Depression, anxiety, stress and demographic determinants of hypertension disease

Language Preference and its Moderating Role in Coping with Stress: The Hispanic Community Health Study/Study of Latinos

Stress and stressful events are widely accepted risk factors for cardiometabolic diseases, including coronary heart disease and diabetes. As language plays a seminal role in development and regulation of emotions and appraisals of stressful situations, it may contribute to documented differences in the stress-cardiometabolic disease association across ethnic groups. We investigated associations between language preferences (Spanish vs English) and downstream health consequences of stress. Using data from the Sociocultural Ancillary Study of the Hispanic Community Health Study/Study of Latinos, we assessed the relationship between reported stress and risk factors (alcohol use, smoking, body mass index, depressive symptoms) and prevalence of self-reported (coronary heart disease, stroke, chronic obstructive pulmonary disease [COPD]) and clinically assessed chronic conditions (diabetes, hypertension) among 5154 Hispanic/Latino adults living in the US. Factor analysis was used to calculate a composite stress variable from participants' self-reported chronic stress, perceived stress, and adverse childhood experiences. Sampling weights and survey methodology were integrated in all analyses to account for this study's complex survey design. After controlling for sociodemographic factors (Hispanic/Latino background, study site, years in the US, social acculturation, education, income, age, sex), higher composite stress scores were associated with elevated risk factors and greater prevalence of coronary heart disease, diabetes, and COPD. Furthermore, the relationship between stress and COPD was significantly stronger among Hispanic/Latino adults who preferred to be interviewed in Spanish (compared to English). Stronger connections between stress and likelihood of drinking alcohol among English-preferring persons also emerged. These results are interpreted in light of the Hispanic health paradox and the role of cultural processes in the development of health risk factors and chronic conditions. Our findings can be integrated into relevant approaches to address health disparities within and across Hispanic/Latino populations in the US.

The Impact of Time Pressure on the Results of Psychotechnical Tests Based on the Findings of Pilot Studies Conducted on a Group of Students of the Silesian University of Technology-A Case Study

The performance of job tasks is increasingly being viewed through the prism of time constraints. Stress, as a consequence of these constraints, can play a dual role: motivating or destructive. This paper addresses the role of time pressure during the implementation of psychotechnical tests. Based on the example of a pilot group, which consisted of students of the Faculty of Mining, Safety Engineering, and Industrial Automation of the Silesian University of Technology, the authors presented the results of the study of the impact of time regime on the assessment of visuomotor coordination, psychomotor reaction time, the ability to focus attention, perceptual speed and accuracy, attention divisibility, and set-shifting. With the use of a survey conducted among the subjects and multivariate analysis (the Analytic Hierarchy Process method), an assessment was made in terms of difficulty levels during the implementation of exercises, including four evaluation criteria: complexity, repetition and timing of emitted signals, and the required accuracy of response to the signals in question. In the process of verifying the consistency of the evaluations carried out, the consistency ratio (CR) was adopted.

Mental Health Conditions According to Stress and Sleep Disorders

The purpose of this study was to compare associations between stress and sleep disorders (insomnia, hypersomnia, and sleep apnea), identify potential modifying effects, and compare associations between stress and types of sleep disorders with selected mental health conditions. Analyses were based on 21,027 employees aged 18–64 years in 2020 who were insured by the Deseret Mutual Benefit Administrators (DMBA). The risk of stress (2.3%) was significantly greater in women, singles, and those with dependent children. The risk of a sleep disorder was 12.1% (2.1% for insomnia, 1.0% for hypersomnia, and 10.1% for sleep apnea). The risk of stress was significantly greater for those with a sleep disorder (136% overall, 179% for insomnia, and 102% for sleep apnea after adjusting for age, sex, marital status, dependent children, and sleep disorders). The risk of stress among those with sleep apnea was significantly greater for singles than for married individuals. Approximately 9.5% had anxiety, 8.5% had depression, 2.0% had ADHD, 0.6% had bipolar disorder, 0.4% had OCD, and 0.1% had schizophrenia. Each of these mental health conditions was significantly positively associated with stress and sleep disorders. Bipolar disorder and schizophrenia were more strongly associated with stress and sleep disorders than were the other mental health conditions. Insomnia was more strongly associated with anxiety, bipolar disorder, OCD, and schizophrenia than was sleep apnea.

A RELAÇÃO ENTRE HIPERTENSÃO ARTERIAL, ANSIEDADE E ESTRESSE: UMA REVISÃO INTEGRATIVA DA LITERATURA

  Este estudo teve por objetivo realizar uma revisão integrativa de literaturapara verificar o que os estudos têm abordado sobre a relação entre estresse e ansiedade em pessoas hipertensas. Para tanto, o levantamento dos estudos foi realizado nas bases PsycINFO, Portal da Capes, Scielo e Medline BVS-PSI, utilizando os descritores ‘hipertensão arterial’ and ‘estresse’ and ‘ansiedade’, e seus correspondentes na língua inglesa ‘arterial hypertension’ and ‘stress’ and ‘anxiety’ e espanhola ‘hipertensión’and ‘estrés’ and ‘ansiedad’, considerando os últimos seis anos (2013 a 2018). Foram selecionados 14 estudos. Os resultados foram agrupados em três categorias: a) o impacto causado pelo diagnóstico de doenças crônicas não transmissíveis, b) fatores psicológicos associados à hipertensão arterial e c)relação saúde física versus saúde mental: uma questão também de método. Os resultados mostraram que ansiedade e estresse, além da depressão podem apresentar-se como aspectos moduladores da hipertensão arterial. Portanto, considera-se necessária a desmistificação da lógica cartesiana entre mente e corpo, para que sejam efetivadas ações de cuidado integral dos sujeitos e de promoção à saúde. Espera-se que os resultados obtidos reafirmem a importância de considerar os aspectos psicológicos e emocionais nas doenças crônicas e que estudos futuros com diferentes delineamentos sejam desenvolvidos na área da psicologia.

Levels and Predictors of Self-Care Among Patients with Hypertension in Pakistan

Background

Globally, hypertension is the leading non-communicable disease and strongest predictor of cardiovascular diseases. To mitigate and prevent hypertension-related complications, self-care behavior adaptation has proven to be vital. In this study, we examined the six clinically prescribed levels of self-care as prescribed by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure and its predictors among a select sample of hypertensive individuals in Karachi, Pakistan.

Methods

This study reports the cross-sectional survey of a sequential mixed method study which assessed the levels of self-care of hypertensive individuals residing in an urban cosmopolitan setting within Karachi Pakistan. Four hundred and two patients were screened using the H-SCALE questionnaire, while socio-demographic predictors of self-care and level of knowledge of hypertension were identified using a study-specific checklist. Self-care was assessed against six clinical domains including medication adherence, diet, weight management, physical activity, and abstinence from alcohol.

Results

Participants were recruited from the two largest tertiary care hospitals in Karachi. Good knowledge about hypertension, including its causes, management, and complications was reported by 4.47% of the participants. Highest levels of self-care adherence were found for abstinence from alcohol (100%), smoking cessation (83.33%), and medication compliance (71.89%), whereas lowest levels were found for diet (27.11%), and physical activity (24.88%). In terms of predictors for self-care, age, male gender, and self-checking of blood pressure at home, followed by the level of education were the most common predictors for each self-care behavior in the given population.

Conclusion

Overall knowledge of self-care for hypertension is sub-optimal among hypertensive patients in Pakistan which is reflected in their behaviors. There is a need to introduce healthcare educational programs in Pakistan which can improve self-care behaviors of hypertensive individuals and potentially reduce the prevalence of associated cardiovascular diseases and its complications.

Factors associated with hypertension in Pakistan: A systematic review and meta-analysis

BACKGROUND

High blood pressure is an important public health concern and the leading risk factor for global mortality and morbidity. To assess the implications of this condition, we aimed to review the existing literature and study the factors that are significantly associated with hypertension in the Pakistani population.

METHODS

We conducted several electronic searches in PubMed, ISI Web of Science, PsycINFO, EMBASE, Scopus, Elsevier, and manually searched the citations of published articles on hypertension from May 2019 to August 2019. We included all studies that examined factors associated with hypertension regardless of the study design. To assess the quality of the research, we used the Newcastle-Ottawa Quality Assessment Scale. We also conducted meta-analyses using the DerSimonian & Laird random-effects model to collate results from at least three studies.

RESULTS

We included 30 cross-sectional and 7 case-control studies (99,391 participants country-wide) in this review and found 13 (35.1%) to be high-quality studies. We identified 5 socio-demographic, 3 lifestyle, 3 health-related, and 4 psychological variables that were significantly associated with hypertension. Adults aged between 30-60 years who were married, living in urban areas with high incomes, used tobacco, had a family history of hypertension, and had comorbidities (overweight, obesity, diabetes, anxiety, stress, and anger management issues) were positively associated with hypertension. On the other hand, individuals having high education levels, normal physical activity, and unrestricted salt in their diet were negatively associated with hypertension.

CONCLUSION

We found several socio-demographic, lifestyle, health-related, and psychological factors that were significantly (positively and negatively) associated with hypertension. Our findings may help physicians and public health workers to identify high-risk groups and recommend appropriate prevention strategies. Further research is warranted to investigate these factors rigorously and collate global evidence on the same.

Altered expression of norepinephrine transporter participate in hypertension and depression through regulated TNF-α and IL-6

Aim: We explored the role of histone modification in the association of depression-hypertension by comparing norepinephrine transporter (NET) gene levels in different depression-hypertensive patients. Then, we analyzed the expression of NET correlation with inflammatory cytokines to provide a new direction for detecting the association mechanism between depression and hypertension.Methods: NE expression levels in serum of diverse groups were detected by enzyme-linked immunosorbent assay. Then histone acetyltransferase (HAT), histone deacetylase (HDAC), H3K27ac, NET, TNF-α, and interleukin-6 (IL-6) were detected by western blot in nine female subjects in different depression and hypertension groups, and Chromatin immunoprecipitation-polymerase chain reaction (Chip-PCR) were used to confirm the degree of acetylation affecting on the transcription level of NET gene. Meanwhile, correlation between NET with TNF/IL-6 was analyzed by SPSS19.0 software program. Finally, Quantitative real-time polymerase chain reaction (qPCR) and western blot were used to detect TNF-α and IL-6 expression levels after NET overexpression or interference treatment in human umbilical vein endothelial cells and Neuro-2a cells.Results: The expression of HAT and H3K27ac had lower levels in D-H and nonD-H group than nonD-nonH group. The results showed that higher acetylation could promote expression of NET genes. Meanwhile, the expression of NET had a significant negative correlation with IL-6 (R = -0.933, p < 0.01) and tumor necrosis factor (TNF) (R = -0.817, p < 0.01) in subjects. In addition, the results confirmed that TNF-α and IL-6 mRNA and protein partial expressions could be inhibited by NET in both HUVECs and Neuronal cells (p < 0.01).Conclusion: In conclusion, differential expression of NET gene might function as an important factor in interaction between depression and hypertension by partially targeting TNF-α and IL-6.

Development of a Self Report Stress Scale Using Item Response Theory-I: Item Selection, Formation of Factor Structure and Examination of Its Psychometric Properties

INTRODUCTION

Due to the absence of Turkish psychometric devices assessing stress, in the present study it was aimed to develop a stress scale, and examine its basic psychometric properties.

METHODS

Current study included two processes, formation of item pool and examination of psychometric properties of the selected items through three studies. In the first study, 611 individuals aged between 18 and 77 responded to 130 selected items. In the second study, 2223 individuals aged between 18 and 68 responded to 80 items. In the third study, 1969 individuals aged between 18 and 79 responded to the final form of 36 items. Further, in study 3 for criterion related validity 163 individuals completed the Coopersmith Self-Esteem Inventory, 113 individuals completed the Beck Anxiety Inventory, 104 individuals completed the Hospital Anxiety and Depression Scale, 107 individuals completed the Beck Depression Inventory, and 265 individuals completed the Perceived Stress Scale. Moreover, in the investigation of test-retest reliability, 119 individuals took the final form of the test after 2 weeks, and 111 individuals took the final form of the test after 3 weeks.

RESULTS

In the first study, out of 130 items, 54 that showed item-total score correlations below 0.30 were excluded from the scale. Fifty-seven items were preserved exactly, and 19 items' sentence structures were changed. Furthermore, by adding 4 new items, 80 were prepared for the second study. In the second study, two factors structure namely "Physiological Reactions/Strain" and "Psychological/Cognitive Appraisals" sub-dimensions were identified, and 36 items were selected via Item Response Theory representing these sub-dimensions. In study 3, exploratory factor analysis provided strong support for our hypothesized two factors structure. Confirmatory factor analysis indicated hypothesized model had a better fit to the data. Internal consistency coefficients were 0.94 for the entire scale, 0.90 for Physiological Reactions/Strain sub-dimension, and 0.91 for Psychological/Cognitive Appraisals sub-dimension. Correlation coefficients between the entire scale and other criterion scales ranged from 0.22 to 0.63. Test-retest correlation coefficients between the first administration of the scale, and the administrations at two and three week intervals were 0.88.

CONCLUSION

Results showed that the scale has basic psychometric requirements provided that the scale will be supported by validity studies.

Prevalence of non-communicable diseases and their risk factors at a semi-urban community, Pakistan

Introduction

Pakistan is currently facing the double burden of communicable (38%) and non- communicable diseases (49%) according to WHO NCD Country Profiles 2014. About 50% of all deaths are attributed to NCD's. The objective of this study was to determine the burden of non-communicable diseases in semi urban community of Islamabad.

Methods

We carried a cross sectional study to estimate the burden of non-communicable diseases in an urban setting, a community based cross sectional survey covering 1210 households was carried out over a period of three months. Households were selected through consecutive non-probability sampling, among which adult females and males who were permanent resident of the community were interviewed through a structured questionnaire in urdu language. SPSS version 21 was used to analyze the data. Descriptive statistics were calculated.

Results

About 38.7% individuals had High BP / IHD, 34.4% had oro-dental health problems, 24.3% were physically disabled and 14.6% had diabetes. Among the risk factors, 48.2% were tobacco user, 13.60% were drug abuser and 1.8% alcoholics.

Conclusion

We conclude that the prevalence of non-communicable diseases is quite high in the above setting as compared to the National indicators, which demands timely intervention to curtail the existing burden of NCD.