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Sun YA, Kalpakavadi S, Prior S, Thrift AG, Waddingham S, Phan H, Gall SL. Socioeconomic status and health-related quality of life after stroke: a systematic review and meta-analysis. Health Qual Life Outcomes 2023; 21:115. [PMID: 37875951 PMCID: PMC10599023 DOI: 10.1186/s12955-023-02194-y] [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: 05/30/2023] [Accepted: 09/27/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Socioeconomic status (SES) is associated with stroke occurrence and survival following stroke but its association with health-related quality of life (HRQoL) following stroke remains uncertain. We performed a systematic review and meta-analysis to examine the association between SES and HRQoL after stroke. METHODS PubMed, SCOPUS, EMBASE, and Web of Science were searched to identify relevant cohort and case-control studies between January 2000 and May 2022. Two authors screened titles, abstracts and full text articles. One author extracted data from all included studies. Meta-analyses were performed for studies with comparable measurements of SES and HRQoL. Random effects models were used to estimate pooled summary standardised mean differences in HRQoL by SES. RESULTS Out of 1,876 citations, 39 studies incorporated measurement of overall HRQoL following stroke and were included in the systematic review, with 17 studies included in the meta-analyses. Overall, reports including education, income, occupation and work status effects on HRQoL after stroke were inconsistent among all included 39 studies. In the global meta-analysis of 17 studies, HRQoL among survivors of stroke was lower in the low SES group than in the high SES group (standardised mean difference (SMD) -0.36, 95% CI -0.52, -0.20, p < 0.0001). When using education and income indicators separately, summary effects were similar to those of the global analysis (low versus high education SMD -0.38, 95% CI -0.57, -0.18, p < 0.0001; low versus high income SMD -0.39, 95% CI -0.59, -0.19, p < 0.0001). CONCLUSIONS Across all SES indicators, people with stroke who have lower SES have poorer overall HRQoL than those with higher SES. Accessibility and affordability of poststroke support services should be taken into consideration when planning and delivering services to people with low SES.
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Affiliation(s)
- Yichao A Sun
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Serah Kalpakavadi
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Sarah Prior
- Tasmanian School of Medicine, Rural Clinical School, University of Tasmania, Burnie, Australia
| | - Amanda G Thrift
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | | | - Hoang Phan
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
- Menzies School for Health Research, Charles Darwin University, Casuarina, Australia
| | - Seana L Gall
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia.
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Pianarosa E, O'Neill M, Kornas K, Diemert LM, Tait C, Rosella LC. Modelling population-level and targeted interventions of weight loss on chronic disease prevention in the Canadian population. Prev Med 2023; 175:107673. [PMID: 37597756 DOI: 10.1016/j.ypmed.2023.107673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 08/21/2023]
Abstract
Obesity is a known risk factor for major chronic diseases. Prevention of chronic disease is a top global priority. The study aimed to model scenarios of population-level and targeted weight loss interventions on 10-year projected risk of chronic disease in Canada using a population-level risk prediction algorithm. The validated Chronic Disease Population Risk Tool (CDPoRT) forecasts 10-year risk of chronic disease in the adult population. We applied CDPoRT to the 2013/14 Canadian Community Health Survey to generate prospective chronic disease estimates for adults 20 years and older in Canada (n = 83,220). CDPoRT was used to model the following scenarios: British Columbia's (BC) and Quebec's (QC) provincial population-level weight reduction targets, a population-level intervention that could achieve weight loss, targeted weight loss interventions for overweight and obese groups, and the combination of a population-level and targeted weight loss intervention. We estimated chronic disease risk reductions and number of cases prevented in each scenario compared with the baseline. At baseline, we predicted an 18.4% risk and 4,151,929 new cases of chronic disease in Canada over the 10-year period. Provincial weight loss targets applied to the Canadian population estimated chronic disease reductions of 0.6% (BC) and 0.1% (QC). The population-level intervention estimated a greater reduction in risk (0.2%), compared to the targeted interventions (0.1%). The combined approach estimated a 0.3% reduction in chronic disease risk. Our modelling predicted that population-level approaches that achieve weight loss in combination with targeted weight loss interventions can substantially decrease the chronic disease burden in Canada.
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Affiliation(s)
- Emilie Pianarosa
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
| | - Meghan O'Neill
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
| | - Kathy Kornas
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
| | - Lori M Diemert
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
| | - Christopher Tait
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
| | - Laura C Rosella
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada; ICES, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Institute for Better Health, Trillium Health Partners, 100 Queensway West, Mississauga, ON L5B 1B8, Canada; Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, Simcoe Hall, 1 King's College Cir, Toronto, ON M5S 1A8, Canada.
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Okwuosa LN, Onu DU, Onyedibe MCC. Perceived stress and health-related quality of life in cancer patients: the mediating role of religious coping. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04510-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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Ipinnimo TM, Adewoye KR, Durowade KA, Elegbede OE, Ojo JO, Dele-Ojo BF, Oluwademilade OJ, Atoyebi OA, Sanni TA, Asake OT, Daramola BW, Fadipe AO. Comparative assessment of health-related quality of life among hypertensive patients attending state and federal government teaching hospitals in Ekiti State, Nigeria. DIALOGUES IN HEALTH 2022; 1:100069. [PMID: 38515920 PMCID: PMC10953898 DOI: 10.1016/j.dialog.2022.100069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/29/2022] [Accepted: 10/30/2022] [Indexed: 03/23/2024]
Abstract
Background Hypertension is a serious health problem and it is one of the diseases that impair health-related quality of life. The central tenet of care should be to improve health-related quality of life and overall well-being and not just be limited to improving clinical outcomes. This study assesses and compares health-related quality of life and its predictors among hypertensive patients in two government hospitals in Ekiti State, Nigeria. Methods This was a comparative cross-sectional study involving 440 hypertensive patients (220 in each group), recruited using a systematic sampling technique within the hospitals. Data on socio-demographic, economic and clinical characteristics including the cost of care for hypertension were collected from the patients. The WHOQoL-BREF questionnaire was used to assess health-related quality of life. Data were entered and analyzed using IBM SPSS Statistics for Windows, Version 22.0. Results All domains of health-related quality of life were better among patients in federal government teaching hospitals, however, only the physical (T = -7.932, p < 0.001) and overall (T = -2.783, p = 0.006) domains were of statistical significance. An inverse relationship between cost and health-related quality of life was found in the two hospitals (State: r = -0.224, p = 0.001; Federal: r = -0.378, p < 0.001). Identified predictors of health-related quality of life were age, locality of residence, income, number of complications, exercise and smoking in both hospitals. Other predictors were marital status, living arrangement, occupation, number of medications, and involvement in religious and spiritual activities among patients in the state government teaching hospital; household size, length of diagnosis, and indirect cost among patients in the federal government teaching hospital. Conclusion There is a need to support hypertensive patients in the state government teaching hospitals to reduce the inequality of low health-related quality of life among them. Identified predictors should be taken into consideration when putting in place policies that will improve the health-related quality of life of these patients.
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Affiliation(s)
| | - Kayode Rasaq Adewoye
- Department of Community Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
- Department of Community Medicine, Afe Babalola University, Ado Ekiti, Nigeria
| | - Kabir Adekunle Durowade
- Department of Community Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
- Department of Community Medicine, Afe Babalola University, Ado Ekiti, Nigeria
| | - Olusegun Elijah Elegbede
- Department of Community Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
- Department of Community Medicine, Afe Babalola University, Ado Ekiti, Nigeria
| | - John Olujide Ojo
- Department of Community Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
- Department of Community Medicine, Afe Babalola University, Ado Ekiti, Nigeria
| | | | - Olarinde Jeffrey Oluwademilade
- Department of Medicine, Federal Teaching Hospital, Ido-Ekiti, Nigeria
- Department of Medicine, Afe Babalola University, Ado-Ekiti, Nigeria
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Hernandez NJ, Bislick L, Engelhoven A, Hunting Pompon R. Self-Report and Caregiver Proxy-Report Agreement of Perceived Chronic Stress and Mutuality in Poststroke Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1700-1710. [PMID: 34048661 DOI: 10.1044/2021_ajslp-20-00248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Background People with aphasia (PWA) report higher levels of stress in comparison to stroke survivors without aphasia. If untreated, chronic stress is known to have detrimental effects to the body and brain and can negatively impact health and well-being. According to extant literature, self- and proxy-report agreement on objective domains is higher than on subjective domains, like chronic stress. In addition, high levels of mutuality, also known as shared feelings between two people, have been strongly associated with low levels of stress in stroke survivors. Little is known, however, of the agreement between self-report and caregiver proxy-report on perceived chronic stress or mutuality in PWA. Purpose The proposed study sought to examine (a) the degree of agreement between caregiver proxy-report and PWA self-report on perceived stress and (b) the relationship between perceived stress and mutuality between PWA and their caregivers. Method The Modified Perceived Stress Scale and the Mutuality Scale were administered to 21 PWA/caregiver dyads. An independent-samples t test was conducted to determine if there were significant differences in perceived stress and mutuality as reported by PWA, their caregiver, and their caregiver's proxy-report. A Pearson correlation was performed to determine the level of agreement across questionnaires. Results There was a moderate correlation between the proxy-report and self-report for perceived stress. On average, proxy-reports for perceived stress were significantly higher than PWA self-reports. Overall, mutuality was high among the dyads. There was moderate agreement between caregiver's mutuality and proxy-report agreement on perceived stress. Lastly, our findings do not indicate that caregiver's perceived stress influenced their perception of the PWA's perceived stress. Conclusion The results of this study provide support for the use of proxy-derived information in perceived stress with the use of a mutuality scale.
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Affiliation(s)
| | - Lauren Bislick
- School of Communication Sciences and Disorders, University of Central Florida, Orlando
| | - Amy Engelhoven
- School of Communication Sciences and Disorders, University of Central Florida, Orlando
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The Association Between Heart Rate Variability and Quality of Life in Patients with Functional Somatic Syndrome and Healthy Controls. Appl Psychophysiol Biofeedback 2021; 46:279-285. [PMID: 34132969 DOI: 10.1007/s10484-021-09515-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Functional somatic syndrome (FSS) includes a spectrum of somatic symptoms with insufficient medical explanation. Its underlying pathophysiology is considered to include dysfunctional stress-responsive systems or autonomic dysfunction. Among the autonomic dysfunction readouts, decreased heart rate variability (HRV) has been shown to be characteristic in patients with FSSs. However, its association with quality of life (QOL) has not been clearly examined. We examined the association between short-term resting HRV and QOL in patients with FSS (n = 47) and healthy controls (n = 28). The time domain parameters of HRV were mean heart rate per minute (HR), coefficient of variation of R-R intervals (CvRR) and root mean square of successive differences (RMSSD). The frequency domain parameters of HRV were low-frequency (LF) power and high-frequency (HF) power by power spectrum analysis. The Japanese version of the WHO's QOL scale (WHOQOL-BREF) (WHO/QOL26) was used for the QOL assessment. There was a significant positive association between the RMSSD and HF power of HRV and all the QOL domains in patients with FSSs who had lower QOL scores on average than controls, while there was no association between HRV and any of the QOL domains in the control group. HF power was more dominantly associated with QOL than the other variables in patients with FSS based on the analysis with a multiple linear regression model. The present study elucidated that the HF power of HRV was dominantly associated with QOL in patients with FSSs who had lower QOL than controls. Vagal index of HRV could be a valuable indicator of the pathological condition and a significant predictor of health-related QOL in patients with FSSs.
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Barradas S, Lucumi D, Agudelo DM, Mentz G. Socioeconomic position and quality of life among Colombian hypertensive patients: The mediating effect of perceived stress. Health Psychol Open 2021; 8:2055102921996934. [PMID: 33747537 PMCID: PMC7905733 DOI: 10.1177/2055102921996934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
This study aimed to assess the relationships between socioeconomic position, perceived stress and Health Related Quality of Life (HRQoL) of patients with hypertension. Data were obtained using the baseline survey of 258 patients from the Social Determinants and Inequities in the Control of Blood Hypertension Program (ProDSICHA). HRQoL was measured with SF-8 Health Survey. Socioeconomic position was measured using education, and the MacArthur Scale. Stress was measured with Perceived Stress Scale. A higher educational level was associated with a higher perception of stress (Coeff = 0.78, p = 0.019). Also, a lower position in the community was associated with a higher perception of stress (Coeff = −0.56, p = 0.027). A higher level of perceived stress was associated with a higher level of mental health (Coeff = 0.64, p = 0.000). No statistical differences were found in the relations between socioeconomic position and physical HRQoL. These findings warrant further research to understand the role of socioeconomic position in physical HRQoL.
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Affiliation(s)
- Susana Barradas
- Universidad de los Andes, Colombia.,Universidad Externado de Colombia, Colombia
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8
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Ayodapo AO, Elegbede OT, Omosanya OE, Monsudi KF. Patient Education and Medication Adherence among Hypertensives in a Tertiary Hospital, South Western Nigeria. Ethiop J Health Sci 2020; 30:243-250. [PMID: 32165814 PMCID: PMC7060389 DOI: 10.4314/ejhs.v30i2.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Hypertension is a global health issue among the adult population with high morbidity and mortality rates. Poor adherence to medication is associated with bad outcome of the disease and wastage of health resources. Therefore, this study aims to determine the role of patient education in medication adherence among hypertensives attending tertiary hospitals in Ekiti State, South Western, Nigeria. Methods This is a descriptive cross-sectional study involving 420 participants attending Family Medicine Department Clinic of Federal Medical Centre (FMC), Ido-Ekiti. Relevant data were collected using semi-structured questionnaire. Results The mean age of respondents was 60.97 ± 11.28 years, and a slight female preponderance (male: female = 1:1.7 over male). Three hundred and forty nine (83.1%) were married, 273(65.0%) were from a monogamous family and 375(89.2%) had family sizes of more than 4. Ninety four (22.4%) had good knowledge about hypertension, and 257(61.2%) were adherent to their medication. Increased medication adherence proportion was observed as knowledge about hypertension improves. The odds of adherence to treatment among subjects with good knowledge is 2 times (OR = 2.320, 95%CI = 1.164, 4.626) higher than among subjects with poor knowledge. Conclusion The proportion of respondents with good knowledge about hypertension is low. However, the adherence among them to medication is higher and statistically significant. Patient education about the disease and its treatment by primary care physicians can help to improve adherence to medication.
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Affiliation(s)
- A O Ayodapo
- Department of Family Medicine, Federal Medical Centre, Birnin-Kebbi, Kebbi State. Nigeria
| | - O T Elegbede
- Department of Family Medicine, Federal Medical Centre, Ido-Ekiti. Ekiti State. Nigeria
| | - O E Omosanya
- Department of Family Medicine, Federal Medical Centre, Ido-Ekiti. Ekiti State. Nigeria
| | - K F Monsudi
- Department of Ophthalmology, Federal Medical Centre, Birnin-Kebbi, Kebbi State. Nigeria
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Pompon RH, Smith AN, Baylor C, Kendall D. Exploring Associations Between a Biological Marker of Chronic Stress and Reported Depression and Anxiety in People With Aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:4119-4130. [PMID: 31652403 DOI: 10.1044/2019_jslhr-l-19-0111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Living with the communication impairment of aphasia can be stressful. Chronic stress, depression, and anxiety are intimately linked, may be more pervasive in people with poststroke aphasia than the general population, and may influence cognitive function and treatment outcomes. In this project, we explored the psychological constructs of depression and anxiety and their associations with a biomarker measure of chronic stress in people with aphasia. Method Fifty-seven participants with aphasia completed measures of depression and anxiety and provided a hair sample from which to extract the stress hormone cortisol. Pearson product-moment correlational analyses were used to identify associations between depression, anxiety, and long-term level of cortisol via hair sample. Results While cortisol level was not associated with depression and anxiety across this sample of people with aphasia, a post hoc analysis showed a significant, positive correlation between a subset of participants with moderate and higher levels of depression and elevated cortisol level. Conclusions Chronic stress, depression, and anxiety have been little explored in people with aphasia to date, yet they are associated with future health consequences and impaired cognitive function, motivating further research as well as consideration of these factors in aphasia rehabilitation.
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Affiliation(s)
- Rebecca Hunting Pompon
- Department of Speech & Hearing Sciences, University of Washington, Seattle
- VA Puget Sound Health Care System, Seattle, WA
| | - Alissa N Smith
- Department of Speech & Hearing Sciences, University of Washington, Seattle
| | - Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Diane Kendall
- Department of Speech & Hearing Sciences, University of Washington, Seattle
- VA Puget Sound Health Care System, Seattle, WA
- University of Pretoria, South Africa
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Lv W, Wang X, Liu J, Yu P. Eight-Section Brocade Exercises Improve the Sleep Quality and Memory Consolidation and Cardiopulmonary Function of Older Adults With Atrial Fibrillation-Associated Stroke. Front Psychol 2019; 10:2348. [PMID: 31695645 PMCID: PMC6818461 DOI: 10.3389/fpsyg.2019.02348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/02/2019] [Indexed: 12/21/2022] Open
Abstract
Purpose: Poor sleep quality is harmful for everyone and potentially even more harmful for older adults with atrial fibrillation-associated stroke (AFAS). This study aims to explore the effects of eight-section brocade (ESB) on sleep quality, memory, and cardiopulmonary function in the older adults with AFAS. Methods: Older adults with AFAS and sleep disorders were recruited and divided into the ESB (EG, n = 85) and control groups (CG, general exercise, n = 85). EG patients received 60 min ESB exercises 5 times a week for 12 weeks; CG patients received normal exercise. Pittsburgh sleep quality index (PSQI) scores (poor sleepers ≥8 and normal sleepers < 8), memory for word pairs (poor memory ≤ 7 and normal memory > 7), left ventricular posterior wall (LVPW) thickness, and maximum ventilation (MV, to evaluate cardiopulmonary function) values were measured. The correlation between sleep and memory quality was analyzed using PSQI scores and word pairs via the Pearson correlation coefficients test. Adjusted Cox models were used to explore an interaction between PSQI and ESB exercise. Results: After 12-week exercise intervention, ESB improved sleep quality, latency, duration, disturbance and daytime dysfunction when compared to conventional exercise. In similar cases, the MV values in the EG were also higher than that in the CG (p = 0.009). ESB intervention could not affect the cardiac structure and left ventricular ejection fraction. Compared with the CG, the ESB intervention reduced PSQI scores and increased memorized word pairs (p < 0.001 for poor and normal sleepers in both unadjusted and adjusted analysis, p = 0.012 and 0.003 for poor and normal memory). The test of Pearson correlation coefficients showed that PSQI scores were strongly associated with the number of word pairs in both unadjusted and adjusted analyses (p < 0.0001). Conclusion: Eight-section brocade exercise improved sleep quality and memory consolidation and cardiopulmonary function by reducing PSQI scores, increasing word pairs and MV values in the older adults with AFAS.
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Affiliation(s)
- Wei Lv
- Department of Cadre Ward, The First Hospital of Jilin University, Changchun, China
| | - Xinxin Wang
- Department of Cadre Ward, The First Hospital of Jilin University, Changchun, China
| | - Jia Liu
- Department of Cardiovascular Medicine, The First Hospital of Jilin University, Changchun, China
| | - Ping Yu
- Department of Cardiovascular Medicine, The First Hospital of Jilin University, Changchun, China
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Booth AO, Wang X, Turner AI, Nowson CA, Torres SJ. Diet-Induced Weight Loss Has No Effect on Psychological Stress in Overweight and Obese Adults: A Meta-Analysis of Randomized Controlled Trials. Nutrients 2018; 10:E613. [PMID: 29757978 PMCID: PMC5986493 DOI: 10.3390/nu10050613] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 05/07/2018] [Accepted: 05/10/2018] [Indexed: 11/17/2022] Open
Abstract
The effect of weight loss on psychological stress is unknown. The study aimed to investigate the effect of diet-induced weight loss in overweight and obese adults on psychological measures of stress through a meta-analysis of randomized controlled trials (RCTs). Databases including Medline Complete, Embase and PsycINFO were searched up to February 2018 for diet-induced weight loss RCTs, which included self-reported assessment of psychological stress. The mean difference between the intervention and control group of changes in stress (intervention-baseline) was used. Ten RCTs were included with 615 participants (502 women, age range 20⁻80 years). Overall, there was no change in stress (mean difference -0.06, 95% CI: -0.17, 0.06, p = 0.33) and no change in the five studies with a significant reduction in weight in the intervention group compared to a control group that lost no weight (mean difference in weight -3.9 Kg, 95% CI: -5.51, -2.29, p < 0.0001; mean difference in stress 0.04, 95% CI: -0.17, 0.25, p = 0.71). For all analyses, there was low heterogeneity. The benefits of weight loss for those who are overweight and obese do not appear to either increase or reduce psychological stress at the end of the weight loss period.
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Affiliation(s)
- Alison O Booth
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia.
| | - Xiaodan Wang
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia.
| | - Anne I Turner
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia.
| | - Caryl A Nowson
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia.
| | - Susan J Torres
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia.
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Education, Socioeconomic Status, and Intelligence in Childhood and Stroke Risk in Later Life: A Meta-analysis. Epidemiology 2018; 28:608-618. [PMID: 28410350 DOI: 10.1097/ede.0000000000000675] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Stroke is the second most common cause of death, and a common cause of dependency and dementia. Adult vascular risk factors and socioeconomic status (SES) are associated with increased risk, but less is known about early life risk factors, such as education, childhood SES, or intelligence (IQ). METHODS We comprehensively searched Medline, PsycINFO, and EMBASE from inception to November 2015. We included all studies reporting data on >50 strokes examining childhood/premorbid IQ, SES, and education. Two reviewers independently screened full texts and extracted and cross-checked data, including available risk factor adjustments. We meta-analyzed stroke risk using hazard ratios (HR), odds ratios (OR), and mean differences (MD). We tested effects of study and participant characteristics in sensitivity analyses and meta-regression, and assessed heterogeneity and publication bias. RESULTS We identified 90 studies examining stroke risk and education (79), SES (10), or IQ (nine) including approximately 164,683 stroke and over 5 million stroke-free participants. Stroke risk increased with lower education (OR = 1.35, 95% CI = 1.24, 1.48), SES (OR = 1.28, 95% CI = 1.12, 1.46), and IQ (HR = 1.17, 95% CI = 1.00, 1.37) in studies reporting point estimates, with similar associations for MD. We found minimal publication bias. Between-study heterogeneity was partly explained by participant age and case ascertainment method. CONCLUSIONS Education, childhood SES, and intelligence have modest but important associations with lifetime stroke, and hence dementia, risks. Future studies distinguishing between the individual and combined effects of education, childhood SES and intelligence are needed to determine the independent contribution of each factor to stroke risk. See video abstract at, http://links.lww.com/EDE/B210.
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Soboka M, Gudina EK, Tesfaye M. Psychological morbidity and substance use among patients with hypertension: a hospital-based cross-sectional survey from South West Ethiopia. Int J Ment Health Syst 2017; 11:5. [PMID: 28053661 PMCID: PMC5209908 DOI: 10.1186/s13033-016-0108-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 12/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Psychological morbidity and substance use disorders have been linked to cardiovascular diseases; affecting patients' medical outcome and quality of life. However, little is known about psychological morbidity and substance use among patients with hypertension in Ethiopia. Therefore, we aimed to assess psychological comorbidity and substance use among hypertensive patients in Southwest Ethiopia. METHODS A cross-sectional study was conducted among 396 hypertensive patients on follow-up at Jimma University Teaching Hospital in Ethiopia during the study period. Structured questionnaires were used to assess alcohol use, khat chewing and cigarette smoking. Psychological morbidity was assessed using the Kessler-6 scale. Multiple logistic regression analysis was carried out to identify the independent association between outcome and explanatory variables. RESULTS The prevalence of psychological morbidity among hypertensive patients was 31.6%. Of the total participants, 31 (7.8%) of them had alcohol use disorders and 79 (19.9%) of them were using khat regularly at the time of the study. Singles were more likely to have psychological morbidity than married participants (AOR = 4.72; 95% CI 1.83, 12.20, p = 0.001), whereas those who were able to 'read and write' were less likely to have psychological morbidity than non-literate ones (AOR = 0.46; 95% CI 0.24, 0.89, p = 0.02). However, no association was seen between psychological morbidity and substance use (khat chewing, alcohol use and cigarette smoking), belief about hypertension, ever discontinuation of medication and lifestyle (exercise, salt consumption). CONCLUSION Psychological morbidity and substance use are prevalent among hypertensive patients on follow-up at the hospital. The findings of the study imply that there is a need for further studies to understand the effect of psychological morbidity on the clinical outcomes of hypertensive patients.
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Affiliation(s)
- Matiwos Soboka
- Department of Psychiatry, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Esayas Kebede Gudina
- Department of Internal Medicine, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Markos Tesfaye
- Department of Psychiatry, College of Health Sciences, Jimma University, Jimma, Ethiopia
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The impact of overweight and obesity on health-related quality of life and blood pressure control in hypertensive patients. J Hypertens 2014; 32:397-407. [PMID: 24366035 DOI: 10.1097/hjh.0000000000000046] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Hypertension and obesity deteriorate patient health-related quality-of-life (HRQoL). This study assessed the impact of overweight and obesity on HRQoL and blood pressure (BP) control in hypertensive participants, according to sex. METHODS HRQoL was assessed using the 12-item Short Form Health Survey in 11,498 white patients treated for hypertension for at least 12 months. Nutritional status was diagnosed according to WHO criteria. RESULTS Overweight and obesity were associated with worse BP control, regardless of sex. In women, overweight and especially obesity were inversely associated with all analyzed HRQoL dimensions. Among men, obesity decreased all HRQoL dimensions, and overweight influenced only physical functioning, role physical, bodily pain, vitality, general health, and Physical Component Score (PCS) but not Mental Component Score (MCS). Overweight in men did not influence social functioning, or emotional and mental health. The BMI values associated with optimal PCS and MCS scores were higher for men than for women. Age-adjusted multivariate regression analysis revealed that PCS score was associated with obesity, higher education level, comorbidities, and antihypertensive therapy duration, whereas MCS score was associated with female sex. Polydrug BP control diminished PCS and MCS. CONCLUSION Overweight and obesity deteriorate BP control, regardless of age and polytherapy. BMI values associated with optimal HRQoL are higher for men than women treated for hypertension. Obesity more strongly diminishes the physical versus mental HRQoL component, regardless of sex. Overweight worsens HRQoL physical components in both sexes and mental component-only in women.
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Ha NT, Duy HT, Le NH, Khanal V, Moorin R. Quality of life among people living with hypertension in a rural Vietnam community. BMC Public Health 2014; 14:833. [PMID: 25113528 PMCID: PMC4137077 DOI: 10.1186/1471-2458-14-833] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 07/31/2014] [Indexed: 11/24/2022] Open
Abstract
Background To respond to growing prevalence of hypertension in Vietnam, it is critical to have an in-depth understanding about quality of life (QOL) among people living with hypertension and related factors. This study aimed to measure QOL among hypertensive people in a rural community in Vietnam, and its association with socio-demographic characteristics and factors related to treatment. Methods This study was conducted in a rural community located 60 km from Ho Chi Minh City. Face-to-face interviews were conducted among 275 hypertensive people aged 50 years and above using WHOQOL-BREF questionnaire. Descriptive statistics were used to examine mean scores of quality of life. Cronbach’s alpha coefficient and Pearson’s correlation coefficient were applied to estimate the internal consistency, and the level of agreement between different domains of WHOQOL-BREF, respectively. Independent T-test and ANOVA test followed by multiple linear regression analyses were used to measure the association between QOL domains and independent variables. Results Both overall WHOQOL-BREF and each domain had a good internal consistency, ranging from 0.65 to 0.88. The QOL among hypertensive patients was found moderate in all domains, except for psychological domain that was fairly low (mean = 49.4). Backward multiple linear regressions revealed that being men, married, attainment of higher education, having physical activities at moderate level, and adherence to treatment were positively associated with QOL. However, older age and presence of co-morbidity were negatively associated with QOL. Conclusion WHOQOL-BREF is a reliable instrument to measure QOL among hypertensive patients. The results revealed low QOL in psychological domain and inequality in QOL across socio-demographic characteristics. Given the results, encouraging physical activities and strengthening treatment adherence should be considered to improve QOL of hypertensive people, especially for psychological aspect. Actions to improve QOL among hypertensive patients targeted towards women, lower educated and unmarried patients are needed in the setting.
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Affiliation(s)
- Ninh Thi Ha
- Institute of Public Health, Ho Chi Minh City, Vietnam.
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Lima MLD, Santos JLF, Sawada NO, Lima LAPD. Quality of life of individuals with stroke and their caregivers in a city of Triângulo Mineiro. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2014; 17:453-64. [DOI: 10.1590/1809-4503201400020013eng] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 12/09/2011] [Indexed: 11/22/2022] Open
Abstract
Objective: To compare the quality of life (QoL) of individuals with stroke and their caregivers. Methods: This is an observational cross-sectional survey, involving 83 individuals who suffered a stroke. The participants were divided into four groups: group of individuals with stroke who have caregivers (44), group of individuals with stroke without caregivers (39), group of caregivers (44) and a reference group (83) in the period of March to May 2010. To assess QoL, the instrument used was the WHOQOL-bref. Results: The highest scores for the four fields were observed increasingly for the group of individuals with stroke with caregivers, the stroke group without caregivers followed by the group of caregivers and the reference group. The comparison of scores between groups showed that the presence of stroke and the fact of being caregiver affect QoL in all domains of WHOQOL-bref. Conclusion: It was possible to understand the negative impact that stroke causes in the lives of the affected ones and their caregivers, in order to better target public health policies.
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Ambaw AD, Alemie GA, W/Yohannes SM, Mengesha ZB. Adherence to antihypertensive treatment and associated factors among patients on follow up at University of Gondar Hospital, Northwest Ethiopia. BMC Public Health 2012; 12:282. [PMID: 22490130 PMCID: PMC3395566 DOI: 10.1186/1471-2458-12-282] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 04/10/2012] [Indexed: 12/21/2022] Open
Abstract
Background Hypertension is an overwhelming global challenge with high morbidity and mortality rates. The prevalence of HTN is estimated to be 6% in Ethiopia and 30% in Addis Ababa. Poor adherence is associated with bad outcome of the disease and wastage of healthcare resources. In Ethiopia, particularly in the study area little is known about treatment adherence and associated factors. Therefore this study aimed to assess adherence to antihypertensive therapy and associated factors among HTN patients on follow up at University of Gondar Referral Hospital. Method Institution based cross sectional study was conducted. Systematic sampling technique was used to select 384 participants. A structured standard questionnaire was used after some modifications. Morisky Medication Adherence Scale was used for labeling patients as adherent or non-adherent. Data were entered and analyzed using SPSS version 16. Results More than half (64.6 %) of the study participants were found to be adherent to their treatment. Sex (AOR = 0.48, 95%CI = 0.28, 0.82), knowledge about HTN and its treatment (AOR = 6.21, 95%CI = 3.22, 11.97), distance from the hospital (AOR = 2.02, 95% CI =1.19-3.43) and co morbidity (AOR = 2.5, 95%CI = 1.01, 6.21) variables were found significantly associated with treatment adherence. Conclusion Only 64.6% of the study subjects were found to be adherent to their treatment. Factors such as sex, distance from the hospital, number of co morbidities, Knowledge about HTN and its treatment were associated with adherence behavior of patients. Early diagnosis and management of co morbidities, adherence counseling and patient education about the disease and its treatment are important to improve adherence status of patients.
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Saleem F, Hassali MA, Shafie AA. A cross-sectional assessment of health-related quality of life (HRQoL) among hypertensive patients in Pakistan. Health Expect 2012; 17:388-95. [PMID: 22390260 DOI: 10.1111/j.1369-7625.2012.00765.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To describe the health-related quality of life (HRQoL) profile of hypertensive population in Pakistan. METHODS A cross-sectional descriptive study was undertaken with a cohort of 385 hypertensive patients attending two public hospitals in Quetta city, Pakistan. The EuroQoL EQ-5D scale was used for the assessment of HRQoL. EQ-5D is a standardized instrument for use as a measure of health outcome and is used in the clinical and economic evaluation of health care as well as population health surveys. The HRQoL was scored using values derived from the UK general population survey. P ≤ 0.05 was taken as significant. RESULTS Two hundred and sixty-five (68.85%) respondents were men with 3.01 ± 0.939 years of history of hypertension. Majority (n = 186, 48.3%) were categorized in age group of 28-37 years with mean age of 39.02 ± 6.596. Education, income and locality had significant relation with HRQoL score. HRQoL was measured poor in our study patients (0.4674 ± 0.2844). CONCLUSION Hypertension has an adverse effect on patients' well-being and HRQoL. Results from this study could be useful in clinical practice, particularly in early treatment of hypertension, at point where improving HRQoL is still possible.
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Affiliation(s)
- Fahad Saleem
- *PhD Candidate, Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia, †Associate Professor, Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia and ‡Senior Lecturer, Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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Faraji J, Sutherland RJ, Metz GA. Stress precipitates functional deficits following striatal silent stroke: A synergistic effect. Exp Neurol 2011; 232:251-60. [DOI: 10.1016/j.expneurol.2011.09.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Revised: 09/03/2011] [Accepted: 09/09/2011] [Indexed: 10/17/2022]
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Baune BT, Thome J. Translational research approach to biological and modifiable risk factors of psychosis and affective disorders. World J Biol Psychiatry 2011; 12 Suppl 1:28-34. [PMID: 21905992 DOI: 10.3109/15622975.2011.603223] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES This review summarizes the literature on (molecular-) biological, medical, environmental and modifiable risk factors for psychosis and mood disorders with the view of their suitability for translational research and mental health practice from preventative and clinical treatment perspectives. METHODS This review summarized literature on biological, medical, environmental and modifiable risk factors for psychosis and mood disorders evaluating their potential for translational research and clinical practice. RESULTS Based on the concept of the gene - environment interaction in the development of mental disorders, we highlight the numerous risk factors reported to contribute to an increased susceptibility to schizophrenia and mood disorders of young adults to late-life. Special emphasis is placed onto the discussion on the requirement of translational and interdisciplinary research approaches integrating basic and clinical neuroscience approaches that may have important implications for future studies and clinical practice. CONCLUSIONS Interdisciplinary research approaches integrating developmental neuroscience and policy makers are encouraged in order to achieve effective prevention and intervention programs addressing environmental, behavioural, biological factors relevant to psychiatric disorders during young ages, adulthood and aging.
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Affiliation(s)
- B T Baune
- Discipline of Psychiatry, University of Adelaide, School of Medicine, Adelaide, Australia.
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Khaw W, Hassan S, Latiffah A. Health-related Quality of Life among Hypertensive Patients Compared with General Population Norms. JOURNAL OF MEDICAL SCIENCES 2011. [DOI: 10.3923/jms.2011.84.89] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Gupta A, Deepika S, Taly AB, Srivastava A, Surender V, Thyloth M. Quality of life and psychological problems in patients undergoing neurological rehabilitation. Ann Indian Acad Neurol 2010; 11:225-30. [PMID: 19893678 PMCID: PMC2771998 DOI: 10.4103/0972-2327.44557] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Revised: 06/30/2008] [Accepted: 07/03/2008] [Indexed: 11/15/2022] Open
Abstract
Aim: To assess the quality of life (QoL) and prevalence of psychological problems (PP) in patients with neurological illness, and their correlation with functional abilities. Materials and Methods: Prospective cross-sectional study conducted in the neurological rehabilitation unit of tertiary research hospital in 30 consecutive hospitalized patients (21 men), age 16-55 years (34.63±11.87). Outcome Measure: WHOQoL-BREF was used to assess QoL. The prevalence of PP was recorded using Hospital Anxiety Depression Scale (HADS) and General Health Questionnaire (GHQ-12). QoL and HADS scores were correlated with functional abilities using mean Barthel Index (BI) Score. Results: The duration of illness was three to 30 months (10.63±7.83) and their primary diagnoses were stroke 12, traumatic spinal cord injury seven and non-traumatic spinal cord lesion 11. Twenty-two patients qualified for GHQ-12 caseness, with 15 patients having distress (score ≥15) and seven having severe problem and psychological distress (score≥20). Twenty five patients had abnormal anxiety and 17 had abnormal depression on HADS (abnormal = 8-21), with moderate to severe anxiety and depression (scores≥11) in nine and three patients respectively. The mean WHOQoL-BREF transformed scores (on WHOQoL 0-100 scale) were (38.83±8.02), (50.76±9.79), (48.53±18.46) and (49.13±10.63) in physical, psychological, social, and environmental domains respectively. The social domain of QoL had significant correlation (P<.05) with functional abilities. Conclusion: Patients with neurological disorders requiring inpatient rehabilitation have impaired QoL that affects all domains of life. There is high prevalence of psychological problems, including anxiety and depression. The social domain of QoL adversely affected functional abilities, but the correlation between PP and functional abilities was insignificant.
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Affiliation(s)
- Anupam Gupta
- Department of Psychiatric and Neurological Rehabilitation, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India.
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Hashmi SK, Afridi MB, Abbas K, Sajwani RA, Saleheen D, Frossard PM, Ishaq M, Ambreen A, Ahmad U. Factors associated with adherence to anti-hypertensive treatment in Pakistan. PLoS One 2007; 2:e280. [PMID: 17356691 PMCID: PMC1805684 DOI: 10.1371/journal.pone.0000280] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2006] [Accepted: 02/13/2007] [Indexed: 01/30/2023] Open
Abstract
Objectives Poor adherence is one of the biggest obstacles in therapeutic control of high blood pressure. The objectives of this study were (i) to measure adherence to antihypertensive therapy in a representative sample of the hypertensive Pakistani population and (ii) to investigate the factors associated with adherence in the studied population. Methods and Results A cross-sectional study was conducted on a simple random sample of 460 patients at the Aga Khan University Hospital (AKUH) and National Institute of Cardiovascular Diseases, Karachi, from September 2005–May 2006. Adherence was assessed using the Morisky Medication Adherence Scale (MMAS), with scores ranging from 0 (non-adherent) to 4 (adherent). In addition to MMAS, patient self-reports about the number of pills taken over a prescribed period were used to estimate adherence as a percentage. AKU Anxiety and Depression Scale (AKU-ADS) was incorporated to find any association between depression and adherence. At a cut-off value of 80%, 77% of the cases were adherent. Upon univariate analyses, increasing age, better awareness and increasing number of pills prescribed significantly improved adherence, while depression showed no association. Significant associations, upon multivariate analyses, included number of drugs that a patient was taking (P<0.02) and whether he/she was taking medication regularly or only for symptomatic relief (P<0.00001). Conclusions Similar to what has been reported worldwide, younger age, poor awareness, and symptomatic treatment adversely affected adherence to antihypertensive medication in our population. In contrast, monotherapy reduced adherence, whereas psychosocial factors such as depression showed no association. These findings may be used to identify the subset of population at risk of low adherence who should be targeted for interventions to achieve better blood pressure control and hence prevent complications.
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Affiliation(s)
| | | | - Kanza Abbas
- Medical College, Aga Khan University, Karachi, Pakistan
| | | | - Danish Saleheen
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
| | - Philippe M. Frossard
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
- * To whom correspondence should be addressed. E-mail:
| | - Mohammad Ishaq
- National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Aisha Ambreen
- Department of Family Medicine, Aga Khan University, Karachi, Pakistan
| | - Usman Ahmad
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
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Magen E, Yosefy C, Viskoper RJ, Mishal J. Treatment of allergic rhinitis can improve blood pressure control. J Hum Hypertens 2006; 20:888-93. [PMID: 16967045 DOI: 10.1038/sj.jhh.1002088] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Owing to high prevalence of arterial hypertension (AH) and allergic rhinitis (AR), these diseases frequently coexist. The study aimed to assess whether improvement of AR by conventional treatment can improve blood pressure (BP) control in this population. Sixty-eight subjects of both sexes aged 35-60 years with AR and AH were randomized into two groups to receive in addition to their antihypertensive medications: treatment group (n=34) Fluticasone nasal 50 microg/spray b.i.d. and Fenoxifenadine 180 mg tablets q.d., and control group (n=34) 0.9% NaCl nasal drops b.i.d. Office BP and AR severity (using the Relative Quality of Life Questionnaire (RQLQ)) and high-sensitive C-reactive protein (hs-CRP) were measured at study entry and after 8 weeks in both groups, without changing of antihypertensive medications. In Treatment group an improvement in RQLQ, significant reduction of systolic BP (SBP) (DSBP 7.4 +/- 4.3 mm Hg, P=0.006) and reduction of hs-CRP level (DCRP 2.05 +/- 1.08; P=0.028) were observed, whereas diastolic BP (DBP) remained unchanged (DDBP 0.9 +/- 1.7 mm Hg, P=0.7). There was a significant correlation between DRQLQ and DSBP (r=0.86; P=0.019) and between DCRP and DSBP (r=0.56; P=0.027). No statistically significant changes of RQLQ, BP and CRP were observed in the control group. In patients with coincidence of AH and AR, medications meant to improve AR attenuate low-grade systemic inflammation and can lower SBP, but not DBP.
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Affiliation(s)
- E Magen
- Internal Medicine 'B' Department, WHO Collaborative Center for Prevention of CVD, Barzilai Medical Center Campus, Ben-Gurion University of Negev, Ashkelon, Israel.
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