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Yeh EJ, Grigolon RB, Rodrigues SR, A Bueno AP. Systematic literature review and meta-analysis of cardiovascular risk factor management in selected Asian countries. J Comp Eff Res 2023; 12:e220085. [PMID: 36861459 PMCID: PMC10402804 DOI: 10.57264/cer-2022-0085] [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: 05/06/2022] [Accepted: 01/20/2023] [Indexed: 03/03/2023] Open
Abstract
Aim: There is a need to understand the management status of hypertension, dyslipidemia/hypercholesterolemia, and diabetes mellitus in the Asia-Pacific region (APAC). Methods: We conducted a systematic literature review and meta-analysis to summarize the awareness, treatment, and/or control rates of these risk factors in adults across 11 APAC countries/regions. Results: We included 138 studies. Individuals with dyslipidemia had the lowest pooled rates compared with those with other risk factors. Levels of awareness with diabetes mellitus, hypertension, and hypercholesterolemia were comparable. Individuals with hypercholesterolemia had a statistically lower pooled treatment rate but a higher pooled control rate than those with hypertension. Conclusion: The management of hypertension, dyslipidemia, and diabetes mellitus was suboptimal in these 11 countries/regions.
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Aburto TC, Gordon‐Larsen P, Poti JM, Howard AG, Adair LS, Avery CL, Popkin BM. Is a Hypertension Diagnosis Associated With Improved Dietary Outcomes Within 2 to 4 Years? A Fixed-Effects Analysis From the China Health and Nutrition Survey. J Am Heart Assoc 2019; 8:e012703. [PMID: 31657282 PMCID: PMC6898848 DOI: 10.1161/jaha.119.012703] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 09/27/2019] [Indexed: 12/20/2022]
Abstract
Background Evidence shows that dietary factors play an important role in blood pressure. However, there is no clear understanding of whether hypertension diagnosis is associated with dietary modifications. The aim of this study is to estimate the longitudinal association between hypertension diagnosis and subsequent changes (within 2-4 years) in dietary sodium, potassium, and sodium-potassium (Na/K) ratio. Methods and Results We included adults (18-75 years, n=16 264) from up to 9 waves (1991-2015) of the China Health and Nutrition Survey. Diet data were collected using three 24-hour dietary recalls and a household food inventory. We used fixed-effects models to estimate the association between newly self-reported diagnosed hypertension and subsequent within-individual changes in sodium, potassium, and Na/K ratio. We also examined changes among couples and at the household level. Results suggest that on average, men who were diagnosed with hypertension decreased their sodium intake by 251 mg/d and their Na/K ratio by 0.19 within 2 to 4 years after diagnosis (P<0.005). Among spouse pairs, sodium intake and Na/K ratio of women decreased when their husbands were diagnosed (P<0.05). Household average sodium density and Na/K ratio decreased, and household average potassium density increased after a man was diagnosed. In contrast, changes were not statistically significant when women were diagnosed. Conclusions Our findings suggest that hypertension diagnosis for a man may result in modest dietary improvements for him, his wife, and other household members. Yet, diagnosis for a woman does not seem to result in dietary changes for her or her household members.
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Affiliation(s)
- Tania C. Aburto
- Department of NutritionGillings School of Global Public HealthUniversity of North Carolina at Chapel HillNC
| | - Penny Gordon‐Larsen
- Department of NutritionGillings School of Global Public HealthUniversity of North Carolina at Chapel HillNC
- Gillings School of Global Public Health and Carolina Population CenterUniversity of North Carolina at Chapel HillNC
| | - Jennifer M. Poti
- Department of NutritionGillings School of Global Public HealthUniversity of North Carolina at Chapel HillNC
| | - Annie G. Howard
- Gillings School of Global Public Health and Carolina Population CenterUniversity of North Carolina at Chapel HillNC
- Department of BiostatisticsGillings School of Global Public HealthUniversity of North Carolina at Chapel HillNC
| | - Linda S. Adair
- Department of NutritionGillings School of Global Public HealthUniversity of North Carolina at Chapel HillNC
- Gillings School of Global Public Health and Carolina Population CenterUniversity of North Carolina at Chapel HillNC
| | - Christy L. Avery
- Gillings School of Global Public Health and Carolina Population CenterUniversity of North Carolina at Chapel HillNC
- Department of EpidemiologyGillings School of Global Public HealthUniversity of North Carolina at Chapel HillNC
| | - Barry M. Popkin
- Department of NutritionGillings School of Global Public HealthUniversity of North Carolina at Chapel HillNC
- Gillings School of Global Public Health and Carolina Population CenterUniversity of North Carolina at Chapel HillNC
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Zhu T, Xue J, Jiang Y, Wang J, Weng W, Chen S. Social Support and Depression Related to Older Adults' Hypertension Control in Rural China. Am J Geriatr Psychiatry 2019; 27:1268-1276. [PMID: 31147243 PMCID: PMC6778510 DOI: 10.1016/j.jagp.2019.04.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/24/2019] [Accepted: 04/24/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study aimed to investigate association between social support and hypertension (HTN) control in rural China older adults, and to what extent depression mediates this relationship. The authors hypothesized that depression severity mediated the relationship between social support and HTN control. METHODS Data for the analyses were obtained from baseline data from a randomized controlled clinical trial of a collaborative depression care management intervention conducted in rural villages of China, with older adults with comorbid depression and HTN. Data included baseline assessments of 2,351 subjects aged 60 years and older, whose blood pressure and depression severity were measured using a calibrated manual sphygmomanometer and the 17-item Hamilton Depression Rating Scale (HDRS-17), respectively. Social support was measured using the 20-item Medical Outcomes Study-Social Support Survey. RESULTS Uncontrolled HTN was associated with older age (t[df = 2349] = 3.16; p < 0.01), higher HDRS-17 score (t[df = 1488] = 5.89; p < 0.001), and lower social support (t[df = 2349] = 5.37; p < 0.001). A significant indirect effect of social support via depression severity in relation to HTN control (a × b = -0.04[0.01]), bootstrap p = 0.0015, and 95% confidence interval (-0.07, -0.02), accounting for 11% of the effect of social support on HTN control. CONCLUSION These findings imply that social support impacts HTN control directly and indirectly through depression. Intervention approaches such as primary care-based collaborative care models should address social support to achieve greater outcomes for depression and HTN management.
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Affiliation(s)
- Tingfei Zhu
- Department of Psychology and Behavior Sciences, Zhejiang University, NO 148 Tianmushan Road, Xixi Campus of Zhejiang University, Hangzhou, Zhejiang, 310028, China
| | - Jiang Xue
- Department of Psychology and Behavior Sciences, Zhejiang University, NO 148 Tianmushan Road, Xixi Campus of Zhejiang University, Hangzhou, Zhejiang, 310028, China
| | - Yuxing Jiang
- Department of Psychology and Behavior Sciences, Zhejiang University, NO 148 Tianmushan Road, Xixi Campus of Zhejiang University, Hangzhou, Zhejiang, 310028, China
| | - Jiayu Wang
- Department of Psychology and Behavior Sciences, Zhejiang University, NO 148 Tianmushan Road, Xixi Campus of Zhejiang University, Hangzhou, Zhejiang, 310028, China
| | - Wenqi Weng
- Department of Psychology and Behavior Sciences, Zhejiang University, NO 148 Tianmushan Road, Xixi Campus of Zhejiang University, Hangzhou, Zhejiang, 310028, China
| | - Shulin Chen
- Department of Psychology and Behavior Sciences, Zhejiang University, Hangzhou, Zhejiang, China.
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Pan J, Wu L, Wang H, Lei T, Hu B, Xue X, Li Q. Determinants of hypertension treatment adherence among a Chinese population using the therapeutic adherence scale for hypertensive patients. Medicine (Baltimore) 2019; 98:e16116. [PMID: 31277112 PMCID: PMC6635171 DOI: 10.1097/md.0000000000016116] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To assess the adherence level of antihypertensive treatment and identify any associated risk factors in a sample of hypertensive patients from China.A cross-sectional study involving 488 Chinese hypertensive patients was conducted in a tertiary hospital in Xi'an, China. Data were collected regarding socio-demographic factors and hypertension-related clinical characteristics. The adherence to treatment was assessed using the previously validated instrument: therapeutic adherence scale for hypertensive patients.A total of 27.46% of patients were compliant with their antihypertensive treatments. Three factors were identified to be independently associated with antihypertensive treatment adherence: gender (P = .034), residence (P = .029), duration of high blood pressure (P < .001). Gender, residence, occupation, and the duration of antihypertensive drugs treatment used were found to have significant effects on treatment adherence in certain categories.Treatment adherence among hypertensive patients in China was poor. More attention and effective strategies should be designed to address factors affecting treatment adherence. Education about hypertension knowledge should be strengthened for patients. Moreover, the importance of lifestyle modification during hypertension treatment is often neglected by patients, therefore, there is an urgent need to educate hypertensive patients about the adherence to lifestyle modifications.
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Affiliation(s)
- Jingjing Pan
- Department of Pharmacy, Xi’an Fourth Hospital
- Xi’an Forth Hospital Affiliated Northwestern Polytechnical University
| | - Lian Wu
- Department of Ophthalmology, Xi’an Fourth Hospital
- Xi’an Forth Hospital Affiliated Northwestern Polytechnical University
| | | | - Tao Lei
- Department of Neurology, Xi’an Fourth Hospital, Xi’an, China
| | - Bin Hu
- Department of Pharmacy, Xi’an Fourth Hospital
| | | | - Qiongge Li
- Department of Pharmacy, Xi’an Fourth Hospital
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Liu E, Feng Y, Yue Z, Zhang Q, Han T. Differences in the health behaviors of elderly individuals and influencing factors: Evidence from the Chinese Longitudinal Healthy Longevity Survey. Int J Health Plann Manage 2019; 34:e1520-e1532. [PMID: 31149759 DOI: 10.1002/hpm.2824] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Health behaviors play an important role in determining individual health status; thus, understanding differences in the health behaviors of elderly individuals and their influencing factors is a prerequisite for the formulation and implementation of health behavior promotion policies for elderly individuals. The objectives of this study were to explore differences in health behaviors among Chinese elderly people and their influencing factors. METHODS Based on data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2014, this paper applied latent class analysis (LCA) to explore differences in the health behaviors of elderly individuals in China and employed a multinomial logit model to identify the influencing factors that cause these differences. RESULTS Results showed that there are five classes of health behaviors among elderly individuals in China: passive, relatively passive, general, relatively positive, and positive, the proportions of which were 31.07%, 15.86%, 24.06%, 17.24%, and 11.76%, respectively. Community medical and health services, pension, living arrangements, and family income were the primary factors explaining differences in the health behaviors of elderly individuals. In addition, there were significant demographic differences in the health behaviors of elderly individuals in China, including gender, age, education, marital status, census register, region, and others. CONCLUSION There are significant differences in the behaviors of elderly individuals in China, and the behaviors of the majority of elderly people are not healthy. China is expected to invest more medical and health resources to tackle health prevention and management and to provide targeted education, guidance, and intervention in elderly health behaviors, urging them to control and correct risky health behaviors with a focus on elderly individuals that are the oldest, are females, have low education levels, and live in the countryside and in towns.
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Affiliation(s)
- Erpeng Liu
- Center for Social Security Studies, Wuhan University, Wuhan, China
| | - Yan Feng
- School of Business, Guizhou Minzu University, Guiyang, China
| | - Zhang Yue
- Department of Social Security, Zhongnan University of Economics and Law, Wuhan, China
| | - Qilin Zhang
- Center for Social Security Studies, Wuhan University, Wuhan, China
| | - Tiankuo Han
- Center for Social Security Studies, Wuhan University, Wuhan, China
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Busingye D, Arabshahi S, Evans RG, Riddell MA, Srikanth VK, Kartik K, Kalyanram K, Zhu X, Suresh O, Howard G, Thrift AG. Knowledge of risk factors for hypertension in a rural Indian population. HEART ASIA 2019; 11:e011136. [PMID: 31031832 DOI: 10.1136/heartasia-2018-011136] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/22/2019] [Accepted: 02/04/2019] [Indexed: 11/04/2022]
Abstract
Objective To study knowledge of risk factors and consequences of hypertension in a rural population in South India. Methods This is a community-based study conducted among adults of a rural population in the Rishi Valley, India. Residents of randomised rural villages were invited to participate in a study of hypertension. We obtained measures of blood pressure, height, weight, waist and hip circumferences and questionnaire-based information on knowledge about hypertension, sociodemographic characteristics and health behaviours. Multivariable logistic regression analyses were conducted to determine the factors associated with knowledge of risk factors for hypertension (knowledge of ≥2 risk factors). Results The study comprised 641 adults; 132 aware and 218 unaware of their hypertension, and 291 with normal blood pressure. Only 31% of participants knew that hypertension adversely affects an individual's health and 7% knew the benefits of treating hypertension. Almost a third (30%) of those aware of their hypertensive status, and 48% overall, did not know any of the risk factors for hypertension. Being aware of one's hypertensive status (OR 2.51, 95% CI 1.44 to 4.39), being treated for hypertension, male sex, younger age, having some schooling, abdominal obesity and physical inactivity were associated with better knowledge of risk factors for hypertension. Conclusion Knowledge of risk factors and consequences of hypertension in this disadvantaged population was poor. There was better knowledge of risk factors in some, but not all, people who were aware of having hypertension. Screening and targeted educational programmes are warranted in this population to improve health behaviours and reduce the consequences of hypertension.
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Affiliation(s)
| | | | - Roger G Evans
- Physiology, Monash University, Clayton, Victoria, Australia
| | | | | | - Kamakshi Kartik
- Rishi Valley Rural Health Centre, Madanapalle, Andhra Pradesh, India
| | - Kartik Kalyanram
- Rishi Valley Rural Health Centre, Madanapalle, Andhra Pradesh, India
| | - Xuan Zhu
- School of Earth, Atmosphere and Environment, Monash University, Clayton, Victoria, Australia
| | - Oduru Suresh
- Rishi Valley Rural Health Centre, Madanapalle, Andhra Pradesh, India
| | - George Howard
- Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Kimani S, Mirie W, Chege M, Okube OT, Muniu S. Association of lifestyle modification and pharmacological adherence on blood pressure control among patients with hypertension at Kenyatta National Hospital, Kenya: a cross-sectional study. BMJ Open 2019; 9:e023995. [PMID: 30782721 PMCID: PMC6340423 DOI: 10.1136/bmjopen-2018-023995] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Association of lifestyle modification and pharmacological adherence among patients with hypertension attending a national referral hospital in Kenya. DESIGN Descriptive, cross-sectional. SETTING Medical wards and outpatient clinic of a national referral hospital. PARTICIPANTS Patients (n=229) diagnosed with primary hypertension for at least 6 months. PRIMARY OUTCOMES Clinical makers, cholesterol levels, anthropometrics, lifestyle/dietary habits adjusted for age, gender and education; antihypertensive adherence; views on prevention of hypertension and adequacy of hypertension information. RESULTS Ageing was associated with elevated diastolic blood pressure (BP) (p<0.05), heart rate (HR) and cholesterol. Females had higher body mass index (BMI). More males reported drinking alcohol and smoking (p<0.001), especially the highly educated. Higher BPs were observed in smokers and drinkers (p<0.05). Daily vegetables and fruits intake were linked to lower BP, HR and BMI (p<0.05). Intake of foods high in saturated fat and cholesterol were associated with raised HR (p<0.05). Respondents on antihypertensive medication, those engaged in healthy lifestyle and took their prescribed medications had lower mean BPs than those on medication only (138/85 vs 140/90). Few respondents (30.8%) considered hypertension as preventable, mainly the single and highly educated (p<0.05). Respondents (53.6%) believed they should stop taking their antihypertensive medication once hypertension is controlled. CONCLUSION Missed targets for BP control and hypertension-related risks are associated with ageing, female gender, fast food and animal fat intake. Alcohol and smoking is common in males associated with poor BP control. Daily vegetables and fruits intake are associated with better BP control and overall hypertension risk reduction. Observed suboptimal BP control despite pharmacological adherence suggests lifestyle modification is needed besides antihypertensive medication. Interventions should address modifiable risk factors aggravated by age and adverse lifestyles through adopting combined lifestyle modification, pharmacological adherence and tailored expert delivered hypertension-related information.
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Affiliation(s)
- Samuel Kimani
- School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
| | - Waithira Mirie
- School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
| | - Margaret Chege
- School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
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Ruan Y, Huang Y, Zhang Q, Qin S, Du X, Sun Y. Association between dietary patterns and hypertension among Han and multi-ethnic population in southwest China. BMC Public Health 2018; 18:1106. [PMID: 30200909 PMCID: PMC6131804 DOI: 10.1186/s12889-018-6003-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 08/30/2018] [Indexed: 12/22/2022] Open
Abstract
Background Different dietary patterns and the risks of hypertension in various diet exposures among multi-ethnic population in southwest China remain extremely scarce. The aim of this study is to identify dietary patterns and explore the association between dietary patterns and the risk of hypertension among Han and multi-ethnic population in southwest China. Methods A representative sample of 3591 participants of Han, and multi-ethnic population were recruited by stratified cluster sampling in Diqing of Yunnan Province, southwest China from September 2012 to January 2013. Participants who were under 18 years old or who could not clearly answer the questions and those who used the anti-hypertensive medication were excluded from this survey. All participants reported their dietary intakes using validated food frequency questionnaires (FFQ), and their blood pressures were measured by standardized procedures. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg. Dietary patterns were identified by factor analysis with principal component. Logistic regression was used to explore the association between dietary patterns and hypertension. Results The overall prevalence of hypertension was 30.5% among Han and multi-ethnic population in Diqing, Yunnan Province. Three dietary patterns were identified in this study, defined as ‘Grassland healthy’, ‘Tuber and meat’, and ‘Fruit and vegetable’. Participants in the 5th quintile of the three dietary patterns were at a lower risk of hypertension compared with those in the 1st quintile. The odds ratio (OR) for the 5th quintile of ‘Grassland healthy’ pattern, ‘Tuber and meat’ and ‘Fruit and vegetable’ was 0.693 (95% CI: 0.537–0.893, p = 0.005), 0.678 (95% CI: 0.530–0.868, p = 0.002), 0.759 (95% CI: 0.593–0.970, p = 0.028), respectively. After further adjustment of participants’ age, the negative association between the ‘Grassland healthy’ pattern and the prevalence of hypertension persisted (OR = 0.703, 95% CI: 0.535–0.924, p = 0.012). However, the significant associations between the other two dietary patterns and hypertension disappeared. Conclusions The ‘Grassland healthy’ dietary pattern is associated with lower risk of hypertension, whereas there is no significant associations between the other two dietary patterns and hypertension among Han and multi-ethnic population in Diqing of Yunnan province, southwest China. Electronic supplementary material The online version of this article (10.1186/s12889-018-6003-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuan Ruan
- Department of nutrition and food hygiene, Centre for Disease Control and Prevention (CDC), No.158 Dongsi Street, Kunming, 650022, Yunnan, China.
| | - Yongshou Huang
- People's hospital of Diqing Tibetan Autonomous Prefecture, No. 19 Chicika Street, Shangri-la, Diqing, 674400, Yunnan, China
| | - Qiang Zhang
- Department of nutrition and food hygiene, Centre for Disease Control and Prevention (CDC), No.158 Dongsi Street, Kunming, 650022, Yunnan, China
| | - Shu Qin
- CDC of Diqing Tibetan Autonomous Prefecture, No. 88 Ren'an Road, Shangri-la, Diqing, 674400, Yunnan, China
| | - Xiaoxia Du
- CDC of Diqing Tibetan Autonomous Prefecture, No. 88 Ren'an Road, Shangri-la, Diqing, 674400, Yunnan, China
| | - Yongxin Sun
- People's hospital of Diqing Tibetan Autonomous Prefecture, No. 19 Chicika Street, Shangri-la, Diqing, 674400, Yunnan, China
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Raji YR, Abiona T, Gureje O. Awareness of hypertension and its impact on blood pressure control among elderly nigerians: report from the Ibadan study of aging. Pan Afr Med J 2017; 27:190. [PMID: 28904715 PMCID: PMC5579467 DOI: 10.11604/pamj.2017.27.190.11682] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/04/2017] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Hypertension is highly prevalent among the elderly. Its awareness has a direct influence on control through drug adherence. Earlier studies have shown that awareness of hypertension is low among sub-Saharan African populations but only a few studies have looked at the prevalence and awareness of hypertension among the elderly. METHODS The Ibadan Study of Ageing is a longitudinal cohort study of the mental and physical health status as well as the functioning of elderly persons residing in the Yoruba-speaking areas of Nigeria. Study was conducted in multiple waves from 2003/2004 to 2009. This report is based on the sample studied in 2007 (N = 1469). Respondents, aged ≥ 65 years, were assessed for the presence of hypertension, its awareness, receipt of and adherence to medication for the condition, and effectiveness of treatment on the control of blood pressure. Blood pressure was measured with the use of digital monitors (Omron MS - 2 Basic Model). Awareness of the diagnosis of hypertension was ascertained by self-reports. We explored social, economic, demographic and clinical correlates of the presence of hypertension, its awareness and control using multiple logistic regression analyses. RESULTS The sample was composed of 809 (55.1%) females and 666 (44.9%) males. The mean age of the participants was 76.9 ± 8.4 years. Hypertension (defined as previous diagnosis by a health provider or a measured blood pressure higher than or equal to 140/90 mm Hg) was recorded in 973 (62.2%) participants, with females having a prevalence of 61.4% and males that of 70.1%. Other than female gender, residing in urban/semi urban areas and being overweight or obesity were associated with the occurrence of hypertension. Among those assessed to have hypertension, 78% were not previously aware of its presence. Factors independently associated with lack of awareness of hypertension included low socioeconomic class (OR 8.21, 95% CI 3.72-18.11, P < 0.001), and BMI >25kg/m2 (OR 3.11, 95% CI 1.36-7.09, P < 0.009). Among those who were aware of the presence of hypertension and were on treatment, 77.3% still had uncontrolled hypertension. Only obesity or overweight (OR 5.56, 95% CI 1.35 - 22.83, P < 0.016) was independently associated with poor blood pressure control. CONCLUSION The prevalence of hypertension among elderly Nigerians is high and those affected are often not aware of having the condition. Only a minority of those who receive treatment for the condition have adequate blood pressure control. The findings highlight the need for improved healthcare for the growing population of elderly persons, with particular attention to early detection and effective control of the condition.
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Affiliation(s)
- Yemi Raheem Raji
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Taiwo Abiona
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oye Gureje
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Khorsandi M, Fekrizadeh Z, Roozbahani N. Investigation of the effect of education based on the health belief model on the adoption of hypertension-controlling behaviors in the elderly. Clin Interv Aging 2017; 12:233-240. [PMID: 28184154 PMCID: PMC5291452 DOI: 10.2147/cia.s117142] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose Hypertension is one of the risk factors for cardiovascular diseases and stroke, and has a direct relationship with aging. The aim of this study was to investigate the effect of education based on the health belief model (HBM) on the adoption of hypertension-controlling behaviors in the elderly. Methods The present quasiexperimental study was conducted on 100 hypertensive elderly persons from Qom, Iran. The questionnaire was completed by the participants before, immediately after, and 3 months after the intervention. Results The results of repeated measure analysis of variance showed a significant difference in the scores of the constructs in the intervention and nonintervention groups before, immediately after, and 3 months after the intervention (P<0.001). Conclusion Education based on the HBM increases the performance and enhances the health beliefs regarding hypertension in the elderly population with hypertension. Therefore, it is recommended to consider the HBM to enhance self-care behaviors in the elderly.
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Busingye D, Arabshahi S, Evans RG, Srikanth VK, Kartik K, Kalyanram K, Riddell MA, Zhu X, Suresh O, Thrift AG. Factors associated with awareness, treatment and control of hypertension in a disadvantaged rural Indian population. J Hum Hypertens 2017; 31:347-353. [PMID: 28054571 DOI: 10.1038/jhh.2016.85] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 07/23/2016] [Accepted: 09/15/2016] [Indexed: 11/09/2022]
Abstract
The aim of this study was to identify factors associated with awareness, treatment and control of hypertension in a rural setting in India. Following screening of the population, all individuals with hypertension (blood pressure (BP) ⩾140/90 mm Hg or taking antihypertensive medications) were invited to participate in this study. We measured BP, height, weight, skinfolds, waist and hip circumference, and administered a questionnaire to obtain information regarding socioeconomic and behavioural characteristics. Multivariable logistic regression was used to determine factors associated with awareness, treatment and control of hypertension. We recruited 277 individuals with hypertension. Awareness (43%), treatment (33%) and control (27%) of hypertension were poor. Greater distance to health services (odds ratio (OR) 0.56 (95% confidence interval (CI)) 0.32-0.98) was associated with poor awareness of hypertension while having had BP measured within the previous year (OR 4.72, 95% CI 2.71-8.22), older age and greater per cent body fat were associated with better awareness. Factors associated with treatment of hypertension were having had BP measured within the previous year (OR 6.18, 95% CI 3.23-11.82), age ⩾65 years, physical inactivity and greater per cent body fat. The only factor associated with control of hypertension was greater per cent body fat (OR 1.05, 95% CI 1.01-1.11). Improving geographic access and utilisation of health services should improve awareness and treatment of hypertension in this rural population. Further research is necessary to determine drivers of control.
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Affiliation(s)
- D Busingye
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - S Arabshahi
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - R G Evans
- Department of Physiology, Cardiovascular Disease Program, Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - V K Srikanth
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - K Kartik
- Rishi Valley Rural Health Centre, Rishi Valley, Andhra Pradesh, India
| | - K Kalyanram
- Rishi Valley Rural Health Centre, Rishi Valley, Andhra Pradesh, India
| | - M A Riddell
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - X Zhu
- School of Earth, Atmosphere and Environment, Monash University, Clayton, Victoria, Australia
| | - O Suresh
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.,Rishi Valley Rural Health Centre, Rishi Valley, Andhra Pradesh, India
| | - A G Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.,Florey Neuroscience Institutes, Melbourne, Victoria, Australia
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Pan J, Lei T, Hu B, Li Q. Post-discharge evaluation of medication adherence and knowledge of hypertension among hypertensive stroke patients in northwestern China. Patient Prefer Adherence 2017; 11:1915-1922. [PMID: 29200832 PMCID: PMC5700759 DOI: 10.2147/ppa.s147605] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The aims of this study were to assess the knowledge of hypertension (HTN) and investigate risk factors associated with medication adherence among hypertensive stroke patients after discharge in northwestern China. PATIENTS AND METHODS A cross-sectional study involving 440 Chinese hypertensive stroke patients was conducted in a tertiary hospital in Xi'an, China. Data were collected by telephone interviews and patients' medical records. RESULTS It was found that 35.23% of patients were compliant with their antihypertensive drug treatments, and 42.95%, 52.27% and 4.77% of patients had poor, moderate and adequate knowledge of HTN, respectively. Gender, blood pressure (BP) categories, BP monitoring and HTN knowledge were independently associated with antihypertensive medication adherence. CONCLUSION The medication adherence among hypertensive stroke patients in northwestern China was poor. Knowledge of HTN was suboptimal. More attention and effective strategies should be designed to the factors affecting medication adherence. As knowledge positively affects medication adherence, clinical pharmacists should play an important role in patients' medication education.
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Affiliation(s)
- Jingjing Pan
- Department of Pharmacy
- Correspondence: Jingjing Pan, Department of Pharmacy, Xi’an Fourth Hospital, 21 JieFang Road, 710004 Xi’an, People’s Republic of China, Tel +86 029 8748 0635 ext 029, Email
| | - Tao Lei
- Department of Neurology, Xi’an Fourth Hospital, Xi’an, People’s Republic of China
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Rodríguez-Abt JC, Solís-Visscher RJ, Rogic-Valencia SJ, Román Y, Reyes-Rocha M. Asociación entre conocimiento de hipertensión arterial y adherencia al tratamiento en pacientes hipertensos del Hospital Nacional Edgardo Rebagliati Martins de Lima, Perú. 2015. REVISTA DE LA FACULTAD DE MEDICINA 2017. [DOI: 10.15446/revfacmed.v65n1.56773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. Conocer sobre hipertensión arterial podría favorecer la adherencia al tratamiento para un mejor control de la presión arterial.Objetivo. Evaluar si existe asociación entre conocimientos sobre hipertensión y adherencia al tratamiento en pacientes hipertensos del Hospital Nacional Edgardo Rebagliati Martins de Lima, Perú.Materiales y métodos. Se realizó un estudio transversal analítico. El muestreo por conveniencia incluyó 340 pacientes hipertensos de consultorios de cardiología en el periodo mayo-agosto de 2015. La variable principal de exposición fue grado de conocimiento sobre hipertensión medida con el cuestionario de conocimientos sobre la hipertensión (CSH) y la variable respuesta fue grado de adherencia al tratamiento medida con el cuestionario Martin-Bayarre-Grau (MBG). Se utilizó regresión de Poisson para calcular razones de prevalencias (RP) con intervalos de confianza del 95% y valor de p<0.05 para establecer significancia estadística.Resultados. Se encontró asociación entre bajo conocimiento de hipertensión y adherencia parcial al tratamiento (RP=1.4; IC95%: 1.2-1.8), tener más de 10 años de hipertensión (RP=0.7; IC95%: 0.6-0.9), no haber recibido información sobre hipertensión (RP=1.4; IC95%: 1.2-1.7) y tiempo de consulta mayor a 15 minutos (RP=0.5; IC95%: 0.3-0.7).Conclusión. Los pacientes con bajo conocimiento de hipertensión tienen más probabilidad de tener adherencia parcial al tratamiento.
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He Z, Cheng Z, Shao T, Liu C, Shao P, Bishwajit G, Feng D, Feng Z. Factors Influencing Health Knowledge and Behaviors among the Elderly in Rural China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13100975. [PMID: 27706061 PMCID: PMC5086714 DOI: 10.3390/ijerph13100975] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 09/06/2016] [Accepted: 09/26/2016] [Indexed: 11/16/2022]
Abstract
Objectives: Health knowledge and behaviors are the key elements that ensure high quality of health for the elderly. This study explored and determined the conditions and factors of health knowledge and behaviors that affect the elderly in rural China. Methods: A cross-sectional research approach and random stratified sampling method were used in 12 towns and 48 villages in the Chongqing Municipality, Henan, and Zhejiang Provinces in China from June to September 2013. The collected data included: (1) socio-demographic characteristics of 1593 elderly people; (2) accuracy rate on health knowledge of the elderly, which was analyzed and compared among the three sample areas by using Chi-square test; and (3) mean scores on the health behaviors of the elderly, which were analyzed and compared by using analysis of variance (ANOVA). The multiple-linear regression method was used to analyze the factors affecting the health knowledge and behaviors of the elderly. Results: Significant differences were observed among the nine items in the health knowledge questionnaire (p = 0.000 < 0.001). The average accuracy rate of the nine items was 57.43%. Significant differences were observed among the eleven items on the health behaviors of the elderly in the sample rural areas (p = 0.000 < 0.001). Age, economic level, degree of education, distance from home to medical institutions and disposable personal income (DPI) can affect the scores of the health knowledge and behaviors of the elderly (p = 0.000 < 0.001). Conclusions: Lack of health knowledge and poor health behaviors are common among the elderly in the sample areas of rural China. This deficiency poses a serious threat on the promotion of health conditions and the improvement of the level of health quality among the elderly. Different types of access to sources of health knowledge should be used to increase health knowledge scores of the elderly. Various potential intervening measures should also be adopted to improve their health behaviors of elderly people.
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Affiliation(s)
- Zhifei He
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
| | - Zhaohui Cheng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
| | - Tian Shao
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
| | - Chunyan Liu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
| | - Piaopiao Shao
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
| | - Ghose Bishwajit
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
| | - Da Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
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Rezaei S, Amin M, Moghaddam M, Mohamed N. 3G post adoption users experience with telecommunications services. ACTA ACUST UNITED AC 2016. [DOI: 10.1108/nbri-01-2016-0007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this study is to examine the impact of service quality, perceived usefulness and users’ cognitive satisfaction to determine the third-generation (3G) mobile phone users’ behavioural retention in using 3G telecommunications services.
Design/methodology/approach
A total of 243 valid questionnaires were collected from 3G users in the Klang Valley, Malaysia. The combination of partial least squares (PLS) path modelling approach and structural equation modelling (SEM; PLS-SEM) technique was used to analyze the measurement and structural model.
Findings
Our empirical assessment supports the proposed research hypotheses and further suggests that service quality is a second-order reflective construct comprising navigation and visual design, management and customer service and system reliability and connection quality.
Originality/value
Prior studies have examined the impact of service quality, perceived usefulness, overall users’ satisfaction and behavioural intention on an information system in general. This study is among the few studies that have attempted to gain insights into 3G users’ post-adoption experience with telecommunications services.
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Li SS, Zhou F, Lu YC, Lyv P, Zhang HF, Yao WM, Gong L, Zhou YL, Yang R, Sheng YH, Xu DJ, Kong XQ, Li XL. Hypertension related knowledge and behaviour associated with awareness, treatment and control of hypertension in a rural hypertensive population: a community based, cross-sectional survey. Blood Press 2016; 25:305-11. [DOI: 10.3109/08037051.2016.1172866] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Huang HT, Kuo YM, Wang SR, Wang CF, Tsai CH. Structural Factors Affecting Health Examination Behavioral Intention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:395. [PMID: 27043606 PMCID: PMC4847057 DOI: 10.3390/ijerph13040395] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 03/10/2016] [Accepted: 03/28/2016] [Indexed: 11/23/2022]
Abstract
Disease screening instruments used for secondary prevention can facilitate early determination and treatment of pathogenic factors, effectively reducing disease incidence, mortality rates, and health complications. Therefore, people should be encouraged to receive health examinations for discovering potential pathogenic factors before symptoms occur. Here, we used the health belief model as a foundation and integrated social psychological factors and investigated the factors influencing health examination behavioral intention among the public in Taiwan. In total, 388 effective questionnaires were analyzed through structural model analysis. Consequently, this study yielded four crucial findings: (1) The established extended health belief model could effectively predict health examination behavioral intention; (2) Self-efficacy was the factor that most strongly influenced health examination behavioral intention, followed by health knowledge; (3) Self-efficacy substantially influenced perceived benefits and perceived barriers; (4) Health knowledge and social support indirectly influenced health examination behavioral intention. The preceding results can effectively increase the acceptance and use of health examination services among the public, thereby facilitating early diagnosis and treatment and ultimately reducing disease and mortality rates.
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Affiliation(s)
| | - Yu-Ming Kuo
- Department of Marketing and Distribution, Tzu Chi University of Science and Technology, Hualien 970, Taiwan.
| | - Shiang-Ru Wang
- Department of Business Administraiton, National Dong Hwa University, Hualien 974, Taiwan.
| | | | - Chung-Hung Tsai
- Department of Health Administration, Tzu Chi University of Science and Technology, Hualien 974, Taiwan.
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Knowledge, Treatment, Control, and Risk Factors for Hypertension among Adults in Southern Iran. Int J Hypertens 2015; 2015:897070. [PMID: 26783454 PMCID: PMC4689970 DOI: 10.1155/2015/897070] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 10/22/2015] [Accepted: 11/02/2015] [Indexed: 11/17/2022] Open
Abstract
Hypertension is the first and the most common risk factor to diseases such as cardiovascular, stroke, and renal diseases. The aim of this study was to determine the factors relevant to hypertension knowledge, treatment, and control in southern Iran. In this cross-sectional study, conducted in Kohgiluye Boyer-Ahmad province, south of Iran, a total of 1836 hypertension patients were randomly selected to participate voluntarily in the study. Hypertension treatment and its control were defined during study. In addition, knowledge about hypertension was measured by hypertension knowledge level scale (HK-LS). Treatment rates were 75.5 and 37.7 percent for female and male, respectively. Habitat, education, income, family history with hypertension, smoking, and time of diagnosis to the disease were found to be related to the treatment of the disease. Control rates were 30.7 and 31.4 for males and females, respectively. Habitat, education, and time of diagnosis to the disease were related to control. Over 50 percent of patients had average knowledge on hypertension. Considering the low rate of control and knowledge on hypertension among patients, health care providers should reinforce their services to improve appropriate knowledge level among elders and, also, plan comprehensive programs to promote health in order to encourage patients change and reform their life style.
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Bilal M, Haseeb A, Lashkerwala SS, Zahid I, Siddiq K, Saad M, Dar MI, Arshad MH, Shahnawaz W, Ahmed B, Yaqub A. Knowledge, Awareness and Self-Care Practices of Hypertension Among Cardiac Hypertensive Patients. Glob J Health Sci 2015; 8:9-19. [PMID: 26383212 PMCID: PMC4803976 DOI: 10.5539/gjhs.v8n2p9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 04/18/2015] [Accepted: 04/14/2015] [Indexed: 01/19/2023] Open
Abstract
Introduction: The most prevalent form of hypertension is systolic blood pressure (SBP) and it is considered to be predisposing risk factor for cardiovascular disease. The objective of the study was to assess self-care practices, knowledge and awareness of hypertension, especially related to SBP among cardiac hypertensive patients. Methodology: A Cross sectional study was conducted on 664 cardiac hypertensive patients, which were selected by non-probability convenience sampling from cardiology outpatient department of three tertiary care hospitals. Face to face interviews were conducted using a pre designed questionnaire. Data was entered and analyzed by SPSS (V17). Results: 81.8%, did not know that hypertension is defined as high blood pressure. 97.1% of the sample population did not know that top measurement of blood pressure was referred to as systolic and only 25.0% correctly recognized normal systolic blood pressure to be less than 140mmHg. 7.4% of the patients consulted their doctor for hypertension once or twice in a month. Risk factor for high blood pressure most commonly identified by the participants was too much salt intake Conclusions: The results state that there is an inadequate general knowledge of hypertension among cardiac patients and they do not recognise the significance of elevated SBP levels. There is a need to initiate programs that create community awareness regarding long term complications of uncontrolled hypertension, particularly elevated SBP levels so that there is an improvement in self-care practices of the cardiacpatients.
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Li X, Kang H, Wang S, Deng Z, Yang T, Jia Y, Yang Y. Knowledge, attitude, and behavior of hepatitis B virus infection among chinese dental interns. HEPATITIS MONTHLY 2015; 15:e25079. [PMID: 26045703 PMCID: PMC4451273 DOI: 10.5812/hepatmon.15(5)2015.25079] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 03/16/2015] [Accepted: 04/19/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Blood is frequently involved in dental treatment procedures, which increases the exposure of dentists to a variety of blood-borne pathogens and microorganisms such as Hepatitis B Virus. OBJECTIVES The current study aimed to assess Chinese dental and medical interns' knowledge, attitude and behavior (KAB) towards Hepatitis B Virus (HBV) infection and to evaluate which exact KAB phase respondents were involved in. PATIENTS AND METHODS A self-administered questionnaire survey was conducted on 313 fifth to eighth year students. Descriptive statistics and bivariate analyses were used to identify correlations between KAB and the results obtained from different grades. RESULTS Despite the fact that Chinese dental interns had good general knowledge level, they lacked the experience with active and artificial immunities against HBV. Graduates forgot basic knowledge and applied the methods without understanding the terms. Compared with the medical interns, dental interns were less willing to treat patients with HBV infection. All three required vaccination doses were received by a significant number of dental interns. However the frequency of antibody titer status check and the use of eye wear or face mask were not satisfying. CONCLUSIONS It is therefore recommended that Chinese dental interns continue improving knowledge level, assume more positive attitude by accumulating clinical experience, and pay more attention to the overlooked procedures. The results of the current study can help the Chinese dental interns on theoretical studies and clinical practices regarding HBV.
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Affiliation(s)
- Xinyi Li
- Department of Microbiology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, China
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - Hengjiu Kang
- College of Engineering, University of California, Davis, United States of America
| | - Shuai Wang
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - Zhaomin Deng
- Department of Microbiology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, China
| | - Ting Yang
- Department of Microbiology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, China
| | - Yiping Jia
- Department of Ultrasound, No.4 West china Teaching Hospital, Sichuan University, Chengdu, China
- Corresponding Authors: Yiping Jia, Department of Ultrasound, No.4 West china Teaching Hospital, Sichuan University, Chengdu, China. Yuan Yang, Department of Microbiology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, China. Tel: +86-18980040777, E-mail:
| | - Yuan Yang
- Department of Microbiology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, China
- Corresponding Authors: Yiping Jia, Department of Ultrasound, No.4 West china Teaching Hospital, Sichuan University, Chengdu, China. Yuan Yang, Department of Microbiology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, China. Tel: +86-18980040777, E-mail:
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Yang SO, Jeong GH, Kim SJ, Lee SH. Correlates of self-care behaviors among low-income elderly women with hypertension in South Korea. J Obstet Gynecol Neonatal Nurs 2013; 43:97-106. [PMID: 24354464 DOI: 10.1111/1552-6909.12265] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To identify correlates of self-care behaviors among elderly, low-income Korean women with hypertension. RESEARCH DESIGN A secondary analysis of data from a community-based intervention trial for hypertension control. SETTING Three community health posts in the Gangwon province, South Korea. PARTICIPANTS Two hundred thirty-four (234) low-income elderly women (age 60-93) who had previously participated in a community-based intervention trial for hypertension control. METHODS The researchers collected data that included patient background characteristics, hypertension self-care behavior, self-efficacy of hypertension control, general knowledge of hypertension, and social support. The data were analyzed using descriptive and inferential statistics, including hierarchical regression analysis. RESULTS The model explained 41.1% of the total variance in hypertension self-care behavior scores. Among elderly, low-income Korean women, the significant factors of their hypertension self-care behavior included: (a) self-efficacy of hypertension control (β = .62), (b) social support (β = .16), and (c) age (β = -.14). Hierarchical regression analysis showed that elderly Korean women that had higher self-efficacy of hypertension control, higher social support, and were younger were more likely to have higher hypertension self-care behavior scores. CONCLUSIONS The results highlight the need for interventions that focus on improving an individual's self-efficacy and social support to enhance hypertension self-care. The findings of this study can help nurses better understand hypertension self-care behavior in elderly, low-income Korean women.
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Michalska M, Rysz J, Pencina MJ, Zdrojewski T, Banach M. The knowledge and awareness of hypertension among patients with hypertension in central Poland: a pilot registry. Angiology 2013; 65:525-32. [PMID: 23650646 DOI: 10.1177/0003319713489166] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
We assessed the differences in the knowledge and level of awareness of hypertension among patients with hypertension from Central Poland; 248 (57.6% females) patients diagnosed with hypertension completed a questionnaire. Most (79%) of the patients were unaware of the optimal blood pressure (BP) range. The elderly patients did not know the symptoms of hypertension (23.7%), were not willing to make lifestyle changes (57%-65%), and had a poor awareness of hypertension therapy in the absence of symptoms (28.7%). Poor BP control occurred mainly in rural residents (10.7%) and in people with higher education (39.3%). Untreated patients with hypertension did not know the symptoms of hypertension (29.2%), rarely measured BP (37.5%), but were more likely to engage in regular physical activity (70.8%). Efforts should be made to improve knowledge of hypertension, especially among the rural population, the elderly patients, those with a low-education level, and in young males who had the highest BP.
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Affiliation(s)
- Marta Michalska
- Department of Hypertension, Medical University of Lodz, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Poland
| | - Michael J Pencina
- Department of Biostatistics, Boston University, Harvard Clinical Research Institute, Boston, MA, USA
| | - Tomasz Zdrojewski
- Department of Hypertension and Diabetology, Medical University in Gdansk, Poland
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Poland
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Li X, Ning N, Hao Y, Sun H, Gao L, Jiao M, Wu Q, Quan H. Health literacy in rural areas of China: hypertension knowledge survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:1125-38. [PMID: 23507738 PMCID: PMC3709308 DOI: 10.3390/ijerph10031125] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 03/08/2013] [Accepted: 03/11/2013] [Indexed: 11/17/2022]
Abstract
We conducted this study to determine levels and correlates of hypertension knowledge among rural Chinese adults, and to assess the association between knowledge levels and salty food consumption among hypertensive and non-hypertensive populations. This face-to-face cross sectional survey included 665 hypertensive and 854 non-hypertensive respondents in the rural areas of Heilongjiang province, China. Hypertension knowledge was assessed through a 10-item test; respondents received 10 points for each correct answer. Among respondents, the average hypertension knowledge score was 26 out of a maximum of 100 points for hypertensive and 20 for non-hypertensive respondents. Hypertension knowledge was associated with marital status, education, health status, periodically reading books, newspapers or other materials, history of blood pressure measurement, and attending hypertension educational sessions. Hypertension knowledge is extremely low in rural areas of China. Hypertension education programs should focus on marginal populations, such as individuals who are not married or illiterate to enhance their knowledge levels. Focusing on educational and literacy levels in conjunction with health education is important given illiteracy is still a prominent issue for the Chinese rural population.
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Affiliation(s)
- Xia Li
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China; E-Mails: (X.L.); (N.N.); (Y.H.); (H.S.); (L.G.); (M.J
| | - Ning Ning
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China; E-Mails: (X.L.); (N.N.); (Y.H.); (H.S.); (L.G.); (M.J
| | - Yanhua Hao
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China; E-Mails: (X.L.); (N.N.); (Y.H.); (H.S.); (L.G.); (M.J
| | - Hong Sun
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China; E-Mails: (X.L.); (N.N.); (Y.H.); (H.S.); (L.G.); (M.J
| | - Lijun Gao
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China; E-Mails: (X.L.); (N.N.); (Y.H.); (H.S.); (L.G.); (M.J
| | - Mingli Jiao
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China; E-Mails: (X.L.); (N.N.); (Y.H.); (H.S.); (L.G.); (M.J
| | - Qunhong Wu
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China; E-Mails: (X.L.); (N.N.); (Y.H.); (H.S.); (L.G.); (M.J
| | - Hude Quan
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin 150081, China; E-Mails: (X.L.); (N.N.); (Y.H.); (H.S.); (L.G.); (M.J
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Dr NW, Calgary, Alberta T2N4Z6, Canada
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Wright-Nunes JA, Luther JM, Ikizler TA, Cavanaugh KL. Patient knowledge of blood pressure target is associated with improved blood pressure control in chronic kidney disease. PATIENT EDUCATION AND COUNSELING 2012; 88:184-8. [PMID: 22459637 PMCID: PMC3404190 DOI: 10.1016/j.pec.2012.02.015] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 02/13/2012] [Accepted: 02/17/2012] [Indexed: 05/12/2023]
Abstract
OBJECTIVE To describe patient hypertension knowledge and associations with blood pressure measurements. METHODS Patients with chronic kidney disease (CKD) were asked about the impact of high blood pressure on kidneys and their target blood pressure goal. Systolic blood pressure was measured using automated sphygmomanometers. RESULTS In 338 adults with hypertension and pre-dialysis CKD, the median [IQR] age was 59 [47,68] years, 45% [n = 152] were women, and 18% [n = 62] were non-white. Lower systolic blood pressure (SBP) was associated with female sex (SBP mmHg median [IQR] 132 [117,149] women vs. 137 [124,152] men; p = 0.04), less advanced CKD (SBP 134 [122,147] stages 1-2 vs. 132 [118,148] stage 3 vs. 140 [125,156] stages 4-5; p = 0.01), and patient ability to correctly identify SBP goal (SBP 134 [119,150] correct vs. 141 [125,154] incorrect; p = 0.05). In adjusted analysis, knowledge of blood pressure goal remained independently associated with lower SBP (-9.96 mmHg [-19.97, -1.95] in correct respondents vs. incorrect; p<0.001). CONCLUSION Patient knowledge of goal blood pressure is independently associated with improved blood pressure control. PRACTICE IMPLICATIONS Interventions to improve patient knowledge of specific blood pressure targets may have an important role in optimizing blood pressure management.
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Affiliation(s)
- Julie A Wright-Nunes
- Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI 48109, USA.
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Ayoade A, Oladipo I. Evaluation of the correlation between self-report and electronic monitoring of adherence to hypertension therapy. Blood Press 2012; 21:161-6. [PMID: 22512239 DOI: 10.3109/08037051.2012.679029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Blood pressure (BP) control remains sub-optimal all over the world. Medication adherence is an important determinant of BP control. None of the available methods for measuring medication adherence is currently regarded as a universal consensus gold standard. In this study, we evaluated the correlation between self-report (Morisky's Medication Adherence Self-assessment Scale) and electronic (eCap) methods of medication adherence assessment. The self-report measure was administered at study entry while electronic compliance data was collected prospectively. Almost all (97.4%) of enrolled patients completed the study. Medication adherence scores ranged from 0 to 100% (69.33, ± 27.57) and 6.6-100% (66.92 ± 22.59) for Morisky's scale and eCap, respectively (Wilcoxon rank sum test, p = 0.253). Modal class interval for adherence scores were 61-80% (n = 28, 37.3%) and 81-100% (n = 23, 30.7%) for the eCap and Morisky's scale respectively. Overall, a weak correlation was found between the two methods (r = 0.056). The weak correlation was also maintained in subgroup analysis defined by attainment of BP control (r = 0.109 vs 0.0009), age (range r = -0.53 to 0.067), sex (0.009 to 0.151), level of education (-0.217 to 0.276), and Mini Mental State Examination score (-0.107 to 0.258). Our findings suggest that these methods are not equivalent in the evaluation of medication adherence.
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Affiliation(s)
- Adedokun Ayoade
- Department of Family Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
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Wee LE, Koh GCH. Individual and neighborhood social factors of hypertension management in a low-socioeconomic status population: a community-based case-control study in Singapore. Hypertens Res 2011; 35:295-303. [PMID: 22089533 DOI: 10.1038/hr.2011.187] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this study was to determine hypertension awareness, treatment and control, as well as to carry out regular blood pressure (BP) screening and monitoring, in a multi-ethnic urban low-socioeconomic status (SES) Asian community; and to compare these estimates with those of a higher-SES community in the same geographic location. We studied a neighborhood of three blocks of rented public flats (lower-SES community) and three adjacent blocks of owner-occupied public flats (higher-SES community) in Taman Jurong, Singapore. BP was measured, and demographic details and reasons for irregular BP screening, monitoring and treatment were collected from 2009 to 2010. Logistic regression was used to determine predictors of hypertension management. Participation was 90.0% (359/400) for the rental flat community and 70.2% (351/500) for the owner-occupied flats. Prevalence, awareness, treatment and control in the low-SES community (rental flats) were 63.9% (228/357), 61.8% (141/228), 69.5% (98/141) and 43.9% (43/98), respectively, whereas in the neighboring community these were 65.0% (228/351), 83.3% (190/228), 85.3% (162/190) and 66.0% (107/162), respectively. Adjusting for other sociodemographic variables, awareness, treatment and control were poorer in the low-SES community. In the low-SES community, awareness was higher among diabetics, dyslipidemics, those ≥60 years and those with regular access to doctors. Treatment was more likely among those ≥60 years, but less likely among those needing financial aid. Control was less likely in the employed. High cost of screening and treatment, if diagnosed, was the most frequently cited barrier among the low-SES group. Hypertension management in those of lower SES is poorer than in those of higher SES. For the lower-SES population, financial barriers need to be addressed.
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Affiliation(s)
- Liang En Wee
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.
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High blood pressure in Chinese ethnic minorities: report from rural Yunnan province. Am J Hypertens 2011; 24:1209-14. [PMID: 21833039 DOI: 10.1038/ajh.2011.127] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Hypertension (HTN) is a growing cause of morbidity and mortality among rural Chinese. While HTN has been studied in various regions of China, little is known about HTN among ethnic minorities in rural China. METHODS A total of 36 villages were randomly selected from Yunnan province, China. From these villages, a total of 1,676 subjects from 10 ethnic minorities and the Han ethnic majority were selected for interview and blood pressure (BP) measurement. From each village, 50-80 men and women between the ages of 50 and 70 years were randomly selected. HTN prevalence, treatment, and control rates of HTN were evaluated in these 11 ethnic groups. RESULTS After controlling for age, gender, body mass index (BMI), smoking, alcohol, and monosodium glutamate intake, prevalence of HTN varied between 25% in the Hani minority and 64% in the Tibetan minority (P < 0.001). Treatment rates varied between 0% in the Hani minority and 41% in the Tibetan minority (P = 0.006). Control rates varied between 0% in the Hani minority and 17% in the Tibetan minority (P = 0.28). Prevalence, treatment, and control rates in the Han ethnic group were 35, 22, and 12%, respectively. CONCLUSIONS The prevalence of HTN varies widely among China's ethnic groups. Treatment and control rates of HTN also vary and are inadequate in the minority ethnic groups as well as in the Han majority.
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Ma C, Chen S, You L, Luo Z, Xing C. Development and psychometric evaluation of the Treatment Adherence Questionnaire for Patients with Hypertension. J Adv Nurs 2011; 68:1402-13. [DOI: 10.1111/j.1365-2648.2011.05835.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Charrois TL, McAlister FA, Cooney D, Lewanczuk R, Kolber MR, Campbell NR, Rosenthal M, Houle SK, Tsuyuki RT. Improving hypertension management through pharmacist prescribing; the rural Alberta clinical trial in optimizing hypertension (Rural RxACTION): trial design and methods. Implement Sci 2011; 6:94. [PMID: 21834970 PMCID: PMC3199859 DOI: 10.1186/1748-5908-6-94] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Accepted: 08/11/2011] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Patients with hypertension continue to have less than optimal blood pressure control, with nearly one in five Canadian adults having hypertension. Pharmacist prescribing is gaining favor as a potential clinically efficacious and cost-effective means to improve both access and quality of care. With Alberta being the first province in Canada to have independent prescribing by pharmacists, it offers a unique opportunity to evaluate outcomes in patients who are prescribed antihypertensive therapy by pharmacists. METHODS The study is a randomized controlled trial of enhanced pharmacist care, with the unit of randomization being the patient. Participants will be randomized to enhanced pharmacist care (patient identification, assessment, education, close follow-up, and prescribing/titration of antihypertensive medications) or usual care. Participants are patients in rural Alberta with undiagnosed/uncontrolled blood pressure, as defined by the Canadian Hypertension Education Program. The primary outcome is the change in systolic blood pressure between baseline and 24 weeks in the enhanced-care versus usual-care arms. There are also three substudies running in conjunction with the project examining different remuneration models, investigating patient knowledge, and assessing health-resource utilization amongst patients in each group. DISCUSSION To date, one-third of the required sample size has been recruited. There are 15 communities and 17 pharmacists actively screening, recruiting, and following patients. This study will provide high-level evidence regarding pharmacist prescribing. TRIAL REGISTRATION Clinicaltrials.gov NCT00878566.
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Affiliation(s)
- Theresa L Charrois
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Factors associated with prevalence, awareness, treatment and control of hypertension in urban adults from 33 communities in China: the CHPSNE Study. Hypertens Res 2011; 34:1087-92. [PMID: 21775998 DOI: 10.1038/hr.2011.99] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Using a randomized multistage cluster sampling, we studied the factors associated with the prevalence, awareness, treatment and control of hypertension (defined as systolic and diastolic blood pressure (BP) measurements ≥140 and 90 mm Hg, respectively, or current drug treatment for hypertension) in a representative sample of the urban Chinese population. The participants were 18-74 years of age and had lived for at least 5 years in an area comprising 33 communities in three cities (Shenyang, Anshan and Jinzhou) in China. A total of 28 830 people were selected; the overall response rate was 87.4% (25 196/28 830). The overall prevalence of hypertension was 28.7% (7237/25 196). Of those with hypertension, 42.9% (3107/7237) were aware of their condition, 28.2% (2042/7237) were receiving treatment and 3.7% (264/7237) were considered controlled. More than half (57.8%) of the hypertensives did not think that high BP would endanger their lives. Multivariate analysis revealed that age, gender, education, occupation, income, body mass index, waist circumference and a family history of hypertension correlated significantly with the prevalence of hypertension. Among all the hypertensives, higher awareness (determined by odds ratios; 95% confidence intervals) was noted for persons who were white-collar workers (1.29; 1.08, 1.53, respectively), overweight (1.48; 1.30, 1.69), obese (3.37; 2.76, 4.11) or had a family history of hypertension (3.07; 2.76, 3.42). Among the individuals aware of their hypertension, treatment was more common in those with a higher level of education and less common among individuals consuming ≥2 alcoholic drinks per day (0.65; 0.52, 0.83). Controlled hypertension was much less common among older persons, and participants who were former smokers (0.49; 0.26, 0.91). The results indicate that more attention is needed to improve the awareness of the potentially fatal nature of hypertension in urban China.
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Wee LE, Koh GCH. Hypertension awareness, treatment and control in an urban low-income setting: a community-based study in Singapore. Prev Med 2010; 51:447-8. [PMID: 20692284 DOI: 10.1016/j.ypmed.2010.07.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Revised: 07/24/2010] [Accepted: 07/28/2010] [Indexed: 11/17/2022]
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Prevalence, awareness, treatment and control of hypertension in the elderly population of Singapore. Hypertens Res 2010; 33:1223-31. [PMID: 20882026 DOI: 10.1038/hr.2010.177] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A comprehensive picture of the management of hypertension in the increasing elderly population in Singapore is lacking. In this study, we assess the prevalence and correlates of hypertension and of awareness, treatment and control of hypertension among 4494 elderly Singaporeans (≥60 years) participating in a recent representative survey. The weighted prevalences of hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or current use of antihypertension medication) and of awareness, treatment and control of hypertension were assessed. We assessed the extent of association of these outcomes with socio-demographic (age, gender, ethnicity, education, housing type, living arrangement and social participation) and health (body mass, diabetes and cognitive status) variables using multivariable logistic regression. Nearly three-fourths (73.9%) of participants were found to have hypertension. Of this number, 30.8% were unaware that they had hypertension, 32.0% were not being treated for the disease and 75.9% had suboptimal control of their blood pressure. Among those aware of their hypertension, only 1.9% were untreated. However, nearly two-thirds (64.5%) of treated hypertensives had suboptimal control. Age, gender, ethnicity, education, housing type, body mass and diabetes were significantly correlated with lack of awareness, treatment and control of hypertension. Although the specific 'at-risk' subgroups varied by the outcome, men and Malays had consistently higher odds for all three unfavorable outcomes. There is a need to improve awareness, treatment and especially control of hypertension among elderly Singaporeans. Primary and secondary prevention efforts targeting the elderly and their primary health-care providers are called for, as are regular data collection efforts based on representative samples.
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Hu P, Bartlett M, Karan RS, Jiang J, Zhang S, Zhang J, Howard D, Yeh CM, Al-Fayoumi S, Jarugula V, Dole WP. Pharmacokinetics, Safety and Tolerability of Single and Multiple Oral Doses of Aliskiren in Healthy Chinese Subjects. Clin Drug Investig 2010; 30:221-8. [DOI: 10.2165/11533050-000000000-00000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Liu Z, Albanese E, Li S, Huang Y, Ferri CP, Yan F, Sousa R, Dang W, Prince M. Chronic disease prevalence and care among the elderly in urban and rural Beijing, China - a 10/66 Dementia Research Group cross-sectional survey. BMC Public Health 2009; 9:394. [PMID: 19843346 PMCID: PMC2770493 DOI: 10.1186/1471-2458-9-394] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Accepted: 10/21/2009] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Demographic ageing is occurring at an unprecedented rate in China. Chronic diseases and their disabling consequences will become much more common. Public policy has a strong urban bias, and older people living in rural areas may be especially vulnerable due to limited access to good quality healthcare, and low pension coverage. We aim to compare the sociodemographic and health characteristics, health service utilization, needs for care and informal care arrangements of representative samples of older people in two Beijing communities, urban Xicheng and rural Daxing. METHODS A one-phase cross-sectional survey of all those aged 65 years and over was conducted in urban and rural catchment areas in Beijing, China. Assessments included questionnaires, a clinical interview, physical examination, and an informant interview. Prevalence of chronic diseases, self-reported impairments and risk behaviours was calculated adjusting for household clustering. Poisson working models were used to estimate the independent effect of rural versus urban residence, and to explore the predictors of health services utilization. RESULTS We interviewed 1002 participants in rural Daxing, and 1160 in urban Xicheng. Those in Daxing were more likely to be younger, widowed, less educated, not receiving a pension, and reliant on family transfers. Chronic diseases were more common in Xicheng, when based on self-report rather than clinical assessment. Risk exposures were more common in Daxing. Rural older people were much less likely to access health services, controlling for age and health. Community health services were ineffective, particularly in Daxing, where fewer than 3% of those with hypertension were adequately controlled. In Daxing, care was provided by family, who had often given up work to do so. In Xicheng, 45% of those needing care were supported by paid caregivers. Caregiver strain was higher in Xicheng. Dementia was strongly associated with care needs and caregiver strain, but not with medical helpseeking. CONCLUSION Apparent better health in Daxing might be explained by under-diagnosis, under-reporting or selective mortality. Far-reaching structural reforms may be needed to improve access and strengthen rural healthcare. The impact of social and economic change is already apparent in Xicheng, with important implications for future long-term care.
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Affiliation(s)
- Zhaorui Liu
- Institute of Mental Health, Peking University, Key Laboratory of Mental Health, Ministry of Health (Peking University), No 51 Hua Yuan Bei Road, Haidian District, Beijing 100191, PR China
| | - Emiliano Albanese
- King's College London, Section of Epidemiology, Health Services & Population Research, De Crespigny Park, London SE5 8AF, UK
| | - Shuran Li
- Institute of Mental Health, Peking University, Key Laboratory of Mental Health, Ministry of Health (Peking University), No 51 Hua Yuan Bei Road, Haidian District, Beijing 100191, PR China
| | - Yueqin Huang
- Institute of Mental Health, Peking University, Key Laboratory of Mental Health, Ministry of Health (Peking University), No 51 Hua Yuan Bei Road, Haidian District, Beijing 100191, PR China
| | - Cleusa P Ferri
- King's College London, Section of Epidemiology, Health Services & Population Research, De Crespigny Park, London SE5 8AF, UK
| | - Fang Yan
- Institute of Mental Health, Peking University, Key Laboratory of Mental Health, Ministry of Health (Peking University), No 51 Hua Yuan Bei Road, Haidian District, Beijing 100191, PR China
| | - Renata Sousa
- King's College London, Section of Epidemiology, Health Services & Population Research, De Crespigny Park, London SE5 8AF, UK
| | - Weimin Dang
- Institute of Mental Health, Peking University, Key Laboratory of Mental Health, Ministry of Health (Peking University), No 51 Hua Yuan Bei Road, Haidian District, Beijing 100191, PR China
| | - Martin Prince
- King's College London, Section of Epidemiology, Health Services & Population Research, De Crespigny Park, London SE5 8AF, UK
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Pan X, Dib HH, Zhu M, Zhang Y, Fan Y. Absence of appropriate hospitalization cost control for patients with medical insurance: a comparative analysis study. HEALTH ECONOMICS 2009; 18:1146-1162. [PMID: 18972328 DOI: 10.1002/hec.1421] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Expose the weak loops in the Chinese medical insurance coverage and uncover hospitals' role of over-pricing hospitalized insured patients compared with those non-insured. METHODS A multi-linear regression method was used to analyze hospitalization expense for insured and uninsured patients with uncomplicated acute appendicitis, cholecystitis, benign uterine tumors, and normal delivery. RESULTS Hospitalization cost is higher among insured than uninsured patients due to longer hospitalization lengths of stay, type of disease (highest among cholecystitis patients), type of gender - females, old-aged people, and type of marital status - singles, as well as drugs expenses, surgical expenses, and other medical acts. CONCLUSION Require a better government's supervision system over medical insurance expenses such as reforming methods of payments, building up new cost compensation mechanism, and unifying and stabilizing prices for each category of medicines.
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Affiliation(s)
- Xilong Pan
- Peking University Health Science Center, Health Policy and Management Department, School of Public Health, Beijing, People's Republic of China
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