VAT) is usually measured with expensive imaging techniques which present financial and practical challenges to population-based studies. We assessed whether cardiometabolic conditions were associated with VAT by using a new and easily measurable anthropometric index previously published and validated. Data (1529 participants) came from the European Health Examination Survey in Luxembourg (2013–2015). Logistic regressions were used to study associations between VAT and cardiometabolic conditions. We observed an increased risk of all conditions associated with VAT. The total adjusted odds ratio (AOR, [95% CI]) for hypertension, prediabetes/diabetes, hypercholesterolemia, and hypertriglyceridemia for the fourth quartile of VAT compared to the lowest were 10.22 [6.75, 15.47]), (5.90 [4.02, 8.67]), (3.60 [2.47, 5.25]) and (7.67 [5.04, 11.67]. We observed higher odds in women than in men for all outcomes with the exception of hypertension. Future studies should investigate the impact of VAT changes on cardiometabolic health and the use of anthropometrically predicted VAT as an accurate outcome when no biomedical imaging is available.
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Affiliation(s)
- Maria Ruiz-Castell
- Department of Population Health, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, 1445, Strassen, Luxembourg.
| | - Hanen Samouda
- Nutrition and Health Research Group, Department of Population Health, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Valery Bocquet
- Competence Centre for Methodology and Statistics, Department of Population Health, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Guy Fagherazzi
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Saverio Stranges
- Department of Population Health, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, 1445, Strassen, Luxembourg.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Kresge Building, 1151 Richmond St, London, ON, N6A 3K7, Canada.,Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, Western Centre for Public Health and Family Medicine, 1465 Richmond St, London, ON, N6G 2M1, Canada
| | - Laetitia Huiart
- Department of Population Health, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, 1445, Strassen, Luxembourg
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Muntner P. Hypertension Across the Life Course: Introduction to an American Journal of Hypertension Compendium. Am J Hypertens 2021; 34:231-233. [PMID: 33821940 DOI: 10.1093/ajh/hpab010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 01/05/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Asemu MM, Yalew AW, Kabeta ND, Mekonnen D. Prevalence and risk factors of hypertension among adults: A community based study in Addis Ababa, Ethiopia. PLoS One 2021; 16:e0248934. [PMID: 33793641 PMCID: PMC8016337 DOI: 10.1371/journal.pone.0248934] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 03/08/2021] [Indexed: 11/19/2022] Open
Abstract
Background In all areas of the World Health Organization, the prevalence of hypertension was highest in Africa. High blood pressure is a significant risk factor for coronary and ischemic diseases, as well as hemorrhagic stroke. However, there were scarce data concerning the magnitude and risk factors of hypertension. Thus, this study aimed to identify the prevalence and associated factors of hypertension among adults in Addis Ababa city. Method A community-based cross-sectional study was conducted from June to October 2018 in Addis Ababa city. Participants aged 18 years and older recruited using a multi-stage random sampling technique. Data were collected by face-to-face interview technique. All three WHO STEPS instruments were applied. Additionally, participants’ weight, height, waist, hip, and blood pressure (BP) were measured according to standard procedures. Multiple logistic regressions were used and Odds ratios with 95% confidence intervals were also calculated to identify associated factors. Results In this study, a total of 3560 participants were included.The median age was 32 years (IQR 25, 45). More than half (57.3%) of the respondents were females. Almost all (96.2%) of participants consumed vegetables and or fruits less than five times per day. Eight hundred and sixty-five (24.3%) of respondents were overweight, while 287 (8.1%) were obese. One thousand forty-one 29.24% (95% CI: 27.75–30.74) were hypertensive, of whom two-thirds (61.95%) did not know that they had hypertension. Factors significantly associated with hypertension were age 30–49 and ≥50 years (AOR = 2.79, 95% CI: 1.39–5.56) and (AOR = 8.23, 95% CI: 4.09–16.55) respectively, being male (AOR = 1.88, 95% CI: 1.18–2.99), consumed vegetables less than or equal to 3 days per week (AOR = 2.44, 95% CI: 1.21–4.93), obesity (AOR = 2.05, 95%CI: 1.13–3.71), abdominal obesity (AOR = 1.70, 95% CI: 1.10–2.64) and high triglyceride level (AOR = 2.06, 95% CI: 1.38–3.07). Conclusion In Addis Ababa, around one in three adults are hypertensive. With a large proportion, unaware of their condition. We recommend integrating regular community-based screening programs as integral parts of the health promotion and disease prevention strategies. Lifestyle interventions shall target the modifiable risk factors associated with hypertension, such as weight loss and increased vegetable consumption.
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Affiliation(s)
- Meseret Molla Asemu
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail: ,
| | | | | | - Desalew Mekonnen
- College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
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Asemu MM, Yalew AW, Kabeta ND, Mekonnen D. Prevalence and risk factors of hypertension among adults: A community based study in Addis Ababa, Ethiopia. PLoS One 2021. [DOI: https://doi.org/10.1371/journal.pone.0248934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background
In all areas of the World Health Organization, the prevalence of hypertension was highest in Africa. High blood pressure is a significant risk factor for coronary and ischemic diseases, as well as hemorrhagic stroke. However, there were scarce data concerning the magnitude and risk factors of hypertension. Thus, this study aimed to identify the prevalence and associated factors of hypertension among adults in Addis Ababa city.
Method
A community-based cross-sectional study was conducted from June to October 2018 in Addis Ababa city. Participants aged 18 years and older recruited using a multi-stage random sampling technique. Data were collected by face-to-face interview technique. All three WHO STEPS instruments were applied. Additionally, participants’ weight, height, waist, hip, and blood pressure (BP) were measured according to standard procedures.
Multiple logistic regressions were used and Odds ratios with 95% confidence intervals were also calculated to identify associated factors.
Results
In this study, a total of 3560 participants were included.The median age was 32 years (IQR 25, 45). More than half (57.3%) of the respondents were females. Almost all (96.2%) of participants consumed vegetables and or fruits less than five times per day. Eight hundred and sixty-five (24.3%) of respondents were overweight, while 287 (8.1%) were obese. One thousand forty-one 29.24% (95% CI: 27.75–30.74) were hypertensive, of whom two-thirds (61.95%) did not know that they had hypertension.
Factors significantly associated with hypertension were age 30–49 and ≥50 years (AOR = 2.79, 95% CI: 1.39–5.56) and (AOR = 8.23, 95% CI: 4.09–16.55) respectively, being male (AOR = 1.88, 95% CI: 1.18–2.99), consumed vegetables less than or equal to 3 days per week (AOR = 2.44, 95% CI: 1.21–4.93), obesity (AOR = 2.05, 95%CI: 1.13–3.71), abdominal obesity (AOR = 1.70, 95% CI: 1.10–2.64) and high triglyceride level (AOR = 2.06, 95% CI: 1.38–3.07).
Conclusion
In Addis Ababa, around one in three adults are hypertensive. With a large proportion, unaware of their condition. We recommend integrating regular community-based screening programs as integral parts of the health promotion and disease prevention strategies. Lifestyle interventions shall target the modifiable risk factors associated with hypertension, such as weight loss and increased vegetable consumption.
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Geographic variations and potential macro-environmental exposure of hypertension: from the China hypertension survey. J Hypertens 2021; 38:829-838. [PMID: 31990899 DOI: 10.1097/hjh.0000000000002352] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The study aimed to investigate the spatial variation of hypertension (HTN) and the associations between the risk of HTN and altitude, longitude, latitude in Chinese population. METHODS The newest China Hypertension Survey (CHS) study, which used a nationally representative sample, was conducted between 2012 and 2015. A total of 451 755 participants aged at least 18 years from 262 county-level regions in 31 provinces were analyzed to explore the geographical variations of HTN prevalence at county-level. A total of 444 375 participants were included in two-level logistic regression model to examine the association between HTN risk and exposure to altitude, longitude, and latitude after adjusting for potential confounding variables at individual level. RESULTS The findings of spatial analysis indicated that there were remarkably high and low HTN prevalence zones. High HTN prevalence zones extended from parts of the southeast to northern China and the northeast. The risk of HTN increased with increasing longitude, with adjusted odds ratios (aORs, 95% confidence interval [CI]) of 2.08 (1.04--4.18), 2.21 (1.15--4.22), 2.54 (1.31--4.93), 2.59 (1.32--5.08), and 2.81 (1.12--7.08) for longitudes of 90-100°E, 100-110°E, 110-120°E, 120-130°E, and at least 130°E, respectively, with a significant dose--response relationship that HTN risks increase as longitude rises from 90°E to ≥130°E(Ptrend <0.001), compared with the longitude group of less than 80°E, consistent with the conclusion that geographical variations of high HTN prevalence zones by spatial analysis. CONCLUSION The findings of remarkably high HTN prevalence zones modified previous understandings about the regional difference of HTN distribution, and provide an important basis for future efforts to prevent and control HTN in different regions of China.
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Shen X, Xiao S, Liu R, Tong G, Liu T, Wang D. Personalized hypertension management based on serial assessment and telemedicine (PHMA): a cluster randomize controlled trial protocol in Anhui, China. BMC Cardiovasc Disord 2021; 21:135. [PMID: 33711941 PMCID: PMC7953659 DOI: 10.1186/s12872-021-01943-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite tremendous investment worldwide, hypertension treatment and control rates remain low. The complexity and long-term dynamics of influencing factors make personalized management inevitable and challenging. This protocol describes Personalized Hypertension Management in Anhui, China (PHMA), a project that uses a package of innovative approaches in tailoring interventions to individual patient's dynamic complications and contexts. METHODS/DESIGN PHMA strives to reduce hypertension harms by eight "objective behaviors" (e.g., self-monitoring and reporting, healthy diet, physical exercise/activities). These objective behaviors are promoted through five intervention measures: support for self- monitoring, supervised machine communications, daily education or reminder messages, weekly blood pressure notification, and quarterly signed feedback. PHMA uses ten categories and over 300 variables in selecting and refining intervention procedures and content for individual patients. Efficacy of the intervention package is evaluated using a cluster randomized controlled trial design involving a total of 60 site communities and 3352 hypertension patients. Primary measure for the evaluation is systolic and diastolic blood pressure; while secondary evaluation measures include quality of life (EQ5D-5L), occurrence of hypertension-related complications (such as cerebral hemorrhage, coronary heart disease, myocardial or cerebral infarction), healthcare utilization and scores of objective behaviors. DISCUSSION PHMA uses novel, low cost and sustainable approaches to tailor interventions to the dynamic conditions and contexts of individual patients. Unlike contemporary approaches to hypertension management which are mainly population based, each participant patient in PHMA applies a unique intervention package and all messages, feedbacks and other materials sent out to individual patients are different from each other. PHMA is the first project that adopts comprehensive tailoring and if proved effective, it should have important implications for future research, practice and policy-making. Trial registration ISRCTN10999269. July 17, 2020; https://doi.org/10.1186/ISRCTN10999269 .
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Affiliation(s)
- Xingrong Shen
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, China
| | - Siyi Xiao
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, China
| | - Rong Liu
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, China
| | - Guixian Tong
- The First Affiliated Hospital of USTC, 17 Lujiang Road, Hefei, China
| | - Tongzhu Liu
- The First Affiliated Hospital of USTC, 17 Lujiang Road, Hefei, China
| | - Debin Wang
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, China
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Tanrygulyyeva M, Tanser F, Tao Y, Tarawneh MR, Tarp J, Tarqui-Mamani CB, Braunerová RT, Taylor A, Taylor J, Tchibindat F, Tebar WR, Tell GS, Tello T, Tham YC, Thankappan KR, Theobald H, Theodoridis X, Thijs L, Thomas N, Thuesen BH, Tichá L, Timmermans EJ, Tjonneland A, Tolonen HK, Tolstrup JS, Topbas M, Topór-Madry R, Torheim LE, Tormo MJ, Tornaritis MJ, Torrent M, Torres-Collado L, Toselli S, Touloumi G, Traissac P, Tran TTH, Trichopoulos D, Trichopoulou A, Trinh OTH, Trivedi A, Tshepo L, Tsigga M, Tsugane S, Tuliakova AM, Tulloch-Reid MK, Tullu F, Tuomainen TP, Tuomilehto J, Turley ML, Twig G, Tynelius P, Tzotzas T, Tzourio C, Ueda P, Ugel E, Ukoli FAM, Ulmer H, Unal B, Usupova Z, Uusitalo HMT, Uysal N, Vaitkeviciute J, Valdivia G, Vale S, Valvi D, van Dam RM, Van der Heyden J, van der Schouw YT, Van Herck K, Van Minh H, Van Schoor NM, van Valkengoed IGM, Vanderschueren D, Vanuzzo D, Varbo A, Varela-Moreiras G, Varona-Pérez P, Vasan SK, Vega T, Veidebaum T, Velasquez-Melendez G, Velika B, Veronesi G, Verschuren WMM, Victora CG, Viegi G, Viet L, Villalpando S, Vineis P, Vioque J, Virtanen JK, Visser M, Visvikis-Siest S, Viswanathan B, Vladulescu M, Vlasoff T, Vocanec D, Vollenweider P, Völzke H, Voutilainen A, Voutilainen S, Vrijheid M, Vrijkotte TGM, Wade AN, Wagner A, Waldhör T, Walton J, Wambiya EOA, Bebakar WMW, Mohamud WNW, de Souza Wanderley Júnior R, Wang MD, Wang N, Wang Q, Wang X, Wang YX, Wang YW, Wannamethee SG, Wareham N, Weber A, Wedderkopp N, Weerasekera D, Weghuber D, Wei W, Weres A, Werner B, Whincup PH, Widhalm K, Widyahening IS, Wiecek A, Wilks RJ, Willeit J, Willeit P, Williams J, Wilsgaard T, Wojtyniak B, Wong-McClure RA, Wong A, Wong JE, Wong TY, Woo J, Woodward M, Wu FC, Wu J, Wu LJ, Wu S, Xu H, Xu L, Yaacob NA, Yamborisut U, Yan W, Yang L, Yang X, Yang Y, Yardim N, Yaseri M, Yasuharu T, Ye X, Yiallouros PK, Yoosefi M, Yoshihara A, You QS, You SL, Younger-Coleman NO, Md Yusof S, Yusoff AF, Zaccagni L, Zafiropulos V, Zainuddin AA, Zakavi SR, Zamani F, Zambon S, Zampelas A, Zamrazilová H, Zapata ME, Zargar AH, Ko Zaw K, Zdrojewski T, Zejglicova K, Vrkic TZ, Zeng Y, Zhang L, Zhang ZY, Zhao D, Zhao MH, Zhao W, Zhen S, Zheng W, Zheng Y, Zholdin B, Zhou M, Zhu D, Zins M, Zitt E, Zocalo Y, Cisneros JZ, Zuziak M, Ezzati M, Filippi S. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight. eLife 2021; 10:e60060. [PMID: 33685583 PMCID: PMC7943191 DOI: 10.7554/elife.60060] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 01/07/2021] [Indexed: 02/05/2023] Open
Abstract
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nayu Ikeda
- National Institutes of Biomedical Innovation, Health and Nutrition
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- Capital Medical University Beijing An Zhen Hospital
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- University of Copenhagen
- Copenhagen University Hospital
| | | | | | | | | | | | | | - Ali Ahmadi
- Shahrekord University of Medical Sciences
| | | | | | | | | | - Kamel Ajlouni
- National Center for Diabetes, Endocrinology and Genetics
| | | | | | | | | | | | | | | | | | | | | | | | - Eman Aly
- World Health Organization Regional Office for the Eastern Mediterranean
| | | | - Parisa Amiri
- Research Center for Social Determinants of Health
| | | | | | | | | | | | | | | | | | - Joana Araújo
- Institute of Public Health of the University of Porto
| | | | | | | | | | | | | | | | | | | | | | | | - Shina Avi
- Tel-Aviv University
- Hebrew University of Jerusalem
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Abdul Basit
- Baqai Institute of Diabetology and Endocrinology
| | | | | | | | | | | | | | | | | | | | | | | | - Judith Benedics
- Federal Ministry of Social Affairs, Health, Care and Consumer Protection
| | | | | | | | | | | | | | | | | | | | | | | | - Hongsheng Bi
- Shandong University of Traditional Chinese Medicine
| | - Yufang Bi
- Shanghai Jiao-Tong University School of Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - João Breda
- World Health Organization Regional Office for Europe
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- Council for Agricultural Research and Economics
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- The Gertner Institute for Epidemiology and Health Policy Research
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- Canadian Fitness and Lifestyle Research Institute
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- The Gertner Institute for Epidemiology and Health Policy Research
| | | | | | | | - Luc Dauchet
- University of Lille
- Lille University Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jia Li Duan
- Beijing Center for Disease Prevention and Control
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- Scuola Superiore Sant'Anna
- Al-Farabi Kazakh National University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Günther Fink
- Swiss Tropical and Public Health Institute
- University of Basel
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- World Health Organization Regional Office for the Eastern Mediterranean
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- Victor Babes University of Medicine and Pharmacy Timisoara
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- Institut National de la Santé et de la Recherche Médicale
- Paris University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Yin Guo
- Capital Medical University Beijing Tongren Hospital
| | | | - Rajeev Gupta
- Eternal Heart Care Centre and Research Institute
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- Beijing Institute of Ophthalmology
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- National Research Institute for Health and Family Planning
| | - Yuna He
- Chinese Center for Disease Control and Prevention
| | | | | | | | | | | | - Ana Henriques
- Institute of Public Health of the University of Porto
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- Institute of Molecular and Clinical Ophthalmology Basel
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- French National Research Institute for Sustainable Development
| | | | | | | | | | | | | | | | | | - Joanne Katz
- Johns Hopkins Bloomberg School of Public Health
| | | | | | | | | | | | | | | | | | - Roya Kelishadi
- Research Institute for Primordial Prevention of Non-communicable Disease
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- PASs Hirszfeld Institute of Immunology and Experimental Therapy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Edwige Landais
- French National Research Institute for Sustainable Development
| | - Vera Lanska
- Institute for Clinical and Experimental Medicine
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- University of Chinese Academy of Sciences
| | | | | | | | | | | | - Lijuan Liu
- Capital Medical University Beijing Tongren Hospital
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- National Research Institute for Health and Family Planning
| | | | | | | | | | - Stefania Maggi
- Institute of Neuroscience of the National Research Council
| | | | | | | | | | - Bernard Maire
- French National Research Institute for Sustainable Development
| | | | | | - Päivi Mäki
- Finnish Institute for Health and Welfare
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jaume Marrugat
- CIBERCV
- Institut Hospital del Mar d'Investigacions Mèdiques
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jie Mi
- Capital Institute of Pediatrics
| | | | | | | | | | | | | | - GK Mini
- Women’s Social and Health Studies Foundation
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marie Moitry
- University of Strasbourg
- Strasbourg University Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jorge Motta
- Instituto Conmemorativo Gorgas de Estudios de la Salud
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jana Námešná
- Banska Bystrica Regional Authority of Public Health
| | | | | | | | | | | | | | | | | | | | - Keiu Nelis
- National Institute for Health Development
| | - Liis Nelis
- National Institute for Health Development
| | | | | | | | | | | | | | | | - Yury P Nikitin
- SB RAS Federal Research Center Institute of Cytology and Genetics
| | - Guang Ning
- Shanghai Jiao-Tong University School of Medicine
| | | | | | - Marianna Noale
- Institute of Neuroscience of the National Research Council
| | | | | | | | | | | | | | | | | | | | - Eha Nurk
- National Institute for Health Development
| | | | | | | | | | | | | | - Kyungwon Oh
- Korea Centers for Disease Control and Prevention
| | | | - Claes Ohlsson
- University of Gothenburg
- Sahlgrenska University Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Domenico Palli
- Institute for Cancer Research, Prevention and Clinical Network
| | | | | | | | | | | | - Francesco Panza
- IRCCS Ente Ospedaliero Specializzato in Gastroenterologia S. de Bellis
| | | | | | - Suyeon Park
- Korea Centers for Disease Control and Prevention
| | | | | | - Ionela M Pascanu
- University of Medicine, Pharmacy, Science and Technology of Târgu Mures
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Iris Pigeot
- Leibniz Institute for Prevention Research and Epidemiology - BIPS
| | | | | | | | | | | | | | | | | | | | | | - Raluca M Pop
- University of Medicine, Pharmacy, Science and Technology of Târgu Mures
| | | | - Miquel Porta
- Institut Hospital del Mar d'Investigacions Mèdiques
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Maria Puiu
- Victor Babes University of Medicine and Pharmacy Timisoara
| | | | | | | | | | | | | | | | | | | | | | - Manu Raj
- Amrita Institute of Medical Sciences
| | | | | | - Ivo Rakovac
- World Health Organization Regional Office for Europe
| | | | | | | | | | - Rafel Ramos
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ana Rito
- National Institute of Health Doutor Ricardo Jorge
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Paola Russo
- Institute of Food Sciences of the National Research Council
| | | | | | | | | | | | | | | | | | - Nader Saki
- Ahvaz Jundishapur University of Medical Sciences
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Savvas Savva
- Research and Education Institute of Child Health
| | - Mathilde Savy
- French National Research Institute for Sustainable Development
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Aletta E Schutte
- University of New South Wales
- The George Institute for Global Health
| | | | | | | | - Abhijit Sen
- Center for Oral Health Services and Research Mid-Norway
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alfonso Siani
- Institute of Food Sciences of the National Research Council
| | | | | | | | | | | | | | | | | | | | | | | | | | - Liam Smeeth
- London School of Hygiene & Tropical Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Igor Spiroski
- Institute of Public Health
- Ss. Cyril and Methodius University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lela Sturua
- National Center for Disease Control and Public Health
| | | | | | | | | | | | | | | | | | | | | | | | | | - Lucjan Szponar
- National Institute of Public Health – National Institute of Hygiene
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Pierre Traissac
- French National Research Institute for Sustainable Development
| | | | | | | | - Oanh TH Trinh
- University of Medicine and Pharmacy at Ho Chi Minh City
| | | | | | | | | | | | | | | | | | | | | | - Gilad Twig
- Tel-Aviv University
- Hebrew University of Jerusalem
| | | | | | | | | | - Eunice Ugel
- Universidad Centro-Occidental Lisandro Alvarado
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Anette Varbo
- Copenhagen University Hospital
- University of Copenhagen
| | | | | | | | - Tomas Vega
- Consejería de Sanidad Junta de Castilla y León
| | | | | | | | | | | | | | | | - Lucie Viet
- National Institute for Public Health and the Environment
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ningli Wang
- Capital Medical University Beijing Tongren Hospital
| | | | | | | | | | | | | | - Adelheid Weber
- Federal Ministry of Social Affairs, Health, Care and Consumer Protection
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Bogdan Wojtyniak
- National Institute of Public Health - National Institute of Hygiene
| | | | | | | | | | - Jean Woo
- The Chinese University of Hong Kong
| | | | | | - Jianfeng Wu
- Shandong University of Traditional Chinese Medicine
| | | | | | - Haiquan Xu
- Institute of Food and Nutrition Development of Ministry of Agriculture and Rural Affairs
| | - Liang Xu
- Beijing Institute of Ophthalmology
| | | | | | - Weili Yan
- Children's Hospital of Fudan University
| | | | | | - Yang Yang
- Shanghai Educational Development Co. Ltd
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- Peking University
- Duke University
| | | | | | - Dong Zhao
- Capital Medical University Beijing An Zhen Hospital
| | | | - Wenhua Zhao
- Chinese Center for Disease Control and Prevention
| | - Shiqi Zhen
- Jiangsu Provincial Center for Disease Control and Prevention
| | | | | | | | - Maigeng Zhou
- Chinese Center for Disease Control and Prevention
| | - Dan Zhu
- Inner Mongolia Medical University
| | - Marie Zins
- Institut National de la Santé et de la Recherche Médicale
- Paris University
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Dhangadamajhi G, Singh S. Malaria link of hypertension: a hidden syndicate of angiotensin II, bradykinin and sphingosine 1-phosphate. Hum Cell 2021; 34:734-744. [PMID: 33683655 DOI: 10.1007/s13577-021-00513-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/22/2021] [Indexed: 01/22/2023]
Abstract
In malaria-endemic countries, the burden of hypertension is on the rise. Although malaria and hypertension seem to have no direct link, several studies in recent years support their possible link. Three bioactive molecules such as angiotensin II (Ang II), bradykinin (BK) and sphingosine 1-phosphate (S1P) are crucial in regulating blood pressure. While the increased level of Ang II and S1P are responsible for inducing hypertension, BK is arthero-protective and anti-hypertensive. Therefore, in the present review, based on available literatures we highlight the present knowledge on the production and bioavailability of these molecules, the mechanism of their regulation of hypertension, and patho-physiological role in malaria. Further, a possible link between malaria and hypertension is hypothesized through various arguments based on experimental evidence. Understanding of their mechanisms of blood pressure regulation during malaria infection may open up avenues for drug therapeutics and management of malaria in co-morbidity with hypertension.
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Affiliation(s)
- Gunanidhi Dhangadamajhi
- Department of Biotechnology, Maharaja Sriramchandra Bhanjadeo University, Takatpur, Baripada, Odisha, 75003, India.
| | - Shailja Singh
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, 110067, India
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84
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Adeloye D, Owolabi EO, Ojji DB, Auta A, Dewan MT, Olanrewaju TO, Ogah OS, Omoyele C, Ezeigwe N, Mpazanje RG, Gadanya MA, Agogo E, Alemu W, Adebiyi AO, Harhay MO. Prevalence, awareness, treatment, and control of hypertension in Nigeria in 1995 and 2020: A systematic analysis of current evidence. J Clin Hypertens (Greenwich) 2021; 23:963-977. [PMID: 33600078 PMCID: PMC8678849 DOI: 10.1111/jch.14220] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/27/2021] [Accepted: 01/31/2021] [Indexed: 12/12/2022]
Abstract
Improved understanding of the current burden of hypertension, including awareness, treatment, and control, is needed to guide relevant preventative measures in Nigeria. A systematic search of studies on the epidemiology of hypertension in Nigeria, published on or after January 1990, was conducted. The authors employed random‐effects meta‐analysis on extracted crude hypertension prevalence, and awareness, treatment, and control rates. Using a meta‐regression model, overall hypertension cases in Nigeria in 1995 and 2020 were estimated. Fifty‐three studies (n = 78 949) met our selection criteria. Estimated crude prevalence of pre‐hypertension (120‐139/80‐89 mmHg) in Nigeria was 30.9% (95% confidence interval [CI]: 22.0%‐39.7%), and the crude prevalence of hypertension (≥140/90 mmHg) was 30.6% (95% CI: 27.3%‐34.0%). When adjusted for age, study period, and sample, absolute cases of hypertension increased by 540% among individuals aged ≥20 years from approximately 4.3 million individuals in 1995 (age‐adjusted prevalence 8.6%, 95% CI: 6.5‐10.7) to 27.5 million individuals with hypertension in 2020 (age‐adjusted prevalence 32.5%, 95% CI: 29.8‐35.3). The age‐adjusted prevalence was only significantly higher among men in 1995, with the gap between both sexes considerably narrowed in 2020. Only 29.0% of cases (95% CI: 19.7‐38.3) were aware of their hypertension, 12.0% (95% CI: 2.7‐21.2) were on treatment, and 2.8% (95% CI: 0.1‐5.7) had at‐goal blood pressure in 2020. Our study suggests that hypertension prevalence has substantially increased in Nigeria over the last two decades. Although more persons are aware of their hypertension status, clinical treatment and control rates, however, remain low. These estimates are relevant for clinical care, population, and policy response in Nigeria and across Africa.
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Affiliation(s)
- Davies Adeloye
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Eyitayo O Owolabi
- Centre for Global Surgery, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Dike B Ojji
- Department of Medicine, Faculty of Clinical Sciences, University of Abuja, Gwagwalada, Abuja, Nigeria
| | - Asa Auta
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, UK
| | | | - Timothy O Olanrewaju
- Department of Medicine, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | | | | | | | | | - Muktar A Gadanya
- Department of Community Medicine, Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
| | | | | | | | - Michael O Harhay
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Siddiqui A, Ganai J, Khan N, Davari S, Mujaddadi A. Effect of differential music tempo on post-exercise cardiovascular recovery parameters in hypertensive individuals: a randomised control trial. COMPARATIVE EXERCISE PHYSIOLOGY 2021. [DOI: 10.3920/cep200005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Hypertensive individuals tend to have autonomic dysfunction indicated by sympathetic dominance or delayed parasympathetic reactivation. A complimentary therapy such as music following exercise is considered to be beneficial in improving autonomic recovery. The purpose of this study was to assess the effect of differential music tempo on post-exercise cardiovascular recovery parameters in hypertensive individuals. Thirty hypertensive individuals were recruited for the present study which were randomly allocated to no music (n=10), slow music (n=10) and fast music (n=10) group. Participants in all three groups were subjected to submaximal exercise bout by Harvard step test. The cardiovascular recovery parameters i.e. heart rate recovery (HRR), blood pressure recovery (BPR) and rating of perceived exertion recovery (RPER) were assessed in all three groups after 1 min, 2 min and 3 min following termination of exercise. A significant decline was observed in HRR (P=0.002) and RPER (P=0.008) following exercise in slow music group as compared to fast and no music while no significant differences were observed in BPR between the three groups. The study concluded that music accelerates post-exercise recovery and slow music has greater effect as compared to fast or no music. These findings may have potential implications in the cardiovascular recovery dynamics in hypertensive individuals participating in submaximal exercise.
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Affiliation(s)
- A.N. Siddiqui
- Department of Rehabilitation Science, Jamia Hamdard University, New Delhi 110062, India
| | - J. Ganai
- Department of Rehabilitation Science, Jamia Hamdard University, New Delhi 110062, India
| | - N. Khan
- Department of Rehabilitation Science, Jamia Hamdard University, New Delhi 110062, India
| | - S. Davari
- Department of Medicine, HIMSR, Jamia Hamdard University, New Delhi 110062, India
| | - A. Mujaddadi
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi 110025, India
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Sudhakaran P. Acupuncture for Hypertension Using Traditional Chinese Medicine Concepts. Med Acupunct 2021; 33:15-21. [PMID: 33613809 DOI: 10.1089/acu.2020.1422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Hypertension affects 25% of the adult population worldwide. Biomedical treatment involves various blockers and is associated with side-effects. Acupuncture was one of the earliest methods of treatment for "hard pulse disease" (now called hypertension); it is effective and is associated with no untoward effects. Various studies showing the effectiveness of acupuncture for addressing hypertension are presented, along with an illustrative case. Acupuncture is effective for reducing blood pressure. This modality can be used as a stand-alone therapy or along with antihypertensive medications-in which case the dosages of the medications can be reduced significantly-and this helps to reduce the side-effects of medications.
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87
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Shin J, Ham D, Paik HY, Shin S, Joung H. Gender Differences in the Risk of Ischemic Heart Disease According to Healthcare Utilization and Medication Adherence among Newly Treated Korean Hypertensive Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1274. [PMID: 33572632 PMCID: PMC7908180 DOI: 10.3390/ijerph18031274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 11/17/2022]
Abstract
We aimed to investigate gender differences in ischemic heart disease (IHD) according to healthcare utilization and medication adherence among newly treated Korean hypertensive adults. The National Sample Cohort version 2.0 of the National Health Insurance Service was used for analysis. Newly treated hypertensive patients ≥ 20 years and without IHD in 2002 were selected from a population that underwent health examination during 2003-2006. Of those patients, 11,942 men and 11,193 women were analyzed and followed up for 10 years. We determined the association between IHD and healthcare utilization and medication adherence using the Cox proportional hazards model. Hypertensive women patients had a lower risk of IHD than men patients (hazard ratio [HR] = 0.93, 95% confidence interval [CI] 0.88-1.00). The IHD risk was increased in patients who visited healthcare providers > 12 times/person-year (HR = 2.97, 95% CI 2.79-3.17), paid high out-of-pocket expense/person-year (HR = 1.55, 95% CI 1.41-1.69), and had medication nonadherence (HR = 1.67, 95% CI 1.58-1.77). However, the risk was decreased in patients who used both urban and rural areas (HR 0.75, 95% CI 0.67-0.84) and mixed types of providers (HR = 0.93, CI 0.88-0.99). The risk of IHD was significantly different between men and women only in the visiting frequency to healthcare providers (men, HR = 3.21, 95% CI 2.93-3.52; women, HR = 2.78, 95% CI 2.53-3.04, p for interaction = 0.0188). In summary, the risk of IHD was similar according to healthcare utilization and medication adherence between men and women, except visiting frequency to healthcare providers.
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Affiliation(s)
- Jiae Shin
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea;
| | - Dongwoo Ham
- Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea;
| | - Hee Young Paik
- Center for Gendered Innovations in Science and Technology Research (GISTeR), Korea Federation of Women’s Science & Technology Associations, 22 Teheran-ro 7-gil, Gangnam-gu, Seoul 06130, Korea;
| | - Sangah Shin
- Department of Food and Nutrition, School of Food Science and Technology, Chung-Ang University, 4726 Seodong-daero, Daedeok-myeon, Gyeonggi-do, Anseong 17546, Korea
| | - Hyojee Joung
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea;
- Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea;
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Menyanu EK, Corso B, Minicuci N, Rocco I, Russell JC, Ware LJ, Chidumwa G, Naidoo NN, Biritwum RB, Kowal PR, Schutte AE, Charlton KE. Determinants of change in blood pressure in Ghana: Longitudinal data from WHO-SAGE Waves 1-3. PLoS One 2021; 16:e0244807. [PMID: 33417616 PMCID: PMC7793275 DOI: 10.1371/journal.pone.0244807] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/16/2020] [Indexed: 01/19/2023] Open
Abstract
The prevalence of hypertension is increasing in low- and middle-income countries, however statistics are generally derived from cross sectional surveys that utilize different methodologies and population samples. We investigated blood pressure (BP) changes over 11-12 years in a large cohort of adults aged 50 years and older (n = 820) included in the World Health Organization's Study on global AGEing and adult health (WHO-SAGE Ghana) Wave 1 (2007/8) with follow up in Wave 3 (2019). Participants' BP were measured in triplicate and a survey completed at both time points. Survey instruments collected information on sociodemographic characteristics, lifestyle, health behaviors and chronic conditions. While no significant difference was found in systolic BP between Waves 1 and 3, diastolic BP decreased by 9.7mmHg (mean = 88.6, 15.4 to 78.9, 13.6 respectively) and pulse pressure increased by 9.5mmHg (44.8, 13.7 to 54.3, 14.1). Awareness of hypertension increased by 37%, from (20% to 57%), but no differences were found for the proportion of hypertensives receiving treatment nor those that had controlled BP. Mixed effects modelling showed a decrease in diastolic BP was associated with increasing age, living in rural areas and having health insurance. Factors associated with an increased awareness of hypertension were residing in urban areas, having health insurance and increasing body mass index. While diagnosis of hypertension has improved over time in Ghana, there is an ongoing need to improve its treatment in older adults.
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Affiliation(s)
- Elias K. Menyanu
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Barbara Corso
- Neuroscience Institute, National Research Council, Padova, Italy
| | - Nadia Minicuci
- Neuroscience Institute, National Research Council, Padova, Italy
| | - Ilaria Rocco
- Neuroscience Institute, National Research Council, Padova, Italy
| | - Joanna C. Russell
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lisa J. Ware
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Glory Chidumwa
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nirmala N. Naidoo
- World Health Organization Data, Analytics and Delivery for Impact Division, Geneva, Switzerland
| | | | - Paul R. Kowal
- Chiang Mai University Research Institute for Health Sciences, Chiang Mai, Thailand
- World Health Organization SAGE, Geneva, Switzerland
| | - Aletta E. Schutte
- School of Public Health and Community Medicine, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Karen E. Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
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Tozivepi SN, Takawira S, Chikaka E, Mundagowa P, Chadambuka EM, Mukora-Mutseyekwa F. The Nexus Between Adherence to Recommended Lifestyle Behaviors and Blood Pressure Control in Hypertensive Patients at Mutare Provincial Hospital, Zimbabwe: A Cross-Sectional Study. Patient Prefer Adherence 2021; 15:1027-1037. [PMID: 34040356 PMCID: PMC8140922 DOI: 10.2147/ppa.s306885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/24/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To determine the association between the achievement of blood pressure (BP) control and adherence to recommended lifestyle behaviors among hypertensive patients seen at Mutare Provincial Hospital, Zimbabwe. PATIENTS AND METHODS A cross-sectional study was conducted using BP readings from three consecutive months. A structured interviewer-administered and pretested questionnaire with components derived from the World Health Organization Stepwise Survey was employed to extract information from 350 purposively selected participants. Measurement of BP was based on the Eighth Joint National Committee Guidelines. Bivariate and multivariate logistic regression analyses were computed using the SPSS package. RESULTS The mean age of the 350 participants was 67±11.38 years. Males made up 35% of the participants and BP control was achieved in 41.4% of the patients. Only 5.1% of the participants reported adherence to all the recommended lifestyle behaviors. Low adherence rates were reported for diet, medication, and physical activity. Bivariate analysis showed that participants who adhered to antihypertensive treatment and alcohol recommendations had reduced odds of having uncontrolled hypertension, while consuming deep-fat fried foods ≥3 times a week was associated with higher odds of uncontrolled BP (p<0.1). Logistic regression analysis revealed that participants who ate traditional whole-grain "sadza" or porridge were more likely to have controlled BP [adjusted odds ratio (AOR): 1.6; 95% confidence interval (CI): 1.0-2.5] while those who did not add salt at the table had reduced odds of having uncontrolled BP by 40% (AOR: 0.6; 95% CI: 0.4-0.9). CONCLUSION Overall, adherence to the recommended lifestyle behaviors which are known to be effective in controlling BP in Mutare was poor. Health workers should include comprehensive health education messages on the importance of compliance with dietary, medication, and physical exercise recommendations when counseling patients. The intervention crafting process should focus on identifying enablers of the recommended lifestyle behaviors in the community and the health delivery system.
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Affiliation(s)
- Samantha N Tozivepi
- Clinical Research Centre, Africa University, Mutare, Manicaland Province, Zimbabwe
| | - Simon Takawira
- Department of Health Sciences, Africa University, Mutare, Manicaland Province, Zimbabwe
| | - Elliot Chikaka
- Department of Health Sciences, Africa University, Mutare, Manicaland Province, Zimbabwe
| | - Paddington Mundagowa
- Clinical Research Centre, Africa University, Mutare, Manicaland Province, Zimbabwe
- Correspondence: Paddington Mundagowa Africa University Clinical Research Center, 132 Herbert Chitepo Street, Mutare, ZimbabweTel +263 773 878 116 Email
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90
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Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension. Nat Rev Cardiol 2021; 18:785-802. [PMID: 34050340 PMCID: PMC8162166 DOI: 10.1038/s41569-021-00559-8] [Citation(s) in RCA: 517] [Impact Index Per Article: 172.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 02/07/2023]
Abstract
High blood pressure is one of the most important risk factors for ischaemic heart disease, stroke, other cardiovascular diseases, chronic kidney disease and dementia. Mean blood pressure and the prevalence of raised blood pressure have declined substantially in high-income regions since at least the 1970s. By contrast, blood pressure has risen in East, South and Southeast Asia, Oceania and sub-Saharan Africa. Given these trends, the prevalence of hypertension is now higher in low-income and middle-income countries than in high-income countries. In 2015, an estimated 8.5 million deaths were attributable to systolic blood pressure >115 mmHg, 88% of which were in low-income and middle-income countries. Measures such as increasing the availability and affordability of fresh fruits and vegetables, lowering the sodium content of packaged and prepared food and staples such as bread, and improving the availability of dietary salt substitutes can help lower blood pressure in the entire population. The use and effectiveness of hypertension treatment vary substantially across countries. Factors influencing this variation include a country's financial resources, the extent of health insurance and health facilities, how frequently people interact with physicians and non-physician health personnel, whether a clear and widely adopted clinical guideline exists and the availability of medicines. Scaling up treatment coverage and improving its community effectiveness can substantially reduce the health burden of hypertension.
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91
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Ashraf K, Haque MR, Amir M, Ahmad N, Ahmad W, Sultan S, Ali Shah SA, Mahmoud Alafeefy A, Mujeeb M, Bin Shafie MF. An Overview of Phytochemical and Biological Activities: Ficus deltoidea Jack and Other Ficus spp. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2021; 13:11-25. [PMID: 34084044 PMCID: PMC8142919 DOI: 10.4103/jpbs.jpbs_232_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/29/2020] [Accepted: 02/12/2020] [Indexed: 11/04/2022] Open
Abstract
Ficus deltoidea Jack (Moraceae) is a well-known medicinal plant used in customary medication among the Malay people to reduce and mend sicknesses such as ulcers, psoriasis, cytotoxicity, cardioprotective, inflammation, jaundice, vitiligo, hemorrhage, diabetes, convulsion, hepatitis, dysentery injuries, wounds, and stiffness. Ficus deltoidea contains a wide variety of bioactive compounds from different phytochemical groups such as alkaloids, phenols, flavonoids, saponins, sterols, terpenes, carbohydrates, and proteins. The genus Ficus has several hundreds of species, which shows excellent therapeutic effects and a wide variety of helpful properties for human welfare. Searching information was collected by using electronic databases including Web of Science, Science Direct, Springer, SciFinder, PubMed, Scopus, Medline, Embase, and Google Scholar. This review is, therefore, an effort to give a detailed survey of the literature on its pharmacognosy, phytochemistry, phytochemical, and pharmacological properties of Ficus and its important species. This summary could be beneficial for future research aiming to exploit the therapeutic potential of Ficus and its useful medicinal species.
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Affiliation(s)
- Kamran Ashraf
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Cawangan Selangor, Kampus Puncak Alam, Selangor Darul Ehsan, Malaysia
| | | | - Mohd Amir
- Department of Natural Products and Alternative Medicine, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Niyaz Ahmad
- Department of Pharmaceutics, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Wasim Ahmad
- Department of Pharmacy, Mohammed Al-Mana College for Medical Sciences, Safaa, Dammam, Saudi Arabia
| | - Sadia Sultan
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Cawangan Selangor, Kampus Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Syed Adnan Ali Shah
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Cawangan Selangor, Kampus Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Ahmed Mahmoud Alafeefy
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Cawangan Selangor, Kampus Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Mohd Mujeeb
- Phytomedicine Laboratory, Department of Pharmacognosy and Phytochemistry, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Muhammad Fikriey Bin Shafie
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Cawangan Selangor, Kampus Puncak Alam, Selangor Darul Ehsan, Malaysia
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92
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Ndejjo R, Wanyenze RK, Nuwaha F, Bastiaens H, Musinguzi G. Barriers and facilitators of implementation of a community cardiovascular disease prevention programme in Mukono and Buikwe districts in Uganda using the Consolidated Framework for Implementation Research. Implement Sci 2020; 15:106. [PMID: 33298098 PMCID: PMC7726905 DOI: 10.1186/s13012-020-01065-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 11/29/2020] [Indexed: 12/01/2022] Open
Abstract
Background In low- and middle-income countries, there is an increasing attention towards community approaches to deal with the growing burden of cardiovascular disease (CVD). However, few studies have explored the implementation processes of such interventions to inform their scale up and sustainability. Using the consolidated framework for implementation research (CFIR), we examined the barriers and facilitators influencing the implementation of a community CVD programme led by community health workers (CHWs) in Mukono and Buikwe districts in Uganda. Methods This qualitative study is a process evaluation of an ongoing type II hybrid stepped wedge cluster trial guided by the CFIR. Data for this analysis were collected through regular meetings and focus group discussions (FGDs) conducted during the first cycle (6 months) of intervention implementation. A total of 20 CHWs participated in the implementation programme in 20 villages during the first cycle. Meeting reports and FGD transcripts were analysed following inductive thematic analysis with the aid of Nvivo 12.6 to generate emerging themes and sub-themes and thereafter deductive analysis was used to map themes and sub-themes onto the CFIR domains and constructs. Results The barriers to intervention implementation were the complexity of the intervention (complexity), compatibility with community culture (culture), the lack of an enabling environment for behaviour change (patient needs and resources) and mistrust of CHWs by community members (relative priority). In addition, the low community awareness of CVD (tension for change), competing demands (other personal attributes) and unfavourable policies (external policy and incentives) impeded intervention implementation. On the other hand, facilitators of intervention implementation were availability of inputs and protective equipment (design quality and packaging), training of CHWs (Available resources), working with community structures including leaders and groups (process—opinion leaders), frequent support supervision and engagements (process—formally appointed internal implementation leaders) and access to quality health services (process—champions). Conclusion Using the CFIR, we identified drivers of implementation success or failure for a community CVD prevention programme in a low-income context. These findings are key to inform the design of impactful, scalable and sustainable CHW programmes for non-communicable diseases prevention and control. Supplementary Information The online version contains supplementary material available at 10.1186/s13012-020-01065-0.
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Affiliation(s)
- Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda. .,Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| | - Rhoda K Wanyenze
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Fred Nuwaha
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Hilde Bastiaens
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Geofrey Musinguzi
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.,Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Parsaeian M, Jafari Khaledi M, Farzadfar F, Mahdavi M, Zeraati H, Mahmoudi M, Khosravi A, Mohammad K. Spatio-temporal analysis of misaligned burden of disease data using a geo-statistical approach. Stat Med 2020; 40:1021-1033. [PMID: 33283326 DOI: 10.1002/sim.8817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 10/06/2020] [Accepted: 11/04/2020] [Indexed: 11/06/2022]
Abstract
Data used to estimate the burden of diseases (BOD) are usually sparse, noisy, and heterogeneous. These data are collected from surveys, registries, and systematic reviews that have different areal units, are conducted at different times, and are reported for different age groups. In this study, we developed a Bayesian geo-statistical model to combine aggregated sparse, noisy BOD data from different sources with misaligned areal units. Our model incorporates the correlation of space, time, and age to estimate health indicators for areas with no data or a small number of observations. The model also considers the heterogeneity of data sources and the measurement errors of input data in the final estimates and uncertainty intervals. We applied the model to combine data from nine different sources of body mass index in a national and sub-national BOD study. The cross-validation results confirmed a high out-of-sample predictive ability in sparse and noisy data. The proposed model can be used by other BOD studies especially at the sub-national level when the areal units are subject to misalignment.
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Affiliation(s)
- Mahboubeh Parsaeian
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Jafari Khaledi
- Department of Statistics, Faculty of Mathematical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Mahdavi
- National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran, Iran.,Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Hojjat Zeraati
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Mahmoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ardeshir Khosravi
- Deputy for Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Kazem Mohammad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Deuschl G, Beghi E, Fazekas F, Varga T, Christoforidi KA, Sipido E, Bassetti CL, Vos T, Feigin VL. The burden of neurological diseases in Europe: an analysis for the Global Burden of Disease Study 2017. LANCET PUBLIC HEALTH 2020; 5:e551-e567. [PMID: 33007212 DOI: 10.1016/s2468-2667(20)30190-0] [Citation(s) in RCA: 269] [Impact Index Per Article: 67.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/12/2020] [Accepted: 08/17/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Neurological disorders account for a large and increasing health burden worldwide, as shown in the Global Burden of Diseases (GBD) Study 2016. Unpacking how this burden varies regionally and nationally is important to inform public health policy and prevention strategies. The population in the EU is older than that of the WHO European region (western, central, and eastern Europe) and even older than the global population, suggesting that it might be particularly vulnerable to an increasing burden of age-related neurological disorders. We aimed to compare the burden of neurological disorders in the EU between 1990 and 2017 with those of the WHO European region and worldwide. METHODS The burden of neurological disorders was calculated for the year 2017 as incidence, prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost, and years lived with disability for the countries in the EU and the WHO European region, totally and, separately. Diseases analysed were Alzheimer's disease and other dementias, epilepsy, headache (migraine and tension-type headache), multiple sclerosis, Parkinson's disease, brain cancer, motor neuron diseases, neuroinfectious diseases, and stroke. Data are presented as totals and by sex, age, year, location and socio-demographic context, and shown as counts and rates. FINDINGS In 2017, the total number of DALYs attributable to neurological disorders was 21·0 million (95% uncertainty interval 18·5-23·9) in the EU and 41·1 million (36·7-45·9) in the WHO European region, and the total number of deaths was 1·1 million (1·09-1·14) in the EU and 1·97 million (1·95-2·01) in the WHO European region. In the EU, neurological disorders ranked third after cardiovascular diseases and cancers representing 13·3% (10·3-17·1) of total DALYs and 19·5% (18·0-21·3) of total deaths. Stroke, dementias, and headache were the three commonest causes of DALYs in the EU. Stroke was also the leading cause of DALYs in the WHO European region. During the study period we found a substantial increase in the all-age burden of neurodegenerative diseases, despite a substantial decrease in the rates of stroke and infections. The burden of neurological disorders in Europe was higher in men than in women, peaked in individuals aged 80-84 years, and varied substantially with WHO European region and country. All-age DALYs, deaths, and prevalence of neurological disorders increased in all-age measures, but decreased when using age-standardised measures in all but three countries (Azerbaijan, Turkmenistan, and Uzbekistan). The decrease was mostly attributed to the reduction of premature mortality despite an overall increase in the number of DALYs. INTERPRETATION Neurological disorders are the third most common cause of disability and premature death in the EU and their prevalence and burden will likely increase with the progressive ageing of the European population. Greater attention to neurological diseases must be paid by health authorities for prevention and care. The data presented here suggest different priorities for health service development and resource allocation in different countries. FUNDING European Academy of Neurology.
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Affiliation(s)
- Günther Deuschl
- Department of Neurology, Universitätsklinikum Schleswig-Holstein, Christian-Albrechts University, Kiel, Germany; European Academy of Neurology, Vienna, Austria
| | - Ettore Beghi
- Department of Neuroscience, Mario Negri Institute for Pharmacological Research, Milan, Italy; European Academy of Neurology, Vienna, Austria.
| | - Franz Fazekas
- Department of Neurology, University of Graz, Graz, Austria; European Academy of Neurology, Vienna, Austria
| | - Timea Varga
- European Academy of Neurology, Vienna, Austria
| | | | | | - Claudio L Bassetti
- European Academy of Neurology, Vienna, Austria; Department of Neurology, University of Bern, Bern, Switzerland
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Valery L Feigin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand; Research Center of Neurology, Moscow, Russia
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Ryu H, Jung J, Moon J. Patterns of change in cardiovascular risks of Korean male workers: a 10-year cohort analysis using the National Health Insurance Service-National Sample Cohort (NHIS-NSC) 2.0 database. BMJ Open 2020; 10:e038446. [PMID: 33154050 PMCID: PMC7646339 DOI: 10.1136/bmjopen-2020-038446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Health behaviour is one of the major determinants of cardiovascular diseases in working population. This study was tried to investigate the trend of cardiovascular health level, the relationship between continuous health behaviours, and changes in the risk of cardiovascular diseases of male workers by using a nationwide database. DESIGN This study is a retrospective cohort study. SETTING AND PARTICIPANTS The study analysed data of 57 837 male workers whose personal health examination data were continuously traced using Korea's National Health Insurance Service-National Sample Cohort 2.0 database. PRIMARY OUTCOME MEASURES A 10-year trend for all cardiovascular risks and change for the risks according to the consistent performance of healthy behaviours. RESULTS The results showed that the risk of being overweight (adjusted OR (aOR) 1.63, 95% CI 1.59 to 1.68) and obese (aOR 1.51, 95% CI 1.47 to 1.56) increased. The index of cardiovascular risk also increased for high fasting glucose (aOR 1.77, 95% CI 1.62 to 1.95) and high total cholesterol (aOR 1.68, 95% CI 1.60 to 1.76), respectively. The risks of high fasting glucose (aOR 2.09, 95% CI 1.40 to 3.13), high triglycerides (aOR 1.27, 95% CI 1.14 to 1.42) and high low-density lipoprotein cholesterol (aOR 1.38, 95% CI 1.14 to 1.66) were increased among high-risk smokers. Similarly, the risk of high total cholesterol (aOR 2.20, 95% CI 1.35 to 3.58) and high triglycerides (aOR 1.42, 95% CI 1.09 to 1.85) were increased among high-risk drinkers. In addition, the increase in the risk of being overweight (aOR 2.20, 95% CI 1.83 to 2.65) and obese (aOR 1.90, 95% CI 1.59 to 2.27) were analysed among who had not consistently exercised. CONCLUSIONS Since the pattern of change in the level of cardiovascular risk related to the continuous health behaviours of male workers was identified, the findings of the present study can be used as basic data to develop health promotion policies for the population.
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Affiliation(s)
- Hosihn Ryu
- College of Nursing, Korea University, Seoul, South Korea
| | - Jiyeon Jung
- College of Nursing, Korea University, Seoul, South Korea
| | - Jihyun Moon
- College of Nursing, Korea University, Seoul, South Korea
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96
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High-normal blood pressure and related cardiovascular risk factors prevalence in the Romanian adult population: insights from the SEPHAR III study. J Hum Hypertens 2020; 35:884-895. [PMID: 32978496 DOI: 10.1038/s41371-020-00417-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/28/2020] [Accepted: 09/15/2020] [Indexed: 11/08/2022]
Abstract
High normal blood pressure (HNBP) is associated with an increased risk of incident high blood pressure (HBP) and of cardiovascular diseases (CVD). To estimate the prevalence of HNBP and related cardiovascular risk factors, a representative sample of 1970 Romanian adults was enrolled in SEPHAR III survey (Study for the Evaluation of Prevalence of Hypertension and Cardiovascular Risk in Romania). All were evaluated for blood pressure values and by a 71-item questionnaire, anthropometric measurements, together with extensive evaluation for target organ damage, blood, and urine sample collection. Prevalence of HNBP was 11% [45.1% had HBP, 43.9% normal BP (NBP)]. HNBP individuals were older (51.14 ± 17.13 years) than subjects with NBP (40.5 ± 15.96 years) but younger than those with HBP (55.79 ± 15.68 years), p < 0.0001 (95% CI 18-85, respectively 18-91). Values of weight, waist circumference, body mass index, total and LDL cholesterol, triglycerides, fasting blood glucose, glycosylated hemoglobin (HbA1c), uric acid, serum creatinine, glomerular filtration rate estimate by CKD-EPI equation, urinary albumin to creatinine ratio, intimae-media thickness, arterial stiffness measurements and diastolic dysfunction, indexed left ventricular mass, interventricular septum and posterior left ventricle wall thickness, left atrial volume, and LA dilatation were significantly higher in HNBP subjects than in NBP. Our study showed that individuals with HNBP represent ~11% and most of them had an elevated total cardiovascular risk. It is essential to educate the public and health care providers to be aware of these individuals and of steps that should be taken to treat modifiable cardiovascular risk factors.
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97
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Picone DS, Schultz MG, Hughes AD, Sharman JE. Cuff Under Pressure for Greater Accuracy. Curr Hypertens Rep 2020; 22:93. [PMID: 32959103 DOI: 10.1007/s11906-020-01103-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To present the evidence that describes what is being measured by upper-arm cuff blood pressure (BP) and the level of accuracy compared with invasive central aortic and brachial BP. Potential causes of inaccuracy and emerging methods are also discussed. RECENT FINDINGS On average cuff systolic BP systematically underestimates invasive brachial systolic BP, although in a given individual it may substantially under- or over-estimate central aortic systolic BP. Such errors may affect individual health management outcomes and distort population level data on hypertension prevalence and control. Oscillometric cuff BP is particularly susceptible to inaccuracy in people with high arterial stiffness and with pathophysiological BP waveform shapes. Emerging cuff-less BP methods will be susceptible to inaccuracy if oscillometric cuff BP is used for calibration. The original purpose of cuff BP was to estimate central aortic BP. Recent evidence has shown substantial inaccuracy of oscillometric cuff BP exists for the measurement of invasive central aortic and brachial BP. Thus, development of more accurate BP methods, through better understanding of oscillometric and BP waveform morphology, is needed to improve health outcomes related to high BP.
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Affiliation(s)
- Dean S Picone
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Private Bag 23, Hobart, 7000, Australia.
| | - Martin G Schultz
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Private Bag 23, Hobart, 7000, Australia
| | - Alun D Hughes
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - James E Sharman
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Private Bag 23, Hobart, 7000, Australia
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98
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Kee YK, Kim M, Oh J, Oh HJ, Ryu D. Sex differences in the blood pressure level associated with increased risks of cardiovascular events: a Korean nationwide population-based cohort study. J Clin Hypertens (Greenwich) 2020; 22:1638-1646. [PMID: 33245619 PMCID: PMC8030021 DOI: 10.1111/jch.13990] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/16/2020] [Accepted: 07/23/2020] [Indexed: 11/27/2022]
Abstract
Hypertension is a leading risk factor for cardiovascular events and death. Despite differences in clinical implications of hypertension between men and women, guidelines establishing optimal blood pressure (BP) targets are still debated. The aim of this study was to investigate sex differences in the BP level associated with increased risks of major adverse cardiac and cerebral events (MACCEs) among antihypertensive-treated patients. Using data from the Korean National Health Insurance Service-National Sample Cohort, we enrolled antihypertensive-treated patients and divided them into four categories: Group 1: SBP < 120 and DBP < 80 mm Hg; Group 2: 120 ≤ SBP < 130 and DBP < 80 mm Hg; Group 3: 130 ≤ SBP < 140 or 80 ≤ DBP < 90 mm Hg; and Group 4: SBP ≥ 140 or DBP ≥ 90 mm Hg. We performed time-dependent cox regression analysis to investigate sex differences in the BP levels that increased the risk of MACCEs. Most of the 98 267 patients fell into Group 3 (53.2% men and 52.8% women) and Group 4 (30.5% men and 28.1% women). During 8.34 ± 2.07 years, there were 8,813 MACCEs and 791 deaths. The incidences of MACCEs and death tended to increase as the BP increased in both sexes. Compared to Group 1, the risk of MACCEs significantly increased only in Group 4 for men, while it significantly increased in Groups 3 and 4 for women. This study shows that there are sex differences in the BP level at which the risk of MACCEs increases. Our finding suggests that sex should be significantly considered when determining the optimal BP target in patients undergoing hypertension treatment.
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Affiliation(s)
- Youn Kyung Kee
- Department of Internal MedicineKangdong Sacred Heart HospitalSeoulKorea
| | - Min‐ho Kim
- Ewha Institute of Convergence MedicineEwha Womans University Mokdong HospitalSeoulKorea
| | - Jongmin Oh
- Department of Occupational and Environmental MedicineSchool of Medicine, Ewha Womans UniversitySeoulKorea
| | - Hyung Jung Oh
- Ewha Institute of Convergence MedicineEwha Womans University Mokdong HospitalSeoulKorea
- Department of NephrologySheikh Khalifa Specialty HospitalUAE
| | - Dong‐Ryeol Ryu
- Research Institute for Human Health InformationEwha Womans University Mokdong HospitalSeoulKorea
- Department of Internal MedicineSchool of MedicineEwha Womans UniversitySeoulKorea
- Tissue Injury Defense Research CenterCollege of MedicineEwha Womans UniversitySeoulKorea
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99
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Silva MR, Silva HH, Capkauskiene S, Rosado-Marques V, Machado-Rodrigues A, Nogueira H, Padez C. Cardiovascular and metabolic risk factors in physically active and inactive Portuguese middle-aged adults: A cross-sectional study. Sci Sports 2020. [DOI: 10.1016/j.scispo.2019.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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100
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Ding Y, Chen D, Ding X, Wang G, Wan Y, Shen Q. A bibliometric analysis of income and cardiovascular disease: Status, Hotspots, Trends and Outlook. Medicine (Baltimore) 2020; 99:e21828. [PMID: 32846827 PMCID: PMC7447358 DOI: 10.1097/md.0000000000021828] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/14/2020] [Accepted: 07/18/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Income is 1 of the socio-economic indicators and could directly influence the health outcomes of cardiovascular disease (CVD). The relationship between income and CVD has attracted more and more scholars' attention in the past 20 years. METHODS To study the current research dynamics of this field, a bibliometric analysis was conducted to evaluate the publications from 1990 to 2018 based on the Science Citation Index Expanded database. By using the Derwent Date Analyzer software, the following aspects were explored: RESULTS:: The USA ranked first in this field, followed by UK and Canada in terms of number of publications. As for institutions, Harvard University took the leading place in the number of publications, as well as the h-index. Plos One had the most publications and "health" was the most frequent used keyword. The leading research area was "public environmental occupational health". CONCLUSIONS In conclusion, the elderly, the children and the puerpera were the main study population in this field and "disease prevention" was the main study direction. The most concerned health issues in this field were "obesity" and "diet". There might be a lack of articles that explore the associations between income and CVD with a global perspective. Articles on this content are urgently warranted.
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Affiliation(s)
- Ye Ding
- School of Public Health, Hangzhou Medical College
| | - Dingwan Chen
- School of Public Health, Hangzhou Medical College
| | - Xufen Ding
- Institute of Information Resources, Zhejiang University of Technology
- Library, Zhejiang University of Technology, Hangzhou, China
| | - Guan Wang
- School of Public Health, Hangzhou Medical College
| | - Yuehua Wan
- Institute of Information Resources, Zhejiang University of Technology
- Library, Zhejiang University of Technology, Hangzhou, China
| | - Qing Shen
- School of Public Health, Hangzhou Medical College
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