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Afam G, Nakalega AP. Hypertension risk perception among young adults in Victoria University Kampala Uganda. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2024; 23:200327. [PMID: 39282604 PMCID: PMC11393586 DOI: 10.1016/j.ijcrp.2024.200327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 08/11/2024] [Accepted: 08/23/2024] [Indexed: 09/19/2024]
Abstract
Introduction Globally, hypertension is becoming a more serious public health concern, with young adults also at risk. Effective intervention techniques require an understanding of young adults' perceptions of the risk factors, enablers, and barriers to adopting healthy lifestyle choices related to hypertension. This research aims to examine hypertension risk perception among young adults at Victoria University Kampala, Uganda. Methods Data were gathered using a structured questionnaire between November 2023 and January 2024. Convenience sampling was used to gather data from young adults at Victoria University Kampala, Uganda. Leslie Kish's formula was used to establish the sample size of 126 respondents. Multiple regression analysis was performed to examine the association between independent variables (barriers, and facilitators) and the dependent variable (perception of hypertension risk). Results The study found that perceptions of certain risk factors, such as smoking (OR = 2.418, p = 0.035), physical inactivity (OR = 1.731, p = 0.008), unhealthy diet (OR = 2.174, p = 0.048), and chronic stress (OR = 1.514, p = 0.028), significantly influenced the likelihood of adopting healthy lifestyle choices. Among the enablers, motivation (OR = 3.491, p = 0.005), availability of time (OR = 3.015, p = 0.011), financial resources (OR = 2.164, p = 0.017), and social support (OR = 2.014, p = 0.026) were strong predictors of healthy behaviour adoption. Conclusion Programs aimed at raising awareness of hypertension risk factors and enhancing enablers such as motivation, time management, and social support are recommended to effectively promote healthy behaviours among this population.
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Affiliation(s)
- Grace Afam
- Department of Public Health, Victoria University, Kampala, 256, Uganda
- Department of Nursing Sciences, Victoria University, Kampala, 256, Uganda
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Magutah K, Mbuthia GW, Osengo G, Odhiambo D, Meiring R. Prevalence of modifiable risk factors for cardiovascular disease among school-going children and adolescents in Eldoret, Kenya. Pan Afr Med J 2024; 47:100. [PMID: 38799190 PMCID: PMC11126747 DOI: 10.11604/pamj.2024.47.100.42340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/17/2023] [Indexed: 05/29/2024] Open
Abstract
Introduction Cardiovascular disease (CVD) prevalence in Kenya is rising. Overweight, pre-hypertension and physical inactivity at younger ages is contributory. These risk factors are inadequately documented among Kenyan children and adolescents, hampering CVD prevention. Methods this cross-sectional study randomly sampled 384 participants from Eldoret, Kenya. After ethical considerations, physical activity was assessed. Body mass index (BMI), Waist-Hip-Ratio (WHR) and Waist-Height-Ratio (WHtR) were determined, and blood pressure (BP) was measured. Results participants were 14.6±2.7 years, and 62.6% were female. Eight percent had BMI ≥25.0 kg/m2. Of these, 87% were in secondary schools. Using SBP, 27.9% had CVD risk (42.5% and 20% for males and females ≥13 years and 26.5% and 27% for those <13 years, respectively). For DBP, 12.8% had elevated-to-hypertensive BP (13.2% and 8.3% for males and females ≥13 years and 11.8% and 25.4% for those <13 years, respectively). Combining SBP and DBP, 8.1%, mostly males, had elevated-to-hypertensive BP. Using respective WHR cutoffs of 0.90 and 0.85, 31% (boys) and 15.6% (girls) were at CVD risk. For WHtR, 39.6% of boys were >0.463 cut-off (0.493±0.02) against 32.4% for girls >0.469 cut-off (0.517±0.05). Of these, 52.6% (boys) and 69.7% (girls) were in secondary schools. Overall, 45% of participants were sports-inactive and 77.2% did minimal physical activities. Conclusion among school-going children and adolescents in Eldoret, Kenya, the prevalence of CVD risk factors was high, especially among boys and in high schools. Large proportions had elevated BP, BMI, WHR and WHtR, and, further, were sedentary, posing a high CVD risk. Lifestyle interventions to mitigate this are urgently needed.
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Affiliation(s)
| | | | | | | | - Rebecca Meiring
- Department of Exercise Science, University of Auckland, Auckland, New Zealand
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Sabapathy K, Mwita FC, Dauya E, Bandason T, Simms V, Dziva Chikwari C, Doyle AM, Ross D, Shah A, Hayes RJ, Schutte AE, Kranzer K, Ferrand RA. Prevalence of hypertension and high-normal blood pressure among young adults in Zimbabwe: findings from a large, cross-sectional population-based survey. THE LANCET. CHILD & ADOLESCENT HEALTH 2024; 8:101-111. [PMID: 38070533 DOI: 10.1016/s2352-4642(23)00287-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND Hypertension is the greatest driver of cardiovascular mortality and onset might be in youth. We aimed to investigate the prevalence of and risk factors for elevated blood pressure (hypertension ≥140 mm Hg systolic, ≥90 mm Hg diastolic, or both) and high-normal blood pressure (130-139 mm Hg systolic, 85-89 mm Hg diastolic, or both) among youth in Zimbabwe. METHODS A population-based, cross-sectional survey of randomly sampled youth aged 18-24 years from 24 urban and peri-urban communities in three provinces (Harare, Bulawayo, and Mashonaland East) in Zimbabwe was conducted between Oct 4, 2021, and June 2, 2022. Standardised questionnaires were used by research assistants to collect sociodemographic, behavioural, and clinical data. Height, bodyweight, and blood pressure were recorded. Three seated blood pressure measurements were taken at standardised timepoints during participant interview using a digital sphygmomanometer and cuffs sized on mid-upper arm circumference. The association of potential risk factors with elevated blood pressure was examined using multivariable logistic regression. FINDINGS 17 682 (94·4%) of 18 729 eligible participants were recruited, 17 637 (99·7%) of whom had complete data, and 16 883 (95·7%) of whom were included in the final study sample after excluding 754 (4·3%) pregnant women. The median age was 20 years (IQR 19-22), 9973 (59·1%) participants were female, and 6910 (40·9%) were male. The prevalence of hypertension was 7·4% (95% CI 7·0-7·8) and high-normal blood pressure was 12·2% (11·7-12·7). Overall, prevalence of hypertension was higher in men (8·7% [95% CI 8·2-9·6]) than in women (6·6% [6·0-6·9]), but with age increased to similar levels (at age 18 years 7·3% [6·2-8·6] and 4·3% [3·5-5·2]; at age 23-24 years 10·9% [9·3-12·6] and 9·5% [8·4-10·7] in men and women, respectively). After adjusting for factors associated with hypertension in the crude analysis, hypertension was associated with male sex (adjusted odds ratio 1·53 [95% CI 1·36-1·74]), increasing age (age 19-20 years 1·20 [1·00-1·44]; age 21-22 years 1·45 [1·20-1·75]; age 23-24 years 1·90 [1·57-2·30], vs age 18 years), and BMI of 30·0 kg/m2 or more (1·94 [1·53-2·47] vs 18·5-24·9 kg/m2). A BMI of 18·5 kg/m2 or less (0·79 [0·63-0·98] vs 18·5-24·9 kg/m2) and living with HIV (0·71 [0·55-0·92]) were associated with lower odds of hypertension. INTERPRETATION Prevalence of elevated blood pressure is high among urban and peri-urban youth in Zimbabwe and increases rapidly with age. Further research is needed to understand drivers of blood pressure elevation and the extent of target organ damage in youth in Zimbabwe and similar sub-Saharan African settings, to guide implementation of prevention and management strategies. FUNDING Wellcome Trust.
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Affiliation(s)
- Kalpana Sabapathy
- Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK.
| | | | - Ethel Dauya
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Tsitsi Bandason
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Victoria Simms
- Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Chido Dziva Chikwari
- Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Aoife M Doyle
- Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - David Ross
- Institute for Life Course Health Research, Stellenbosch University, Tygerberg, South Africa
| | - Anoop Shah
- Department of Noncommunicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Richard J Hayes
- Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Aletta E Schutte
- School of Population Health, University of New South Wales, Sydney, NSW, Australia; The George Institute for Global Health, Sydney, NSW, Australia
| | - Katharina Kranzer
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Rashida Abbas Ferrand
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
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Nsanya MK, Abramson R, Kisigo GA, Hickner A, Nyanza EC, Peck RN, Kapiga SH. Hypertension among adolescents in sub-Saharan Africa: a systematic review. Front Cardiovasc Med 2023; 10:1251817. [PMID: 38155990 PMCID: PMC10754047 DOI: 10.3389/fcvm.2023.1251817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/18/2023] [Indexed: 12/30/2023] Open
Abstract
Introduction Hypertension (HTN) among adolescents is common in high-income countries, and leads to increased premature cardiovascular diseases (CVD). In sub-Saharan Africa (SSA), the prevalence of HTN among adolescents, associated risk factors and CVD complications are not well-described. Such data is needed for planning public health programs to prevent premature CVD in SSA. Methods We systematically searched 5 databases (MEDLINE, Embase, Google Scholar, Web of Science, and African Index Medicus) from their establishment to December 2021. Key search terms were: adolescent, arterial hypertension, and names of the 48 countries in SSA. We used Covidence® to manage the search results. The review was registered in the Open Science Framework (OSF) https://osf.io/p5sbt/. Results We identified 4,008 articles out of which we screened 3,088 abstracts, and reviewed 583 full-text articles. We finally included 92 articles that were published between 1968 to December 2021. The majority were cross-sectional studies (80%) and conducted in school settings (78%). The risk of bias was low for 59 studies (64.1%), moderate for 29 studies (31.5%), and high for 4 studies (4.3%). Overall, the prevalence of HTN varied widely from 0.18% to 34.0% with a median (IQR) of 5.5% (3.1%, 11.1%). It was relatively higher in studies using automated blood pressure (BP) devices, and in studies defining HTN using thresholds based on percentile BP distribution for one's height, age, and sex. In addition, the prevalence of HTN was significantly higher in studies from Southern Africa region of SSA and positively correlated with the year of publication. Across studies, traditional risk factors such as age, sex, body mass index, and physical inactivity, were commonly found to be associated with HTN. In contrast, non-traditional risk factors related to poverty and tropical diseases were rarely assessed. Only three studies investigated the CVD complications related to HTN in the study population. Conclusion The prevalence of HTN among adolescents in SSA is high indicating that this is a major health problem. Data on non-traditional risk factors and complications are scarce. Longitudinal studies are needed to clearly define the rates, causes, and complications of HTN. Systematic Review Registration https://osf.io/p5sbt/, identifier (10.17605/OSF.IO/P5SBT).
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Affiliation(s)
- Mussa K Nsanya
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
| | - Rachel Abramson
- Weill Cornell Medicine - Cornell University, New York, NY, United States
| | - Godfrey A Kisigo
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Andy Hickner
- Weill Cornell Medicine - Cornell University, New York, NY, United States
| | - Elias C Nyanza
- Catholic University of Health and Allied Sciences, School of Public Health, Mwanza, Tanzania
| | - Robert N Peck
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Weill Cornell Medicine - Cornell University, New York, NY, United States
- Catholic University of Health and Allied Sciences, School of Public Health, Mwanza, Tanzania
| | - Saidi H Kapiga
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Craig A, Breet Y, Gafane-Matemane LF, Norris SA, Kruger R. Detecting and Managing Childhood Onset Hypertension in Africa: A Call to Action. Curr Hypertens Rep 2023; 25:211-230. [PMID: 37318686 PMCID: PMC10491553 DOI: 10.1007/s11906-023-01247-3] [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] [Accepted: 05/22/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE OF REVIEW To review recent evidence on childhood hypertension across Africa, identifying knowledge gaps, challenges and priorities, and highlight clinical perspectives in managing primary hypertension. RECENT FINDINGS Only 15 of the 54 African countries reported on absolute blood pressure (BP) measures, elevated BP, pre- and/or hypertension. The reported hypertension prevalence ranged between 0.0 and 38.9%, while elevated BP and/or pre-hypertnesion ranged from 2.7 to 50.5%. Childhood BP nomograms are lacking across Africa and the rates of hypertension were based on guidelines developed in countries with the lowest to no number of children from African ancestry. The recent studies across Africa also showed little to no detail when reporting BP specific methodology. No recent data informing the use or effectiveness of antihypertensive agents in children and adolesents are available. Childhood hypertension is on the rise, while data from Africa remains vastly under-represented. Collaborative research, resources, and policies need to be strengthened in addressing the growing public health concern of childhood onset hypertension on this continent.
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Affiliation(s)
- A Craig
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Y Breet
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - L F Gafane-Matemane
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - S A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Development and Health, University of Southampton, Southampton, UK
| | - R Kruger
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa.
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
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Chen A, Waite L, Mocumbi AO, Chan YK, Beilby J, Ojji DB, Stewart S. Elevated blood pressure among adolescents in sub-Saharan Africa: a systematic review and meta-analysis. Lancet Glob Health 2023; 11:e1238-e1248. [PMID: 37474231 DOI: 10.1016/s2214-109x(23)00218-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND More people from sub-Saharan Africa aged between 20 years and 60 years are affected by end-organ damage due to underlying hypertension than people in high-income countries. However, there is a paucity of data on the pattern of elevated blood pressure among adolescents aged 10-19 years in sub-Saharan Africa. We aimed to provide pooled estimates of high blood pressure prevalence and mean levels in adolescents aged 10-19 years across sub-Saharan Africa. METHODS In this systematic review and meta-analysis, we searched PubMed, Google Scholar, African Index Medicus, and Embase to identify studies published from Jan 1, 2010, to Dec 31, 2021. To be included, primary studies had to be observational studies of adolescents aged 10-19 years residing in sub-Saharan African countries reporting the pooled prevalence of elevated blood pressure or with enough data to compute these estimates. We excluded studies on non-systemic hypertension, in African people not living in sub-Saharan Africa, with participant selection based on the presence of hypertension, and with adult cohorts in which we could not disaggregate data for adolescents. We independently extracted relevant data from individual studies using a standard data extraction form. We used a random-effects model to estimate the pooled prevalence of elevated blood pressure and mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels overall and on a sex-specific basis. This study is registered with PROSPERO (CRD42022297948). FINDINGS We identified 2559 studies, and assessed 81 full-text studies for eligibility, of which 36 studies comprising 37 926 participants aged 10-19 years from ten (20%) of 49 sub-Saharan African countries were eligible. A pooled sample of 29 696 adolescents informed meta-analyses of elevated blood pressure and 27 155 adolescents informed meta-analyses of mean blood pressure. Sex data were available from 26 818 adolescents (14 369 [53·6%] were female and 12 449 [46·4%] were male) for the prevalence of elevated blood pressure and 23 777 adolescents (12 864 [54·1%] were female and 10 913 [45·9%] were male) for mean blood pressure. Study quality was high, with no low-quality studies. The reported prevalence of elevated blood pressure ranged from 4 (0·2%) of 1727 to 1755 (25·1%) of 6980 (pooled prevalence 9·9%, 95% CI 7·3-12·5; I?=99·2%, pheterogeneity<0·0001). Mean SBP was 111 mm Hg (95% CI 108-114) and mean DBP was 68 mm Hg (66-70). 13·4% (95% CI 12·9-13·9; pheterogeneity<0·0001) of male participants had elevated blood pressure compared with 11·9% (11·3-12·4; pheterogeneity<0·0001) of female participants (odds ratio 1·04, 95% CI 0·81-1·34; pheterogeneity<0·0001). INTERPRETATION To our knowledge, this systematic review and meta-analysis is the first systematic synthesis of blood pressure data specifically derived from adolescents in sub-Saharan Africa. Although many low-income countries were not represented in our study, our findings suggest that approximately one in ten adolescents have elevated blood pressure across sub-Saharan Africa. Accordingly, there is an urgent need to improve preventive heart-health programmes in the region. FUNDING None.
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Affiliation(s)
| | - Laura Waite
- Victorian Department of Health, Melbourne, VIC, Australia
| | - Ana O Mocumbi
- Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique; Instituto Nacional de Saúde, Marracuene, Mozambique
| | - Yih-Kai Chan
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Justin Beilby
- Torrens University Australia, Adelaide, SA, Australia
| | - Dike B Ojji
- Department of Internal Medicine, Faculty of Clinical Sciences, University of Abuja, Abuja, Nigeria; Cape Heart Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Simon Stewart
- Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique; Cape Heart Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa; Institute for Health Research, University of Notre Dame, Fremantle, WA, Australia.
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Vo HK, Nguyen DV, Vu TT, Tran HB, Nguyen HTT. Prevalence and risk factors of prehypertension/hypertension among freshman students from the Vietnam National University: a cross-sectional study. BMC Public Health 2023; 23:1166. [PMID: 37328903 PMCID: PMC10276403 DOI: 10.1186/s12889-023-16118-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 06/13/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Prehypertension (PHT) and hypertension (HTN) in young adults are essential risk factors for other cardiovascular diseases (CVD) in later years of life. However, there is a lack of knowledge about the burden and risk factors of PHT/HTN for Vietnamese youth. The aim of this study was to investigate the prevalence of PHT/HTN and risk factors among university students in Hanoi, Vietnam. METHODS This study was designed as a cross-sectional investigation with 840 students (394 males and 446 females) randomly sampled from freshmen of Vietnam National University, Hanoi (VNU). Socio-demographic, anthropometric, and lifestyle data were collected using questionnaire forms and physical measurements. HTN was defined as blood pressure (BP) ≥ 140/90 mmHg and/or current treatment with antihypertensive medications. PHT was defined as a systolic BP from 120 to 139 mmHg and/or a diastolic BP from 80 to 89 mmHg. Body mass index (BMI) was classified according to the WHO diagnostic criteria for Asian adults: normal weight (BMI 18.5-22.9 kg/m2), underweight (BMI < 18.5 kg/m2), overweight (BMI 23-24.9 kg/m2), and obese (BMI ≥ 25 kg/m2). Bivariable and multivariable log-binomial regression analyses were conducted to explore the association of PHT/HTN with different risk factors. RESULTS The overall prevalence of prehypertension and hypertension was 33.5% [95% CI: 30.3-36.8%] (54.1% in men and 15.3% in women) and 1.4% [95% CI: 0.7-2.5%] (2.5% in men and 0.5% in women), respectively. Regarding CVD major risk factors, 119 (14.2%) were identified as overweight/obese, 461 (54.9%) were physical inactivity, 29.4% of men and 8.1% of women reported consuming alcohol. The multivariable analysis indicated the male sex (adjusted prevalence ratio [aPR] = 3.07; 95% CI: 2.32-4.06), alcohol consumption (aPR = 1.28; 95% CI: 1.03-1.59) and obesity (aPR = 1.35; 95% CI: 1.08-1.68) as the independent risk factors for PHT/HTN. CONCLUSIONS The results revealed the high burden of prehypertension and hypertension among university freshmen in VNU. Male sex, alcohol consumption, and obesity were identified as important risk factors for PHT/HTN. Our study suggests an early screening program for PHT/HTN and campaigns to promote a healthy lifestyle for young adults in Vietnam.
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Affiliation(s)
- Hong-Khoi Vo
- Neurology Center, Bach Mai Hospital, Hanoi, Vietnam
- Department of Neurology, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam
| | - Dung Viet Nguyen
- Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam.
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam.
| | - Thom Thi Vu
- Department of Basic Medical Sciences, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam
| | - Hieu Ba Tran
- Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
| | - Hoai Thi Thu Nguyen
- Department of Internal Medicine, VNU-University of Medicine and Pharmacy, Hanoi, Vietnam.
- Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam.
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de Oliveira ACF, Brito VGB, Ramos GHADS, Werlang MLC, Fiais GA, Dornelles RCM, Antoniali C, Nakamune ACMS, Fakhouri WD, Chaves-Neto AH. Analysis of salivary flow rate, biochemical composition, and redox status in orchiectomized spontaneously hypertensive rats. Arch Oral Biol 2023; 152:105732. [PMID: 37257259 DOI: 10.1016/j.archoralbio.2023.105732] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE This study aimed to analyze the salivary flow rate, biochemical composition, and redox status in orchiectomized spontaneously hypertensive rats (SHR) compared to normotensive Wistar rats. DESIGN Thirty-two young adult male SHR and Wistar (3-months-old) rats were randomly distributed into four groups; either castrated bilaterally (ORX) or underwent fictitious surgery (SHAM) as Wistar-SHAM, Wistar-ORX, SHR-SHAM, and SHR-ORX. Two months beyond castration, pilocarpine-induced salivary secretion was collected from 5-month-old rats to analyze salivary flow rate, pH, buffer capacity, total protein, amylase, calcium, phosphate, sodium, potassium, chloride, thiobarbituric acid reactive substances (TBARs), carbonyl protein, nitrite, and total antioxidant capacity. RESULTS The salivary flow rate was higher in the Wistar-ORX compared to the Wistar-SHAM group, while remaining similar between the SHR-SHAM and SHR-ORX groups. ORX did not affect pH and salivary buffer capacity in both strains. However, salivary total protein and amylase were significantly reduced in the Wistar-ORX and SHR-ORX compared to the respective SHAM groups. In both ORX groups, salivary total antioxidant capacity and carbonylated protein were increased, while lipid oxidative damage (TBARs) and nitrite concentration were higher only in the Wistar-ORX than in the Wistar-SHAM group. In the Wistar-ORX and SHR-ORX, the salivary calcium, phosphate, and chloride were increased while no change was detected in the SHAM groups. Only salivary buffering capacity, calcium, and chloride in the SHR-ORX adjusted to values similar to Wistar-SHAM group. CONCLUSION Hypertensive phenotype mitigated the orchiectomy-induced salivary dysfunction, since the disturbances were restricted to alterations in the salivary biochemical composition and redox state.
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Affiliation(s)
| | - Victor Gustavo Balera Brito
- Department of Basic Sciences, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas - SBFis, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | | | - Matheus Lima Cypriano Werlang
- Department of Basic Sciences, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas - SBFis, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Gabriela Alice Fiais
- Department of Basic Sciences, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas - SBFis, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Rita Cássia Menegati Dornelles
- Department of Basic Sciences, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas - SBFis, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Cristina Antoniali
- Department of Basic Sciences, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas - SBFis, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil; Programa de Pós-Graduação em Ciência Odontológica, School of Dentistry, Araçatuba, São Paulo, Brazil
| | | | - Walid D Fakhouri
- Center for Craniofacial Research, Department of Diagnostic and Biomedical Sciences, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Antonio Hernandes Chaves-Neto
- Department of Basic Sciences, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil; Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas - SBFis, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil; Programa de Pós-Graduação em Ciência Odontológica, School of Dentistry, Araçatuba, São Paulo, Brazil.
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9
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Migisha R, Ario AR, Kadobera D, Bulage L, Katana E, Ndyabakira A, Elyanu P, Kalamya JN, Harris JR. High blood pressure and associated factors among HIV-infected young persons aged 13 to 25 years at selected health facilities in Rwenzori region, western Uganda, September-October 2021. Clin Hypertens 2023; 29:6. [PMID: 37060073 PMCID: PMC10105389 DOI: 10.1186/s40885-022-00230-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/15/2022] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND High blood pressure (HBP), including hypertension (HTN), is a predictor of cardiovascular events, and is an emerging challenge in young persons. The risk of cardiovascular events may be further amplified among people living with HIV (PLHIV). We determined the prevalence of HBP and associated factors among PLHIV aged 13 to 25 years in Rwenzori region, western Uganda. METHODS We conducted a cross-sectional study among PLHIV aged 13 to 25 years at nine health facilities in Kabarole and Kasese districts during September 16 to October 15, 2021. We reviewed medical records to obtain clinical and demographic data. At a single clinic visit, we measured and classified BP as normal (< 120/ < 80 mmHg), elevated (120/ < 80 to 129/ < 80), stage 1 HTN (130/80 to 139/89), and stage 2 HTN (≥ 140/90). We categorized participants as having HBP if they had elevated BP or HTN. We performed multivariable analysis using modified Poisson regression to identify factors associated with HBP. RESULTS Of the 1,045 PLHIV, most (68%) were female and the mean age was 20 (3.8) years. The prevalence of HBP was 49% (n = 515; 95% confidence interval [CI], 46%-52%), the prevalence of elevated BP was 22% (n = 229; 95% CI, 26%-31%), and the prevalence of HTN was 27% (n = 286; 95% CI, 25%-30%), including 220 (21%) with stage 1 HTN and 66 (6%) with stage 2 HTN. Older age (adjusted prevalence ratio [aPR], 1.21; 95% CI, 1.01-1.44 for age group of 18-25 years vs. 13-17 years), history of tobacco smoking (aPR, 1.41; 95% CI, 1.08-1.83), and higher resting heart rate (aPR, 1.15; 95% CI, 1.01-1.32 for > 76 beats/min vs. ≤ 76 beats/min) were associated with HBP. CONCLUSIONS Nearly half of the PLHIV evaluated had HBP, and one-quarter had HTN. These findings highlight a previously unknown high burden of HBP in this setting's young populations. HBP was associated with older age, elevated resting heart rate, and ever smoking; all of which are known traditional risk factors for HBP in HIV-negative persons. To prevent future cardiovascular disease epidemics among PLHIV, there is a need to integrate HBP/HIV management.
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Affiliation(s)
| | - Alex Riolexus Ario
- Public Health Fellowship Program, Kampala, Uganda
- Ministry of Health, Kampala, Uganda
| | | | | | | | | | - Peter Elyanu
- Baylor College of Medicine Children's Foundation-Uganda, Kampala, Uganda
| | - Julius N Kalamya
- Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention (CDC), Kampala, Uganda
| | - Julie R Harris
- Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala, Uganda
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10
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Gewa CA, Onyango AC, Opiyo RO, Gittelsohn J, Cheskin LJ. Patterns and predictors of elevated blood pressure and hypertension among primary school children in urban Kenya. J Hypertens 2022; 40:2513-2520. [PMID: 36093874 DOI: 10.1097/hjh.0000000000003287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We examined the prevalence of elevated blood pressure (BP) and hypertension among 390 primary school children of different socioeconomic status (SES) in two urban settings in Kenya and explored the association between children's BP status and their sociodemographic characteristics, dietary behaviours and overweight/obesity status. METHODS Children's BP and anthropometric measurements were taken and parents, with the help of their children, completed questionnaires on the children's dietary behaviours. An average of three BP readings was used to calculate BP percentiles by age, sex and height. BMI-for-age z-scores, waist-circumference-to-height ratio and the sum of skinfold measures were calculated. We utilized prevalence ratio analysis to examine the association between BP and sociodemographic characteristics, dietary behaviours and overweight/obesity. RESULTS About 9% of the school children had elevated BP and 33% had stage 1 hypertension. Among overweight children, the proportion of children with elevated BP was 1.85-fold greater and the proportion of children with hypertension was 1.83-fold greater compared with children with healthy body weight. Similar patterns of significant associations were seen among obese children, children with central obesity and children with high total skinfold values. The proportion of children with hypertension was 1.42-fold greater among children with high frequency of consumption of chips/crisps compared with children with lower frequency of consumption. CONCLUSION These results increase our understanding BP patterns and determinants among school children in Kenya and can help inform noncommunicable disease prevention efforts.
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Affiliation(s)
- Constance A Gewa
- Department of Nutrition & Food Studies, College of Health & Human Services, George Mason University, Fairfax, Virginia, USA
| | | | - Rose O Opiyo
- School of Public Health, University of Nairobi, Nairobi, Kenya
| | - Joel Gittelsohn
- Department of International Health, Bloomberg School of Public Health, John Hopkins University
| | - Lawrence J Cheskin
- Department of Nutrition & Food Studies, College of Health & Human Services, George Mason University, Fairfax, Virginia, USA
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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11
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Kansiime S, Webb EL, Kusemererwa S, Lule SA, Niwaha AJ, Seeley J, Karabarinde A, Hansen CH, Newton R. Blood pressure levels among children in rural Uganda: results from 1913 children in a general population survey. J Hum Hypertens 2022; 36:1021-1026. [PMID: 34537817 DOI: 10.1038/s41371-021-00610-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/27/2021] [Accepted: 09/08/2021] [Indexed: 11/08/2022]
Abstract
Despite increasing levels of adult hypertension in sub-Saharan Africa (SSA), there is limited information on elevated blood pressure among children in SSA. We described the distribution of blood pressure among children in rural Uganda and estimated hypertension prevalence. We conducted a cross-sectional study in south-western Uganda, collecting demographic, anthropometric and blood pressure measurements from children aged 6-12 years. Children with elevated blood pressure (systolic and/or diastolic blood pressure greater or equal to the 95th percentile for age, height and sex) were invited for two further assessments 6-18 months later. We described blood pressure distribution at first assessment, assessed associations with demographic and anthropometric characteristics and estimated prevalence of hypertension as defined by having elevated blood pressure on three separate occasions months apart. Blood pressure (BP) was measured in 1913 children (50% male, 3% overweight or obese, 22% stunted) at the first assessment. Mean (SD) systolic and diastolic BP at first assessment was 113.4 mmHg (±10.8) and 69.5 mmHg (±8.3), respectively, and 44.2% had elevated BP. Older age, higher BMI, and being female were associated with higher BP, and stunted height was associated with lower BP. An estimated 7.8% [95% CI:(6.6-9.1)], (males: 6.8%, females: 9.0%), had elevated BP on three separate occasions, and were considered hypertensive. High blood pressure levels among adults in SSA may be set early in life. In this study, obesity (a common lifestyle modifiable risk factor in other settings) was largely irrelevant. More research is needed to understand the main drivers for elevated blood pressure in SSA further.
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Affiliation(s)
- Sheila Kansiime
- Medical Research Council/ Uganda Virus Research Council and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda.
- Medical Research Council International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK.
| | - Emily L Webb
- Medical Research Council International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Sylvia Kusemererwa
- Medical Research Council/ Uganda Virus Research Council and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Swaib A Lule
- Medical Research Council/ Uganda Virus Research Council and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
- University College London, Institute for Global Health, London, UK
| | - Anxious J Niwaha
- Medical Research Council/ Uganda Virus Research Council and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Janet Seeley
- Medical Research Council/ Uganda Virus Research Council and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Alex Karabarinde
- Medical Research Council/ Uganda Virus Research Council and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
| | - Christian Holm Hansen
- Medical Research Council/ Uganda Virus Research Council and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
- Medical Research Council International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Robert Newton
- Medical Research Council/ Uganda Virus Research Council and London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, Uganda
- Department of Health Sciences, University of York, York, UK
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12
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Malindisa EK, Balandya E, Mashili F, Iddi S, Njelekela M. The magnitude of type 2 diabetes mellitus and cardiovascular disease risk factors among young adults in urban settings: a cross-sectional survey in Mwanza, Tanzania. Pan Afr Med J 2022; 42:19. [PMID: 35812257 PMCID: PMC9228915 DOI: 10.11604/pamj.2022.42.19.22184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 04/10/2022] [Indexed: 11/09/2022] Open
Abstract
Introduction traditionally, non-communicable diseases were diseases of public health concern in developed countries. Due to economic transition, they are becoming more prevalent in low and middle-income countries. Despite the trend, little has been done in the population of young adults of developing countries. This research aimed to explore the magnitude of type 2 diabetes mellitus, hypertension, dyslipidemia, and abdominal obesity among the young adult population in an urban setting of Tanzania. Methods the current research used a cross-sectional community-based design, involving apparently healthy young adults aged 18 to 34 years, not known to have diabetes, hypertension, or dyslipidemia. Data on socio-demographic characteristics, medical history, anthropometry, blood pressure, and lipids were obtained per standard operating procedures and analyzed using STATA 13. Association between outcome variables (type 2 diabetes mellitus, hypertension, dyslipidemia, and abdominal obesity) and predictor variables (age, sex, education level, occupation, and economic status) were assessed by logistic regression. Results 245 young adults with a median age of 21 (interquartile range [IQR]: 18-25) were recruited. Prevalence of diabetes mellitus and of impaired glucose tolerance (IGT) were 7.8% and 15.5% respectively. Abdominal obesity and dyslipidemia were present in 11.8% and 45.1% respectively. 34.3% had hypertension and the risk was significantly higher in males compared to females (OR 1.8, 95%CI 1.1, 3.1). The atherogenic coefficient was significantly associated with abdominal obesity; other atherogenic indices did not show significant associations with current disease conditions. Conclusion alarmingly high prevalence of diabetes mellitus, impaired glucose tolerance, hypertension, abdominal obesity, and dyslipidemia were observed among young adults in Mwanza. This study highlights the need for concerted efforts for interventions targeting young adults in combating diabetes and cardiovascular disease (CVD) risk factors in Tanzania.
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Affiliation(s)
| | - Emmanuel Balandya
- Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Fredirick Mashili
- Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Shabani Iddi
- Department of Physiology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Marina Njelekela
- Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
- Deloitte Consulting Limited, Dar Es Salaam, Tanzania
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14
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Khoo YY, Farid NDN, Choo WY, Omar A. Prevalence, awareness, treatment and control of young-onset hypertension in Malaysia, 2006-2015. J Hum Hypertens 2022; 36:106-116. [PMID: 33536547 PMCID: PMC8766289 DOI: 10.1038/s41371-020-00478-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/03/2020] [Accepted: 12/10/2020] [Indexed: 01/31/2023]
Abstract
The continuous presence of elevated blood pressure (BP) when young is a strong predictor of future cardiovascular risk. This study aimed to elucidate the prevalence, awareness, treatment and control of young-onset hypertension (YOH) in Malaysia during the period 2006-2015. Data on respondents aged 18-39 diagnosed with YOH according to the 7th Joint National Committee Report (USA) were extracted from three National Health and Morbidity Surveys (2006, 2011, and 2015). The prevalence of YOH remained stable: 17.7%, 95% CI [17.0, 18.3] in 2006, 17.0%, 95% CI [16.0, 17.9] in 2011 and 18.4%, 95% CI [17.4, 19.4] in 2015. Awareness, treatment and control rates were suboptimal; 15% were aware of their diagnosis, of which less than 50% were on treatment and less than 40% who were on treatment had their BP controlled. Trend analysis revealed a significant increase in YOH prevalence among urban dwellers; those with no formal and tertiary education and middle-income earners. YOH awareness and treatment rates were lower among respondents <30 years; however, when treated, this group achieved overall better control rates. Females had higher awareness and treatment rates, but lower control. Treatment rates remained stable for all ethnicities with the exception of Chinese, which decreased. This study narrows the knowledge gap on YOH epidemiology in Malaysia by providing crucial information on the pervasiveness of hypertension among young adults. Results can be used to develop non-communicable disease policies and health promotion strategies specially targeted at young adults who are in the prime of life.
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Affiliation(s)
- Yi Yi Khoo
- grid.10347.310000 0001 2308 5949Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nik Daliana Nik Farid
- grid.10347.310000 0001 2308 5949Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ,grid.10347.310000 0001 2308 5949Centre for Population Health, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wan Yuen Choo
- grid.10347.310000 0001 2308 5949Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Azahadi Omar
- grid.415759.b0000 0001 0690 5255Biostatistics and Data Repository, National Institutes of Health, Ministry of Health, Selangor, Malaysia
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Crouch SH, Soepnel LM, Kolkenbeck-Ruh A, Maposa I, Naidoo S, Davies J, Norris SA, Ware LJ. Paediatric Hypertension in Africa: A Systematic Review and Meta-Analysis. EClinicalMedicine 2022; 43:101229. [PMID: 34917909 PMCID: PMC8665406 DOI: 10.1016/j.eclinm.2021.101229] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The burden of cardiovascular disease (CVD) and hypertension is rapidly increasing in low- and middle-income countries. This is evident not only in adults, but also in children. Recent estimates of prevalence in children are lacking, particularly in Africa. As such, we conducted a systematic review and meta-analysis to provide updated estimates of paediatric hypertension in Africa. METHODS We searched PubMed and EBSCO to identify articles published from January 2017 to November 2020. Studies were assessed for quality. We combined results for meta-analyses using a random effects model (Freeman-Tukey arcsine transformation). Heterogeneity was quantified using the I2 statistic. FINDINGS In the narrative synthesis of 53 studies, publication bias was low for 28, moderate for 24, and high for one study. Hypertension prevalence ranged substantially (0·2%-38·9%). Meta-analysis included 41 studies resulting in data on 52918 participants aged 3 to 19 years from ten countries. The pooled prevalence for hypertension (systolic/diastolic BP≥95th percentile) was 7·45% (95%CI 5·30-9·92, I2=98.96%), elevated blood pressure (BP, systolic/diastolic BP≥90th percentile and <95th percentile) 11·38% (95%CI 7·94-15·33, I2=98.97%) and combined hypertension/elevated BP 21·74% (95%CI 15·5-28·69, I2=99.48%). Participants categorized as overweight/with obesity had a higher prevalence of hypertension (18·5% [95%CI 10·2-28·5]) than those categorized as underweight/normal (1·0% [95%CI 0·1-2·6], 4·8% [95%CI 2·9-7·1], p<0·001). There were significant differences in hypertension prevalence when comparing BP measurement methods and classification guidelines. INTERPRETATION Compared to a previous systematic review conducted in 2017, this study suggests a continued increase in prevalence of paediatric hypertension in Africa, and highlights the potential role of increasing overweight/obesity. FUNDING This research was funded in part by the Wellcome Trust [Grant number:214082/Z/18/Z]. LJW and SAN are supported by the DSI-NRF Centre of Human Development at the University of the Witwatersrand.
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Affiliation(s)
- Simone H. Crouch
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Larske M. Soepnel
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Correspondence and reprint to: Dr. Larske M. Soepnel. Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Huispost nr. STR 6.131 P.O. Box 85500 3508 GA, Utrecht, The Netherlands
| | - Andrea Kolkenbeck-Ruh
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Innocent Maposa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa School of Public Health
| | - Sanushka Naidoo
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Justine Davies
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Shane A. Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Health and Human Development, University of Southampton, Southampton, United Kingdom
| | - Lisa J. Ware
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
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Kavishe BB, Kweka BV, Nitsch D, PrayGod G, Jeremiah K, Faurholt-Jepsen D, Filteau S, Olsen MF, Kitilya BW, Krogh-Madsen R, Friis H, Peck R. Risk factors for impaired renal function in HIV-infected and HIV-uninfected adults: cross-sectional study in North-Western Tanzania. BMC Nephrol 2021; 22:355. [PMID: 34715799 PMCID: PMC8555220 DOI: 10.1186/s12882-021-02563-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/13/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Although the burden of impaired renal function is rising in sub-Saharan Africa (SSA), little is known about correlates of impaired renal function in the region. We determined factors associated with estimated glomerular filtration rate (eGFR) and impaired renal function in HIV-infected and HIV-uninfected adults. METHODS We undertook cross-sectional analysis of data from 1947 adults at enrolment for a cohort study on diabetes and associated complications in HIV patients in Mwanza, north-western Tanzania. A structured questionnaire was used to collect data on sociodemography, smoking, alcohol, physical activity, antiretroviral therapy (ART) and anthropometry. We measured blood pressure, tested blood samples for creatinine, glucose and HIV, and performed Kato Katz for Schistosoma mansoni. Correlates of eGFR (mL/min/1.73 m2) and impaired renal function (eGFR< 60 mL/min/1.73 m2) were determined using linear regression and logistic regression, respectively. RESULTS 655 (34%) participants were HIV-uninfected, 956 (49%) were ART-naive HIV-infected and 336 (17%) were HIV-infected adults on ART. The mean age was 41 years (SD12) and majority (59%) were females. Overall, the mean eGFR was 113.6 mL/min/1.73 m2 but 111.2 mL/min/1.73 m2 in HIV-uninfected, 109.7 mL/min/1.73 m2 in ART-naive HIV-infected and 129.5 mL/min/1.73 m2 in HIV-infected ART-experienced adults, and respective prevalence of impaired renal function was 7.0, 5.7, 8.1 and 6.3%. Correlates of lower eGFR were increasing age, higher socioeconomic status, unhealthy alcohol drinking, higher body mass index and diabetes mellitus. Anaemia was associated with 1.9 (95% Confidence Interval (CI):1.2, 2.7, p = 0.001) higher odds of impaired renal function compared to no anaemia and this effect was modified by HIV status (p value 0.02 for interaction). CONCLUSION Impaired renal function is prevalent in this middle-aged study population. Interventions for prevention of impaired renal function are needed in the study population with special focus in HIV-infected adults and those with high socioeconomic status. Interventions targeting modifiable risk factors such as alcohol and weight reduction are warranted.
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Affiliation(s)
| | - Belinda V Kweka
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
| | - Dorothea Nitsch
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - George PrayGod
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
| | - Kidola Jeremiah
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
| | | | - Suzanne Filteau
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Mette Frahm Olsen
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Brenda W Kitilya
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
| | - Rikke Krogh-Madsen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Copenhagen, Denmark
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Robert Peck
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Weill Cornell Medical College, New York, USA
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17
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Martin SL, Matare CR, Kayanda RA, Owoputi I, Kazoba A, Bezner Kerr R, Nnally L, Khan M, Locklear KH, Dearden KA, Dickin KL. Engaging fathers to improve complementary feeding is acceptable and feasible in the Lake Zone, Tanzania. MATERNAL & CHILD NUTRITION 2021; 17 Suppl 1:e13144. [PMID: 34241956 PMCID: PMC8269136 DOI: 10.1111/mcn.13144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/05/2020] [Accepted: 01/04/2021] [Indexed: 11/27/2022]
Abstract
In Tanzania, suboptimal complementary feeding practices contribute to high stunting rates. Fathers influence complementary feeding practices, and effective strategies are needed to engage them. The objectives of this research were to examine the acceptability and feasibility of (1) tailored complementary feeding recommendations and (2) engaging fathers in complementary feeding. We conducted trials of improved practices with 50 mothers and 40 fathers with children 6-18 months. At visit 1, mothers reported current feeding practices and fathers participated in focus group discussions. At visit 2, mothers and fathers received individual, tailored counselling and chose new practices to try. After 2 weeks, at visit 3, parents were interviewed individually about their experiences. Interview transcripts were analysed thematically. The most frequent feeding issues at visit 1 were the need to thicken porridge, increase dietary diversity, replace sugary snacks and drinks and feed responsively. After counselling, most mothers agreed to try practices to improve diets and fathers agreed to provide informational and instrumental support for complementary feeding, but few agreed to try feeding the child. At follow-up, mothers reported improved child feeding and confirmed fathers' reports of increased involvement. Most fathers purchased or provided funds for recommended foods; some helped with domestic tasks or fed children. Many participants reported improved spousal communication and cooperation. Families were able to practice recommendations to feed family foods, but high food costs and seasonal unavailability were challenges. It was feasible and acceptable to engage fathers in complementary feeding, but additional strategies are needed to address economic and environmental barriers.
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Affiliation(s)
- Stephanie L. Martin
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNCUSA
- Carolina Population CenterUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Cynthia R. Matare
- Program in International Nutrition, Division of Nutritional SciencesCornell UniversityIthacaNYUSA
| | | | - Ibukun Owoputi
- Program in International Nutrition, Division of Nutritional SciencesCornell UniversityIthacaNYUSA
| | | | | | | | - Maliha Khan
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Kamryn H. Locklear
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | | | - Katherine L. Dickin
- Program in International Nutrition, Division of Nutritional SciencesCornell UniversityIthacaNYUSA
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18
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Nsanya MK, Ayieko P, Hashim R, Mgema E, Fitzgerald D, Kapiga S, Peck RN. Sustained high blood pressure and 24-h ambulatory blood pressure monitoring in Tanzanian adolescents. Sci Rep 2021; 11:8397. [PMID: 33864003 PMCID: PMC8052360 DOI: 10.1038/s41598-021-87996-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/30/2021] [Indexed: 12/20/2022] Open
Abstract
Estimates for prevalence of high blood pressure (BP) among adolescents in Africa vary widely and few studies, if any, have documented the results of the recommended stepwise BP screening. In this cross-sectional study in Tanzania, we aimed to estimate prevalence of sustained high BP in 3 public secondary schools using the American Academy of Pediatrics BP screening strategy. On Day 1, one screening automated office BP (AOBP) measurement (Step 1) was followed by two more AOBP measurements (Step 2). Repeat AOBP measurements were obtained after about one month on adolescents with high AOBP measurements on Day 1 (Step 3). Participants with sustained high BP underwent 24-h ambulatory BP monitoring (step 4). Of all 500 enrolled participants, the prevalence of high blood pressure at each step in the process was 36.6% (183), 25.6% (128), 10.2% (51), and 2.6%(13) respectively for Steps 1-4. All except 6 students completed all 4 steps of the BP screening algorithm as indicated. We conclude that diagnosis of hypertension in African adolescents should use multiple AOBP measurements over multiple days followed by 24-h ABPM. Screening for high BP in school settings appears to be feasible and could provide a platform for cardiovascular disease education and health promotion.
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Affiliation(s)
- Mussa K Nsanya
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania.
| | - Philip Ayieko
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- London School of Hygiene and Tropical Medicine, London, UK
| | - Ramadhan Hashim
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
| | - Ezekiel Mgema
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
| | | | - Saidi Kapiga
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- London School of Hygiene and Tropical Medicine, London, UK
| | - Robert N Peck
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Weill Cornell Medical College, New York, USA
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19
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Zhou DD, Luo M, Shang A, Mao QQ, Li BY, Gan RY, Li HB. Antioxidant Food Components for the Prevention and Treatment of Cardiovascular Diseases: Effects, Mechanisms, and Clinical Studies. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6627355. [PMID: 33574978 PMCID: PMC7864729 DOI: 10.1155/2021/6627355] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/09/2021] [Accepted: 01/15/2021] [Indexed: 12/12/2022]
Abstract
Cardiovascular diseases (CVDs) have gained increasing attention because of their high prevalence and mortality worldwide. Epidemiological studies revealed that intake of fruits, vegetables, nuts, and cereals could reduce the risk of CVDs, and their antioxidants are considered as the main contributors. Moreover, experimental studies showed that some antioxidant natural products and their bioactive compounds exerted beneficial effects on the cardiovascular system, such as polyphenols, polysaccharides, anthocyanins, epigallocatechin gallate, quercetin, rutin, and puerarin. The mechanisms of action mainly included reducing blood pressure, improving lipid profile, ameliorating oxidative stress, mitigating inflammation, and regulating gut microbiota. Furthermore, clinical trials confirmed the cardiovascular-protective effect of some antioxidant natural products, such as soursop, beetroot, garlic, almond, and green tea. In this review, we summarized the effects of some antioxidant natural products and their bioactive compounds on CVDs based on the epidemiological, experimental, and clinical studies, with special attention paid to the relevant mechanisms and clinical trials.
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Affiliation(s)
- Dan-Dan Zhou
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Min Luo
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Ao Shang
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Qian-Qian Mao
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Bang-Yan Li
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Ren-You Gan
- Research Center for Plants and Human Health, Institute of Urban Agriculture, Chinese Academy of Agricultural Sciences, Chengdu 610213, China
| | - Hua-Bin Li
- Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
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20
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Katamba G, Agaba DC, Migisha R, Namaganda A, Namayanja R, Turyakira E. Prevalence of hypertension in relation to anthropometric indices among secondary adolescents in Mbarara, Southwestern Uganda. Ital J Pediatr 2020; 46:76. [PMID: 32487198 PMCID: PMC7268267 DOI: 10.1186/s13052-020-00841-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/25/2020] [Indexed: 02/07/2023] Open
Abstract
Background Studies investigating the prevalence of hypertension and its correlation with anthropometric indices among adolescents are still scarce compared to those conducted in adults of greater than 40 years. So far, no other study estimating the prevalence and correlates of hypertension among adolescents in Uganda has been found. Objective The purpose of this study, therefore, was to asses the prevalence of hypertension and its correlation with anthropometric indices among adolescents in Mbarara Municipality, southwestern Uganda. Methods A cross-sectional study was carried out among 616 secondary school adolescents aged 12–19 years in Mbarara Municipality, Uganda. Blood pressure and anthropometric indices were determined by standard methods. In the statistical analysis, linear regression analysis was done to assess the relationship between blood pressure and anthropometric indices. Results Overall prevalence of hypertension among adolescents was at 3.1% (n = 19) while prehypertension was 7.1% (n = 44). There was a statistically significant correlation between blood pressure, neck circumference, waist to hip ratio and body mass index at bivariate analysis. In multivariate analysis for anthropometric indices and sex, only neck circumference remained significantly correlated with blood pressure (p < 0.05). Conclusion The prevalence of hypertension among adolescents in the study setting was low. An increase in neck circumference results in an increase in blood pressure among adolescents.
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Affiliation(s)
- Godfrey Katamba
- Department of Physiology, King Ceasor University, P.O Box 88, Kampala, Uganda.
| | - David Collins Agaba
- Department of Physiology, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda
| | - Richard Migisha
- Department of Physiology, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda
| | - Agnes Namaganda
- Department of Physiology, King Ceasor University, P.O Box 88, Kampala, Uganda
| | - Rosemary Namayanja
- Department of Physiology, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda
| | - Eleanor Turyakira
- Department of Community Health, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda
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