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Gobezie MY, Hassen M, Tesfaye NA, Solomon T, Demessie MB, Fentie Wendie T, Tadesse G, Kassa TD, Berhe FT. Prevalence of uncontrolled hypertension and contributing factors in Ethiopia: a systematic review and meta-analysis. Front Cardiovasc Med 2024; 11:1335823. [PMID: 38660480 PMCID: PMC11040565 DOI: 10.3389/fcvm.2024.1335823] [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: 11/09/2023] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
Background Uncontrolled hypertension (HTN) is a major risk factor for cardiovascular and cerebrovascular disease. The prevalence of HTN in the Ethiopian adult population is almost 20%.This study aimed to determine the prevalence of uncontrolled HTN and its contributing factors among patients with HTN in Ethiopia undergoing treatment. Methods Electronic bibliographic databases such as PubMed, Google Scholar, Hinari (Research4Life), Embase, and Scopus were searched for original records in the English language that assessed HTN control in Ethiopia and were available before 29 June 2023. The data were extracted using a format prepared in Microsoft Excel and exported to the software STATA 17.0 for analysis. The study protocol was registered at PROSPERO with the reference number CRD42023440121. Results A total of 26 studies with 9,046 patients with HTN were included in the systematic review and meta-analysis, of which 11 studies were used to assess factors contributing to uncontrolled blood pressure (BP) in patients in Ethiopia. The estimated prevalence of uncontrolled HTN in the population of Ethiopia is 51% [95% confidence interval (CI), 42%-60%]. The subgroup analysis, based on the assessment tools, region, and follow-up period, revealed that the prevalence of uncontrolled BP was highest following the guidelines of the American Heart Association/American College of Cardiology (AHA/ACC) (89%; 95% CI: 87%-91%) and in Addis Ababa (58%; 95% CI: 40%-76%), and the lowest proportion of uncontrolled BP was in the 3-month follow-up period (34%; 95% CI: 29%-39%). The presence of diabetes mellitus showed the highest impact (pooled odds ratio: 5.19; CI: 1.41-19.11) for uncontrolled HTN. The univariate meta-regression method confirmed that the sample size, year of publication, and subgroups were not sources of heterogeneity in the pooled estimates. Egger's regression test did not indicate the presence of publication bias. Conclusion More than half of the hypertensive patients in Ethiopia have uncontrolled BP. Diabetes mellitus, advanced age, male sex, and the presence of comorbidities are among the factors contributing to uncontrolled HTN in Ethiopia. The concerned bodies working in this area should implement interventional strategies and recommendations that might be helpful in achieving optimal BP in hypertensive patients. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023440121, PROSPERO (CRD42023440121).
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Affiliation(s)
- Mengistie Yirsaw Gobezie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Minimize Hassen
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Nuhamin Alemayehu Tesfaye
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tewodros Solomon
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mulat Belete Demessie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Teklehaimanot Fentie Wendie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Getachew Tadesse
- Department of Statistics, College of Natural Sciences, Wollo University, Dessie, Ethiopia
| | - Tesfaye Dessale Kassa
- Department of Clinical Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Fentaw Tadese Berhe
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
- Public Health & Economics Modeling Group, School of Medicine & Dentistry, Griffith University, Gold Coast, QLD, Australia
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Cherfane M, Vallée A, Kab S, Salameh P, Goldberg M, Zins M, Blacher J. Risk factors for uncontrolled blood pressure among individuals with hypertension on treatment: the CONSTANCES population-based study. Int J Epidemiol 2024; 53:dyae027. [PMID: 38412540 DOI: 10.1093/ije/dyae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 02/06/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND We aimed to assess factors associated with uncontrolled blood pressure (BP) among individuals with hypertension on treatment, by sex. METHODS We conducted a nested cross-sectional analysis using data from the population-based cohort study CONSTANCES, designed as a randomly selected sample of French adults aged 18-69 years at study inception. We included 11 760 participants previously diagnosed with hypertension and taking antihypertensive medications. Uncontrolled BP was defined as mean systolic BP ≥140 mmHg and/or mean diastolic BP ≥90 mmHg. Sex-specific age-adjusted multivariable analyses were performed using logistic regression models stratified by stages of uncontrolled hypertension. RESULTS The mean age of participants was 59.4 years. The prevalence of uncontrolled BP was 51.4%, and it was higher in men than in women [adjusted odds ratio (aOR), 1.80; 95% CI, 1.67-1.94]. In both sexes, the lower the age, the lower the prevalence of uncontrolled hypertension. Low level of education and history of cardiovascular events had, respectively, higher and lower odds of uncontrolled BP. In men, additional risk factors included overweight and obesity (aOR, 1.15; 95% CI, 1.00-1.32; and aOR, 1.45; 95% CI, 1.23-1.70, respectively), lack of physical activity (aOR, 1.20; 95% CI, 1.04-1.40), low adherence to a Dietary Approach to Stop Hypertension diet (aOR, 1.21; 95% CI, 1.05-1.40) and heavy alcohol consumption (aOR, 1.33; 95% CI, 1.08-1.63), with the last two factors persisting across different stages of uncontrolled BP. CONCLUSIONS From a population-based perspective, socio-economic and behavioural characteristics were risk factors for uncontrolled hypertension, but they differed by sex and by stage of uncontrolled hypertension. Modifiable risk factors, such as weight, diet, physical activity and alcohol consumption, have an important role in the control of hypertension.
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Affiliation(s)
- Michelle Cherfane
- Population Health Division, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- Nutritional Epidemiology Research Unit (EREN), Inserm U1153, Paris 13 University Sorbonne Paris Cité, Bobigny, France
- INSPECT-LB, Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
| | - Alexandre Vallée
- Faculty of Medicine, Université Paris Cité, Paris, France
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hôtel-Dieu Hospital, AP-HP, Paris, France
| | - Sofiane Kab
- Population-Based Epidemiological Cohorts Unit, Inserm, UMS011, Villejuif, France
| | - Pascale Salameh
- Population Health Division, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
- INSPECT-LB, Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Marcel Goldberg
- Faculty of Medicine, Université Paris Cité, Paris, France
- Population-Based Epidemiological Cohorts Unit, Inserm, UMS011, Villejuif, France
| | - Marie Zins
- Faculty of Medicine, Université Paris Cité, Paris, France
- Population-Based Epidemiological Cohorts Unit, Inserm, UMS011, Villejuif, France
| | - Jacques Blacher
- Nutritional Epidemiology Research Unit (EREN), Inserm U1153, Paris 13 University Sorbonne Paris Cité, Bobigny, France
- Faculty of Medicine, Université Paris Cité, Paris, France
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hôtel-Dieu Hospital, AP-HP, Paris, France
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Sarfika R, Sulistiawati, Afriyanti E, Saifudin IMMY. Self-care behavior among adult patients with hypertension in Padang, West Sumatra, Indonesia: A cross-sectional study. BELITUNG NURSING JOURNAL 2023; 9:595-602. [PMID: 38130680 PMCID: PMC10731429 DOI: 10.33546/bnj.2915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/25/2023] [Accepted: 10/26/2023] [Indexed: 12/23/2023] Open
Abstract
Background Self-care behavior is crucial in preventing chronic diseases, such as hypertension, which has become highly prevalent in Indonesia. Hypertension, often referred to as the "silent killer" due to its asymptomatic nature, can easily go unnoticed. Neglecting its treatment can lead to severe complications, including heart disease, heart failure, and stroke. Despite adults with hypertension feeling well, embracing self-care behavior, including making healthy lifestyle choices, disease management, and enhancing life quality, remains essential. Objective This study aimed to describe the self-care behavior of adult patients with hypertension in Indonesia. Methods A cross-sectional study design was employed, involving 270 participants selected through consecutive sampling. Data were collected between 15 March and 4 April 2023, using the Hypertension Blood Pressure Self Care Profile (HBP-SCP) questionnaire in six public healthcare centers in Padang City, West Sumatra, Indonesia. The data were analyzed using descriptive analysis, Mann-Whitney, and Kruskal-Wallis tests. Results The self-care behavior among adult patients with hypertension was at a moderate level (Mean = 49.78, SD = 6.64), and it had significant differences according to ethnicity (p = 0.041), marital status (p = 0.017), and body mass index (p = 0.008). Conclusion The findings highlight the influence of diverse ethnic backgrounds, various marital statuses, and differing body mass index levels, which may lead to distinct approaches to managing hypertension. These results offer valuable insights for nurses and other healthcare professionals to develop comprehensive strategies to enhance self-care among adult patients with hypertension.
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Affiliation(s)
- Rika Sarfika
- Mental Health and Community Department, Faculty of Nursing, Universitas Andalas, Padang, West Sumatra, Indonesia
| | - Sulistiawati
- Faculty of Nursing, Universitas Andalas, Padang, West Sumatra, Indonesia
| | - Esi Afriyanti
- Medical and Surgical Department, Faculty of Nursing, Universitas Andalas, Padang, West Sumatra, Indonesia
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Jarab AS, Hamam HW, Al-Qerem WA, Heshmeh SRA, Mukattash TL. Blood pressure control and its associated factors among patients with heart failure in Jordan. J Hum Hypertens 2023; 37:977-984. [PMID: 36774405 DOI: 10.1038/s41371-023-00807-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/16/2023] [Accepted: 01/31/2023] [Indexed: 02/13/2023]
Abstract
Uncontrolled blood pressure (BP) has been associated with increased risk of cardiovascular events including heart failure. This study aimed to explore the factors associated with poor BP control among patients with heart failure at two major outpatient cardiology clinics in Jordan. Variables including socio-demographics, biomedical variables, in addition to disease and medication characteristics were collected using medical records and custom-designed questionnaire. The validated 4-item Medication Adherence Scale was used to assess medication adherence. Binary logistic regression analysis was conducted to explore the significant and independent predictors of poor BP control. Regression analysis results revealed that being not satisfied with the prescribed medication (OR = 2.882; 95% CI: 1.458-5.695; P < 0.01), reporting moderate medication adherence (OR = 0.203; 95% CI: 22 0.048-0.863; P < 0.05), not receiving digoxin (OR = 3.423; 95% CI: 1.346-8.707; P < 0.05), and not receiving aldosterone antagonist (OR = 2.044; 95% CI: 1.038-4.025; P < 0.05) were associated with poor BP control. Future interventions should focus on increasing medication satisfaction and enhancing medication adherence, in order to improve BP control among patients with heart failure.
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Affiliation(s)
- Anan S Jarab
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan.
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.
| | - Hanan W Hamam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan
| | - Walid A Al-Qerem
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, P.O. Box 130, Amman, 11733, Jordan
| | - Shrouq R Abu Heshmeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan
| | - Tareq L Mukattash
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan
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Farhadi F, Aliyari R, Ebrahimi H, Hashemi H, Emamian MH, Fotouhi A. Prevalence of uncontrolled hypertension and its associated factors in 50-74 years old Iranian adults: a population-based study. BMC Cardiovasc Disord 2023; 23:318. [PMID: 37355590 PMCID: PMC10290783 DOI: 10.1186/s12872-023-03357-x] [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: 10/24/2022] [Accepted: 06/19/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND By the lengthening of life span, the incidence of chronic diseases such as hypertension and uncontrolled hypertension has increased. This study aims to determine the prevalence of uncontrolled hypertension and its related factors in the age group of 50-74 years in Shahroud, northeast Iran. METHODS The data of the third phase of the Shahroud Eye Cohort Study were used in this study. This phase of the cohort study included 4394 participants aged 50 to 74 years from the previous phases. In addition to ophthalmological and optometric examinations, demographic characteristics, blood biochemistry tests, and blood pressure measurements were performed in this phase. Individuals with a blood pressure ≥ 140/90 mm/Hg (being treated or not treated with antihypertensive medicines) were defined as uncontrolled hypertension. In patients with diabetes and chronic kidney disease, blood pressure equal to or higher than 130/80 mm/Hg was considered uncontrolled hypertension. Descriptive statistics and multiple logistic regression were used to analyze the data. FINDINGS Overall, the prevalence of uncontrolled hypertension out of all the participants was 61.7% (95% CI: 60.3-63.2). Multiple regression results showed that the male gender (OR: 2.1, 95% CI: 1.5-2.9), patients with diabetes (OR:3.2, 95% CI: 2.4-4.3), and patients with chronic kidney disease (CKD) (OR: 3.2, 95% CI: 2.5-4.1) increased the risk of uncontrolled hypertension while in patients with cardiovascular disease (OR: 0.6, 95% CI: 0.4-0.8) and polypharmacy (OR: 0.2, 95% CI: 0.1-0.2) reduced the risk of uncontrolled hypertension. CONCLUSION The present study showed that uncontrolled hypertension has a high prevalence, and factors such as male gender, diabetes, and CKD are associated with this disorder. So, it is recommended to take the necessary measures to formulate and implement immediate actions to prevent or control hypertension.
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Affiliation(s)
- Fariba Farhadi
- Student Research Committee, School of Nursing & Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Roqayeh Aliyari
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hossein Ebrahimi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Untreated hypertension and prognosis paradox in acute ischemic stroke. Neurol Sci 2023; 44:2087-2095. [PMID: 36759490 DOI: 10.1007/s10072-023-06653-8] [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: 04/27/2022] [Accepted: 01/30/2023] [Indexed: 02/11/2023]
Abstract
INTRODUCTION This study is to explore the long-term functional outcome of antihypertensive medication-naïve, untreated hypertension (HTN) patients with acute ischemic stroke compared to those with no prior HTN and those with treated HTN. PATIENTS AND METHODS We analyzed a prospectively collected stroke registry of all patients with acute ischemic stroke consecutively admitted to Incheon St. Mary's Hospital. Patients who received reperfusion therapy were excluded. Long-term functional outcomes were assessed at a 3-month follow-up visit using the modified Rankin Scale. RESULTS A total of 1044 patients was enrolled. Compared to patients with no or treated HTN, those with untreated HTN had higher odds for more favorable outcomes (adjusted odds ratio (OR): 1.7 [95% CI: 1.0-2.7, p = 0.050*] and 1.7 [95% CI: 1.0-2.8, p = 0.047*], respectively) when the stroke was large vessel atherosclerosis (LAA)/cardioembolic (CE) with large vessel occlusion/stenosis. However, no such association was observed when there was no large vessel occlusion or stenosis, in total patients, or if the index stroke was related to SVO. In untreated HTN patients with LAA/CE and large vessel occlusion/stenosis compared to patients in the lowest mean arterial pressure quartile (< 96.7 mmHg), patients in the second and third highest quartiles had higher odds of favorable outcomes. CONCLUSIONS Patients with untreated HTN had significantly more favorable outcomes at 3 months after ischemic stroke compared to those with no or treated HTN when the stroke was LAA/CE with large vessel occlusion/stenosis. Untreated HTN patients also showed an association between higher MAP and favorable outcomes.
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Gwak DY, Lee SA. Lifestyle Behaviors According to the Duration of Hypertension: Korea National Health and Nutrition Examination Survey 2016-2018. J Korean Med Sci 2022; 37:e343. [PMID: 36536544 PMCID: PMC9763709 DOI: 10.3346/jkms.2022.37.e343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/22/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The aim of this study was to examine the lifestyle characteristics of hypertensive patients and to investigate the association between the duration of hypertension and lifestyle characteristics. METHODS A total 16,508 adults (including 5,933 hypertensive patients) aged 20 years and older who participated in the 7th Korea National Health and Nutrition Examination Survey 2016-2018 were analyzed. Multiple logistic regression analysis was performed to examine the association between the duration of hypertension and lifestyle factors. RESULTS The longer duration of hypertension was associated with lower risk of drinking in men (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.66-0.93), and this observation remained when participants with hypertension for ≥ 13 years were compared to those with hypertension for < 1 year (OR, 0.57; 95% CI, 0.37-0.88). On the other hand, increased duration of hypertension increased the odds of engaging in high physical activity (PA) in women (OR, 1.72; 95% CI, 1.15-2.56), particularly in men with hypertension for 6-12 years (OR, 1.66; 95% CI, 1.03-2.69) and women with hypertension for ≥ 13 years (OR, 3.64; 95% CI, 1.38-9.62). CONCLUSION In conclusion, adoption and maintenance of healthy lifestyle habits, particularly drinking cessation in men, and PA in both men and women was observed, and differences were observed depending on the duration of hypertension.
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Affiliation(s)
- Do-Yeoun Gwak
- Department of Medical Bigdata Convergence, Kangwon National University, Chuncheon, Korea
| | - Sang-Ah Lee
- Department of Medical Bigdata Convergence, Kangwon National University, Chuncheon, Korea
- Department of Preventive Medicine, Kangwon National University College of Medicine, Chuncheon, Korea.
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Elnaem MH, Mosaad M, Abdelaziz DH, Mansour NO, Usman A, Elrggal ME, Cheema E. Disparities in Prevalence and Barriers to Hypertension Control: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114571. [PMID: 36361453 PMCID: PMC9655663 DOI: 10.3390/ijerph192114571] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/16/2022] [Accepted: 10/31/2022] [Indexed: 05/29/2023]
Abstract
Controlling hypertension (HTN) remains a challenge, as it is affected by various factors in different settings. This study aimed to describe the disparities in the prevalence and barriers to hypertension control across countries of various income categories. Three scholarly databases-ScienceDirect, PubMed, and Google Scholar-were systematically examined using predefined search terms to identify potentially relevant studies. Original research articles published in English between 2011 and 2022 that reported the prevalence and barriers to HTN control were included. A total of 33 studies were included in this systematic review. Twenty-three studies were conducted in low and middle-income countries (LMIC), and ten studies were from high-income countries (HIC). The prevalence of hypertension control in the LMIC and HIC studies ranged from (3.8% to 50.4%) to (36.3% to 69.6%), respectively. Concerning barriers to hypertension control, patient-related barriers were the most frequently reported (n = 20), followed by medication adherence barriers (n = 10), lifestyle-related barriers (n = 8), barriers related to the affordability and accessibility of care (n = 8), awareness-related barriers (n = 7), and, finally, barriers related to prescribed pharmacotherapy (n = 6). A combination of more than one category of barriers was frequently encountered, with 59 barriers reported overall across the 33 studies. This work reported disparities in hypertension control and barriers across studies conducted in LMIC and HIC. Recognizing the multifactorial nature of the barriers to hypertension control, particularly in LMIC, is crucial in designing and implementing customized interventions.
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Affiliation(s)
- Mohamed Hassan Elnaem
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia
- Quality Use of Medicines Research Group, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan 25200, Malaysia
| | - Manar Mosaad
- Department of Internal Medicine, Ministry of Health, Alexandria Governorate 5517176, Egypt
| | - Doaa H Abdelaziz
- Pharmacy Practice & Clinical Pharmacy Department, Faculty of Pharmacy, Future University in Egypt, Cairo 4740011, Egypt
| | - Noha O. Mansour
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Mansoura University, Mansoura 7650030, Egypt
| | - Abubakar Usman
- Discipline of Clinical Pharmacy, Universiti Sains Malaysia, Penang 11800, Malaysia
| | | | - Ejaz Cheema
- School of Pharmacy, University of Management and Technology, Lahore 54770, Pakistan
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The Role of Lifestyle Factors in Controlling Blood Pressure among Hypertensive Patients in Two Health Facilities in Urban Ghana: A Cross-Sectional Study. Int J Hypertens 2020; 2020:9379128. [PMID: 33005451 PMCID: PMC7508215 DOI: 10.1155/2020/9379128] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/18/2020] [Accepted: 08/29/2020] [Indexed: 12/20/2022] Open
Abstract
Introduction Despite efforts to combat hypertension by pharmacotherapy, hypertension control rates remain low. Lifestyle modifications of individuals diagnosed with hypertension have prospects for the prevention and control of hypertension. This study assessed the effect of modifiable lifestyle factors on blood pressure control among adults in urban Accra. Methods In this cross-sectional study, 360 diagnosed hypertensive patients who were ≥18 years old, selected from two secondary-level referral hospitals in the Greater Accra Region, were interviewed. Demographic information, diet components, and exercise assessments as well as blood pressure measurements were taken. Chi-squared tests and binomial logistic regression were used to determine the association between demographic and lifestyle factors with blood pressure control. Area under the receiver-operator curves (AUROC) was used to identify lifestyle factors predicting optimal blood pressure control among patients diagnosed with hypertension. Results Approximately 54.2% of participants had no knowledge of either causes or complications of hypertension. Similarly, 52.5% of patients that had not achieved blood pressure control lacked knowledge of causes or complications of hypertension. Longer time since diagnosis of 2–5 years (AOR = 0.08 (95% CI: 0.01–0.47)) and 6–10 years (AOR = 0.08 (95% CI: 0.01–0.50)) and diets, mainly composed of meat (AOR = 0.13 (95% CI: 0.02–0.70)) and starch (AOR = 0.14 (95% CI: 0.03–0.79)), predicted poor blood pressure control compared to patients diagnosed within a year and diets without meat and starch as main components, respectively. Additionally, engaging in some physical activity of 30 minutes to one hour (AOR = 5.64 (95% CI: 2.08–15.32)) and more than an hour (AOR = 11.38, 95% CI: 2.01–64.47)) predicted blood pressure control. Conclusion The study concludes that increased physical activity, abstaining from alcohol and smoking, increased intake of fruits and vegetables, and reduced intake of carbohydrates, meat, and fat have a positive influence on blood pressure control. Lifestyle modifying factors have a key role in complementing pharmacotherapy in hypertension control.
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Cherfan M, Vallée A, Kab S, Salameh P, Goldberg M, Zins M, Blacher J. Unhealthy behaviors and risk of uncontrolled hypertension among treated individuals-The CONSTANCES population-based study. Sci Rep 2020; 10:1925. [PMID: 32024888 PMCID: PMC7002708 DOI: 10.1038/s41598-020-58685-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/19/2019] [Indexed: 11/09/2022] Open
Abstract
From an epidemiological standpoint, quantifying the individual and the combined effect of lifestyle factors on uncontrolled blood pressure (BP) deserves further evaluation. We aimed to examine the individual and combined associations between unhealthy behaviors and uncontrolled hypertension among treated hypertensive adults. Cross-sectional analysis was conducted using data from CONSTANCES, an ongoing French population-based cohort study. Uncontrolled BP was defined as mean systolic BP ≥140 mmHg and/or mean diastolic BP ≥90 mmHg. Unhealthy behaviors were considered as heavy alcohol consumption, low or medium adherence to dietary recommendations, sedentary physical activity level, and overweight. A total of 10,710 hypertensive treated volunteer participants were included and 56.1% had uncontrolled hypertension; of them, 2.0%, 24.5%, 54.0% and 19.5% exhibited 0, 1, 2 or ≥3 unhealthy behaviors respectively. In men, there was an increased odds of uncontrolled hypertension with heavy alcohol drinking compared to light-or-never (adjusted odds ratio 1.34, 95% CI 1.10-1.63), with low as well as with medium adherence to dietary recommendations compared to high (p < 0.05 for both), and with overweight or obesity compared to a normal body mass index (p ≤ 0.001 for both). In addition, men reporting a combination of ≥3 unhealthy behaviors compared to none, had an increased odds of hypertension of 1.67 (95% CI 1.09-2.53). Unhealthy behaviors described as, heavy alcohol consumption, non-adherence to dietary recommendations and overweight are associated with uncontrolled hypertension, at the individual and combined level, and particularly in men. Improvement of modifiable lifestyle factors could offer considerable benefits in the management of hypertension.
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Affiliation(s)
- Michelle Cherfan
- Nutritional Epidemiology Research Unit (EREN), Inserm U1153, Inra U1125, Cnam, Crnh, Paris 13 University Sorbonne Paris Cite, Bobigny, France.,Faculty of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Alexandre Vallée
- Faculty of Medicine, Paris-Descartes University, Paris, France.,Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hôtel-Dieu Hospital; AP-HP, Paris, France
| | - Sofiane Kab
- Population-based Epidemiological Cohorts Unit, Inserm, UMS011, Villejuif, France
| | - Pascale Salameh
- Faculty of Public Health, Lebanese University, Fanar, Lebanon.,Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie (INSPECT-LB), Beirut, Lebanon
| | - Marcel Goldberg
- Faculty of Medicine, Paris-Descartes University, Paris, France.,Population-based Epidemiological Cohorts Unit, Inserm, UMS011, Villejuif, France
| | - Marie Zins
- Faculty of Medicine, Paris-Descartes University, Paris, France.,Population-based Epidemiological Cohorts Unit, Inserm, UMS011, Villejuif, France
| | - Jacques Blacher
- Nutritional Epidemiology Research Unit (EREN), Inserm U1153, Inra U1125, Cnam, Crnh, Paris 13 University Sorbonne Paris Cite, Bobigny, France. .,Faculty of Medicine, Paris-Descartes University, Paris, France. .,Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Hôtel-Dieu Hospital; AP-HP, Paris, France.
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Dagenais GR, Jung H, Lonn E, Bogaty PM, Dehghan M, Held C, Avezum A, Jansky P, Keltai M, Leiter LA, Lopez-Jaramillo P, Toff WD, Bosch J, Yusuf S. Effects of Lipid-Lowering and Antihypertensive Treatments in Addition to Healthy Lifestyles in Primary Prevention: An Analysis of the HOPE-3 Trial. J Am Heart Assoc 2018; 7:JAHA.118.008918. [PMID: 30033433 PMCID: PMC6201479 DOI: 10.1161/jaha.118.008918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background It is not clear whether the effects of lipid‐lowering or antihypertensive medications are influenced by adherence to healthy lifestyle factors. We assessed the effects of both drug interventions in subgroups by the number of healthy lifestyle factors in participants in the HOPE‐3 (Heart Outcomes Prevention Evaluation) trial. Methods and Results In this primary prevention trial, 4 healthy lifestyle factors (nonsmoking status, physical activity, optimal body weight, and healthy diet) were recorded in 12 521 participants who were at intermediate risk of cardiovascular disease (CVD) and were randomized to rosuvastatin, candesartan/hydrochlorothiazide, their combination, or matched placebos. Median follow‐up was 5.6 years. The outcome was a composite of CVD events. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models. Participants with ≥2 healthy lifestyle factors had a lower rate of CVD compared with those with fewer factors (HR: 0.85; 95% CI, 0.73–1.00). Rosuvastatin reduced CVD events in participants with ≥2 healthy lifestyle factors (HR: 0.74; 95% CI, 0.62–0.90) and in participants with <2 factors (HR: 0.79; 95% CI, 0.61–1.01). Consistent results were observed with combination therapy (≥2 factors: HR: 0.74; 95% CI, 0.57–0.97; <2 factors: HR: 0.61; 95% CI, 0.43–0.88). Candesartan/hydrochlorothiazide tends to reduce CVD only in participants with <2 healthy lifestyle factors (HR: 0.78; 95% CI, 0.61–1.00). Conclusions Healthy lifestyles are associated with lower CVD. Rosuvastatin alone and combined with candesartan/hydrochlorothiazide is beneficial regardless of healthy lifestyle status; however, the benefit of antihypertensive treatment appears to be limited to patients with less healthy lifestyles. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT00239681.
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Affiliation(s)
- Gilles R Dagenais
- Quebec Heart and Lung University Institute, Laval University, Quebec City, Quebec, Canada
| | - Hyejung Jung
- Population Health Research Institute, Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada
| | - Eva Lonn
- Population Health Research Institute, Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada
| | - Peter M Bogaty
- Quebec Heart and Lung University Institute, Laval University, Quebec City, Quebec, Canada
| | - Mahshid Dehghan
- Population Health Research Institute, Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada
| | - Claes Held
- Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center, Uppsala, Sweden
| | - Alvaro Avezum
- Dante Pazzanese Institute of Cardiology, University Santo Amaro, São Paulo, Brazil
| | - Petr Jansky
- University Hospital Motol, Prague, Czech Republic
| | | | - Lawrence A Leiter
- Li Ka Shing Knowledge Institute, St. Michael's Hospital and Departments of Medicine and Nutritional Sciences, University of Toronto, Ontario, Canada
| | - Patricio Lopez-Jaramillo
- Research Department, FOSCAL, Medical School, University of Santander (UDES), Bucaramanga, Colombia
| | - William D Toff
- Department of Cardiovascular Sciences, University of Leicester, and NIHR Leicester Biomedical Research Centre, Leicester, United Kingdom
| | - Jackie Bosch
- Population Health Research Institute, Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada
| | - Salim Yusuf
- Population Health Research Institute, Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada
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Jahangiry L, Ghanbari J, Abbasalizad Farhangi M, Sarbakhsh P, Ponnet K. Predictors of poor blood pressure control among Iranian hypertensive patients. BMC Res Notes 2017; 10:668. [PMID: 29202794 PMCID: PMC5715656 DOI: 10.1186/s13104-017-2971-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/21/2017] [Indexed: 11/17/2022] Open
Abstract
Objective The aim of this study is to investigate factors associated with poor blood pressure (BP) control in older hypertensive patients living in Iran. Poorly controlled hypertension was defined as blood pressure greater than or equal to 140/90 mmHg. Multiple logistic regressions were performed to identify factors associated with poor BP control. Results More than half of the patients (55.1%) had poor control of hypertension. Multivariate logistic regression analysis showed that being over 60 years of age (OR 1.67; 95% CI 1.18–2.37; p = .003), being widowed or divorced (OR 1.56; 95% CI 1.03–2.35; p = .035], smoking (OR 1.78; 95% CI 1.07–2.65; p = .01], BMI > 25 kg/m2 (OR 1.51 95% CI 1.05–2.78), having a waist circumference ≥ 90 cm (OR 1.7; 95% CI 1.2–2.42; p = .003], the use of calcium channel blockers (OR 2.69; 95% CI 1.26–5.72; p = .01], and the use of angiotensin converting enzyme inhibitors (OR 1.66; 95% CI 1.01–2.72; p = .044] contributed significantly to poor control of hypertension. Making a key BP control screening target (such as age over 60 and waist circumference of 90 cm or more) for cardiovascular specialists and other health care practitioners is needed for elderly patients at risk for poor BP control. Electronic supplementary material The online version of this article (10.1186/s13104-017-2971-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Leila Jahangiry
- Health Education and Health Promotion Department, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran.,Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jalileh Ghanbari
- Health Education and Health Promotion Department, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Department of Community Nutrition, Faculty of Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvin Sarbakhsh
- Epidemiology and Biostatistics Department, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Koen Ponnet
- Department of Communication Sciences, MICT-IMEC, Faculty of Political and Social Sciences, Ghent University, Ghent, Belgium.,Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
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13
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Portela PP, Mussi FC, Gama GGG, Santos CADST. Fatores associados ao descontrole da pressão arterial em homens. ACTA PAUL ENFERM 2016. [DOI: 10.1590/1982-0194201600043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Resumo Objetivo Verificar os fatores associados ao descontrole da pressão arterial em homens. Métodos Estudo exploratório, de corte transversal, realizado em centro de referência para doenças cardiovasculares, em Salvador-BA, lócus para o núcleo de referência do programa de saúde do homem do Ministério da Saúde. Amostra foi selecionada por conveniência totalizando 130 homens atendidos em centro de saúde, submetidos a entrevista, avaliação clínica e antropométrica. Na análise bivariada empregou-se o Qui-quadrado de Pearson ou Exato de Fisher realizando-se posteriormente análise de regressão logística múltipla sendo a OR corrigida pelo modelo de Poisson. Adotou-se significância estatística de 5%. Resultados Constatou-se alta prevalência de descontrole da pressão arterial (65,4%), de hábitos de vida inadequados e de excesso de peso. Não houve associação estatisticamente significante entre descontrole dos níveis pressóricos e variáveis sociodemográficas, hábitos de vida e medidas antropométricas. Na regressão, o descontrole da pressão arterial associou-se ao uso inadequado da medicação (RP: 1,35, IC 95%: 1,03; 1,76). Conclusão O uso inadequado da medicação foi reforçado como importante fator associado ao descontrole. Medidas efetivas para mudança deste panorama são emergenciais e desafiam profissionais e autoridades públicas.
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Kim IG, So WY, Sung DJ. The relationships between lifestyle factors and hypertension in community-dwelling Korean adults. J Phys Ther Sci 2015; 27:3689-92. [PMID: 26834333 PMCID: PMC4713772 DOI: 10.1589/jpts.27.3689] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 09/02/2015] [Indexed: 12/21/2022] Open
Abstract
[Purpose] This study was performed to determine whether certain lifestyle factors are associated with hypertension in community-dwelling Korean adults. [Subjects and Methods] The subjects were 586 males and 1,135 females > 20 years old who had visited a public health promotion center in Seoul, Republic of Korea to take a survey related to lifestyle factors. Hypertension status was defined according to the criteria of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure VII report. [Results] The relationships between lifestyle factors and hypertension status were assessed using multivariate logistic regression analysis after adjusting for age and gender. Only mental stress and economic status significantly predicted hypertension status. [Conclusion] We conclude that sleep duration, education level, frequency of drinking and smoking status were not associated with hypertension status. However, economic status and mental stress were significantly associated with hypertension in community-dwelling Korean adults, regardless of age or gender.
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Affiliation(s)
- Ill-Gwang Kim
- Department of Leisure Sport, School of Human Service,
Seowon University, Republic of Korea
| | - Wi-Young So
- Sports and Health Care Major, College of Humanities and
Arts, Korea National University of Transportation, Republic of Korea
| | - Dong Jun Sung
- Division of Sport Science, College of Science and
Technology, Konkuk University,
Republic of Korea
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15
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Donahue KE, Vu MB, Halladay JR, Miller C, Garcia BA, Cummings DM, Cene CW, Hinderliter A, Little E, Rachide M, DeWalt D. Patient and practice perspectives on strategies for controlling blood pressure, North Carolina, 2010-2012. Prev Chronic Dis 2014; 11:E69; quiz E69. [PMID: 24762533 PMCID: PMC4008946 DOI: 10.5888/pcd11.130157] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction Patient and practice perspectives can inform development of team-based approaches to improving blood pressure control in primary care. We used a community-based participatory research approach to assess patient and practice perceptions regarding the value of team-based strategies for controlling blood pressure in a rural North Carolina population from 2010 through 2012. Methods In-depth interviews were conducted with 41 adults with hypertension, purposely sampled to include diversity of sex, race, literacy, and blood pressure control, and with key office staff at 5 rural primary care practices in the southeastern US “stroke belt.” Interviews explored barriers to controlling blood pressure, the practice’s role in controlling blood pressure, and opinions on the use of team care delivery. Results Patients reported that provider strategies to optimize blood pressure control should include regular visits, medication adjustment, side-effect discussion, and behavioral counseling. When discussing team-based approaches to hypertension care, patients valued verbal encouragement, calls from the doctor’s office, and the opportunity to ask questions. However, they voiced concerns about the effect of having too many people involved in their care. Practice staff focused on multiple, broad methods to control blood pressure including counseling, regular office visits, media to improve awareness, and support groups. An explicit focus of delivering care as teams was a newer concept. Conclusion When developing a team approach to hypertension treatment, patients value high-quality communication and not losing their primary relationship with their provider. Practice staff members were open to a team-based approach but had limited knowledge of what such an approach would entail.
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Affiliation(s)
- Katrina E Donahue
- University of North Carolina at Chapel Hill, Department of Family Medicine, 590 Manning Dr, Chapel Hill, NC 27599.
| | - Maihan B Vu
- University of North Carolina, Chapel Hill, North Carolina
| | | | | | | | | | - Crystal W Cene
- University of North Carolina, Chapel Hill, North Carolina
| | | | - Edwin Little
- primary care practices in eastern North Carolina
| | | | - Darren DeWalt
- University of North Carolina, Chapel Hill, North Carolina
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Sutamtewagul G, Dumrongmoncolgul N, Kijsirichareanchai K, Gadwala S, Arvandi A, Suarez J, Meyerrose G. Effect of Alcohol Intake in Patients with Hypertension Currently on Medication Treatment. ALCOHOLISM TREATMENT QUARTERLY 2014. [DOI: 10.1080/07347324.2013.833785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Soo KL, Wan Abdul Manan WM, Wan Suriati WN. The Bahasa Melayu version of the Global Physical Activity Questionnaire: reliability and validity study in Malaysia. Asia Pac J Public Health 2012; 27:NP184-93. [PMID: 22234832 DOI: 10.1177/1010539511433462] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to assess the reliability and concurrent validity of the Bahasa Melayu version of the Global Physical Activity Questionnaire (GPAQ-M) by comparing it with the short form of the International Physical Activity Questionnaire (IPAQ-S) and objectively measuring physical activity using a Yamax DigiWalker (Yamax, Tokyo, Japan) pedometer. A total of 100 adults aged between 20 and 58 years from Kelantan in Malaysia voluntarily participated in this study. The Wilcoxon signed-rank analysis showed no significant differences in 2-week test-retest scores for total metabolic equivalent∙minutes∙per week and 4 domains of the GPAQ-M. There was a low but significant relationship between time spent on total physical activity measured by the GPAQ-M and average steps per day recorded using the pedometer (r s = .265, P = .013). Significant correlations were also found between GPAQ-M and the IPAQ-S for varying levels of intensity during physical activities (r s = .309-.466, P < .01).
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Affiliation(s)
- K L Soo
- Universiti Sains Malaysia, Kota Bharu, Malaysia
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