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Nesterovich Grushina D, Álvarez Moleiro M. Nursing intervention with a gender approach in patients with arterial hypertension: a scoping review. Women Health 2024; 64:626-635. [PMID: 39164794 DOI: 10.1080/03630242.2024.2392134] [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: 02/14/2024] [Revised: 07/15/2024] [Accepted: 08/07/2024] [Indexed: 08/22/2024]
Abstract
This scoping review aims to identify and synthesize the available literature describing the use of the gender approach in research and nursing clinical practice related to hypertension. The review was conducted following the scoping review framework recommended by Arksey and O'Malley. Elements related to content were chosen following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Data were extracted using a predesigned table and were presented narratively after the content analysis. The PubMed, CINAHL, Web of Science, PsycINFO, Cochrane, Scopus, ScienceDirect and ERIC databases were consulted between March 2022 and June 2024. Reference lists from all sources and gray literature were also reviewed to identify additional publications. A total of 18 studies were finally included in this scoping review. Most of the studies (83 percent) represent gender as a biological variable (sex), and only a few of them (22 percent) analyzed psychological or social differences. In addition, several studies include unequal representations of each sex, most of them use the terms "sex" and "gender" as incorrect or interchangeable, which makes it difficult to evaluate the results from a gender perspective. There is still a substantial gap in the literature related to nurses' intervention with a gender approach in patients with hypertension. Future studies should focus on improving health interventions by considering gender to improve equality and efficiency in health outcomes associated with hypertension and other cardiovascular risk factors.
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Affiliation(s)
- Daria Nesterovich Grushina
- Stress and Health Research Group, Faculty of Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
- Primary Health Care Center, Congrés, Institut Català de la Salut, Barcelona, Spain
- Health and Sports Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Álvarez Moleiro
- Stress and Health Research Group, Faculty of Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Basic, Developmental and Educational Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
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Néri A, Xavier R, Matos S, Almeida M, Ladeira R, Lopes A, Lino D, Lázaro A, Cairutas R, Silva J, Lima J, Chaves M, Silva R, Silva G. Factors associated with non-treatment of hypertension and gender differences at baseline in the ELSA-Brasil cohort. Braz J Med Biol Res 2024; 57:e12937. [PMID: 38359271 PMCID: PMC10868185 DOI: 10.1590/1414-431x2023e12937] [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: 04/08/2023] [Accepted: 11/26/2023] [Indexed: 02/17/2024] Open
Abstract
The treatment of arterial hypertension (AH) contributes to the reduction of morbidity and mortality. Gender differences are likely to play a role, as non-treatment is associated with clinical and sociodemographic aspects. The aim of this study was to investigate the factors associated with non-treatment of AH and gender differences in hypertensive individuals from the ELSA-Brasil cohort. The study was conducted with 5,743 baseline hypertensive cohort participants. AH was considered if there was a previous diagnosis or if systolic blood pressure (SBP) was ≥140 and/or diastolic BP (DBP) was ≥90 mmHg. Sociodemographic and anthropometric data, lifestyle, comorbidities, and use of antihypertensive medications were evaluated through interviews and in-person measurements. Treatment with renin-angiotensin-aldosterone system inhibitors (RAASi) or other antihypertensive medications and non-treatment were evaluated with multivariate logistic regression. Non-treatment was observed in 32.8% of hypertensive individuals. Of the 67.7% treated individuals, 41.1% received RAASi. Non-treatment was associated with alcohol consumption in women (OR=1.41; 95%CI: 1.15-1.73; P=0.001), lowest schooling level in men (OR=1.70; 95%CI: 1.32-2.19; P<0.001), and younger age groups in men and women (strongest association in males aged 35-44 years: OR=4.58, 95%CI: 3.17-6.6, P<0.001). Among those using RAASi, a higher proportion of white, older individuals, and with more comorbidities was observed. The high percentage of non-treatment, even in this civil servant population, indicated the need to improve the treatment cascade for AH. Public health policies should consider giving special attention to gender roles in groups at higher risk of non-treatment to reduce inequities related to AH in Brazil.
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Affiliation(s)
- A.K.M. Néri
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, CE, Brasil
- Serviço de Cardiologia, Hospital Universitário Walter Cantídio, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - R.M.F. Xavier
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - S.M.A. Matos
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - M.C.C. Almeida
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brasil
| | - R.M. Ladeira
- Hospital João XXIII, Fundação Hospitalar do Estado de Minas Gerais, Secretaria Estadual de Saúde, Belo Horizonte, MG, Brasil
| | - A.A. Lopes
- Departamento de Medicina Interna/Nefrologia, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - D.O.C. Lino
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, CE, Brasil
| | - A.P.P. Lázaro
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, CE, Brasil
| | - R.V.B.M. Cairutas
- Serviço de Cardiologia, Hospital Universitário Walter Cantídio, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - J.H. Silva
- Serviço de Cardiologia, Hospital Universitário Walter Cantídio, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - J.M.O. Lima
- Serviço de Cardiologia, Hospital Universitário Walter Cantídio, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - M.C. Chaves
- Serviço de Cardiologia, Hospital Universitário Walter Cantídio, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - R.P. Silva
- Serviço de Cardiologia, Hospital Universitário Walter Cantídio, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - G.B. Silva
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, CE, Brasil
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Liu F, Chang H, Liu X. Adherence Behaviors and Related Factors Among Elderly Hypertensive Patients in China: Evidence from the China Health and Retirement Longitudinal Study. Patient Prefer Adherence 2023; 17:3539-3553. [PMID: 38152445 PMCID: PMC10752232 DOI: 10.2147/ppa.s445789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/18/2023] [Indexed: 12/29/2023] Open
Abstract
Background Non-adherence or partial adherence is the main reason for poor therapeutic effect of hypertension. This paper aims to assess adherence behaviors and related factors among elderly hypertensive patients in China. Methods Participants aged ≥60 years, with hypertension, and with complete data in 2018 interviews of the China Health and Retirement Longitudinal Study (CHARLS) were included. The adherence behaviors included medication, blood pressure monitoring and the combined adherence behaviors. Referring to the social-ecological theory, correlates of adherence behaviors were divided into three layers, namely demographic characteristics, health behaviors, living environment and retirement. Univariate and multivariable logistic regression models were performed to identify factors of adherence behaviors. Results The prevalence of medication adherence (76.58%) was higher than that of blood pressure monitoring adherence (20.08%), and the full adherence rate was 18.53%. Self-rated health status, smoking status, living area, and health education status were detected to be associated with medication adherence and blood pressure monitoring adherence (all p < 0.05). Gender, sleep duration, health examination, and physical exercise were also detected to be associated with blood pressure monitoring adherence (all p < 0.05). Self-rated health status and health education status were detected to be associated with partially and fully adherence, while age, living area, and life satisfaction were detected to be associated with partially adherence, smoking status, sleep duration, health examination, and pension reliance were detected to be associated with fully adherence (all p < 0.05). Conclusion Our study reveals the poor adherence behaviors of elderly hypertensive patients in China. This is most evident among those who were male, 60-69 years old, living in rural areas, self-reported being healthier, those without health examination and health education. Targeting these vulnerable populations, we suggest to strengthen health education, increase the publicity of basic public health services and enhance the self-management ability of hypertensive patients.
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Affiliation(s)
- Fengyu Liu
- School of Public Health, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
- School of Public Health, National Key Laboratory of Health Technology Assessment (National Health Commission of the People’s Republic of China), Global Health Institute, Fudan University, Shanghai, People’s Republic of China
| | - Huajing Chang
- School of Public Health, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
| | - Xiaojun Liu
- School of Public Health, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
- School of Health Management, Provincial Research Center for Healthcare Reform and Development of Fujian, Health Research Institute, Fujian Medical University, Fuzhou, Fujian, People’s Republic of China
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Singh A, Dixit P. Sex-specific prevalence, awareness, treatment and control of hypertension in adults in India: a study for developing sex-specific public policy from the longitudinal ageing study in India (LASI) data 2017-2018. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:85. [PMID: 37626344 PMCID: PMC10464490 DOI: 10.1186/s41043-023-00404-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/28/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND AND OBJECTIVE Hypertension is a key risk factor for cardiovascular disease and the leading cause of mortality among Indian adults. The difference in health status between men and women is becoming a great burden in itself worldwide. This study aimed to examine the differences between men and women in the prevalence, awareness, treatment, and control of hypertension and related risk factors among people aged 45 and older in India using data from the Longitudinal Ageing Study in India in 2017-2018. METHODS Descriptive statistics were presented separately for males and females. Multivariable logistic regression was used to analyze the socio-demographic, lifestyle behaviours, and biological factors associated with the prevalence of hypertension. All statistical analyses were conducted using Stata Version 16.0 statistical software. The study of the data was conducted using survey weights available in the LASI datasets. KEY FINDINGS Overall, the study found that 45.1% of the study population had hypertension, with 26.9% self-reporting their condition and 30% having hypertension at the time of measurement. Approximately 41% of males and 59% of females had hypertension. The self-reported hypertension of men was found to differ significantly from measured hypertension by 8.7%, while in women the difference was only 1.2%. Diabetes was found to increase the odds of having hypertension in both males (OR = 3.65, 95% CI (3.37-3.97)) and females (OR = 3.46, 95% CI (3.21-3.74)). CONCLUSION The difference between self-reported and measured hypertension in men and women is contributing to sex-gender and health inequalities that must be addressed. For adult females with hypertension, it is important to prioritize obesity, education level, physical activity, and regular clinic visits to manage chronic conditions. Based on our findings, policy recommendations can be made to focus on increasing women's literacy, promoting men's screening for hypertension, banning tobacco and alcohol sales, and organizing hypertension awareness campaigns specifically for men and in rural areas.
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Affiliation(s)
- Ayushi Singh
- School of Health Systems Studies (SHSS), Tata Institute of Social Sciences (TISS), V. N. Purav Marg, Deonar, Mumbai, 400088, India.
| | - Priyanka Dixit
- Centre for Health and Social Sciences, School of Health Systems Studies (SHSS), Tata Institute of Social Sciences (TISS), V. N. Purav Marg, Deonar, Mumbai, 400088, India
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Shin D, Choi J, Lee HY. Suboptimal control status of young hypertensive population. Clin Hypertens 2023; 29:13. [PMID: 37122032 PMCID: PMC10150511 DOI: 10.1186/s40885-023-00237-6] [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: 08/08/2022] [Accepted: 03/15/2023] [Indexed: 05/02/2023] Open
Abstract
The prevalence of hypertension (HT) among young adults aged 18 to 39 years is estimated to be 3.7% to 8.6% worldwide. Although the prevalence of HT in young adults is lower than that of the overall population, those with HT are at substantially increased risk of cardiovascular events compared to those without HT. HT in young adults should be taken with even more caution as longer exposure to higher blood pressure leads to a higher lifetime risk of HT-mediated organ damage. However, young patients with HT show low awareness of HT compared to older patients. Also, they are more prone to show low treatment adherence despite the good efficacy of the treatment. Other risk factors that hinder HT control among young adults include alcohol intake, smoking, low physical activity, emotional stress, job stress, metabolic syndrome, and obesity. This review aimed to illustrate the suboptimal control status of the young hypertensive population and to propose strategies for improvement.
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Affiliation(s)
- Donghun Shin
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - JungMin Choi
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hae-Young Lee
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Cífková R, Bruthans J, Strilchuk L, Wohlfahrt P, Krajčoviechová A, Šulc P, Jozífová M, Eremiášová L, Pudil J, Linhart A, Widimský J, Filipovský J, Mayer O, Škodová Z, Lánská V. Longitudinal trends in blood pressure, prevalence, awareness, treatment, and control of hypertension in the Czech population. Are there any sex differences? Front Cardiovasc Med 2022; 9:1033606. [DOI: 10.3389/fcvm.2022.1033606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022] Open
Abstract
BackgroundHypertension is the most common cardiovascular disease which substantially increases cardiovascular morbidity and mortality. Despite the broad availability of antihypertensive medication, control of hypertension is not satisfactory worldwide.ObjectiveThe study aim was to assess longitudinal trends in blood pressure, prevalence, awareness, treatment, and control of hypertension in a representative population sample of the Czechia from 1985 to 2016/2017, focusing on sex differences.MethodsA total of 7,606 men and 8,050 women aged 25–64 years were screened for major CV risk factors in seven independent cross-sectional surveys run consistently in the same six country districts of the Czechia between 1985 and 2016/2017. The population samples were randomly selected.ResultsOver a study period of 31/32 years, there was a significant decline in systolic and diastolic blood pressure in both sexes, whereas the prevalence of hypertension decreased only in women. There was an increase in hypertension awareness in both sexes over the entire study period with consistently higher rates in women. The proportion of individuals treated with antihypertensive drugs increased significantly in both sexes throughout the study, again with consistently higher rates in women. Control of hypertension increased significantly over the study period with consistently higher rates in women. The age-adjusted trends in blood pressure, prevalence, awareness, and treatment of hypertension were significantly different in men and women, always in favor of women. The age-adjusted trends in control of hypertension in treated patients were equally poor in both sexes.ConclusionThere are significant differences in longitudinal trends in blood pressure, prevalence, awareness, treatment, and control of hypertension between men and women, always in favor of women except for the control of hypertension in treated patients, where it is equally poor in both sexes.
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Griffin BL, Bolch CA, Bourjeily G, Madsen TE, Hasnain M, McGregor AJ, Merhi BO, Pratt-Chapman ML, Romano M, Trott J, Tong I. Hypertension: Are Current Guidelines Inclusive of Sex and Gender? J Womens Health (Larchmt) 2022; 31:1391-1396. [PMID: 36178463 PMCID: PMC9836675 DOI: 10.1089/jwh.2022.0103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: Hypertension (HTN) accounts for one in five deaths of American women. Major societies worldwide aim to make evidence-based recommendations for HTN management. Sex- or gender-based differences exist in epidemiology and management of HTN; in this study, we aimed to assess sex- and gender-based language in major society guidelines. Materials and Methods: We reviewed HTN guidelines from four societies: the American College of Cardiology (ACC), the American College of Emergency Physicians (ACEP), the European Society of Cardiology (ESC), and the Eighth Joint National Committee (JNC8). We quantified the sex- and gender-based medicine (SGBM) content by word count in each guideline as well as identified the gender of guideline authors. Results: Two of the four HTN guidelines (ACC, ESC) included SGBM content. Of these two guidelines, there were variations in the quantity and depth of content coverage. Pregnancy had the highest word count found in both guidelines (422 words in ACC and 1,523 words in ESC), which represented 2.45% and 3.04% of the total words in each guideline, respectively. There was minimal coverage, if any, of any other life periods. The number of women authors did not impact the SGBM content within a given guideline. Conclusions: Current HTN management guidelines do not provide optimal guidance on sex- and gender-based differences. Inclusion of sex, gender identity, hormone therapy, pregnancy and lactation status, menopause, and advanced age in future research will be critical to bridge the current evidence gap. Guideline writing committees should include diverse perspectives, including cisgender and transgender persons from diverse racial and ethnic backgrounds.
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Affiliation(s)
- Brooke L. Griffin
- Midwestern University Chicago College of Pharmacy, Downers Grove, Illinois, USA
| | - Charlotte A. Bolch
- Midwestern University Chicago College of Pharmacy, Downers Grove, Illinois, USA
| | - Ghada Bourjeily
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- The Miriam Hospital, Women's Medicine Collaborative, Providence, Rhode Island, USA
| | - Tracy E. Madsen
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Memoona Hasnain
- University of Illinois College of Medicine, Chicago, Illinois, USA
| | - Alyson J. McGregor
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Basma O. Merhi
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Mandi L. Pratt-Chapman
- The George Washington University School of Medicine and Health Science, Washington, District of Columbia, USA
| | - Mary Romano
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Justina Trott
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Iris Tong
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- The Miriam Hospital, Women's Medicine Collaborative, Providence, Rhode Island, USA
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Farrukh F, Abbasi A, Jawed M, Almas A, Jafar T, Virani SS, Samad Z. Hypertension in Women: A South-Asian Perspective. Front Cardiovasc Med 2022; 9:880374. [PMID: 36035921 PMCID: PMC9399392 DOI: 10.3389/fcvm.2022.880374] [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: 02/21/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Hypertension is an important contributor to cardiovascular disease related morbidity and mortality. Despite the magnitude of its negative impact on cardiovascular outcomes, treatment and control of hypertension remain suboptimal in both men and women. Materials and Methods Numerous databases, i.e., PubMed, ScienceDirect, etc., were searched using keywords to identify relevant studies to our narrative review. The findings from the most pertinent articles were summarized and integrated into our narrative review on hypertension in women. Results The pathophysiology of essential hypertension is still being delineated in both men and women; there are multiple sex specific factors in association with the development of hypertension in women, including age, combined oral contraceptives (COCs), polycystic ovarian syndrome (PCOS), preeclampsia, etc. There are several sex specific considerations in antihypertensives drug choices. Discussion Despite the magnitude of its negative impact on cardiovascular outcomes, treatment and control of hypertension remain suboptimal in women. Medical treatment and adherence is uniquely challenging for South Asian women due to a variety of socio-cultural-economic factors. Further research is warranted to identify optimal sex-specific treatment options that will improve the control of hypertension and decrease the risk of subsequent cardiovascular disease in both genders.
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Affiliation(s)
| | - Amin Abbasi
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Misbah Jawed
- Medical College, Ziauddin University, Karachi, Pakistan
| | - Aysha Almas
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Tazeen Jafar
- Medical College, Aga Khan University, Karachi, Pakistan.,Baylor College of Medicine, Houston, TX, United States
| | | | - Zainab Samad
- Medical College, Aga Khan University, Karachi, Pakistan.,Department of Medicine, Duke University, Durham, NC, United States
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Şen S, Demirkol D, Kaşkal M, Gezer M, Bucak AY, Gürel N, Selalmaz Y, Erol Ç, Üresin AY. Evaluation of Risk Factors Associated With Antihypertensive Treatment Success Employing Data Mining Techniques. J Cardiovasc Pharmacol Ther 2022; 27:10742484221136758. [DOI: 10.1177/10742484221136758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objective: This study aimed to evaluate the effects of potential risk factors on antihypertensive treatment success. Methods: Patients with hypertension who were treated with antihypertensive medications were included in this study. Data from the last visit were analyzed retrospectively for each patient. To evaluate the predictive models for antihypertensive treatment success, data mining algorithms (logistic regression, decision tree, random forest, and artificial neural network) using 5-fold cross-validation were applied. Additionally, study parameters between patients with controlled and uncontrolled hypertension were statistically compared and multiple regression analyses were conducted for secondary endpoints. Results: The data of 592 patients were included in the analysis. The overall blood pressure control rate was 44%. The performance of random forest algorithm (accuracy = 97.46%, precision = 97.08%, F1 score = 97.04%) was slightly higher than other data mining algorithms including logistic regression (accuracy = 87.31%, precision = 86.21%, F1 score = 85.74%), decision tree (accuracy = 76.94%, precision = 70.64%, F1 score = 76.54%), and artificial neural network (accuracy = 86.47%, precision = 83.85%, F1 score = 84.86%). The top 5 important categorical variables (predictive correlation value) contributed the most to the prediction of antihypertensive treatment success were use of calcium channel blocker (−0.18), number of antihypertensive medications (0.18), female gender (0.10), alcohol use (−0.09) and attendance at regular follow up visits (0.09), respectively. The top 5 numerical variables contributed the most to the prediction of antihypertensive treatment success were blood urea nitrogen (−0.12), glucose (−0.12), hemoglobin A1c (−0.12), uric acid (−0.09) and creatinine (−0.07), respectively. According to the decision tree model; age, gender, regular attendance at follow-up visits, and diabetes status were identified as the most critical patterns for stratifying the patients. Conclusion: Data mining algorithms have the potential to produce predictive models for screening the antihypertensive treatment success. Further research on larger populations and longitudinal datasets are required to improve the models.
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Affiliation(s)
- Selçuk Şen
- Division of Clinical Pharmacology, Department of Medical Pharmacology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Denizhan Demirkol
- Department of Management Information Systems, Aydın Adnan Menderes University, Aydın, Turkey
- Department of Computer Engineering, Aydın Adnan Menderes University, Aydın, Turkey
| | - Mert Kaşkal
- Department of Medical Pharmacology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Murat Gezer
- Department of Informatics, Istanbul University, Istanbul, Turkey
| | - Ayşenur Yaman Bucak
- Division of Clinical Pharmacology, Department of Medical Pharmacology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nermin Gürel
- Istanbul Prof. Dr. Cemil Tascioglu City Hospital, University of Health Sciences, Istanbul, Turkey
| | - Yasemin Selalmaz
- Department of Medical Pharmacology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Çiğdem Erol
- Department of Informatics, Istanbul University, Istanbul, Turkey
- Department of Botany, Faculty of Science, Istanbul University, Istanbul, Turkey
| | - Ali Yağız Üresin
- Division of Clinical Pharmacology, Department of Medical Pharmacology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Shehab A, Bhagavathula AS, AlHajri N. Sex differences in the antihypertensive treatment and risk of uncontrolled hypertension in 5308 hypertensive patients in the United Arab Emirates. Blood Press Monit 2021; 26:333-340. [PMID: 34001757 DOI: 10.1097/mbp.0000000000000539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sex differences in the antihypertensive medications used to control blood pressure and risk factor control in hypertensive patients is poorly understood. METHODS We conducted a retrospective review of the patients newly diagnosed with hypertension registered for treatment in 52 outpatient settings across Abu Dhabi province between 1 January and 31 December 2017. We explored sex differences in risk factors and treatment management over 6 months of the follow-up period of each patient. Multiple logistic regression models were used to identify factors associated with poor BP control. RESULTS A total of 5308 patients (2559 men and 2849 women) were identified. We observed an increase in SBP and DBP levels in men (1.72/1.13 mmHg) and only SBP in women (0.87/-0.021 mmHg) with increased incidence of comorbidities overtime. The overall BP control was suboptimal (65%) (<140/90 mmHg) with no significant difference between women (65.3%) and men (64.2%). In men with dyslipidemia, use of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker with diuretics and in women, only calcium channel blockers showed higher for BP control. Factors significantly associated with poor BP control in men are being overweight and obese, and dyslipidemia in men. After the age of 50, women in contrast to men, with dyslipidemia and heart rate >80 beats per minute are less likely to maintain hypertension control. CONCLUSION Sex-specific analysis indicated that BP control among United Arab Emirates men and women was suboptimal (65%). Interventions aiming to achieve better control of BP in hypertensive patients with metabolic syndrome should be emphasized.
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Affiliation(s)
| | - Akshaya Srikanth Bhagavathula
- Institute of Public Health, College of Medicine and Health Sciences, College of Medicine and Health Sciences, UAE University, Al Ain
| | - Noora AlHajri
- Department of Epidemiology and Population Health, Khalifa University, Abu Dhabi, UAE
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Guerrero-Díaz DV, Hernández-Vásquez A, Montoya-Rivera WC, Rojas-Roque C, Chacón Díaz MA, Bendezu-Quispe G. Undiagnosed hypertension in Peru: analysis of associated factors and socioeconomic inequalities, 2019. Heliyon 2021; 7:e07516. [PMID: 34296015 PMCID: PMC8282964 DOI: 10.1016/j.heliyon.2021.e07516] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/13/2021] [Accepted: 07/05/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To determine the factors associated and measure the socioeconomic inequalities in people with undiagnosed hypertension in Peru. MATERIALS AND METHODS An observational, cross-sectional, analytical study was performed using data from the 2019 Demographic and Family Health Survey (ENDES, acronym in Spanish) database. The dependent variable was the presence of undiagnosed hypertension (mean systolic blood pressure ≥140 mmHg and/or mean diastolic blood pressure ≥90 mmHg in the two blood pressure measurements and with no prior diagnosis of hypertension by a health care professional). Adjusted prevalence ratios were estimated to determine the factors associated with undiagnosed hypertension. The socioeconomic inequality in undiagnosed hypertension was estimated using concentration curves and the Erreygers concentration index. RESULTS 67.2% of 3697 persons with hypertension had not been diagnosed. Non-diagnosis of hypertension was more prevalent in men who were residents of the Coast and in inhabitants residing at more than 3000 m above sea level. Being 50 years of age or older, having health insurance, being obese and having diabetes mellitus were associated with a lower prevalence of undiagnosed hypertension. Inequality of the non-diagnosis of hypertension was found to be concentrated in the poorest population. CONCLUSIONS At least one out of every two adult Peruvians with hypertension have not been diagnosed with this condition. Socioeconomic inequality was found, as well as socio-demographic and health-related factors associated with undiagnosed hypertension. Our findings identify some population subgroups in which interventions for screening and treatment of hypertension should be prioritized in order to reduce both inequalities and complications of hypertension among the most vulnerable.
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Affiliation(s)
| | - Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | | | | | | | - Guido Bendezu-Quispe
- Universidad Privada Norbert Wiener, Centro de Investigación Epidemiológica en Salud Global, Lima, Peru
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Awareness, treatment, control, and determinants of dyslipidemia among adults in China. Sci Rep 2021; 11:10056. [PMID: 33980884 PMCID: PMC8115030 DOI: 10.1038/s41598-021-89401-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 04/26/2021] [Indexed: 11/20/2022] Open
Abstract
Effective management of dyslipidemia is important. This study aimed to determine the awareness, treatment, control, and determinants of dyslipidemia in middle-aged and older Chinese adults in China. Using data from the 2015 China National Stroke Screening and Prevention Project (CNSSPP), a nationally representative sample of 135,403 Chinese adults aged 40 years or more were included in this analysis. Dyslipidemia was defined by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults final report (NCEP-ATP III) and the 2016 Chinese guidelines for the management of dyslipidemia in adults. Models were constructed to adjust for subjects’ characteristics with bivariate and multivariable logistic regression analyses. Overall, 51.1% of the subjects were women. Sixty-four percent were aware of their condition, of whom 18.9% received treatment, and of whom 7.2% had adequately controlled dyslipidemia. Dyslipidemia treatment was higher in men from rural areas than their urban counterparts. The multivariable logistic regression models revealed that women, urban residents, and general obesity were positively related to awareness. Women, married respondents, and current drinkers had higher odds of treatment. Age group, overweight, general obesity, urban residence, and women were independent determinants of control. Dyslipidemia awareness rate was moderately high, but treatment and control rates were low. Results can be used to develop policies and health promotion strategies with special focus on middle-aged and older adults.
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