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Kranz S, Sharma B, Pourafshar S, Mallawaarachchi I, Ma JZ, Scialla JJ. Fruit and Vegetable Intake Patterns, Kidney Failure, and Mortality in Adults with and without Chronic Kidney Disease in the United States. J Nutr 2024; 154:2205-2214. [PMID: 38754840 DOI: 10.1016/j.tjnut.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 05/06/2024] [Accepted: 05/13/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Fruits and vegetables (F&Vs) are vital components of healthy diets but may be restricted in chronic kidney disease (CKD) to avoid high-potassium intake. We previously generated F&V patterns for patients in the National Health and Nutrition Examination Survey (NHANES) and demonstrated an increased prevalence of the overall low-intake pattern in patients with CKD. OBJECTIVE To evaluate the association of F&V patterns (overall low intake, high unprocessed, moderate processed, and high ultraprocessed) with the risk of kidney failure and its composite with death. METHODS Adults in NHANES III with valid dietary data and longitudinal follow-up for kidney failure and death were included. F&V patterns were identified using 24-h dietary recalls and latent class analysis, yielding 4 patterns. Cox models were used to evaluate the prospective association between each pattern and hazard of kidney failure or a composite of kidney failure or death over ≤20 y. Models were adjusted for demographics and select comorbidities and weighted for the complex survey design. Secondary analyses evaluated serum carotenoids as objective biomarkers of F&V intake. RESULTS Among 16,726 eligible participants in NHANES III, F&V consumption consistent with the high-ultraprocessed pattern associated with the highest risk of kidney failure after demographic and comorbidity adjustment, but attenuated with adjustment for kidney function. The high unprocessed pattern associated with the lowest adjusted risk of death or kidney failure combined [hazard ratio (HR): 0.73; 95% confidence interval (CI): 0.65, 0.81 relative to overall low intake]. Higher-serum carotenoids were associated with a lower adjusted risk of death or kidney failure combined (HR: 0.57; 95% CI: 0.49, 0.65 for quartile 4 compared with quartile 1). Results were similar in patients with CKD at baseline. CONCLUSIONS Higher intake of unprocessed F&Vs was associated with better outcomes in the general population and patients with CKD. Results emphasize the need to safely improve F&V intake in CKD.
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Affiliation(s)
- Sibylle Kranz
- Department of Kinesiology, Curry School of Education and Human Development, University of Virginia, Charlottesville, VA, United States
| | - Binu Sharma
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Shirin Pourafshar
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Indika Mallawaarachchi
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Jennie Z Ma
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Julia J Scialla
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States; Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States.
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Mat Nasir N, Md Isa Z, Ismail NH, Ismail R, Mohd Tamil A, Jaafar MH, Mohamed Yassin MS, Zainol Abidin N, Ab Razak NH, Zulkifli A, Yusof KH. A cross-sectional analysis of the PURE study on minerals intake among Malaysian adult population with hypertension. Sci Rep 2024; 14:8590. [PMID: 38615144 PMCID: PMC11016102 DOI: 10.1038/s41598-024-59206-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 04/08/2024] [Indexed: 04/15/2024] Open
Abstract
Hypertension (HPT) is the leading modifiable risk factor for cardiovascular diseases and premature death worldwide. Currently, attention is given to various dietary approaches with a special focus on the role of micronutrient intake in the regulation of blood pressure. This study aims to measure the dietary intake of selected minerals among Malaysian adults and its association with HPT. This cross-sectional study involved 10,031 participants from the Prospective Urban and Rural Epidemiological study conducted in Malaysia. Participants were grouped into HPT if they reported having been diagnosed with high blood pressure [average systolic blood pressure (SBP)/average diastolic blood pressure (DBP) ≥ 140/90 mm Hg]. A validated food frequency questionnaire (FFQ) was used to measure participants' habitual dietary intake. The dietary mineral intake of calcium, copper, iron, magnesium, manganese, phosphorus, potassium, sodium, and zinc was measured. The chi-square test was used to assess differences in socio-demographic factors between HPT and non-HPT groups, while the Mann-Whitney U test was used to assess differences in dietary mineral intake between the groups. The participants' average dietary intake of calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, sodium, and zinc was 591.0 mg/day, 3.8 mg/day, 27.1 mg/day, 32.4 mg/day, 0.4 mg/day, 1431.1 mg/day, 2.3 g/day, 27.1 µg/day, 4526.7 mg/day and 1.5 mg/day, respectively. The intake was significantly lower among those with HPT than those without HPT except for calcium and manganese. Continuous education and intervention should be focused on decreasing sodium intake and increasing potassium, magnesium, manganese, zinc, and calcium intake for the general Malaysian population, particularly for the HPT patients.
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Affiliation(s)
- Nafiza Mat Nasir
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Selangor Branch, Jalan Hospital, Sungai Buloh, Selangor, Malaysia
| | - Zaleha Md Isa
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia.
| | - Noor Hassim Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
| | - Rosnah Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
| | - Azmi Mohd Tamil
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
| | - Mohd Hasni Jaafar
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
| | - Mohamed Syarif Mohamed Yassin
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Selangor Branch, Jalan Hospital, Sungai Buloh, Selangor, Malaysia
| | - Najihah Zainol Abidin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
- Department of Diagnostic and Allied Health Science, Faculty of Health and Life Sciences, Management and Science University, Shah Alam, Selangor, Malaysia
| | - Nurul Hafiza Ab Razak
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
| | - Aziemah Zulkifli
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
- Institute for Environment and Development (LESTARI), Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Khairul Hazdi Yusof
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
- Risk Management Unit, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
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Wan Y, Ma D, Shang Q, Xu H. Association between dietary flavonoid intake and hypertension among U.S. adults. Front Immunol 2024; 15:1380493. [PMID: 38680497 PMCID: PMC11046732 DOI: 10.3389/fimmu.2024.1380493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/22/2024] [Indexed: 05/01/2024] Open
Abstract
Background Hypertension is one of the major risk factors for cardiovascular disease. Dietary flavonoids have been reported to reduce inflammation, protect against oxidative stress, protect the vascular endothelium, and improve vascular health. However, the relationship between dietary flavonoid intake and the prevalence of hypertension remains controversial. Methods This study included 8010 adults from the 2007-2010 and 2017-2018 National Health and Nutrition Examination Surveys (NHANES). The relationship between dietary flavonoid intake and the prevalence of hypertension was explored by weighted logistic regression and weighted restricted cubic spline. Results We found an inverse relationship between total anthocyanin intake and the prevalence of hypertension in the fourth quartile compared with the first quartile [0.81(0.66,0.99), p = 0.04]. Moreover, the prevalence of hypertension tended to decrease with increasing total anthocyanin intake in participants over 60 years of age. In addition, we found a U-shaped relationship between the prevalence of hypertension and total flavan-3-ol intake. Total flavan-3-ol intake was inversely associated with hypertension prevalence in the third quartile compared with the first quartile [0.79 (0.63,0.99), p = 0.04]. Moreover, there was a significant negative association between the prevalence of hypertension and total flavan-3-ol intake when total flavan-3-ol intake was below 48.26 mg/day. Conclusion Our study found a negative association between the prevalence of hypertension and moderate total anthocyanins intake and total flavan-3-ols intake. Our study provides evidence from a population-based study for a negative association between dietary flavonoid intake and the prevalence of hypertension.
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Affiliation(s)
- Yingying Wan
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Dan Ma
- China Academy of Chinese Medical Sciences, Xiyuan Hospital Suzhou Hospital, Suzhou, China
| | - Qinghua Shang
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hao Xu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Islam MM, Oyarzun-Gonzalez X, Bose-Brill S, Donneyong MM. Supplemental Nutrition Assistance Program and Adherence to Antihypertensive Medications. JAMA Netw Open 2024; 7:e2356619. [PMID: 38393731 PMCID: PMC10891466 DOI: 10.1001/jamanetworkopen.2023.56619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/22/2023] [Indexed: 02/25/2024] Open
Abstract
Importance Nonadherence to antihypertensive medications is associated with uncontrolled blood pressure, higher mortality rates, and increased health care costs, and food insecurity is one of the modifiable medication nonadherence risk factors. The Supplemental Nutrition Assistance Program (SNAP), a social intervention program for addressing food insecurity, may help improve adherence to antihypertensive medications. Objective To evaluate whether receipt of SNAP benefits can modify the consequences of food insecurity on nonadherence to antihypertensive medications. Design, Setting, and Participants A retrospective cohort study design was used to assemble a cohort of antihypertensive medication users from the linked Medical Expenditure Panel Survey (MEPS)-National Health Interview Survey (NHIS) dataset for 2016 to 2017. The MEPS is a national longitudinal survey on verified self-reported prescribed medication use and health care access measures, and the NHIS is an annual cross-sectional survey of US households that collects comprehensive health information, health behavior, and sociodemographic data, including receipt of SNAP benefits. Receipt of SNAP benefits in the past 12 months and food insecurity status in the past 30 days were assessed through standard questionnaires during the study period. Data analysis was performed from March to December 2021. Exposure Status of SNAP benefit receipt. Main Outcomes and Measures The main outcome, nonadherence to antihypertensive medication refill adherence (MRA), was defined using the MEPS data as the total days' supply divided by 365 days for each antihypertensive medication class. Patients were considered nonadherent if their overall MRA was less than 80%. Food insecurity status in the 30 days prior to the survey was modeled as the effect modifier. Inverse probability of treatment (IPT) weighting was used to control for measured confounding effects of baseline covariates. A probit model was used, weighted by the product of the computed IPT weights and MEPS weights, to estimate the population average treatment effects (PATEs) of SNAP benefit receipt on nonadherence. A stratified analysis approach was used to assess for potential effect modification by food insecurity status. Results This analysis involved 6692 antihypertensive medication users, of whom 1203 (12.8%) reported receiving SNAP benefits and 1338 (14.8%) were considered as food insecure. The mean (SD) age was 63.0 (13.3) years; 3632 (51.3%) of the participants were women and 3060 (45.7%) were men. Although SNAP was not associated with nonadherence to antihypertensive medications in the overall population, it was associated with a 13.6-percentage point reduction in nonadherence (PATE, -13.6 [95% CI, -25.0 to -2.3]) among the food-insecure subgroup but not among their food-secure counterparts. Conclusions and Relevance This analysis of a national observational dataset suggests that patients with hypertension who receive SNAP benefits may be less likely to become nonadherent to antihypertensive medication, especially if they are experiencing food insecurity. Further examination of the role of SNAP as a potential intervention for preventing nonadherence to antihypertensive medications through prospectively designed interventional studies or natural experiment study designs is needed.
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Affiliation(s)
- Md. Mohaimenul Islam
- Outcomes and Translational Sciences, College of Pharmacy, The Ohio State University, Columbus
| | - Ximena Oyarzun-Gonzalez
- Outcomes and Translational Sciences, College of Pharmacy, The Ohio State University, Columbus
| | - Seuli Bose-Brill
- Division of General Internal Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus
| | - Macarius M. Donneyong
- Outcomes and Translational Sciences, College of Pharmacy, The Ohio State University, Columbus
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Delpino FM, Dos Santos FS, Flores TR, Cerqueira HS, Santos HO. The effects of blueberry and cranberry supplementation on blood pressure in patients with cardiovascular diseases: A systematic review and meta-analysis of randomized clinical trials. Phytother Res 2024; 38:646-661. [PMID: 37963472 DOI: 10.1002/ptr.8069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 09/18/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023]
Abstract
Blueberries and cranberries are berry fruits with the highest number of randomized clinical trials (RCTs) focusing on blood pressure (BP). This systematic review and meta-analysis of RCTs analyzed the effects of blueberry and cranberry supplementation alone and in concert with systolic BP (SBP) and diastolic BP (DBP) in patients with cardiometabolic diseases. The searches were performed until August 2023 in the following databases: PubMed, Scopus, Web of Science, Cochrane, and Embase. Studies that examined the effects of blueberry or cranberry intake/supplementation were included. The risk of bias was evaluated using the Rob 2 scale. A meta-analysis was performed to estimate the effects of blueberry and cranberry supplementation on BP levels in patients with cardiometabolic diseases. A total of 17 articles were included, from which two found significant results from blueberry and/or cranberry supplementation in reducing BP. Pooled results revealed statistically non-significant reductions of -0.81 mm Hg for SBP (95% confidence interval [CI]: -2.26, 0.63; I2 = 0%) and -0.15 mm Hg for DBP (95% CI: -1.36, 1.05; I2 = 27%). Blueberry and/or cranberry supplementation had neutral effects on SBP and DBP in patients with cardiometabolic diseases, regardless of duration or age. Further high-quality studies are needed to firmly establish clinical efficacy.
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Affiliation(s)
| | - Francine Silva Dos Santos
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Thaynã Ramos Flores
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Joshi JS, Shanoo A, Patel N, Gupta A. From Conception to Delivery: A Comprehensive Review of Thyroid Disorders and Their Far-Reaching Impact on Feto-Maternal Health. Cureus 2024; 16:e53362. [PMID: 38435202 PMCID: PMC10907906 DOI: 10.7759/cureus.53362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
This comprehensive review delves into the multifaceted landscape of thyroid disorders during pregnancy, exploring their impact from conception to postpartum considerations. Key findings highlight the intricate interplay between maternal thyroid health and fetal development, emphasizing the critical importance of timely screening and targeted interventions. The evolving landscape of research and technology suggests a paradigm shift toward personalized approaches in clinical practice, emphasizing integrated care models and the integration of telehealth platforms. Postpartum considerations, including postpartum thyroiditis, underscore the necessity for ongoing monitoring and intervention for maternal well-being. Implications for clinical practice encompass healthcare provider education, public awareness campaigns, and policy advocacy for standardized screening guidelines. The call to action resonates for increased research funding to advance understanding and improve outcomes. By fostering awareness, education, and collaborative efforts, this review aims to navigate the complexities of thyroid disorders during pregnancy, ensuring a healthier start for both mothers and their infants.
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Affiliation(s)
- Jalormy S Joshi
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Amardeep Shanoo
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nainita Patel
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aishwarya Gupta
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Kavian JA. White Coat Hypertension: A Benign Finding or a Masked Risk Factor? South Med J 2023; 116:962-963. [PMID: 38051171 DOI: 10.14423/smj.0000000000001628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
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Geremew G, Ambaw F, Bogale EK, Yigzaw ZA. Adherence to Lifestyle Modification Practices and Its Associated Factors Among Hypertensive Patients in Bahir Dar City Hospitals, North West Ethiopia. Integr Blood Press Control 2023; 16:111-122. [PMID: 38050636 PMCID: PMC10693782 DOI: 10.2147/ibpc.s436815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/23/2023] [Indexed: 12/06/2023] Open
Abstract
Background Globally, hypertension affects 1.4 billion adults, accounting for 31% of the world population. The prevention and control of hypertension is not addressed only by pharmacological management. Even though the prevalence of uncontrolled hypertension and its complications is increasing every day, Adherence to lifestyle modification practice among diagnosed hypertensive individuals is low for a number of reasons. The study aims to assess adherence to lifestyle modification practices and associated factors among hypertensive patients at Bahir Dar city hospitals, in North West Ethiopia. Methods An institutional-based cross-sectional study design was conducted at Bahir Dar city from October 30 to November 30, 2022. A stratified sampling technique was used. For the data quality pre-test was done, the questionnaire was checked for completion, the assumption of binary logistic regression (VIF 1.8 and no outlier), and model fit using the Hosmer and Lemeshow's test was checked. Binary logistic and multivariate logistic regression were used to find significant variables after the data were entered into EpiInfo and analyzed using SPSS version 23. Results The overall adherence to lifestyle modification practices was about 32.4%. From the independent factors, above secondary educational status (AOR = 0.201 95% CI (0.081-0.499)), good knowledge (AOR = 3.323 95% CI (1.79-6.168)), good self-efficacy (AOR = 3.553 95% CI (1.91-6.613)), good social support (AOR = 8.339 95% CI (4.251-16.357)), and good patient-physician relationship (AOR = 2.424 95% CI (1.309-4.490)) were statistically significant predictors of adherence to lifestyle modification practices. Conclusion Only one-third of the participants had adhered to the recommended lifestyle modifications. Educational status, knowledge, self-efficacy, social support, and patient-physician relationships were significant factors. Healthcare organizations should develop programs to raise hypertension patients' awareness and degree of self-efficacy that aid in adherence to advised lifestyle changes.
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Affiliation(s)
- Gebeyaw Geremew
- Department of Nursing, Tibebe Ghion Comprehensive Specialized Hospital, Bahir Dar, Ethiopia
| | - Fentie Ambaw
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eyob Ketema Bogale
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Zeamanuel Anteneh Yigzaw
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Feren N, Thapar R, Unnikrishnan B, Mithra P, Kumar N, Holla R, BB D, Kotian H. Effectiveness of multi-component modular intervention among adults with prehypertension in a village of Dakshina Kannada district - a community-based interventional study - protocol. F1000Res 2023; 12:667. [PMID: 38577228 PMCID: PMC10993661 DOI: 10.12688/f1000research.129131.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION The Joint National Committee (JNC 7) report on Prevention, Detection, Evaluation, and Treatment of Hypertension, defined "prehypertension," as individuals with a Systolic Blood Pressure (SBP) in the range of 120-139 mmHg and a (diastolic blood pressure) DBP of 80-89 mmHg. Prehypertension is directly linked with hypertension which is a precursor of CVDs. Owing to its high conversion rate to hypertension, it is important to identify individuals with blood pressures in this category and bring about lifestyle modifications in them that can prevent them from being hypertensive and from developing cardiovascular diseases later in life. METHODS This randomized controlled trial will be done among the selected pre-hypertensive adults of all genders residing in Kateel Gram panchayat, Dakshina Kannada district, Karnataka. A baseline survey will be done initially to assess the level of prehypertension among the study population. To study the effectiveness of the intervention, 142 individuals will be randomly allocated using block randomization technique to intervention and control groups. A multi-component module (educational intervention) will be developed, validated, and administered to participants in the intervention group, while the control group receives standard care. Each participant will then be followed up once in four months till the end of the study period of one year to assess for changes in SBP, DBP, WHR, BMI, stress levels, and usage of tobacco and alcohol. ETHICS AND DISSEMINATION Institutional Ethics Committee approval was obtained from Kasturba Medical College in Mangalore, India. The plans for dissemination of findings include presenting at scientific conferences and publishing in scholarly journals.
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Affiliation(s)
- Neneh Feren
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Rekha Thapar
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - B Unnikrishnan
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Prasanna Mithra
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Nithin Kumar
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Ramesh Holla
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Darshan BB
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Himani Kotian
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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Kim B, Park H. The effects of auricular acupressure on blood pressure, stress, and sleep in elders with essential hypertension: a randomized single-blind sham-controlled trial. Eur J Cardiovasc Nurs 2023; 22:610-619. [PMID: 36594992 DOI: 10.1093/eurjcn/zvad005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/25/2022] [Accepted: 12/31/2022] [Indexed: 01/04/2023]
Abstract
AIMS Reduction of blood pressure and improvement of stress and sleep disorders in patients with essential hypertension were important factors. This study aimed to examine the effects of auricular acupressure on blood pressure, stress, and sleep quality among elderly with essential hypertension in Korea. METHODS AND RESULTS This study was a single-blind, randomized, placebo-controlled study. The experimental group (n = 23) received 8 weeks of auricular acupressure intervention on specific acupoints (superior triangular fossa, Shenmen, kidney, heart, and occiput) related to blood pressure, pulse rate, stress, and sleep, whereas the control group (n = 23) received auricular acupressure on non-specific acupoints. The primary outcomes were the systolic and diastolic blood pressure measured weekly. The secondary outcomes were the pulse rate, heart rate variability, actigraphy measured through Fitbit, and the Pittsburgh sleep quality index (PSQI) were measured before and after the experiment. There were statistically significant differences between two groups in systolic blood pressure (F = 5.67, P = 0.022), diastolic blood pressure (17.53, P < 0.001), and pulse rate (F = 6.78, P = 0.013) over time. Stress index (χ2 = 2.12, P = 0.040) and sleep efficiency (χ2 = 3.57, P = 0.001) were also significantly different before and after the experiment. However, there was no significant difference in the PSQI. CONCLUSION The findings showed that auricular acupressure leads to improvements in blood pressure, stress, and sleep in elderly people with essential hypertension. Therefore, auricular acupressure can be used as an alternative nursing intervention for hypertension prevention, stress, and sleep management. REGISTRATION WHO ICTRP KCT0007364.
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Affiliation(s)
- Bomi Kim
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, South Korea
| | - Hyojung Park
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, South Korea
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Nomura A. Digital health, digital medicine, and digital therapeutics in cardiology: current evidence and future perspective in Japan. Hypertens Res 2023; 46:2126-2134. [PMID: 37258624 PMCID: PMC10230462 DOI: 10.1038/s41440-023-01317-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/21/2023] [Indexed: 06/02/2023]
Abstract
Ten years passed since Japan set out the Action Plan of Growth Strategy that declared the initiatives of digitalization for medicine, nursing care, and healthcare to achieve the world's most advanced medical care. The initiatives formed the foundation of the Japanese national strategy and have been continuously refined, resulting in the current environment of digital health and digital medicine. Digital health-related terminologies are organized, such as "digital health," "digital medicine," and "digital therapeutics" (DTx), as well as several common digital technologies, including artificial intelligence, machine learning, and mobile health (mHealth). DTx is included in mHealth and is a novel disease treatment option. Also, this article thoroughly describes DTx in Japan and compares it with those in the US and Germany, the leading countries in digital health-related policies, regulations, and their development status. In Japan, two of three DTx applications that have been approved and reimbursed by the Ministry of Health, Labor, and Welfare are explained in detail in relation to cardiovascular medicine. When added to a standard smoking cessation program, the DTx system for nicotine dependence significantly improved the continuous abstinence rate. Moreover, the DTx for hypertension together with the guideline-based hypertension management was effective in patients aged 65 years or younger who were diagnosed with essential hypertension without antihypertensive agents, and it was also found to be cost-effective. DTx in cardiovascular medicine, with consideration on safety, efficacy, and cost-effectiveness, could be widely used not only through basic experiments and clinical studies but also through social implementation.
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Affiliation(s)
- Akihiro Nomura
- College of Transdisciplinary Sciences for Innovation, Kanazawa University, Kanazawa, Japan.
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan.
- Frontier Institute of Tourism Sciences, Kanazawa University, Kanazawa, Japan.
- Department of Biomedical Informatics, CureApp Institute, Karuizawa, Japan.
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Sibley D, Chen M, West MA, Matthew AG, Santa Mina D, Randall I. Potential mechanisms of multimodal prehabilitation effects on surgical complications: a narrative review. Appl Physiol Nutr Metab 2023; 48:639-656. [PMID: 37224570 DOI: 10.1139/apnm-2022-0272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Continuous advances in prehabilitation research over the past several decades have clarified its role in improving preoperative risk factors, yet the evidence demonstrating reduced surgical complications remains uncertain. Describing the potential mechanisms underlying prehabilitation and surgical complications represents an important opportunity to establish biological plausibility, develop targeted therapies, generate hypotheses for future research, and contribute to the rationale for implementation into the standard of care. In this narrative review, we discuss and synthesize the current evidence base for the biological plausibility of multimodal prehabilitation to reduce surgical complications. The goal of this review is to improve prehabilitation interventions and measurement by outlining biologically plausible mechanisms of benefit and generating hypotheses for future research. This is accomplished by synthesizing the available evidence for the mechanistic benefit of exercise, nutrition, and psychological interventions for reducing the incidence and severity of surgical complications reported by the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). This review was conducted and reported in accordance with a quality assessment scale for narrative reviews. Findings indicate that prehabilitation has biological plausibility to reduce all complications outlined by NSQIP. Mechanisms for prehabilitation to reduce surgical complications include anti-inflammation, enhanced innate immunity, and attenuation of sympathovagal imbalance. Mechanisms vary depending on the intervention protocol and baseline characteristics of the sample. This review highlights the need for more research in this space while proposing potential mechanisms to be included in future investigations.
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Affiliation(s)
- Daniel Sibley
- Faculty of Kinesiology, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Maggie Chen
- Faculty of Kinesiology, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Malcolm A West
- Faculty of Medicine, Cancer Sciences, University of Southampton, UK
- NIHR Southampton Biomedical Research Centre, Perioperative and Critical Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Andrew G Matthew
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Ian Randall
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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13
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Baharvand P, Malekshahi F, Babakhani A. Perception of hypertension and adherence to hypertension treatment among patients attending a hospital in western Iran: A cross-sectional study. Health Sci Rep 2023; 6:e1501. [PMID: 37599662 PMCID: PMC10435721 DOI: 10.1002/hsr2.1501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/22/2023] Open
Abstract
Background and Aims Hypertension is the third leading cause of death in the world and is estimated to be increased by about 60% by 2025. Beliefs about hypertension can predict patient adherence to hypertension treatment. This study aims to investigate the perceptions of hypertension and adherence to hypertension treatment among patients in Khorramabad, Iran. Methods This is a descriptive/analytical study with a cross-sectional design. Participants were 265 patients with a history of hypertension referred to a hospital in Khorramabad, Lorestan Province in western Iran in 2020, who were selected using a convenience sampling method. A demographic form, the brief illness perception questionnaire-revised (BIPQ-R), and Morisky medication adherence scale (MMAS-8) were used for collecting data. The collected data were analyzed in SPSS v.22 software using descriptive statistics, Pearson's correlation test, independent t-test, one-way ANOVA, and regression analysis. Results The mean scores of BIPQ-R and MMAS-8 were 49.05 ± 15.45 (out of 80) and 3.69 ± 1.62 (out of 8), respectively. There was a significant relationship between the mean scores of MMAS-8 and BIPQ-R in total (p < 0.001). Perceptions of illness consequences (B = 4.59, p = 0.005), personal control (B = 0.190, p = 0.047), and symptoms (B = 1.77, p = 0.005) could significantly predict treatment adherence of patients. In illness perception, there were significant differences among patients with different places of residence (p = 0.032), educational levels (p = 0.001), and employment status (p = 0.010). In treatment adherence, there were significant differences among patients with different places of residence (p = 0.042) and educational levels (p = 0.045). Conclusion Treatment adherence of hypertensive patients in western Iran is at a low level, while their perception of hypertension is at a moderate level. Clinical physicians are recommended to pay attention to the perception of illness in these patients (especially unemployed and less educated patients living in rural areas) to improve their adherence to treatment and blood pressure control.
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Affiliation(s)
- Parastoo Baharvand
- Department of Social MedicineSocial Determinants of Health Research Center, School of Medicine, Lorestan University of Medical SciencesKhorramabadIran
| | - Farideh Malekshahi
- Department of Social MedicineSocial Determinants of Health Research Center, School of Medicine, Lorestan University of Medical SciencesKhorramabadIran
| | - Amirpourya Babakhani
- Department of Social MedicineSchool of Medicine, Lorestan University of Medical SciencesKhorramabadIran
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14
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Kodela P, Okeke M, Guntuku S, Lingamsetty SSP, Slonovschi E. Management of Hypertension With Non-pharmacological Interventions: A Narrative Review. Cureus 2023; 15:e43022. [PMID: 37674940 PMCID: PMC10478605 DOI: 10.7759/cureus.43022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2023] [Indexed: 09/08/2023] Open
Abstract
Hypertension (HTN) is a condition that affects nearly half of the adult population in the United States. HTN is the elevation of blood pressure (BP) 130/80 mm Hg or higher. Untreated high blood pressure may increase the risk of myocardial infarction, stroke, and other serious complications. BP over 180/120 mm Hg with end-organ damage is called a hypertensive emergency. Despite advancements in medicine and treatment options, the global burden of HTN has been increasing due to the advancing age of the population and an increasing prevalence of obesity. Non-pharmacological management of HTN has gained prominence worldwide due to its additional benefits and positive impact on the overall health of individuals, having almost no side effects and reducing the financial burden of medication expenses. This article has compiled studies like systematic reviews, meta-analyses, and randomized controlled trials and reviewed the role of non-pharmacological management of HTN, including lifestyle modifications like exercise, weight loss, dietary interventions like dietary approaches to stop hypertension (DASH) diet, low sodium diet, limiting alcohol consumption, smoking cessation and stress management to help control blood pressure. However, non-pharmacological interventions should be initiated in an early phase, and for proper management of HTN, we may need to include both pharmacological and non-pharmacological interventions. This article explored and integrated various studies to highlight the role of non-pharmacological interventions to manage HTN. We also examined the need for more research studies for strategies to alleviate morbidity and mortality associated with HTN.
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Affiliation(s)
- Pratyusha Kodela
- Internal Medicine, Shri B.M. Patil Medical College, Hospital and Research Center, Vijayapura, IND
| | - Monalisa Okeke
- Internal Medicine, Drexel University College of Medicine, Philadelphia, USA
| | | | | | - Eduard Slonovschi
- Surgery, Universitatea de Medicină și Farmacie Iuliu Haţieganu Facultatea de Medicină, Cluj-Napoca, ROU
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15
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Kavyani Z, Musazadeh V, Safaei E, Mohammadi Asmaroud M, Khashakichafi F, Ahrabi SS, Dehghan P. Antihypertensive effects of Nigella sativa supplementation: An updated systematic review and meta-analysis of randomized controlled trials. Phytother Res 2023; 37:3224-3238. [PMID: 37341696 DOI: 10.1002/ptr.7891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 04/04/2023] [Accepted: 05/09/2023] [Indexed: 06/22/2023]
Abstract
Clinical studies have suggested that Nigella Sativa (N. sativa) supplementation may effectively reduce blood pressure, but the findings are controversial. Therefore, this study aimed to examine the effects of N. sativa on blood pressure in adults. PubMed, Cochrane Library, Web of Science, Scopus, Embase databases, and Google Scholar were searched till August 2022. To analyze weighted mean differences (WMDs), a random-effects model was utilized. Nonlinear dose-response analysis and a meta-regression were conducted. N. sativa supplementation was effective in reducing both systolic (WMD: -3.06 mmHg; 95% CI: -3.89 to -2.22, p < 0.001; I2 = 84.7%, p < 0.001) and diastolic blood pressure (WMD = -2.69 mmHg; 95% CI: -3.72, -1.66, p < 0.001; I2 = 97.3%, p < 0.001). The current meta-analysis suggests that N. sativa supplementation can improve blood pressure and claims that N. sativa could be used as an effective approach to blood pressure management.
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Affiliation(s)
- Zeynab Kavyani
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vali Musazadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ehsan Safaei
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Sana Sedgh Ahrabi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvin Dehghan
- Nutrition Research Center, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
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Ojangba T, Boamah S, Miao Y, Guo X, Fen Y, Agboyibor C, Yuan J, Dong W. Comprehensive effects of lifestyle reform, adherence, and related factors on hypertension control: A review. J Clin Hypertens (Greenwich) 2023. [PMID: 37161520 DOI: 10.1111/jch.14653] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 05/11/2023]
Abstract
Despite the effectiveness of currently available antihypertensive medications, there is still a need for new treatment strategies that are more effective in certain groups of hypertensive and for additional resources to combat hypertension. However, medication non-adherence was previously recognized as a major problem in the treatment of hypertension. The mechanisms behind the positive impacts of lifestyle changes might occur in different ways. In comparison with other studies, the efficacy and effectiveness of lifestyle modifications and antihypertensive pharmaceutical treatment for the prevention and control of hypertension and concomitant cardiovascular disease have been demonstrated in randomized controlled trials. However, in this review, the attitudinal lifestyle modifications and barriers to blood pressure control were elaborated on. An effective method for reducing blood pressure (BP) and preventing cardiovascular events with antihypertensive medications has been outlined. Maintaining healthy lifestyle factors (body mass index, diet, smoking, alcohol consumption, sodium excretion, and sedentary behavior) could lower systolic blood pressure BP by 3.5 mm Hg and reduce the risk of cardiovascular disease (CVD) by about 30%, regardless of genetic susceptibility to hypertension. Conducting a lifestyle intervention using health education could improve lifestyle factors, such as reducing salt, sodium, and fat intake, changing eating habits to include more fruits and vegetables, not smoking, consuming less alcohol, exercising regularly, maintaining healthy body weight, and minimizing stressful conditions. Each behavior could affect BP by modulating visceral fat accumulation, insulin resistance, the renin-angiotensin-aldosterone system, vascular endothelial function, oxidative stress, inflammation, and autonomic function. Evidence of the joint effect of antihypertensive medications and lifestyle reforms suggests a pathway to reduce hypertension.
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Affiliation(s)
- Theodora Ojangba
- Department of Social Science and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
- Henan Research Center for HTA, Zhengzhou, China
- Department of Food Science and Technology, University for Development Studies, Tamale, Ghana
| | - Solomon Boamah
- Department of Food Science and Technology, University for Development Studies, Tamale, Ghana
- College of Plant Protection, Gansu Agricultural University, Lanzhou, China
| | - Yudong Miao
- Department of Social Science and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
- Henan Research Center for HTA, Zhengzhou, China
| | - Xinghong Guo
- Department of Social Science and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
- Henan Research Center for HTA, Zhengzhou, China
| | - Yifei Fen
- Department of Social Science and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, China
- Henan Research Center for HTA, Zhengzhou, China
| | - Clement Agboyibor
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Jingjing Yuan
- College of Plant Protection, Gansu Agricultural University, Lanzhou, China
| | - Wenyong Dong
- Department of Hypertension, People's Hospital of Zhengzhou University, Zhengzhou, China
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17
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Butel-Simoes LE, Haw TJ, Williams T, Sritharan S, Gadre P, Herrmann SM, Herrmann J, Ngo DTM, Sverdlov AL. Established and Emerging Cancer Therapies and Cardiovascular System: Focus on Hypertension-Mechanisms and Mitigation. Hypertension 2023; 80:685-710. [PMID: 36756872 PMCID: PMC10023512 DOI: 10.1161/hypertensionaha.122.17947] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Cardiovascular disease and cancer are 2 of the leading causes of death worldwide. Although improvements in outcomes have been noted for both disease entities, the success of cancer therapies has come at the cost of at times very impactful adverse events such as cardiovascular events. Hypertension has been noted as both, a side effect as well as a risk factor for the cardiotoxicity of cancer therapies. Some of these dynamics are in keeping with the role of hypertension as a cardiovascular risk factor not only for heart failure, but also for the development of coronary and cerebrovascular disease, and kidney disease and its association with a higher morbidity and mortality overall. Other aspects such as the molecular mechanisms underlying the amplification of acute and long-term cardiotoxicity risk of anthracyclines and increase in blood pressure with various cancer therapeutics remain to be elucidated. In this review, we cover the latest clinical data regarding the risk of hypertension across a spectrum of novel anticancer therapies as well as the underlying known or postulated pathophysiological mechanisms. Furthermore, we review the acute and long-term implications for the amplification of the development of cardiotoxicity with drugs not commonly associated with hypertension such as anthracyclines. An outline of management strategies, including pharmacological and lifestyle interventions as well as models of care aimed to facilitate early detection and more timely management of hypertension in patients with cancer and survivors concludes this review, which overall aims to improve both cardiovascular and cancer-specific outcomes.
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Affiliation(s)
- Lloyd E Butel-Simoes
- Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia
- College of Health and Medicine, University of Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Tatt Jhong Haw
- College of Health and Medicine, University of Newcastle, NSW Australia
- Newcastle Centre of Excellence in Cardio-Oncology, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Trent Williams
- College of Health and Medicine, University of Newcastle, NSW Australia
- Newcastle Centre of Excellence in Cardio-Oncology, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Shanathan Sritharan
- Department of Medicine, Hunter New England Local Health District, NSW, Australia
| | - Payal Gadre
- Department of Medicine, Hunter New England Local Health District, NSW, Australia
| | - Sandra M Herrmann
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
| | - Joerg Herrmann
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55902, USA
| | - Doan TM Ngo
- College of Health and Medicine, University of Newcastle, NSW Australia
- Newcastle Centre of Excellence in Cardio-Oncology, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Aaron L Sverdlov
- Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia
- College of Health and Medicine, University of Newcastle, NSW Australia
- Newcastle Centre of Excellence in Cardio-Oncology, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
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18
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Ing CT, Park MLN, Vegas JK, Haumea S, Kaholokula JK. Neighborhood level facilitators and barriers to hypertension management: A Native Hawaiian perspective. Heliyon 2023; 9:e13180. [PMID: 36798760 PMCID: PMC9925873 DOI: 10.1016/j.heliyon.2023.e13180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/25/2023] Open
Abstract
Native Hawaiians have a disproportionately high prevalence of hypertension, which is an important and modifiable risk factor for cardiovascular disease (CVD). To reduce CVD among Native Hawaiians, we must better understand facilitators and barriers to hypertension management (i.e., diet, physical activity, stress reduction) unique to Native Hawaiians. Despite evidence of neighborhood-level facilitators and barriers to hypertension management in other populations, there is limited research in Native Hawaiians. Participants from a randomized controlled trial (n = 40) were recruited for 5 focus groups. All participants were self-reported Native Hawaiians and had uncontrolled hypertension. Discussions elicited experiences and perceptions of neighborhood-level stressors as they relate to participants' hypertension management efforts. Audio recordings were transcribed and analyzed using ATLAS.ti for emergent themes. Five themes were identified: neighborhood description, community resources, neighborhood change, safety, and social connectedness. Novel barriers to hypertension control included loss of culture and loss of respect for elders, change in community feel, and over-development. Facilitators included social cohesion and collective power. These data provide a deeper understanding of how Native Hawaiians experience neighborhood factors and how those factors impact their efforts to improve their diets, physical activity, and stress management. The findings help to inform the development of multilevel CVD prevention programs. Further research is needed to explore the subtheme of social and emotional stress related to neighborhood change and CVD health risk due to cultural and historic trauma references.
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Affiliation(s)
- Claire Townsend Ing
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI, USA
- Corresponding author. Department of Native Hawaiian Health University of Hawai‘i 677 Ala Moana Blvd, Suite 1016B Honolulu, HI 96813, USA.
| | - Mei Linn N. Park
- Thompson School of Social Work & Public Health, University of Hawai‘i, Honolulu, HI, USA
| | - J. Kahaulahilahi Vegas
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI, USA
- Thompson School of Social Work & Public Health, University of Hawai‘i, Honolulu, HI, USA
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Fatores sociodemográficos e clínicos associados à ansiedade em mulheres hipertensas: estudo transversal. ACTA PAUL ENFERM 2023. [DOI: 10.37689/acta-ape/2023ao02951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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20
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Denche-Zamorano A, Basilio-Fernández B, Herrera-Guerrero P, Garcia-Gordillo MA, Castillo-Paredes A, Rojo-Ramos J, Gómez-Paniagua S, Barrios-Fernandez S. A Cross-Sectional Study on the Associations between Depression and Anxiety, Medication Use for These Diseases and Physical Activity Level in Spanish People with Hypertension. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1803. [PMID: 36767173 PMCID: PMC9914456 DOI: 10.3390/ijerph20031803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
Hypertension (HTN) has a high prevalence in the overall population, affecting people's mental health. Physical Activity (PA) has proven to be an effective tool to improve mental health. This study analyzed the associations between Depression and Anxiety prevalence, medication use for these disorders (antidepressants and anxiolytics) and Physical Activity Level (PAL) in people with HTN. A cross-sectional study was conducted with data from the Spanish National Health Survey 2017 (ENSE2017) with a final sample of 3228 individuals over 15 years of age with HTN who resided in Spain. Data normality was assessed through the Kolmogorov-Smirnov test. Associations between Depression and Anxiety prevalence, antidepressant and anxiolytic use and PAL were studied using a chi-square test. Possible differences between Depression and Anxiety prevalence and medication use according to the PAL were analyzed with a z-test for independent proportions. Depression or Anxiety and antidepressant and anxiolytic use odds ratios (OR) were calculated for every PAL group, taking the "Very Active" group as a reference. Risk factors were evaluated using multiple binary logistic regression. Dependency relationships were found between Depression and Anxiety prevalence, antidepressant and anxiolytic use and PAL (p < 0.001). The Inactive group displayed the highest prevalence and medication use according to their PAL (p < 0.05). Higher ORs for Depression or Anxiety and pharmacological treatments used were also found in the Inactive group compared to the other PAL groups.
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Affiliation(s)
- Angel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Belinda Basilio-Fernández
- Department of Nursing, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain
| | - Pedro Herrera-Guerrero
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | | | - Antonio Castillo-Paredes
- Grupo AFySE, Investigación en Actividad Física y Salud Escolar, Escuela de Pedagogía en Educación Física, Facultad de Educación, Universidad de Las Américas, Santiago 8370040, Chile
| | - Jorge Rojo-Ramos
- Physical Activity for Education, Performance and Health, Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | | | - Sabina Barrios-Fernandez
- Occupation, Participation, Sustainability and Quality of Life (Ability Research Group), Nursing and Occupational Therapy College, University of Extremadura, 10003 Caceres, Spain
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Shao T, Liang L, Zhou C, Tang Y, Gao W, Tu Y, Yin Y, Malone DC, Tang W. Short-term efficacy of non-pharmacological interventions for global population with elevated blood pressure: A network meta-analysis. Front Public Health 2023; 10:1051581. [PMID: 36711409 PMCID: PMC9880179 DOI: 10.3389/fpubh.2022.1051581] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/30/2022] [Indexed: 01/14/2023] Open
Abstract
Background This study aims to compare the potential short-term effects of non-pharmacological interventions (NPIs) on prehypertensive people, and provide evidence for intervention models with potential in future community-based management. Methods In this Bayesian network meta-analysis, Pubmed, Embase, and Web of science were screened up to 16 October 2021. Prehypertensive patients (systolic blood pressure, SBP 120-139 mmHg/diastolic blood pressure, DBP 80-89 mmHg) with a follow-up period longer than 4 weeks were targeted. Sixteen NPIs were identified during the scope review and categorized into five groups. Reduction in SBP and DBP was selected as outcome variables and the effect sizes were compared using consistency models among interventions and intervention groups. Grade approach was used to assess the certainty of evidence. Results Thirty-nine studies with 8,279 participants were included. For SBP, strengthen exercises were the most advantageous intervention group when compared with usual care (mean difference = -6.02 mmHg, 95% CI -8.16 to -3.87), and combination exercise, isometric exercise, and aerobic exercise were the three most effective specific interventions. For DBP, relaxation was the most advantageous intervention group when compared with usual care (mean difference = -4.99 mmHg, 95% CI -7.03 to -2.96), and acupuncture, meditation, and combination exercise were the three most effective specific interventions. No inconsistency was found between indirect and direct evidence. However, heterogeneity was detected in some studies. Conclusion NPIs can bring short-term BP reduction benefits for prehypertensive patients, especially exercise and relaxation. NPIs could potentially be included in community-based disease management for prehypertensive population once long-term real-world effectiveness and cost-effectiveness are proven. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=151518, identifier: CRD42020151518.
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Affiliation(s)
- Taihang Shao
- Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
| | - Leyi Liang
- Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yaqian Tang
- Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
| | - Wenqing Gao
- Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
| | - Yusi Tu
- Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
| | - Yue Yin
- Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
| | - Daniel C. Malone
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, United States,Daniel C. Malone ✉
| | - Wenxi Tang
- Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China,Department of Public Affairs Management, School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China,*Correspondence: Wenxi Tang ✉
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22
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Chen Y, Yuan J, Lei X, Cheng Y, Wei X. Metabolic status and vascular endothelial structure in obese hypertensive patients treated with non-pharmacological therapies: A systematic review and meta-analysis. PLoS One 2022; 17:e0279582. [PMID: 36583997 PMCID: PMC9803191 DOI: 10.1371/journal.pone.0279582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 12/11/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE This meta-analysis aimed to evaluate the efficacy of non-drug treatment on metabolism and vascular endothelium in obese hypertension. METHODS Relevant publications were searched in the PubMed, Embase, and Cochrane Library databases for clinical studies on the effects of non-pharmacological treatments in obese hypertensive patients published from inception to April 2022. After searching and screening the literature, information was extracted, and the quality of the literature was evaluated by the investigators. Data processing was performed using Rev Man 5.3 statistical analysis software, while the TSA 0.9 software was used for sequential analysis of blood pressure and endothelial-related indicators. RESULTS A total of 8 literature articles with 480 patients were included. The analysis showed that non-pharmacological treatment effectively reduced systolic blood pressure, diastolic blood pressure, heart rate, body weight, body mass index, glucose levels, soluble intercellular adhesion molecule 1, triglycerides, triglycerides, Low-density lipoprotein. For tumor necrosis factor α, soluble vascular cell adhesion molecule 1, high-density lipoprotein, C-reactive protein, high-sensitive C-reactive protein, and total antioxidant status by dietary supplements mainly. In contrast, no significant treatment effect was observed for Endothelin-1. Sequential analysis of the trial showed definitive evidence for improvement in blood pressure and inflammation. CONCLUSION Non-pharmacological treatment of obese hypertensive patients may reduce blood pressure, body weight, and blood glucose, control inflammatory factor release and improve vascular endothelium to some extent.
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Affiliation(s)
- Yingru Chen
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jie Yuan
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xueli Lei
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yan Cheng
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
- * E-mail: (YC); (XW)
| | - Xijin Wei
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
- * E-mail: (YC); (XW)
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Suriyawong W, Kao TSA, Robbins LB, Ling J, Malete L. Psychosocial Determinants of Recommended Lifestyle Behaviors among Hypertensive Patients: An Integrative Literature Review. West J Nurs Res 2022; 45:455-468. [PMID: 36515369 DOI: 10.1177/01939459221144177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Healthy lifestyle levels are low among adults with hypertension (HTN). Unfortunately, psychosocial factors contributing to patients' inability to meet healthy lifestyle recommendations are not well-understood. This integrative review examined the relationships of three psychosocial factors (self-efficacy, outcome expectancy, and social support) with dietary adherence (DA) and physical activity (PA) among adults with HTN. In total, 24 peer-reviewed studies were assessed. Results showed self-efficacy had small-to-large relationships with PA (r = 0.02-0.46) and DA (r = 0.06-0.79), with the strength of the associations varying by the assessed domain and country of origin. However, few studies reported a small relationship between the remaining factors (outcome expectancy and social support) and PA and DA. Thus, more efforts are needed to delineate the contributions of social support and outcome expectancies on DA or PA. When designing an intervention that focuses on improving PA or DA among adults with HTN, these psychosocial factors should be targeted.
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Affiliation(s)
- Wachira Suriyawong
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.,College of Nursing, Michigan State University, East Lansing, MI, USA
| | | | | | - Jiying Ling
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Leapetswe Malete
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA
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Vay-Demouy J, Lelong H, Neudorff P, Gabet A, Grave C, Blacher J, Olié V. Underuse of lifestyle recommendations in hypertension management in France: The Esteban study. J Clin Hypertens (Greenwich) 2022; 24:1266-1275. [PMID: 36177966 PMCID: PMC9581092 DOI: 10.1111/jch.14576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022]
Abstract
Lifestyle recommendations are first‐line elements in the management of arterial hypertension. This cross‐sectional study aimed to analyze the level to which lifestyle recommendations are used in hypertension management in France, using data from the Esteban study, which was implemented by Santé Publique France, France's public health agency, from 2014 to 2016 on a representative sample of the French population. The study sample comprised 440 adult Esteban participants who were aware they had hypertension and were aged 18–74 years old. The main outcomes were the proportion of participants who received lifestyle recommendations in their hypertension management plan, and the proportion of recommendations according to the three following dimensions: physical activity, weight loss, and changes in diet. Over half (57.0%) of the 440 participants declared they did not receive lifestyle recommendations as part of their hypertension management plan in the year preceding the study. Of these, 39.0% did not receive pharmacological treatment either. Physical activity was recommended to 31.8% of sedentary participants and weight loss to 26.8% of participants with overweight or obesity. One‐fifth of the study sample (20.1%) received dietary recommendations. Of these, 69% and 10.7% were advised to limit their salt and alcohol intake, respectively. Lifestyle interventions are too rarely recommended in hypertension management plans in France. Adherence to lifestyle recommendations needs in‐depth discussion not only at the time of diagnosis but also throughout follow‐up.
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Affiliation(s)
- Juliette Vay-Demouy
- Diagnosis and Therapeutic Center, Hôtel-Dieu University Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France
| | - Hélène Lelong
- Diagnosis and Therapeutic Center, Hôtel-Dieu University Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France
| | - Pauline Neudorff
- Diagnosis and Therapeutic Center, Hôtel-Dieu University Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France
| | - Amélie Gabet
- French Public Health Agency, Saint-Maurice, France
| | | | - Jacques Blacher
- Diagnosis and Therapeutic Center, Hôtel-Dieu University Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France
| | - Valérie Olié
- French Public Health Agency, Saint-Maurice, France
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Evaluation of Psychological Distress, Self-Care, and Medication Adherence in Association with Hypertension Control. Int J Hypertens 2022; 2022:7802792. [PMID: 36059588 PMCID: PMC9436608 DOI: 10.1155/2022/7802792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/03/2022] [Accepted: 08/10/2022] [Indexed: 11/18/2022] Open
Abstract
Background. Most of the patients with hypertension (HTN) who undergo medical therapy unaccompanied by psychological and behavioral interventions may not achieve their goal in HTN treatment. Self-care is a key factor in controlling HTN. Given that depression, stress, and anxiety are the most psychological disorders in chronic illnesses. Their impact on self-care, quality of life, and HTN control must be studied more. Methods. We analyzed the difference in medication adherence in 252 patients with low vs. high psychological distress. Also, patients with controlled and uncontrolled HTN were compared according to their psychological distress scores. We further assessed the relation of psychological distress, self-care, and medication adherence with patients’ demographic characteristics. Results. 61.3% of our participants were female with a mean age of 60.6 ± 11.35 and male participants had a mean age of 60.5 ± 11.55. The psychological distress score was significantly higher in women with uncontrolled HTN (
value = 0.044). Also, individuals with controlled HTN tend to have a higher medication adherence score (
value = 0.01) and higher self-care score (
value = 0.033). Hypertensive females had a higher psychological distress score (3.35 ± 2.05) and a lower self-care score (64.05 ± 8.16). There was a positive relationship between age and drug adherence. The self-care score was higher (65.95 ± 7.88) in patients having lower psychological distress levels. Conclusion. A lower psychological distress score can result in better self-care, enhancing the probability of better HTN control; thus, psychological interventions may be necessary for the treatment of HTN. However, more studies are needed to assess the effectiveness of this intervention.
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Shori AB, Tin YP, Baba AS. Codonopsis pilosula and fish collagen yogurt: Proteolytic, potential Angiotensin-I converting enzyme (ACE) inhibitory activity and sensory properties. Lebensm Wiss Technol 2022. [DOI: 10.1016/j.lwt.2022.113729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wang C, Zheng Y, Zhang Y, Liu D, Guo L, Wang B, Zuo H. Dietary Patterns in Association With Hypertension: A Community-Based Study in Eastern China. Front Nutr 2022; 9:926390. [PMID: 35873413 PMCID: PMC9305172 DOI: 10.3389/fnut.2022.926390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThis study aimed to explore the association between dietary patterns and hypertension based on a community–based survey in Suzhou, Eastern China.MethodsThis cross–sectional analysis was undertaken from the subset of the Suzhou Food Consumption and Health State Survey in 2018–2019. Adults aged ≥ 18 years were invited to participate in this survey. Dietary intake was collected by a 24–h dietary recall and a weighing method over three consecutive days (including two weekdays and one weekend day). Dietary patterns were defined using factor analysis. Association between the dietary patterns and hypertension was examined by multivariable logistic regression models with adjustment for covariates. Moreover, sensitivity analysis was used to reinforce our findings.ResultsA total of 2,718 participants were included in the final analysis. Rice-vegetable pattern, fast food pattern, fruit-dairy pattern, and wheat-meat pattern were identified. We observed that the fruit-dairy pattern was inversely associated with hypertension after adjustment for all the covariates (OR = 0.55; 95% CI: 0.40, 0.75; P = 0.002). The association between the wheat-meat pattern and hypertension was attenuated and became statistically nonsignificant in sensitivity analyses. The other two patterns were not significantly associated with hypertension (P > 0.05).ConclusionThe fruit-dairy pattern was inversely associated with the risk of hypertension among Chinese adults. Our findings further emphasize the important role of optimal diet combination in the prevention of hypertension.
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Affiliation(s)
- Cuicui Wang
- School of Public Health, Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Yanmin Zheng
- Department of Nutrition and Food Hygiene, Suzhou Center for Disease Control and Prevention, Suzhou, China
| | - Ya Zhang
- School of Public Health, Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Dong Liu
- School of Public Health, Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Li Guo
- Department of Disease Prevention and Health Care, Soochow University Hospital, Soochow University, Suzhou, China
| | - Bo Wang
- Department of Nutrition and Food Hygiene, Suzhou Center for Disease Control and Prevention, Suzhou, China
- *Correspondence: Bo Wang
| | - Hui Zuo
- School of Public Health, Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
- Hui Zuo
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Mechanisms underlying the effects of caloric restriction on hypertension. Biochem Pharmacol 2022; 200:115035. [DOI: 10.1016/j.bcp.2022.115035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/07/2022] [Accepted: 04/07/2022] [Indexed: 11/20/2022]
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Pio-Abreu A, Trani-Ferreira F, Silva GV, Bortolotto LA, Drager LF. Directly observed therapy for resistant/refractory hypertension diagnosis and blood pressure control. Heart 2022; 108:1952-1956. [PMID: 35444006 DOI: 10.1136/heartjnl-2022-320802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 04/04/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To test the impact of directly observed therapy (DOT) at hospital for checking not only adherence/diagnosis in patients with resistant (RHTN) and refractory (RefHTN) hypertension but also blood pressure (BP) control after hospital discharge. METHODS During 2 years, Brazilian patients with clinical suspicion of RHTN/RefHTN after several attempts (≥3) to control BP in the outpatient setting were invited to perform DOT (including low-sodium diet and supervised medications intake) at the hospital. RHTN and RefHTN were categorised using standard definitions. After hospital discharge, we evaluated the BP values and the number of antihypertensive drugs prescribed by physicians who were not involved with the investigation. RESULTS We studied 83 patients clinically suspected for RHTN (31%) and RefHTN (69%) (mean age: 53 years; 76% female; systolic BP 177±28 mm Hg and diastolic BP 106±21 mm Hg; number of antihypertensive drugs: 5.3±1.3). DOT confirmed RHTN in 77%, whereas RefHTN was confirmed in only 32.5%. The number of antihypertensive drugs reduced to 4.5±1.3 and systolic/diastolic BP at hospital discharge reduced to 131±17 mm Hg/80±12 mm Hg. After hospital discharge, systolic BP remained significantly lower than the last outpatient visit prehospital admission (delta changes (95% CI): 1 month: -25.7 (-33.8 to -17.6) mm Hg; 7 months: -27.3 (-35.5 to -19.1) mm Hg) despite fewer number of antihypertensive classes (1 month: -1.01 (-1.36 to -0.67); 7 months: -0.77 (-1.11 to -0.42)). Similar reductions were observed for diastolic BP. CONCLUSIONS DOT at hospital is helpful not only in confirming/excluding RHTN/RefHTN phenotypes, but also in improving BP values and BP control and in reducing the need for antihypertensive drugs after hospital discharge.
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Affiliation(s)
- Andrea Pio-Abreu
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Fernanda Trani-Ferreira
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Giovanio V Silva
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Luiz A Bortolotto
- Unidade de Hipertensão, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Luciano F Drager
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil .,Unidade de Hipertensão, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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He L, Yan Y, Wang Y, Sun Y, La Y, Liu J, Cai Y, Cao X, Feng Q. Identifying Excessive Intake of Oil and Salt to Prevent and Control Hypertension: A Latent Class Analysis. Front Cardiovasc Med 2022; 9:782639. [PMID: 35463793 PMCID: PMC9019702 DOI: 10.3389/fcvm.2022.782639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction To identify health hazard behaviors and provide a basis for targeted management and intervention for patients with hypertension, we classified their health-related behaviors. Methods A multi-stage random sampling method was used to conduct an on-site questionnaire survey among residents aged ≥15 years in a certain urban area of Taiyuan City, Shanxi Province, China. A latent class analysis was used to classify the lifestyle behaviors of patients with hypertension. The lifestyle behavior characteristics of different types of patients with hypertension and their awareness of hypertension were assessed. Results The prevalence of hypertension in Taiyuan City was 19.5%. Patients with hypertension were classified into three clusters according to their lifestyle patterns: smoking and drinking (13.35%), excessive edible oil and salt intake (68.27%), and healthy behavior (18.38%). Comparing the three latent classes of lifestyle, the distribution of age, sex, marital status, and education level was different (P < 0.05). The awareness of hypertension and the rate of control among the three classes were also different (P < 0.05). Conclusion The lifestyle behaviors of patients with hypertension have evident classification characteristics. Approximately two-thirds of the patients with hypertension have an excessive intake of oil and salt. Therefore, targeted and precise intervention measures should be taken to control the intake of oil and salt in this cohort.
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Affiliation(s)
- Lu He
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
- *Correspondence: Lu He
| | - Yan Yan
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yuxiao Wang
- Department of Health Economics, School of Management, Shanxi Medical University, Taiyuan, China
| | - Yudan Sun
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yuanyuan La
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jie Liu
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yutong Cai
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Xi Cao
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Qilong Feng
- Department of Physiology, Key Laboratory of Cellular Physiology, Ministry of Education, Shanxi Medical University, Taiyuan, China
- Qilong Feng
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Nair KR, V.S A, S.K. K, P. UD. Spices and Hypertension: An Insight for Researchers. CURRENT NUTRITION & FOOD SCIENCE 2022. [DOI: 10.2174/1573401317666211122144827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
:
Hypertension is a global public health concern since it can lead to complications like
stroke, heart disease, and kidney failure. These complications can add to a disability, increase
healthcare costs, and can even result in mortality. In spite of the availability of a large number of
anti-hypertensive drugs, the control of blood pressure is suboptimal in many patients. Spices have
been used as flavouring agents and in treating diseases in folk medicine since they are considered
to be rich sources of phytochemicals, especially polyphenols. Hence, during recent years, there has
been renewed interest among researchers in exploring natural sources, especially spices, in an attempt
to find cheaper alternatives with fewer side effects. Our aim is to review the relevant preclinical
and clinical studies focused on the potential use of spices in the management of hypertension.
Studies conducted on the most common spices, such as celery, cinnamon, cardamom, garlic, ginger,
saffron, and turmeric, have been elaborated in this review. These spices may lower blood pressure
via several possible mechanisms, including antioxidant effect, increase in nitric oxide production,
reduction in calcium ion concentration, modulation of the renin-angiotensin pathway, etc.
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Affiliation(s)
- Kavyanjana R. Nair
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS-Kochi - 682041,
Kerala, India
| | - Arya V.S
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS-Kochi - 682041,
Kerala, India
| | - Kanthlal S.K.
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS-Kochi - 682041,
Kerala, India
| | - Uma Devi P.
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS-Kochi - 682041,
Kerala, India
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Jiang Q, Gong D, Li H, Zhang D, Hu S, Xia Q, Yuan H, Zhou P, Zhang Y, Liu X, Sun M, Lv J, Li C. Development and Validation of a Risk Score Screening Tool to Identify People at Risk for Hypertension in Shanghai, China. Risk Manag Healthc Policy 2022; 15:553-562. [PMID: 35386277 PMCID: PMC8977866 DOI: 10.2147/rmhp.s354057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/14/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to develop a screening tool based on a risk scoring approach that could identify individuals at high risk for hypertension in Shanghai, China. Methods A total of 3147 respondents from the 2013 Shanghai Chronic Disease and Risk Factor Surveillance were randomly divided into the derivation group and validation group. The coefficients obtained from multivariable logistic regression were used to assign a score to each variable category. The receiver operating characteristic (ROC) curve was used to find the optimal cut-off point and to evaluate the screening performance. Results Age, family history of hypertension, having diabetes, having dyslipidemia, body mass index, and having abdominal obesity contributed to the risk score. The area under the ROC curve was 0.817 (95% CI: 0.797–0.836). The optimal cut-off value of 20 had a sensitivity of 83.4%, and a specificity of 64.3%, demonstrating good performance. Conclusion We developed a simple and valid screening tool to identify individuals at risk for hypertension. Early detection could be beneficial for high-risk groups to better manage their conditions and delay the progression of hypertension and related complications.
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Affiliation(s)
- Qiyun Jiang
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, People’s Republic of China
- Research Institute of Health Development Strategies, Fudan University, Shanghai, People’s Republic of China
| | - Dan Gong
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, People’s Republic of China
- Research Institute of Health Development Strategies, Fudan University, Shanghai, People’s Republic of China
| | - Huiqi Li
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Donglan Zhang
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, USA
| | - Suzhen Hu
- Department of Medical Affairs, Liaocheng People’s Hospital, Liaocheng, People’s Republic of China
| | - Qinghua Xia
- Department of Chronic Disease Prevention and Control, Changning District Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Hong Yuan
- Department of Chronic Disease Prevention and Control, Jiading District Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Peng Zhou
- Department of Chronic Disease Prevention and Control, Changning District Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Yiying Zhang
- Department of Chronic Disease Prevention and Control, Jiading District Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Xing Liu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, People’s Republic of China
| | - Mei Sun
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, People’s Republic of China
- Research Institute of Health Development Strategies, Fudan University, Shanghai, People’s Republic of China
| | - Jun Lv
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, People’s Republic of China
- Research Institute of Health Development Strategies, Fudan University, Shanghai, People’s Republic of China
| | - Chengyue Li
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, People’s Republic of China
- Research Institute of Health Development Strategies, Fudan University, Shanghai, People’s Republic of China
- Correspondence: Chengyue Li; Jun Lv, Department of Health Policy and Management, School of Public Health, Fudan University, P.O. Box 177, 130 Dong’an Road, Shanghai, 200032, People’s Republic of China, Tel +86-21-33561022; +86-21-33563953, Fax +86-21-33563380, Email ;
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Cernota M, Kroeber ES, Demeke T, Frese T, Getachew S, Kantelhardt EJ, Ngeh EN, Unverzagt S. Non-pharmacological interventions to achieve blood pressure control in African patients: a systematic review. BMJ Open 2022; 12:e048079. [PMID: 35228272 PMCID: PMC8886440 DOI: 10.1136/bmjopen-2020-048079] [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] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES This systematic review aims to evaluate the evidence of non-pharmacological strategies to improve blood pressure (BP) control in patients with hypertension from African countries. DESIGN We performed a systematic review and searched Medline, Central, CINAHL and study registers until June 2020 for randomised studies on interventions to decrease BP of patients with hypertension in African countries. We assessed the study quality using the Cochrane risk of bias tool and narratively synthesised studies on non-pharmacological hypertension interventions. SETTING We included studies conducted in African countries. PARTICIPANTS Adult African patients with a hypertension diagnosis. INTERVENTIONS Studies on non-pharmacological interventions aiming to improve BP control and treatment adherence. OUTCOMES Main outcomes were BP and treatment adherence. RESULTS We identified 5564 references, included 23 with altogether 18 153 participants from six African countries. The studies investigated educational strategies to improve adherence (11 studies) and treatment by healthcare professionals (5 studies), individualised treatment strategies (2 studies), strategies on lifestyle including physical activity (4 studies) and modified nutrition (1 study). Nearly all studies on educational strategies stated improved adherence, but only three studies showed a clinically relevant improvement of BP control. All studies on individualised strategies and lifestyle changes resulted in clinically relevant effects on BP. Due to the type of interventions studied, risk of bias in domain blinding of staff/participants was frequent (83%). Though incomplete outcome data in 61% of the studies are critical, the general study quality was reasonable. CONCLUSIONS The identified studies offer diverse low-cost interventions including educative and task-shifting strategies, individualised treatment and lifestyle modifications to improve BP control. Especially trialled physical activity interventions show clinically relevant BP changes. All strategies were trialled in African countries and may be used for recommendations in evidence-based guidelines on hypertension in African settings. PROSPERO REGISTRATION NUMBER CRD42018075062.
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Affiliation(s)
- Monique Cernota
- Institute of General Practice and Family Medicine, Center of Health Sciences, Martin-Luther-Universität Halle-Wittenberg Medizinische Fakultät, Halle, Germany
| | - Eric Sven Kroeber
- Institute of General Practice and Family Medicine, Center of Health Sciences, Martin-Luther-Universität Halle-Wittenberg Medizinische Fakultät, Halle, Germany
| | - Tamiru Demeke
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Center of Health Sciences, Martin-Luther-Universität Halle-Wittenberg Medizinische Fakultät, Halle, Germany
| | - Sefonias Getachew
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eva Johanna Kantelhardt
- Institute for Medical Epidemiology, Biostatistics and Informatics, Center of Health Sciences, Martin-Luther-Universität Halle-Wittenberg Medizinische Fakultät, Halle, Germany
| | - Etienne Ngeh Ngeh
- Physiotherapy Department, Regional Hospital Bamenda, Bamenda, Cameroon
- Research Organization for Health Education and Rehabilitation-Cameroon(ROHER-CAM), St. Louis University Bamenda, Bamenda, Cameroon
- African Regional Community, Guidelines International Network (G-I-N), Bamenda, Cameroon
| | - Susanne Unverzagt
- Institute of General Practice and Family Medicine, Center of Health Sciences, Martin-Luther-Universität Halle-Wittenberg Medizinische Fakultät, Halle, Germany
- Department of Primary Care, Universität Leipzig Medizinische Fakultät, Leipzig, Germany
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Desfika S, Ichwan M, Ardinata D. Wet Cupping’s Effect on Nitric Oxide Levels in Hypertensive Patients. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Wet cupping is a non-pharmacological therapy that has been shown to assist hypertensive patients with blood pressure reduction. However, the underlying mechanisms by which wet-cupping lowers blood pressure are currently unknown. More scientific investigation is necessary to explain the mechanism by which wet cupping lowers blood pressure, particularly the role of nitric oxide (NO).
AIM: The study aimed to show the effect of wet cupping on NO levels in hypertensive patients.
METHODS: A pre-experimental study using a single group pre-test and post-test design to monitor changes in blood NO levels and blood pressure in 45 hypertensive patients in Medan after 4 weeks of wet cupping therapy. The patients’ blood NO levels, as well as their systolic and diastolic blood pressures (SBP and DBP), were measured before and after 4 weeks of wet cupping.
RESULTS: After 4 weeks of wet cupping, blood NO levels significantly increased (0.00704 mol/mL, p=0.039), while SBP and DBP levels significantly decreased (12.644 mmHg and 7.111 mmHg, respectively, p<0.001). However, there was no correlation between increased blood NO levels and reductions in SBP and DBP (p=0.468 and p=0.299, respectively).
CONCLUSION: This study found that after 4 weeks of cupping therapy, the decrease in SBP and DBP was not accompanied by an increase in blood NO levels.
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Bouchard J, Valookaran AF, Aloud BM, Raj P, Malunga LN, Thandapilly SJ, Netticadan T. Impact of oats in the prevention/management of hypertension. Food Chem 2022; 381:132198. [PMID: 35123221 DOI: 10.1016/j.foodchem.2022.132198] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 12/24/2022]
Abstract
Oats are a rich source of a soluble fibre, beta-glucan, phenolic compounds, as well as functional lipid and protein components that could potentially aid in preventing and managing hypertension. Processing techniques commonly used to manufacture oat based foods have been shown to improve its physiological efficacy. Hypertension is a common condition that is a risk factor for cardiovascular disease, a primary cause of mortality worldwide. Though exercise and pharmacological interventions are often used in the management of hypertension, diet is an incredibly important factor. One preclinical study and a handful of clinical studies have shown that oat components/products are effective in lowering blood pressure. However, research in this area is limited and more studies are needed to elucidate the anti-hypertensive potential of oats.
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Affiliation(s)
- Jenny Bouchard
- Richardson Center for Functional Foods and Nutraceuticals, Winnipeg, MB, Canada; Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada; Morden Research and Development Centre, Agriculture and Agri-Food Canada, Morden, MB, Canada
| | - Aleena Francis Valookaran
- Morden Research and Development Centre, Agriculture and Agri-Food Canada, Morden, MB, Canada; Canadian Centre for Agri-Food Research in Health and Medicine , Winnipeg, MB, Canada
| | | | - Pema Raj
- Morden Research and Development Centre, Agriculture and Agri-Food Canada, Morden, MB, Canada; Canadian Centre for Agri-Food Research in Health and Medicine , Winnipeg, MB, Canada
| | - Lovemore Nkhata Malunga
- Richardson Center for Functional Foods and Nutraceuticals, Winnipeg, MB, Canada; Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada; Morden Research and Development Centre, Agriculture and Agri-Food Canada, Morden, MB, Canada
| | - Sijo Joseph Thandapilly
- Richardson Center for Functional Foods and Nutraceuticals, Winnipeg, MB, Canada; Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada; Morden Research and Development Centre, Agriculture and Agri-Food Canada, Morden, MB, Canada.
| | - Thomas Netticadan
- Morden Research and Development Centre, Agriculture and Agri-Food Canada, Morden, MB, Canada; Canadian Centre for Agri-Food Research in Health and Medicine , Winnipeg, MB, Canada; Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada.
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36
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Siew-Keah L, Hann K, Hoe S, En L, Chin L, Chan MS, Kang T, Ang-Lim C. Awareness and perceived barriers in practicing healthy living to prevent hypertension among young adults in Malaysia. ASIAN PAC J TROP MED 2022. [DOI: 10.4103/1995-7645.364001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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37
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Hamer O, Hill JE, Harrison J. Blood pressure targets: comparing lower versus standard targets for people with hypertension. BRITISH JOURNAL OF CARDIAC NURSING 2021; 16:0133. [PMID: 38737520 PMCID: PMC7615951 DOI: 10.12968/bjca.2021.0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
In this commentary, Hamer, Hill and Harrison critically appraise a systematic review comparing lower versus standard targeted blood pressure and how this impacts morbidity and mortality in people with hypertension.
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Affiliation(s)
- Oliver Hamer
- Synthesis, Economic Evaluation and Decision Science Group, University of Central Lancashire, Preston, Lancashire, UK
| | - James Edward Hill
- Synthesis, Economic Evaluation and Decision Science Group, University of Central Lancashire, Preston, Lancashire, UK
| | - Joanna Harrison
- Synthesis, Economic Evaluation and Decision Science Group, University of Central Lancashire, Preston, Lancashire, UK
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Cao Y, Sathish T, Haregu T, Wen Y, de Mello GT, Kapoor N, Oldenburg B. Factors Associated With Hypertension Awareness, Treatment, and Control Among Adults in Kerala, India. Front Public Health 2021; 9:753070. [PMID: 34790643 PMCID: PMC8591131 DOI: 10.3389/fpubh.2021.753070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/11/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Hypertension, the most significant risk factor for cardiovascular disease, is an increasing contributor to global health burden, particularly in low- and middle-income countries (LMICs) such as India. While the rates of hypertension awareness, treatment, and control in India have been reported in several studies, the factors associated with these rates are less well-understood. Existing studies are predominantly cross-sectional, and the factors examined are limited. Understanding the predictors associated with these rates, using more rigorous study designs, is crucial for the development of strategies to improve hypertension management. Aims: To examine a range of factors associated with hypertension awareness, treatment, and control using both cross-sectional and longitudinal analyses. Methods: Data was derived from a population-based sample of 1,710 participants from Kerala, aged 30–60 years. We examined a comprehensive range of factors, including demographic, behavioral factors, anthropometric, clinical measures, psychosocial factors and healthcare utilization. Multilevel mixed effects logistic regression was used for both cross-sectional and longitudinal analyses (repeated measures for all variables across 2 years) to determine the factors associated with awareness, treatment, and control of hypertension. Results: A total of 467 (27.3%) participants had hypertension at baseline. Among those, the rates of awareness, treatment, and control of hypertension were 54.4, 25.5, and 36.4%, respectively. Being male (OR 0.27, 95% CI 0.14–0.53) and consumption of alcohol (OR 0.49, 95% CI 0.31–0.80) were significant predictors of poorly controlled hypertension (longitudinal analysis). Depression (OR 2.04, 95% CI 1.15–3.61) and fair-to-poor self-perceived health status (OR 1.87, 95% CI 1.15–3.04) were associated with increased hypertension awareness, whereas anxiety (OR 1.97, 95% CI 1.04–3.71) was associated with increased hypertension treatment (cross-sectional analysis). Seeking outpatient service in the past 4 weeks was associated with higher awareness (OR 1.09, 95% CI 1.27–2.87), treatment (OR 1.73, 95% CI 1.20–2.50) and control (OR 1.96, 95% CI 1.37–2.80) (longitudinal analysis). Conclusion: Our findings suggest the importance of considering psychosocial factors and better engagement with health services in hypertension management, as well as giving more attention to body fat control and largely male-related behaviors such as alcohol consumption, taking into account of some Indian specific attributes.
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Affiliation(s)
- Yingting Cao
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.,Implementation Science Lab, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Thirunavukkarasu Sathish
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.,Population Health Research Institute (PHRI), McMaster University, Hamilton, ON, Canada
| | - Tilahun Haregu
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.,Implementation Science Lab, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Yu Wen
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.,Implementation Science Lab, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Gabrielli Thais de Mello
- Research Centre for Physical Activity and Health (NuPAF), Federal University of Santa Catarina, Florianópolis, Brazil
| | - Nitin Kapoor
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.,Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
| | - Brian Oldenburg
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.,Implementation Science Lab, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,School of Psychology and Public Health, LaTrobe University, Melbourne, VIC, Australia
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39
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Valsakumar A, Dinesh S, Prasad G, Shetty P. Immediate effect of cold mud pack therapy on autonomic variables in primary hypertensive individuals: a randomized trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 19:799-806. [PMID: 34757704 DOI: 10.1515/jcim-2021-0421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/25/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Mud pack or compress is an easily accessible, cost-effective, efficient treatment modality used in naturopathy to manage and prevent various chronic illnesses. This study sought to elucidate the effectiveness of cold spinal mud packs on improving neuro-cardiac parameters among hypertensive individuals. METHODS A total of 100 hypertensive subjects aged 30-50 years were randomly allocated into two groups: Cold spinal mud pack (CSMP) and prone rest. Blood Pressure (BP) and Heart Rate Variability (HRV) were assessed at three-time points: Baseline, After 20 min (T1), After 60 min (T2). This single-blinded randomized controlled trial was registered in the Clinical Trials Registry-India (CTRI/2019/12/022492). RESULTS After 20 min of CSMP showed a statistically significant reduction (p<0.01) in mean values of Systolic BP, Diastolic BP, and in HRV attained statistically significant change (p<0.01) in mean score in the frequency domain except for Very low-frequency power (VLF) and a significant difference found in the mean score of time-domain values (p<0.01) when compared to control group and 95% confidence interval (CI) will be provided for each effect. CONCLUSIONS CSMP reduces the sympathetic tone and shifts the sympathovagal balance in favor of parasympathetic dominance, contributing to a decrease in BP and effective changes in components of HRV.
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Affiliation(s)
- Abitone Valsakumar
- Department of Naturopathy, SDM College of Naturopathy and Yogic Sciences, Affiliated to RGUHS, Bangalore, Karnataka, India
| | - Sujatha Dinesh
- Division of Natural Therapeutics, SDM College of Naturopathy and Yogic Sciences, Affiliated to RGUHS, Bangalore, Karnataka, India
| | - Ganesh Prasad
- Department of Naturopathy, SDM College of Naturopathy and Yogic Sciences, Affiliated to RGUHS, Bangalore, Karnataka, India
| | - Prashanth Shetty
- SDM College of Naturopathy and Yogic Sciences, Affiliated to RGUHS, Bangalore, Karnataka, India
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Maruyama S, Segawa Y, Hashimoto H, Kitamura S, Kimura M, Osera T, Kurihara N. Role of alginate in the mechanism by which brown seaweed Saccharina japonica intake alleviates an increase in blood pressure in 2-kidney, 1-clip renovascular hypertensive rats. Clin Exp Hypertens 2021; 44:72-82. [PMID: 34724868 DOI: 10.1080/10641963.2021.1991943] [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: 12/22/2022]
Abstract
BACKGROUND The intake of Saccharina japonica (SJ), a widely consumed brown seaweed, has been reported to decrease blood pressure (BP) in hypertensive rats. It has been suggested that this effect is related to an increase in fecal sodium excretion (SE) by alginate (Alg) to the gastrointestinal tract; however, the mechanism is still unclear. This study investigated how different seaweeds with different amounts of Alg suppressed BP increase and enhanced fecal SE in 2-kidney, 1-clip renovascular hypertensive (2K1C) rats given SJ diet. METHODS Rats with 2K1C or sham operation were fed a normal-/high-salt diet with some kinds of seaweeds (5.0%, w/w) or SJ extract with different Alg contents for 6 weeks. We measured systolic BP every week and mean arterial pressure at the end, and measured the total and molecular weights of Alg in each seaweed. Then, we evaluated the relationship of the Alg amount in each seaweed with the suppression of BP increase in 2K1C rats. Finally, urinary and fecal SE for 24 h was measured. RESULTS The intake of SJ, SJ extract, Saccharina ochotensis (SO) blades and SO roots suppressed BP increase in 2K1C rats, but the strength was not proportional to the amounts of Alg contained in the seaweeds. Although SJ intake increased fecal SE in 2K1C rats fed a high-salt diet, the fecal SE was much less than urinary SE. CONCLUSION The sodium excretion in feces by Alg in SJ may not be one of the major mechanisms by which SJ intake attenuates hypertension in 2K1C rats.
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Affiliation(s)
- Saki Maruyama
- Hygiene and Preventive Medicine, Kobe Women's University, Kobe, Japan
| | - Yukiko Segawa
- Hygiene and Preventive Medicine, Kobe Women's University, Kobe, Japan.,Cookery and Confectionery, Osaka Seikei College, Osaka, Japan
| | - Hiroko Hashimoto
- Hygiene and Preventive Medicine, Kobe Women's University, Kobe, Japan.,Nutrition, Osaka Seikei College, Osaka, Japan
| | - Saori Kitamura
- Hygiene and Preventive Medicine, Kobe Women's University, Kobe, Japan
| | - Mariko Kimura
- Faculty of Home Economics, Kobe Women's University, Kobe, Japan
| | - Tomoko Osera
- Hygiene and Preventive Medicine, Kobe Women's University, Kobe, Japan.,Nutrition and Health Sciences, Toyo University, Gunma, Japan
| | - Nobutaka Kurihara
- Hygiene and Preventive Medicine, Kobe Women's University, Kobe, Japan
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Ruberti OM, Yugar-Toledo JC, Moreno H, Rodrigues B. Hypertension telemonitoring and home-based physical training programs. Blood Press 2021; 30:428-438. [PMID: 34714208 DOI: 10.1080/08037051.2021.1996221] [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: 10/20/2022]
Abstract
PURPOSE Hypertensive patients with access to telemedicine can receive telemonitoring of blood pressure and cardiovascular risk factors such as sedentary lifestyle, diet, and remote supervision of treatment compliance. Faced with this challenge, electronic devices for telemonitoring of BP have gained space. They have shown to be effective in the follow-up of hypertensive patients and assist in the adherence and control of associated risk factors such as physical inactivity and obesity. MATERIALS AND METHODS Narrative Review. RESULTS The use of advanced smartwatches, smartphone apps, and online software for monitoring physical activity is increasingly common. Electronic equipment is briefly presented here as a support for better addressing some cardiovascular variables. Using various automated feedback services with a follow-up multidisciplinary clinical team is the ideal strategy. CONCLUSION Mobile health can improve risk factors and health status, particularly for hypertensive patients, improving access to cardiac rehabilitation and reducing the cost.
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Affiliation(s)
- Olívia Moraes Ruberti
- Laboratory of Cardiovascular Investigation & Exercise, School of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Heitor Moreno
- Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Bruno Rodrigues
- Laboratory of Cardiovascular Investigation & Exercise, School of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil.,Laboratory of Cardiovascular Pharmacology & Hypertension, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
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42
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Soares MM, Guedes GR, Rodrigues SM, Dias CA. [Interactions between drug treatment adherence, blood pressure targets, and depression in hypertensive individuals receiving care in the Family Health Strategy]. CAD SAUDE PUBLICA 2021; 37:e00061120. [PMID: 34495089 DOI: 10.1590/0102-311x00061120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 12/17/2020] [Indexed: 11/21/2022] Open
Abstract
The study analyzes interactions between drug treatment adherence, blood pressure targets, and depression in a probabilistic sample of hypertensive individuals treated in the Family Health Strategy in Governador Valadares, Minas Gerais State, Brazil. This is a cross-sectional study with 641 hypertensive individuals 40 years or older, residing in the urban area of Governador Valadares. Structured scripts were used to collect data in home interviews, with a focus on the following indicators: Medication Assessment Questionnaire (MAQ), Beck Depression Inventory (BDI), and blood pressure measurement. Due to the simultaneity of the target events (depression, blood pressure target, and adherence), we applied a system of recursive and simultaneous nonlinear equations. The results suggest that the odds of meeting the blood pressure target increase significantly with adherence to treatment; they also suggest that individuals that meet the blood pressure target show 2.6 higher odds of treatment adherence. Adherence has a protective effect against depression: individuals with minimal adherence show 8.4 higher odds of developing depressive symptoms when compared to those with maximum adherence. Drug treatment adherence is related simultaneously to blood pressure control and lower levels of depression. Promoting drug treatment adherence is essential for ensuring that individuals remain normotensive, with the potential for reducing levels of depression. These positive externalities can reduce pressure on the health system, with simultaneous gains in quality of life for hypertensive individuals.
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Affiliation(s)
| | | | | | - Carlos Alberto Dias
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Teófilo Otoni, Brasil
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Septiani V, Kartidjo P, Islamiyah AN, Aziz MSW A, Rukmawati I. Identification of Drug-Related Problems in Hypertension Comorbid Type 2 Diabetes Mellitus Patients at Primary Health Care Center Batununggal District Bandung. BORNEO JOURNAL OF PHARMACY 2021. [DOI: 10.33084/bjop.v4i3.1971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Many factors can increase the risk of hypertension, one of which is diabetes mellitus. The study aims to provide an overview of Drug-Related Problems (DRPs) in patients with hypertension comorbid type 2 diabetes mellitus at Primary Health Care Center Batununggal District Bandung. This research was an observational study with retrospective data collection and descriptive analysis. Data were taken from patient prescriptions January-December 2019 period. The sample inclusion criteria are patients aged 30-75 years, patients diagnosed with hypertension comorbid type 2 diabetes mellitus, and patients treated in January-December 2019. The number of samples that met the inclusion criteria was 268 patients, of which 69 patients (25.75%) are male, and 199 patients (74.25%) are female. 164 patients (61.2%) are aged 60-75 years old. It is found that 1 case (0.37%) has the drug-related problem of drug overdose and as many as 34 cases (12.69%) have potential drug interactions.
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Lari A, Fatahi S, Sohouli MH, Shidfar F. The Impact of Chromium Supplementation on Blood Pressure: A Systematic Review and Dose-Response Meta‑Analysis of Randomized‑Controlled Trials. High Blood Press Cardiovasc Prev 2021; 28:333-342. [PMID: 34081296 DOI: 10.1007/s40292-021-00456-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 04/16/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Potential effects of chromium supplementation on blood pressure (BP) have been examined in several interventional studies. Nevertheless, findings in this context are controversial. AIM Therefore, the current systematic review and meta-analysis aimed to comprehensively assess the impact of chromium supplementation on BP. METHODS Five online databases including Web of Science, Scopus, Embase, Google Scholar, and PubMed were systematically searched from inception to March 2020. We included all randomized clinical trials (RCTs) evaluating the effects of chromium supplementation on systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) in humans. RESULTS The random-effects meta-analysis of 11 eligible RCTs with 637 participants demonstrated the significant decline in both SBP (WMD - 2.51 mmHg; 95% CI - 4.97 to - 0.05, p = 0.04) and DBP (WMD - 1.04 mmHg; 95% CI - 1.96 to - 0.12, p = 0.026) following supplementation with chromium. In subgroup analysis, studies that were administered chromium yeast and brewer's yeast, showed greater decrease in SBP. Also, in stratification based on participants' health status, significant reduction in SBP only was seen in diabetic patients with chronic heart disease (CHD). Nonlinear dose-response analysis revealed a significant influence of chromium dosage on SBP changes. CONCLUSION The current meta-analysis, indicated that supplementation with chromium significantly decrease SBP and DBP. In subgroup analysis, administration of chromium yeast and brewer's yeast resulted in greater reduction in SBP. Further large-scale RCTs with better design are needed to confirm these findings.
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Affiliation(s)
- Abolfazl Lari
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, Iran
| | - Somaye Fatahi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, Iran
| | - Mohammad Hassan Sohouli
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, Iran.
- Student Research Committee, Faculty of public health Branch, Iran University of Medical Sciences, Tehran, Iran.
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, Iran.
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Bahloul A, Ellouze T, Hammami R, Charfeddine S, Triki S, Abid L, Kammoun S. [Impact of socioeconomic factors on blood pressure control: Observational study about 2887 hypertensive patients]. Ann Cardiol Angeiol (Paris) 2021; 70:259-265. [PMID: 34144787 DOI: 10.1016/j.ancard.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/21/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Despite therapeutic progress, less than half of hypertensive patients are controlled. The objective of this study was to examine the links between blood pressure control and socioeconomic factors. METHODS We used data collected in the cardiology department of Sfax University Hospital as part of the Tunisian national hypertension registry. We studied the associations between the socio-economic variables (educational level, profession, medical insurance) and optimal blood pressure control (SBP<140mmHg and DBP<90mmHg) using logistic regression models. RESULTS The average age of our population was 65 and the sex ratio was 0.95. We found, as expected, the clinical and behavioral factors associated with a good blood pressure control, namely: female sex, low-sodium diet, therapeutic compliance, and regular physical activity. However, obesity and an increased number of antihypertensive drugs have been associated with poor blood pressure control. The study of the effect of socio-economic variables on BP control finds a significant gradient against the most disadvantaged social categories for our three social variables in the univariate analysis. The inclusion of clinical and behavioral factors in the multivariate analysis attenuated these associations but did not fully explain them. CONCLUSION Our study shows that there are social inequalities in the control of blood pressure. Social justice and improving living conditions are probably the real solutions to the problem of these social inequalities in health.
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Affiliation(s)
- A Bahloul
- Service de cardiologie, centre hospitalo-universitaire Hèdi-Chaker, Sfax, Tunisie.
| | - T Ellouze
- Service de cardiologie, centre hospitalo-universitaire Hèdi-Chaker, Sfax, Tunisie
| | - R Hammami
- Service de cardiologie, centre hospitalo-universitaire Hèdi-Chaker, Sfax, Tunisie
| | - S Charfeddine
- Service de cardiologie, centre hospitalo-universitaire Hèdi-Chaker, Sfax, Tunisie
| | - S Triki
- Service de cardiologie, centre hospitalo-universitaire Hèdi-Chaker, Sfax, Tunisie
| | - L Abid
- Service de cardiologie, centre hospitalo-universitaire Hèdi-Chaker, Sfax, Tunisie
| | - S Kammoun
- Service de cardiologie, centre hospitalo-universitaire Hèdi-Chaker, Sfax, Tunisie
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Reis F, Alves M, Caldeira D. Cochrane Corner: Withdrawal of antihypertensive drugs in older people. Rev Port Cardiol 2021; 40:391-393. [PMID: 34187643 DOI: 10.1016/j.repce.2020.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 11/23/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Filipa Reis
- Serviço de Medicina III, Hospital Pulido Valente, CHLN, Lisboa, Portugal
| | - Mariana Alves
- Serviço de Medicina III, Hospital Pulido Valente, CHLN, Lisboa, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Portugal; Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Daniel Caldeira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Portugal; Centro Cardiovascular da Universidade de Lisboa - CCUL, CAML, Faculdade de Medicina, Universidade de Lisboa, Portugal; Serviço de Cardiologia, Hospital Universitário de Santa Maria - CHULN, Portugal.
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47
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Reis F, Alves M, Caldeira D. Cochrane Corner: Withdrawal of antihypertensive drugs in older people. Rev Port Cardiol 2021; 40:391-393. [PMID: 33865664 DOI: 10.1016/j.repc.2020.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 11/15/2022] Open
Affiliation(s)
- Filipa Reis
- Serviço de Medicina III, Hospital Pulido Valente, CHLN, Lisboa, Portugal
| | - Mariana Alves
- Serviço de Medicina III, Hospital Pulido Valente, CHLN, Lisboa, Portugal; Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Portugal; Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Daniel Caldeira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Portugal; Centro Cardiovascular da Universidade de Lisboa - CCUL, CAML, Faculdade de Medicina, Universidade de Lisboa, Portugal; Serviço de Cardiologia, Hospital Universitário de Santa Maria - CHULN, Portugal.
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48
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Wondmieneh A, Gedefaw G, Getie A, Demis A. Self-Care Practice and Associated Factors among Hypertensive Patients in Ethiopia: A Systematic Review and Meta-Analysis. Int J Hypertens 2021; 2021:5582547. [PMID: 33898063 PMCID: PMC8052173 DOI: 10.1155/2021/5582547] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/31/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Hypertension is one of the leading causes of morbidity and mortality in developing countries including Ethiopia. Self-care practice has been provided as one of the most important preventive mechanisms of hypertension and is considered as a basic treatment for hypertension. There is no national-level study that assesses hypertensive self-care practice in Ethiopia. Therefore, this study aimed to assess the pooled level of hypertensive self-care practices and associated factors in Ethiopia. METHODS This study was carried out using published and unpublished articles accessed from databases: PubMed/MEDLINE, HENARI, Google Scholar, Web of Science, Scopus, African Journals, and university repositories. Data were extracted using a standard data extraction format. Data analysis was carried out using STATA version 11. Heterogeneity across the included studies was assessed using Cochrane's Q statistics and I 2 test with its corresponding p values. Publication bias was determined using Egger's test and presented with a funnel plot. The pooled level of hypertensive self-care practice was estimated using a random-effects meta-analysis model. RESULTS This systematic review included 17 cross-sectional studies with 5,248 study participants. The overall pooled level of self-care practice among hypertensive patients in Ethiopia was 41.55% (95% CI 33.06, 50.05). Participant formal education (AOR = 2.82; 95% CI 2.18, 3.64) and good knowledge of hypertension (AOR = 4.04; 95% CI 2.19, 7.44) were significantly associated with self-care practice among hypertensive patients in Ethiopia. CONCLUSION In this study, more than half of hypertensive patients had poor hypertensive self-care practice in Ethiopia. Participant's formal education and good knowledge of hypertension were significantly associated with self-care practice among people living with hypertension in Ethiopia. Therefore, based on the evidence of this study, we recommended that programmers and policymakers should enhance the awareness of hypertensive patients on self-care practice domains and strengthen local programs working on noncommunicable diseases.
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Affiliation(s)
- Adam Wondmieneh
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia
| | - Getnet Gedefaw
- Department of Midwifery, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia
| | - Addisu Getie
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia
| | - Asmamaw Demis
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia
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49
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A Systematic Review of the Efficacy of DASH Diet in Lowering Blood Pressure Among Hypertensive Adults. TOP CLIN NUTR 2021. [DOI: 10.1097/tin.0000000000000238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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50
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Muñoz Aguilera E, Suvan J, Orlandi M, Miró Catalina Q, Nart J, D'Aiuto F. Association Between Periodontitis and Blood Pressure Highlighted in Systemically Healthy Individuals: Results From a Nested Case-Control Study. Hypertension 2021; 77:1765-1774. [PMID: 33775115 DOI: 10.1161/hypertensionaha.120.16790] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Eva Muñoz Aguilera
- From the Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, United Kingdom (E.M.A., J.S., M.O., F.D.).,Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain (E.M.A., Q.M.C., J.N.)
| | - Jean Suvan
- From the Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, United Kingdom (E.M.A., J.S., M.O., F.D.)
| | - Marco Orlandi
- From the Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, United Kingdom (E.M.A., J.S., M.O., F.D.)
| | - Queralt Miró Catalina
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain (E.M.A., Q.M.C., J.N.)
| | - Jose Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain (E.M.A., Q.M.C., J.N.)
| | - Francesco D'Aiuto
- From the Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, United Kingdom (E.M.A., J.S., M.O., F.D.)
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