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Wang K, Shafique S, Wang N, Walter SM, Xie X, Piamjariyakul U, Winstanley EL. Early-onset alcohol, tobacco, and illicit drug use with age at onset of hypertension: a survival analysis. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1129-1141. [PMID: 38104055 DOI: 10.1007/s00127-023-02596-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE To examine the associations of age when first substance use and early-onset substance use before age 18 with age at onset (AAO) of hypertension. METHODS This study included 19,270 individuals with AAO of hypertension from the 2015-2019 National Survey on Drug Use and Health. Age when first use of 10 substance use variables included alcohol, daily cigarettes, cigars, smokeless tobacco, marijuana, cocaine, hallucinogens, lysergic acid diethylamide (LSD), inhalants, and methamphetamine use. The outcome was AAO of hypertension and variable cluster analysis was used to classify the exposures and outcome. Substance use status was classified into three categories: early-onset substance use (first used substance before age 18), late-onset substance use (first used substance after age 18), and never used. RESULTS The mean AAO of hypertension was 42.7 years. Age when first use of 10 substance use variables had significant correlations with AAO of hypertension (all p values < 0.001). Individuals with early-onset alcohol, cigars, smokeless tobacco, marijuana, hallucinogens, inhalants, cocaine, LSD, and methamphetamine use revealed significantly earlier onset of hypertension than those never used. Compared with never used substances, the Cox regression model showed that early-onset alcohol, smokeless tobacco, marijuana, inhalants, and methamphetamine use had an increased risk of AAO of hypertension [hazard ratio (HR) (95%CI) = 1.22 (1.13, 1.31), 1.36 (1.24, 1.49), 1.85 (1.75, 1.95), 1.41 (1.30, 1.52), and 1.27 (1.07,1.50), respectively]. CONCLUSION These findings suggest that intervention strategies or programs focusing on preventing early-onset substance use before age 18 may delay the onset of adult hypertension.
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Affiliation(s)
- Kesheng Wang
- Department of Family and Community Health, School of Nursing, Health Sciences Center, West Virginia University, 64 Medical Center Drive, Morgantown, WV, 26506, USA.
| | - Saima Shafique
- Department of Family and Community Health, School of Nursing, Health Sciences Center, West Virginia University, 64 Medical Center Drive, Morgantown, WV, 26506, USA
- Office of Research and Scholarly Activities, School of Nursing, Health Sciences Center, West Virginia University, 64 Medical Center Drive, Morgantown, WV, 26506, USA
| | - Nianyang Wang
- Department of Health Policy and Management, School of Public Health, University of Maryland, College Park, MD, 20742, USA
| | - Suzy Mascaro Walter
- Department of Family and Community Health, School of Nursing, Health Sciences Center, West Virginia University, 64 Medical Center Drive, Morgantown, WV, 26506, USA
| | - Xin Xie
- Department of Economics and Finance, College of Business and Technology, East Tennessee State University, Johnson City, TN, 37614, USA
| | - Ubolrat Piamjariyakul
- Office of Research and Scholarly Activities, School of Nursing, Health Sciences Center, West Virginia University, 64 Medical Center Drive, Morgantown, WV, 26506, USA
| | - Erin L Winstanley
- Department of Behavioral Medicine and Psychiatry, School of Medicine, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, 26506, USA
- Department of Neuroscience, West Virginia University, Morgantown, WV, 26506, USA
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Xu L, Gao Z, He M, Yang M. Effectiveness of the knowledge, attitude, practice intervention model in the management of hypertension in the elderly. J Clin Hypertens (Greenwich) 2024; 26:465-473. [PMID: 38468407 PMCID: PMC11088428 DOI: 10.1111/jch.14770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 03/13/2024]
Abstract
This study illustrated the effectiveness of the knowledge, attitude, practice (KAP) intervention model for community hypertension in the elderly by the community physician-led, describing the study design and baseline data. The aim of the study was to compare the changes in the elderly hypertensive population before and after the KAP intervention model by managing the elderly hypertensive patients for a period of 1 year. Basic information and risk factors affecting blood pressure control based on baseline data of recruited elderly hypertensive patients. The management approach consists of two parts: (1) the unified management of the community physician to whom the patient belongs; and (2) the management of the contracted patient by the community physician. The aim was to demonstrate the anti-hypertensive effectiveness (control rate, blood pressure reduction, and pulse pressure), the distribution of blood pressure types, and the change of the KAP in elderly hypertensive patients before and after the intervention. The KAP intervention model was administered to 2660 elderly hypertensive patients in a 1-year period. The blood pressure control rate improved by 54.03%. Mean values of overall systolic and diastolic blood pressure decreased by 16.00 and 5.31 mmHg, respectively. The proportion of isolated systolic hypertension (ISH) and systolic-diastolic hypertension (SDH) decreased by 29.14% and 24.81%, respectively. The KAP compliance improved significantly. These results suggest that the community physician-led KAP intervention model is effective in the management of hypertension in the elderly.
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Affiliation(s)
- Li‐Shuang Xu
- Department of CardiologySchool of China Medical UniversityLiaoningChina
| | - Zhi‐Guang Gao
- Department of General PracticeChaoyang Central HospitalLiaoningChina
| | - Mei He
- Department of CardiologySchool of China Medical UniversityLiaoningChina
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Pang L, Kottu L, Guo Z, Shi Y, Ferdous M, Zhao Y, Tang M, Liu W, Fang J, Fu H, Wu X, Ma M, Wang H, Merkus D, Duo L. Dawning public health services dogma: An indigenous Southwest Chinese perspective in managing hypertension-with or without the "BPHS"? Front Public Health 2022; 10:1017795. [PMID: 36438225 PMCID: PMC9686286 DOI: 10.3389/fpubh.2022.1017795] [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: 08/12/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
Background To alleviate the rising mortality burden due to hypertension and other non-communicable diseases, a new public health policy initiative in 2009 called the Basic Public Health Services (BPHS). Program was introduced by the Chinese government. The goal of the study is to assess the feasibility and impact of a nationwide health care service-the "BPHS". Methods From January to December 2021, a stratified multistage random sampling method in the survey was conducted to select 6,456 people from 8 cities/districts in Yunnan Province, China, who were above the age of 35 years. 1,521 hypertensive patients were previously aware of their high blood pressure status were matched to the BPHS program database based on ID number and then further divided into BPHS group and non-BPHS (control) group. The results of the current study are based on their responses to a short structured questionnaire, a physical examination, and laboratory tests. The association between BPHS management and its effect on the control of hypertension was estimated using multivariable logistic regression models. We evaluated the accessibility and efficacy of BPHS health care services by analyzing various variables such as blood pressure, BMI, lifestyle modification, anti-hypertensive drugs taken, and cardiovascular risk factors. Results Among the 1,521 hypertensive patients included in this study, 1,011 (66.5%) were managed by BPHS programme. The multivariable logistic regression model demonstrated that the BPHS facilitated hypertension control (OR = 1.640, 95% CI: 1.237-2.175). A higher proportion of participants receiving lifestyle guidance from the BPHS management showed lowering of total cholesterol. In comparison to the non-BPHS group, those under BPHS management adhered better to antihypertensive medications either single drug (54.3%) or in combination (17.3%) of drugs. Additionally, we also noticed that urban areas with centralized and well-established digital information management system had better hypertension treatment and control. Conclusions Nearly two-thirds of the hypertensive patients in Yunnan Province were included in BPHS management. The impact of the national BPHS program was evident in lowering risk factors for cardiovascular diseases, promoting healthy lifestyles, lowering blood pressure, increasing medication adherence, and the better control rate of hypertension.
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Affiliation(s)
- Linhong Pang
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China,School of Public Health, Kunming Medical University, Kunming, China
| | - Lakshme Kottu
- Division of Experimental Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Zihong Guo
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Yi Shi
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Misbahul Ferdous
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yajing Zhao
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Mingjing Tang
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Wei Liu
- School of Public Health, Kunming Medical University, Kunming, China
| | - Jiayu Fang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Hongchen Fu
- School of Public Health, Kunming Medical University, Kunming, China
| | - Xia Wu
- School of Public Health, Kunming Medical University, Kunming, China
| | - Min Ma
- School of Public Health, Kunming Medical University, Kunming, China
| | - Huadan Wang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Daphne Merkus
- Division of Experimental Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands,Walter Brendel Center of Experimental Medicine (WBex), LMU Munich, Munich, Germany
| | - Lin Duo
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China,*Correspondence: Lin Duo
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Fan H, Zhang X. Effects of smoking intensity trajectory, cumulative smoking exposure, and the number of years since quitting on the subsequent risk of hypertension. J Clin Hypertens (Greenwich) 2022; 24:937-944. [PMID: 35765239 PMCID: PMC9278583 DOI: 10.1111/jch.14534] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 06/06/2022] [Accepted: 06/15/2022] [Indexed: 11/27/2022]
Abstract
The aim of this study was to investigate the effects of smoking intensity trajectory, cumulative smoking exposure, and the number of years since quitting on the subsequent risk of hypertension in Chinese adults. The study included 2783 men and 3416 women who participated in at least three waves of the China Health and Nutrition Survey. Information regarding smoking behavior was obtained using a standardized questionnaire. The trajectory of smoking intensity was determined using a group‐based trajectory model. The number of pack‐years of smoking and the number of years since quitting were calculated. The incidence of hypertension was 18.2% and 15.5% in men and women, respectively, during a median follow‐up duration of 4 years. Male participants with trajectories denoting light and moderate smoking had increased risks of hypertension compared with those with trajectories denoting non‐smoking (Ps < .05). Compared with male participants with 0 pack‐years, those with < 5.5 pack‐years had a higher risk of hypertension (P < .05). Male participants with ≥5.5 pack‐years and weight gain had a higher risk of hypertension compared with those with 0 pack‐years and weight loss (P < .05). However, smoking was not related to an increased risk of hypertension in women. Additionally, similar to never smoking, having quit within 2–5 years or ≥5 years was not associated with the incidence of hypertension in men. The results of this study showed that light/moderate smoking or high cumulative smoking exposure accompanied by weight gain increased the risk of hypertension in Chinese men and smoking cessation decreased this effect.
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Affiliation(s)
- Hui Fan
- Department of Epidemiology and Health Statistics, School of Public Health, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Xingyu Zhang
- Thomas E.Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, USA
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Xi C, Shi D, Cui X, Wang G. Safety, efficacy and airway complications of the flexible laryngeal mask airway in functional endoscopic sinus surgery: A retrospective study of 6661 patients. PLoS One 2021; 16:e0245521. [PMID: 33539365 PMCID: PMC7861430 DOI: 10.1371/journal.pone.0245521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/30/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Although the flexible laryngeal mask airway (FLMA) provides considerable advantages in head and neck procedures, little is known about its safety and efficacy in functional endoscopic sinus surgery (FESS). We conducted a retrospective study to evaluate the success rate of FLMA and relevant airway complications in FESS under general anaesthesia. METHODS A retrospective review of consecutive patients who underwent FESS for chronic rhinosinusitis was performed from 2015 to 2019. All patients scheduled for FLMA ventilation were identified. Patient characteristics, length of the surgery, FLMA size, failed FLMA cases requiring endotracheal intubation, immediate adverse airway events and delayed airway injuries were recorded. The primary outcomes included the FLMA success rate, which was defined as primary success after induction and final success after the whole surgical procedure. The secondary outcomes were specific clinical factors associated with FLMA failure and airway complications related to FLMA usage. RESULTS Of the 6661 patients included in our study, primary success was achieved in 6572 (98.7%), and final success was achieved in 6512 (97.8%). Failure occurred in 89 patients (1.3%) during induction, in 14 (0.2%) during surgical preparation and in 46 (0.7%) during the intraoperative procedure. All patients with failed FLMA ventilation were successfully switched to endotracheal intubation. Male sex, advanced age, higher American Society of Anesthesiologists grade (ASA) and higher body mass index (BMI) were independent risk factors associated with failed FLMA. Immediate adverse respiratory events were observed in 0.85% of the patients, and delayed airway injuries associated with use of FLMA were observed in 0.07%. CONCLUSION This retrospective study demonstrates a high success rate for FLMA (97.8% in 6661 patients undergoing FESS). Adverse airway events and injuries associated with FLMA are rare, but clinicians should remain vigilant so that early diagnosis and prompt treatment can be provided.
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Affiliation(s)
- Chunhua Xi
- Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Dongjing Shi
- Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xu Cui
- Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Guyan Wang
- Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- * E-mail:
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