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Jambarsang S, Soodejani MT, Tate R, Sefidkar R. How well do obesity indices predict undiagnosed hypertension in the Persian cohort (Shahedieh) adults community population of all ages? Health Sci Rep 2024; 7:e1897. [PMID: 38405171 PMCID: PMC10885643 DOI: 10.1002/hsr2.1897] [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: 10/05/2023] [Revised: 12/28/2023] [Accepted: 01/24/2024] [Indexed: 02/27/2024] Open
Abstract
Background and Aims Hypertension is the leading preventable risk factor for cardiovascular disease, chronic kidney disease and cognitive impairment, and mortality and disability worldwide. Since prevention, early detection, and treatment of blood pressure improve public health, the aim of present study was to determine the best obesity indices and estimate the optimal cut-off point for each one to predict the risk of elevated/stage 1 and undiagnosed hypertension in the population of center of Iran based on American ACC/AHA 2020 guidelines. Methods This cross-sectional study was performed on 9715 people who enrolled in 2018 in Persian Adult Cohort in Shahedieh area of Yazd, Iran in 2018. The anthropometric indices including body mass index (BMI) and waist circumference (WC), wrist circumference, hip circumference, waist-to-hip ratio, and waist-to height ratio of individuals, were extracted. The receiver operating characteristic curve was utilized to determine the optimum cut-off point of each anthropometric index to predict hypertension stages and compare their predictive power by age-sex categories. Statistical analysis was done using SPSS version 23.0. Results The results showed that BMI has the best predictive power to recognize the risk of elevated/stage 1 hypertension for female (area under the curve [AUC] = 0.72 and optimal cut-off = 30.10 kg/m2) and WC for male (AUC = 0.66 and optimal cut-off = 93.5 cm) in 35-45 age group. BMI had the best predictive power for the risk of undiagnosed hypertension for 35-45 years old male (AUC = 0.73 and optimal cut-off = 28.90 kg/m2) and female (AUC = 0.75 and optimal cut-off = 5.10 kg/m2), and hip circumference revealed similar predictive power for female as well (AUC = 0.75 and optimal cut-off = 112 cm). Conclusion Based on our findings, BMI and WC, which are simple, inexpensive, and noninvasive means, are the best markers to predict the risk of elevated/stage 1 and undiagnosed hypertension in young Iranians. It shows that the approach of reducing hypertension prevalence through primary prevention, early detection, and enhancing its treatment is achievable.
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Affiliation(s)
- Sara Jambarsang
- Center for Healthcare Data Modeling, Departments of Biostatistics and EpidemiologyShahid Sadoughi University of Medical SciencesYazdIran
| | - Moslem Taheri Soodejani
- Center for Healthcare Data Modeling, Departments of Biostatistics and EpidemiologyShahid Sadoughi University of Medical SciencesYazdIran
| | - Robert Tate
- Centre on AgingUniversity of ManitobaWinnipegCanada
- Department of Community Health Sciences, Max Rady College of MedicineUniversity of ManitobaWinnipegCanada
| | - Reyhane Sefidkar
- Center for Healthcare Data Modeling, Departments of Biostatistics and EpidemiologyShahid Sadoughi University of Medical SciencesYazdIran
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Mekonene M, Baye K, Gebremedhin S. Epidemiology of hypertension among adults in Addis Ababa, Ethiopia. Prev Med Rep 2023; 32:102159. [PMID: 36895825 PMCID: PMC9989685 DOI: 10.1016/j.pmedr.2023.102159] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 02/16/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023] Open
Abstract
The public health significance of hypertension is increasing in low- and middle-income countries. However, there is limited epidemiological evidence in Ethiopia. We assessed the prevalence of hypertension and explored its predictors among adults in Addis Ababa, Ethiopia. A community-based cross-sectional study was conducted from April to May 2021 among randomly selected adults aged 18-64 years. A face-to-face interview using an adapted STEPwise Approach to NCD Risk Factor Surveillance (STEPS) questionnaire was conducted. Multilevel mixed-effects logistic regression model was fitted to determine factors associated with hypertension. The sample consisted of a total of 600 adults (mean age: 31.2 ± 11.4 years, 51.7% women). The overall age-standardized prevalence of hypertension was 22.1% and 47.8% according to the Seventh Joint National Commission (JNC7) and the 2017 American Heart Association (AHA) guidelines, respectively. About 25.6% were newly diagnosed with hypertension. The age groups of 40-54 years (AOR = 8.97; 95% CI: 2.35,34.23), and 55-64 years (AOR = 19.28; 95% CI: 3.96,93.83) as compared to the 18-24 age group, male sex (AOR = 2.90; 95% CI: 1.22,6.87), obesity (AOR = 1.92; 95% CI: 1.02,3.59), abdominal obesity (AOR = 4.26; 95% CI: 1.42,12.81), and very poor sleep quality (AOR = 3.35; 95% CI: 1.15,9.78) were independent predictors of hypertension. This study revealed that the burden of hypertension among adults is very high. Hypertension is independently associated with older age group, male sex, obesity, abdominal obesity, and poor sleep quality. Therefore, the study highlights the need to develop regular blood pressure surveillance programs, weight loss intervention, and improvement of sleep quality.
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Affiliation(s)
- Mulugeta Mekonene
- Center for Food Science and Nutrition, Addis Ababa University, P.O. Box 150201, Addis Ababa, Ethiopia.,Sport Science Academy, Wollo University, P.O. Box 1145, Dessie, Ethiopia
| | - Kaleab Baye
- Center for Food Science and Nutrition, Addis Ababa University, P.O. Box 150201, Addis Ababa, Ethiopia
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Wu B, Guo X, Feng L, Gao J, Xia W, Xie P, Ma S, Liu H, Zhao D, Qu G, Sun C, Lowe S, Bentley R, Sun Y. Combined exposure to multiple dioxins and dioxin-like polychlorinated biphenyls on hypertension among US adults in NHANES: a cross-sectional study under three statistical models. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:28730-28744. [PMID: 36401011 DOI: 10.1007/s11356-022-24271-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
Dioxins and dioxin-like polychlorinated biphenyls (DL-PCBs) are mainly released as by-products of human activities, often in the form of mixtures, and the potential harm on human health deserves attention. Therefore, our study aimed to analyze the combined effect of dioxins and DL-PCB exposures on hypertension (HTN) among US adults. Data of eligible participants were acquired from the National Health and Nutrition Examination Survey (NHANES). Multiple logistic regression models with adjustment for covariates were applied to explore the associations between 13 persistent organic pollutants (POPs) and HTN. Stratified analyses and interaction analyses were then conducted by age and gender. Finally, the combined effects of dioxins and DL-PCBs on HTN were assessed by the weighted quantile sum (WQS) model and the Bayesian kernel machine regression (BKMR) model. A total of 976 adults were included in our study, of whom 397 had HTN. Spearman correlations indicated positive correlations among 13 POPs. And most of them (except PCB28, PCB66, and 1,2,3,4,7,8,9-hpcdf) had significant effects on HTN. The result of WQS revealed that mixed exposure to dioxins and DL-PCBs was significantly associated with increased risk of HTN (OR: 2.205; 95% CIs: 1.555, 3.127). The BKMR model also presented a positive trend of HTN risk with exposure to multiple dioxins and DL-PCBs. And 1,2,3,4,6,7,8,9-ocdd may be the main factor for this positive association. Considering the limitations of our cross-sectional study with the small sample, further prospective studies are necessary to validate our findings.
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Affiliation(s)
- Birong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Linya Feng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Juan Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Weihang Xia
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Peng Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Dongdong Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
- Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, IL, 60657, USA
| | - Scott Lowe
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Rachel Bentley
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
- Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
- Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006, Anhui, China.
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Using Online Grocery Applications during the COVID-19 Pandemic: Their Relationship with Open Innovation. JOURNAL OF OPEN INNOVATION: TECHNOLOGY, MARKET, AND COMPLEXITY 2022; 8. [PMCID: PMC9906733 DOI: 10.3390/joitmc8020093] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
This present research examines the behavioral intentions of Filipinos to use online grocery applications during the novel COVID-19 pandemic. The study proposes an integration of the health belief model (HBM) and the Unified Theory of Acceptance and Use of Technology (UTAUT2) to identify the factors affecting the acceptance and usage of Filipinos of online grocery applications in terms of the impact of health risk for COVID-19. To accurately measure the factors and their relationship to behavioral intentions and usage behavior, a questionnaire was developed and distributed to 373 residents in the Philippines. Partial least squares structural equation modeling (PLS-SEM) was applied as an analytical method for this study. The results revealed that performance expectancy, perceived benefits, perceived severity, and cues to action significantly influenced the behavioral intentions and usage of online grocery apps during the COVID-19 pandemic. The study’s findings can be utilized as a theoretical framework for future researchers of consumer behavior; e-commerce developers; and grocery industry retailers, to enhance the innovation and services of online grocery applications. The results of this study may also be used and capitalized on by investors and managers to apply in strategizing when developing and marketing online grocery applications among consumers. Moreover, the framework of this study may be adopted and utilized by other online markets, even in different counties. Further theoretical and practical aspects are discussed in this paper.
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Sepanlou S, Najafi F, Poustchi H, Parsaeian M, Ahmadi A, Somi M, Moradpour F, Alizadeh-Navaei R, Gohari A, Zamani B, Esmaeilinadimi A, Rezaianzadeh A, Mansour-Ghanaei F, Bahramali E, Ansari-Moghaddam A, Hamzeh B, Zanganeh Yousefabadi E, Zare Sakhvidi MJ, Mohebbi I, Fattahi MR, Nejatizadeh A, Marioryad H, Motamed-Gorji N, Roozafzai F, Eghtesad S, Mohammadi Z, Shayanrad A, Sharafkhah M, Etemadi A, Kamangar F, Juraschek SP, Malekzadeh R. Prevalence, awareness, treatment, and control of hypertension based on ACC/AHA versus JNC7 guidelines in the PERSIAN cohort study. Sci Rep 2022; 12:4057. [PMID: 35260709 PMCID: PMC8904851 DOI: 10.1038/s41598-022-07896-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 02/28/2022] [Indexed: 02/08/2023] Open
Abstract
In this cross-sectional population-based study, we used the baseline data of the Prospective Epidemiologic Research Studies in IrAN cohort study collected in Iran from 2014 to 2020. The main outcomes were the prevalence of hypertension and proportion of awareness, treatment, and control based on the 2017 ACC/AHA guideline compared to the seventh report of the Joint National Committee (JNC7). Of the total of 163,770 participants, aged 35-70 years, 55.2% were female. The sex-age standardized prevalence of hypertension was 22.3% (95% CI 20.6, 24.1) based on the JNC7 guideline and 36.5% (31.1, 41.8) based on the ACC/AHA guideline. A total of 24,312 participants [14.1% (10.1, 18.1)] were newly diagnosed based on the ACC/AHA guideline. Compared to adults diagnosed with hypertension based on the JNC7 guideline, the newly diagnosed participants were mainly young literate males who had low levels of risk factors and were free from conventional comorbidities of hypertension. About 30.7% (25.9, 35.4) of them (4.3% of the entire population) were eligible for pharmacologic intervention based on the ACC/AHA guideline. Implementation of the new guideline may impose additional burden on health systems. However, early detection and management of elevated blood pressure may reduce the ultimate burden of hypertension in Iran.
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Affiliation(s)
- Sadaf Sepanlou
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Parsaeian
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ahmadi
- Department of Epidemiology and Biostatistics, Modeling in Health Research Center, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mohammadhossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Moradpour
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Gohari
- Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Bijan Zamani
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Ali Esmaeilinadimi
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Abbas Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Bahramali
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Elham Zanganeh Yousefabadi
- Department of Internal Medicine, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Javad Zare Sakhvidi
- Occupational Health Research Centre, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Iraj Mohebbi
- Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Mohammad Reza Fattahi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azim Nejatizadeh
- Molecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | | | - Nazgol Motamed-Gorji
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzin Roozafzai
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sareh Eghtesad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amaneh Shayanrad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Sharafkhah
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Farin Kamangar
- Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, USA
| | - Stephen P Juraschek
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, North Kargar Ave., Tehran, 14117-13135, Iran.
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Mahdavi-Roshan M, Rezazadeh A, Joukar F, Khorshidi Y, Naghipour M, Mansour-Ghanaei F. Dietary supplements consumption and its association with socioeconomic factors, obesity and main non-communicable chronic diseases in the north of Iran: the PERSIAN Guilan Cohort Study (PGCS). BMC Nutr 2021; 7:84. [PMID: 34906216 PMCID: PMC8672625 DOI: 10.1186/s40795-021-00488-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/29/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Dietary supplements (DSs) use have become a growing trend worldwide, and it may be affected by demographic and sociocultural factors. Some people use supplements with the thought that they can improve their health, reduce symptoms and prevent disease. The aim of the present study was to define the frequency of DS use and its association with socioeconomic factors among participants with selected main non-communicable chronic diseases (NCDs) (diabetes, cardiovascular disease (CVD), hypertension (HTN), cancers, and obesity in the north of Iran. METHODS This large cross-sectional study was conducted as a part of the PERSIAN Guilan cohort study. Supplement use during last year and its type, demographic factors, socioeconomic status, lifestyle habits were asked by face-to-face interview. The history of chronic disease was defined by a trained team. Data were analyzed using SPSS. The chance of supplement use according to demographic, socioeconomic, and lifestyle variables and history of chronic disease was analyzed by logistic regression. RESULTS 10,520 men and women aged 35-70 years in Some'e Sara County (including urban regions and 39 villages) were studied. About 25% of participants consumed DSs. The highest consumption of DS was calcium/vitamin D (11.1%), ferrous sulfate (8.8%), and vitamin D pearl or ampoule (7.7%). The highest percent of the history of chronic disease was central obesity (62.7%), HTN (43.2%), and general obesity (32.7), respectively. After adjustment for confounders, those with female gender, the highest age ranges (55-65 and > 65 years), high academic education, living in urban regions, and good economic status were more likely to be DSs consumers; however, married and smoker subjects were more likely to consume DS. Participants who had a history of diabetes, HTN, CVD, Obesity, and Central Obesity were more likely to intake DS in comparison with healthy subjects. CONCLUSION This study showed that a quarter of the participants were DS users. Female sex, older age groups, and higher educated participants, and among chronic disease, patients with HTN, CVD, and diabetes were more likely to be users of any DS.
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Affiliation(s)
- Marjan Mahdavi-Roshan
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Razi Hospital, Sardar-Jangle Avenue, Rasht, Iran
| | - Arezoo Rezazadeh
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Behehshti University of Medical Sciences, Tehran, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Razi Hospital, Sardar-Jangle Avenue, Rasht, Iran
- Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Yasaman Khorshidi
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Behehshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Naghipour
- Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Razi Hospital, Sardar-Jangle Avenue, Rasht, Iran.
- Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran.
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