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Yu Q, Zuo G. Impact of urbanisation on the gaps of hypertension prevalence, awareness and treatment among older age in China: a cross-sectional study. BMJ Open 2022; 12:e057065. [PMID: 35772814 PMCID: PMC9247652 DOI: 10.1136/bmjopen-2021-057065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To examine the impact of urbanisation on the prevalence, awareness and treatment of hypertension among elderly in China. DESIGN This cross-sectional study used data from the most recent nationally representative Chinese Longitudinal Healthy Longevity Survey, 2018. SETTING People in urban and rural communities from 500 sample areas in 22 Chinese provinces. PARTICIPANTS After exclusion, this study surveyed 9859 participants in the final analysis. PRIMARY AND SECONDARY OUTCOME MEASURES The main dependent variables were prevalence, awareness and treatment of hypertension defined as (1) systolic blood pressure (BP)≥140 mm Hg, diastolic BP≥90 mm Hg or (2) taking antihypertensive drugs. Hypertension awareness was defined as a previous diagnosis of hypertension by a health professional, and hypertension treatment was defined as undergoing BP treatment. RESULTS The prevalence of hypertension was lower among semiurbanised adults than among non-urbanised rural adults (OR=0.94, 95% CI=0.90 to 0.99; p<0.05). The probabilities of awareness (OR=1.10, 95% CI=1.01 to 1.20; p<0.05) and treatment (OR=1.17, 95% CI=1.08 to 1.26; p<0.001) of hypertension were significantly lower among non-urbanised adults than among urban-born adults. Urbanisation in eastern (OR=0.93, 95% CI=0.88 to 0.99; p<0.05) and western China (OR=1.11, 95% CI=1.01 to 1.23; p<0.05) was associated with the prevalence of hypertension. The urbanisation level was also associated with hypertension awareness and treatment in eastern (OR=1.17, 95% CI=1.04 to 1.32; p<0.01; OR=1.26, 95% CI=1.14 to 1.40; p<0.001), central (OR=1.31, 95% CI=1.05 to 1.63; p<0.05; OR=1.29, 95% CI=1.08 to 1.55; p<0.01) and western China (OR=1.28, 95% CI=1.07 to 1.53; p<0.01; OR=1.34, 95% CI=1.15 to 1.57; p<0.001). The Blinder-Oaxaca decomposition suggested that approximately 42% and 39% of the urban-rural gap in hypertension awareness and treatment, respectively, could be attributed to coefficient difference. CONCLUSIONS Public health programmes and policies for chronic diseases should adjust with urbanisation and combine individual-centred strategies.
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Affiliation(s)
- Qiutong Yu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - Genyong Zuo
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
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Mahadzir MDA, Quek KF, Ramadas A. Group-Based Lifestyle Intervention Strategies for Metabolic Syndrome: A Scoping Review and Strategic Framework for Future Research. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57111169. [PMID: 34833387 PMCID: PMC8624746 DOI: 10.3390/medicina57111169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Group-based lifestyle interventions reap social support benefits and have been implemented among individuals with various chronic diseases. However, there is a lack of consolidated evidence on its approaches to prevent or manage metabolic syndrome (MetS). This scoping review aims to assess the group-based lifestyle interventional strategies for MetS and provide a strategic framework for future research in this area. Materials and Methods: Scholarly databases (OVID Medline, SCOPUS, PUBMED, PsycINFO, EMBASE, and Cochrane Central Register of Controlled Trials) and reference lists of included publications were systematically searched using appropriate keywords and MeSH terms. Peer-reviewed articles published from the start of indexing to 31 December 2020 focused on individuals with or at risk for MetS were included. Results: Thirteen interventions were identified, with seven conducted among adults with MetS and six in the population at risk for MetS. Three study designs were reported-randomised controlled trials (RCTs), pre-post interventions, and quasi-experiments. Most of the interventions were based in the community or community organisations, multifaceted, led by a multidisciplinary healthcare team, and assisted by peer educators. Waist circumference showed the most promising MetS-related improvement, followed by blood pressure. Conclusions: There is growing evidence supporting group-based lifestyle interventions to improve MetS-related risk factors. In summary, four strategies are recommended for future research to facilitate group-based interventions in preventing and managing MetS.
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Azizan NA, Majid HA, Nahar Mohamed A, Su TT. Improvement of nutritional intake for the low-income urban dwellers with hypertension in Malaysia. SAGE Open Med 2020; 8:2050312120960563. [PMID: 33014371 PMCID: PMC7509715 DOI: 10.1177/2050312120960563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 08/31/2020] [Indexed: 01/08/2023] Open
Abstract
Objective: To ascertain the effect of dietary practice modification and a peer-support home blood pressure monitoring program on the nutritional intake (macronutrients and micronutrients), blood pressure and biochemical profiles of hypertension patients in a low-income community setting. Methods: This is a pre- and post-measurement intervention study conducted in low-income community housing projects in Kuala Lumpur, Malaysia. A total of 90 participants aged 18 years and above with hypertension received intervention. The participants were divided into small groups and received instructions on the use of home blood pressure measurement. They also attended a series of talks on dietary intake modification and exercise demonstration for the first six months (active phase). In another 6 months (maintenance phase), they received only pamphlet and SMS reminders. Their anthropometry, blood pressure, dietary, and biochemical parameter changes were measured at baseline, 6 months, and 12 months of intervention. Results: Macronutrients and micronutrients showed a significant improvement at the end of 12-month dietary intervention. The energy, carbohydrate, protein, total fat, sodium, and potassium are showing significant reduction from baseline to end of the 12-month intervention. There is no significant reduction in blood pressure. Fasting blood glucose, renal sodium, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol showed a significant improvement, after controlling for age and reported physical activity. Conclusion: The intervention improved the nutritional intake and biochemical profiles of the low-income urban population with hypertension. This promising result should be replicated in a larger scale study.
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Affiliation(s)
- Nurul Ain Azizan
- Center of Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, Pulau Pinang, Malaysia
| | - Hazreen Abdul Majid
- Center of Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.,Harvard Chan School of Public Health, Boston, MA, USA
| | - Azmi Nahar Mohamed
- Sports Medicine Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO), Jeffery Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
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Mahadzir MDA, Quek KF, Ramadas A. Process Evaluation of a Nutrition and Lifestyle Behavior Peer Support Program for Adults with Metabolic Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082641. [PMID: 32290570 PMCID: PMC7215631 DOI: 10.3390/ijerph17082641] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 01/02/2023]
Abstract
Metabolic Syndrome (MetS) is a cluster of risk factors that increases the risk for diabetes and cardiovascular diseases. Lifestyle intervention is the gold standard of MetS management and prevention. Despite the growing positive influence of peer support-based interventions on management of various chronic diseases, its potential among adults with MetS has not been elucidated. We describe the development and process evaluation of a nutrition and lifestyle behavior “PEeR SUpport program for ADults with mEtabolic syndrome” (PERSUADE) using a systematic five-step approach—(i) review of evidence; (ii) focus group discussions; (iii) behavioral matrix development; (iv) module development; and (v) feasibility and process evaluation. High program adherence was recorded with 81.3% of participants attending all peer sessions. Participants’ content satisfaction score was high (93.3%) while peer leadership score was satisfactory (70.0%). There were significant reductions in all anthropometric and metabolic parameters assessed post intervention, except for diastolic blood pressure. Significant correlations were found between reductions in body fat and triglyceride, and content satisfaction. Peer leadership was only significantly correlated with reduction in triglyceride. Future studies can explore aspects of module interactivity, use of social media, and other means to stimulate consistent engagement of participants, as well as extending the implementations to other lifestyle-related diseases.
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Affiliation(s)
| | | | - Amutha Ramadas
- Correspondence: (M.D.A.M.); (A.R.); Tel.: +60-1-2512-2567 (M.D.A.M.); +60-3-5515-9660 (A.R.)
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Pan J, Wu L, Wang H, Lei T, Hu B, Xue X, Li Q. Determinants of hypertension treatment adherence among a Chinese population using the therapeutic adherence scale for hypertensive patients. Medicine (Baltimore) 2019; 98:e16116. [PMID: 31277112 PMCID: PMC6635171 DOI: 10.1097/md.0000000000016116] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To assess the adherence level of antihypertensive treatment and identify any associated risk factors in a sample of hypertensive patients from China.A cross-sectional study involving 488 Chinese hypertensive patients was conducted in a tertiary hospital in Xi'an, China. Data were collected regarding socio-demographic factors and hypertension-related clinical characteristics. The adherence to treatment was assessed using the previously validated instrument: therapeutic adherence scale for hypertensive patients.A total of 27.46% of patients were compliant with their antihypertensive treatments. Three factors were identified to be independently associated with antihypertensive treatment adherence: gender (P = .034), residence (P = .029), duration of high blood pressure (P < .001). Gender, residence, occupation, and the duration of antihypertensive drugs treatment used were found to have significant effects on treatment adherence in certain categories.Treatment adherence among hypertensive patients in China was poor. More attention and effective strategies should be designed to address factors affecting treatment adherence. Education about hypertension knowledge should be strengthened for patients. Moreover, the importance of lifestyle modification during hypertension treatment is often neglected by patients, therefore, there is an urgent need to educate hypertensive patients about the adherence to lifestyle modifications.
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Affiliation(s)
- Jingjing Pan
- Department of Pharmacy, Xi’an Fourth Hospital
- Xi’an Forth Hospital Affiliated Northwestern Polytechnical University
| | - Lian Wu
- Department of Ophthalmology, Xi’an Fourth Hospital
- Xi’an Forth Hospital Affiliated Northwestern Polytechnical University
| | | | - Tao Lei
- Department of Neurology, Xi’an Fourth Hospital, Xi’an, China
| | - Bin Hu
- Department of Pharmacy, Xi’an Fourth Hospital
| | | | - Qiongge Li
- Department of Pharmacy, Xi’an Fourth Hospital
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Su TT, Majid HA, Nahar AM, Azizan NA, Hairi FM, Thangiah N, Dahlui M, Bulgiba A, Murray LJ. Correction to: The effectiveness of a life style modification and peer support home blood pressure monitoring in control of hypertension: protocol for a cluster randomized controlled trial. BMC Public Health 2017; 17:864. [PMID: 29110641 PMCID: PMC5674734 DOI: 10.1186/s12889-017-4862-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 10/16/2017] [Indexed: 11/17/2022] Open
Affiliation(s)
- Tin Tin Su
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Hazreen Abdul Majid
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Azmi Mohamed Nahar
- Department of Sports Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nurul Ain Azizan
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nithiah Thangiah
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Maznah Dahlui
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Awang Bulgiba
- Julius Centre University of Malaya (JCUM), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Liam J Murray
- Centre for Public Health, Queen's University of Belfast, Belfast, Ireland
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Nejati S, Zahiroddin A, Afrookhteh G, Rahmani S, Hoveida S. Effect of Group Mindfulness-Based Stress-Reduction Program and Conscious Yoga on Lifestyle, Coping Strategies, and Systolic and Diastolic Blood Pressures in Patients with Hypertension. J Tehran Heart Cent 2015; 10:140-8. [PMID: 26697087 PMCID: PMC4685370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Healthy lifestyle and ineffective coping strategies are deemed significant variables among patients with hypertension. This study attempted to determine the status of these variables following intervention via the mindfulness-based stress-reduction program (MBSRP) in patients with hypertension. METHOD This study was a randomized clinical trial. The study sample, consisting of 30 patients referring to the Hypertension Clinic of Imam Hossein Hospital in 2013, was assigned either to the intervention (recipient of the MBSRP and conscious yoga) or to the control group (recipient of yoga training). The intervention group had 8 training sessions over 8 weeks. Lifestyle and coping strategies as well as blood pressure were measured in the intervention group before intervention and then immediately thereafter and at 2 months' follow-up and were compared to those in the control group at the same time points. RESULT The mean age of the patients in the intervention (40% women) and control (53% women) groups was 43.66 ± 5.14 and 43.13 ± 5.04 years, respectively. The results showed that the mean scores of lifestyle (p value < 0.05), emotion-focused coping strategies (p value < 0.001), problem-focused coping strategies (p value < 0.001), diastolic blood pressure (p value < 0.001), and systolic blood pressure (p value < 0.001) were significantly different between the intervention and control groups after the intervention. CONCLUSION Applying an intervention based on the MBSRP may further improve the lifestyle and coping strategies of patients with hypertension.
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Affiliation(s)
- Somayeh Nejati
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Corresponding Author: Somayeh Nejati, Behavioral Sciences Research Center of Shahid Beheshti University of Medical Sciences, Imam Hossein Hospital, Nezam Abad, Shahid Madani Street, Tehran, Iran. 617763141. Tel: + 98 919 1695180. Fax: +98 21 77553034.
| | - Alireza Zahiroddin
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | - Soheila Rahmani
- Department of Psychology and Educational Sciences, Semnan University, Semnan, Iran.
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