1
|
Zare MG, Okati-Aliabad H, Ansari-Moghaddam A, Mohammadi M, Shahraki-Sanavi F. Prevalence and risk factors of pre-hypertension and hypertension among adults in Southeastern Iran: Findings from the baseline survey of the Zahedan adult cohort study. PLoS One 2023; 18:e0295270. [PMID: 38060532 PMCID: PMC10703255 DOI: 10.1371/journal.pone.0295270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/17/2023] [Indexed: 12/18/2023] Open
Abstract
Hypertension (HTN) stands as the leading modifiable risk factor for cardiovascular disease(CVD) and premature death globally. Understanding its prevalence and risk factors is essential for effective prevention and management of HTN. This study aimed to investigate the prevalence of Pre-hypertension (pre-HTN), HTN, and its risk factors in adults participating in the Zahedan adult cohort study (ZACS). This cross-sectional study used the baseline data of the ZACS. Ordinal logistic regression analysis was used to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for potential risk factors. Among the 10,016 participants in this study, 60.89% were women, with an average age of 50.44 ± 9.18 years. The prevalence of pre-HTN and HTN was 42.03% (men 45.44%, women 39.84%) and 18.47% (men 21.09%, women 16.79%), respectively. Being male, older age, having higher socioeconomic status (SES), being overweight and obese, having a family history of HTN, comorbidities such as diabetes and CVD, as well as abnormal blood lipid levels (triglycerides and HDL cholesterol) were the most significant predictors of pre-HTN and HTN. These findings highlight that more than half of the participants in this study exhibit pre-HTN or HTN, placing them at risk for CVD and stroke. Implementing comprehensive preventive strategies tailored to these identified risk factors is imperative to alleviate the disease burden, enhance disease management, and improve HTN treatment and control.
Collapse
Affiliation(s)
- Mojtaba Gholami Zare
- Department of Epidemiology, MSc Candidate of Epidemiology, School of Public Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hassan Okati-Aliabad
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Mahdi Mohammadi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | | |
Collapse
|
2
|
Zhan R, Liu L, Yang M, Ren Y, Ge Z, Shi J, Zhou K, Zhang J, Cao H, Yang L, Liu K, Sheng J, Tao F, Wang S. Associations of 10 trace element levels in the whole blood with risk of three types of obesity in the elderly. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 45:9787-9806. [PMID: 37847362 DOI: 10.1007/s10653-023-01747-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/29/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Currently, over 2 billion people worldwide suffer from obesity, which poses a serious health risk. More and more attention is being given to the effects of trace elements on obesity in recent years. Synergistic or antagonistic interactions among these elements can adversely or positively impact human health. However, epidemiological evidence on the relationship between trace element exposure levels and obesity has been inconclusive. METHODS Baseline data of 994 participants from the Cohort of Elderly Health and Environment Controllable Factors were used in the present study. ICP-MS was used to measure the concentrations of 10 trace elements in the whole blood of the older population. Binary logistic regression, restricted cubic splines (RCS) models, and Bayesian kernel machine regression (BKMR) models were employed to assess single, nonlinear, and mixed relationships between 10 trace element levels and three types of obesity based on body mass index (BMI), waist circumference (WC), and body fat percentage (BFP) in the elderly. RESULTS Based on BMI, WC and BFP, 51.8% of the included old population were defined as general overweight/obesity, 67.1% as abdominal obesity, and 36.2% as having slightly high/high BFP. After multivariable adjustment, compared with the lowest tertile, the highest tertile of blood selenium (Se) concentration was associated with an increased risk of all three types of obesity. Additionally, compared with the lowest tertile, higher tertiles of strontium (Sr) concentrations were associated with a lower risk of general overweight/obesity and having slightly high/high BFP, and the highest tertile of barium (Ba) was associated with a lower risk of having slightly high BFP, while higher tertiles of arsenic (As) concentrations were associated with an increased risk of having slightly high/high BFP, and the highest tertile of manganese (Mn) was associated with a higher risk of abdominal obesity. BKMR analyses showed a strong linear positive association between Se and three types of obesity. Higher blood levels of trace element mixture were associated with increased obesity risks in a dose-response pattern, with Se having the highest value of the posterior inclusion probability (PIP) within the mixture. CONCLUSIONS In this study, we found higher Se levels were associated with an elevated risk of obesity and high levels of Ba, Pb and Cr were associated with a decreased risk of obesity. Studies with larger samples are needed to confirm these findings.
Collapse
Affiliation(s)
- Rui Zhan
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental, Toxicology of Anhui Higher Education Institutes, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Lin Liu
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Maoyuan Yang
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yating Ren
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Zhihao Ge
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Jun Shi
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Ke Zhou
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Jiebao Zhang
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Hongjuan Cao
- Lu'an Center of Disease Control and Prevention, Lu'an, Anhui, China
| | - Linsheng Yang
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental, Toxicology of Anhui Higher Education Institutes, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Kaiyong Liu
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental, Toxicology of Anhui Higher Education Institutes, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Jie Sheng
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental, Toxicology of Anhui Higher Education Institutes, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Fangbiao Tao
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental, Toxicology of Anhui Higher Education Institutes, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Sufang Wang
- School of Public Health, Anhui Medical University, Hefei, Anhui, China.
- Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Hefei, Anhui, China.
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health and Aristogenics/Key Laboratory of Environmental, Toxicology of Anhui Higher Education Institutes, No 81 Meishan Road, Hefei, 230032, Anhui, China.
| |
Collapse
|
3
|
Shu L, Zhang J, Jia L, Wang J, Han Z. Effect of lipid accumulation product on the development of hypertension among nondiabetic individuals in eastern China: A cross-sectional study. J Clin Hypertens (Greenwich) 2023; 25:784-793. [PMID: 37433158 PMCID: PMC10423760 DOI: 10.1111/jch.14696] [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: 03/30/2023] [Revised: 06/13/2023] [Accepted: 06/25/2023] [Indexed: 07/13/2023]
Abstract
This study was aimed at assessing the risk factors for hypertension (HTN) and prehypertension (PHT) in order to clarify the role of lipid accumulation product (LAP) in the development of HTN among nondiabetic individuals. A large cross-sectional study was conducted in community health service centers in urban Bengbu, Anhui Province, China. All participants completed an interview questionnaire and procedures to obtain physical measurements and biochemical indicators. Multivariate logistic regression was used to test for the prevalence of HTN and PHT in relation to each quartile increase in LAP level and family history of HTN. The resulting interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI). A total of 7733 subjects were enrolled in the study. The overall prevalence rates of PHT and HTN were 37.1% and 24.8%, respectively. After adjusting for confounding factors, multinomial logistic regression analysis showed that compared with subjects in LAP quartile 1, those in quartile 3 (OR, 1.257; 95% CI, 1.062-1.494) and quartile 4 (OR, 1.323; 95% CI, 1.101-1.592) had a significantly higher risk for HTN (p for trend < .001). A significant interaction was observed between LAP and family history of HTN in men (AP, 0.1661; 95% CI, 0.0024-0.3296; SI, 1.4037; 95% CI, 1.0599-1.8593) and in women (RERI, 1.4111; 95% CI, 0.1458-2.9678; AP, 0.1662; 95% CI, 0.0085-0.3237; SI, 1.3886; 95% CI, 1.0568-1.8247). The results demonstrated that the interactive effects of LAP with family history of HTN may influence the development of HTN synergistically.
Collapse
Affiliation(s)
- Li Shu
- School of public healthBengbu medical collegeBengbuAnhuiChina
| | - Jiaye Zhang
- School of public healthBengbu medical collegeBengbuAnhuiChina
| | - Linlin Jia
- School of public healthBengbu medical collegeBengbuAnhuiChina
| | - Jinchen Wang
- School of public healthBengbu medical collegeBengbuAnhuiChina
| | - Ziyan Han
- School of public healthBengbu medical collegeBengbuAnhuiChina
| |
Collapse
|
4
|
El-Sayed Awaad A, El-Bestar S, El-Gilany AH, Al-Wehedy A, El Hadidy SS. Cardiovascular risk factors among train drivers, Mansoura, Egypt. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2023; 78:329-338. [PMID: 37431719 DOI: 10.1080/19338244.2023.2230119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/21/2023] [Indexed: 07/12/2023]
Abstract
Cardiovascular risk factors and diseases are the most prevalent health conditions in train drivers. A comparative cross-sectional study was carried out to estimate the prevalence of some cardiovascular risk factors among train drivers. A pre-designed questionnaire was used to collect socio-demographic and occupational data. Physical activity and dietary habits were assessed, psychological distress was measured. Out of 100 recruited train drivers, 62% had obesity, 46% were hypertensive, 72.8% had dyslipidemia, and 71% had mild and/or moderate level of psychological distress. Being a train driver is independently associated with the likelihood of having obesity (AOR = 14.2) and psychological distress (AOR = 6.6). The prevalence of various cardiovascular risk factors was significantly higher among train drivers than the comparison group. Being a train driver is independently associated with obesity and psychological distress.
Collapse
Affiliation(s)
- Asmaa El-Sayed Awaad
- Public Health & Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Sohair El-Bestar
- Public Health & Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Abdel-Hady El-Gilany
- Public Health & Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Adel Al-Wehedy
- Public Health & Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Samah Saleh El Hadidy
- Public Health & Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| |
Collapse
|
5
|
Yeh EJ, Grigolon RB, Rodrigues SR, A Bueno AP. Systematic literature review and meta-analysis of cardiovascular risk factor management in selected Asian countries. J Comp Eff Res 2023; 12:e220085. [PMID: 36861459 PMCID: PMC10402804 DOI: 10.57264/cer-2022-0085] [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: 05/06/2022] [Accepted: 01/20/2023] [Indexed: 03/03/2023] Open
Abstract
Aim: There is a need to understand the management status of hypertension, dyslipidemia/hypercholesterolemia, and diabetes mellitus in the Asia-Pacific region (APAC). Methods: We conducted a systematic literature review and meta-analysis to summarize the awareness, treatment, and/or control rates of these risk factors in adults across 11 APAC countries/regions. Results: We included 138 studies. Individuals with dyslipidemia had the lowest pooled rates compared with those with other risk factors. Levels of awareness with diabetes mellitus, hypertension, and hypercholesterolemia were comparable. Individuals with hypercholesterolemia had a statistically lower pooled treatment rate but a higher pooled control rate than those with hypertension. Conclusion: The management of hypertension, dyslipidemia, and diabetes mellitus was suboptimal in these 11 countries/regions.
Collapse
|
6
|
Rezaianzadeh A, Jafari F, Ghoddusi Johari M, Karami H. Awareness, Treatment, and Control of Hypertension among 10663 Adults Based on the Baseline Data of the Kherameh Cohort Study. J Tehran Heart Cent 2023; 18:102-108. [PMID: 37637280 PMCID: PMC10459349 DOI: 10.18502/jthc.v18i2.13319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/13/2023] [Indexed: 08/29/2023] Open
Abstract
Background A comprehensive strategy to reduce the complications of hypertension (HTN) should include prevention approaches, such as increasing awareness, early diagnosis, and adequate treatment. The present study aimed to assess awareness, treatment, and control of HTN and their related factors in Kherameh, Iran. Methods This cross-sectional study was performed on 10 663 individuals aged between 40 and 70 years using the Kherameh cohort data. HTN was defined as either systolic/diastolic blood pressure ≥140/90 mmHg or taking medications. Logistic regression was used to investigate the relationship between awareness, treatment, and control of HTN and demographic factors, comorbidities, and a family history of diseases. Results Out of 10 663 participants, 4719 (44.3%) were men, and the average age of the participants was 51.94±8.27 years. The rates of the prevalence, awareness, treatment, and control of HTN were 27.7% (95% CI, 26.86 to 28.54), 80.3% (95% CI, 79.56 to 81.04), 78% (95% CI, 77.22 to 78.78), and 53.6% (95% CI, 52.66 to 54.54), respectively. Age, gender, body mass index, and cardiovascular disease were associated with all the dependent variables in the regression model. Additionally, occupation, diabetes, chronic diseases, a history of cardiovascular disease in first and second-degree relatives and a history of chronic diseases in second-degree relatives were related to all the dependent variables except for treatment. Conclusion A high percentage of the patients were aware of their disease, but a smaller proportion were on medication. Consequently, about half the patients had blood pressure below 140/90 mmHg.
Collapse
Affiliation(s)
- Abbas Rezaianzadeh
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Jafari
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Hamed Karami
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
7
|
Hou C, Zhong Y, Zhang L, Liu M, Yan F, Chen M, Wang Y, Xu P, Su M, Hu C, Di B. Estimating the prevalence of hypertension in 164 cities in China by wastewater-based epidemiology. JOURNAL OF HAZARDOUS MATERIALS 2023; 443:130147. [PMID: 36283217 DOI: 10.1016/j.jhazmat.2022.130147] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/12/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
Hypertension is the most common chronic non-infectious disease and a severe problem for public health in China. There were 244.5 million people aged over 18 years in China who had hypertension in 2015, and hypertension-related death accounted for more than 25 % of all causes of death in China every year. To monitor the hypertension prevalence in near real-time, a wastewater-based epidemiology (WBE) approach by using metoprolol acid as a biomarker was conducted in 164 cities in China. LC-MS/MS was utilized to quantify metoprolol acid in sewage, and satisfactory method validation results were achieved. The average concentration of metoprolol acid in sewage was 943.1 ± 671.1 ng/L, and the back-calculated consumption of metoprolol based on metoprolol acid was 932.0 ± 390.5 mg/day/1000inh on average, ranging from 76.7 to 3275.7 mg/day/1000inh. The prevalence of metoprolol was estimated to be 0.83 % ± 0.35 %, and the estimated hypertension prevalence in the population aged over 15 years was ultimately assessed to be 28.56 % ± 10.44 % ranging from 14.28 % to 44.28 % and was consistent with the China Hypertension Survey result of 27.9 %. This research demonstrated that estimating hypertension prevalence by WBE with metoprolol acid as a biomarker is feasible in Chinese cities.
Collapse
Affiliation(s)
- Chenzhi Hou
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China
| | - Yuling Zhong
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China
| | - Lan Zhang
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China
| | - Muyuan Liu
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China
| | - Fang Yan
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China
| | - Mengyi Chen
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China
| | - Youmei Wang
- China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China; National Narcotics Laboratory, Drug Intelligence and Forensic Center of the Ministry of Public Security of the People's Republic of China, Beijing 100741, PR China; Key Laboratory of Drug Monitoring and Control, Ministry of Public Security, People's Republic of China, Beijing 100741, PR China
| | - Peng Xu
- China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China; National Narcotics Laboratory, Drug Intelligence and Forensic Center of the Ministry of Public Security of the People's Republic of China, Beijing 100741, PR China; Key Laboratory of Drug Monitoring and Control, Ministry of Public Security, People's Republic of China, Beijing 100741, PR China
| | - Mengxiang Su
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China
| | - Chi Hu
- China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China; Department of Pharmaceutical Engineering, School of Engineering, China Pharmaceutical University, Nanjing 211198, PR China.
| | - Bin Di
- Department of Pharmacy, China Pharmaceutical University, No.24 Tongjiaxiang Road, Nanjing 210009, PR China; China National Narcotics Control Commission-China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, PR China.
| |
Collapse
|
8
|
Lu Y, Wiltshire HD, Baker JS, Wang Q, Ying S. The effect of Tabata-style functional high-intensity interval training on cardiometabolic health and physical activity in female university students. Front Physiol 2023; 14:1095315. [PMID: 36923290 PMCID: PMC10008870 DOI: 10.3389/fphys.2023.1095315] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/09/2023] [Indexed: 02/28/2023] Open
Abstract
Introduction: The increasing prevalence of metabolic syndrome and physical inactivity enhances exposure to cardiometabolic risk factors in university students. High-intensity interval training (HIIT) improved cardiometabolic health in clinical adults but the evidence in the university setting is limited. Furthermore, few studies examined the effect of low-volume HIIT on habitual physical activity (PA). Therefore, the primary aim of this study was to evaluate the efficacy of 12-week Tabata-style functional HIIT for improving multiple cardiometabolic health outcomes and habitual PA. We also investigated whether changes in habitual PA over the intervention period had an impact on exercise-induced health outcomes. Methods: 122 female freshmen were randomized into the Tabata group (n = 60) and the control (n = 62). The Tabata training protocol involved 8 × 20 s maximal repeated functional exercises followed by 10 s rest with a frequency of 3 times per week for 12 weeks. Body composition, maximal oxygen uptake (VO2max), blood pressure (BP), blood lipids, fasting glucose and insulin, C-reactive protein and PA were objectively measured using standardized methods. Dietary intake was measured using a valid food frequency questionnaire. All variables were measured pre- and post-intervention. Results: Mixed linear modelling results showed that there were large intervention effects on VO2max (p < 0.001, d = 2.53, 95% CI: 2.03 to 3.00 for relative VO2max; p < 0.001, d = 2.24, 95% CI: 1.76 to 2.68 for absolute VO2max), resting heart rate (p < 0.001, d = -1.82, 95% CI: -2.23 to -1.37), systolic BP (p < 0.001, d = -1.24, 95% CI: -1.63 to -0.84), moderate-to-vigorous intensity physical activity (MVPA) (p < 0.001, d = 2.31, 95% CI: 1.83 to 2.77), total PA (p < 0.001, d = 1.98, 95% CI: 1.53 to 2.41); moderate effects on %BF (p < 0.001, d = -1.15, 95% CI: -1.53 to -0.75), FM (p < 0.001, d = -1.08, 95% CI: -1.46 to -0.69), high-density lipoprotein (HDL) (p < 0.001, d = 1.04, 95% CI: 0.65 to 1.42), total cholesterol (p = 0.001, d = -0.64, 95% CI: -1.00 to -0.26); small effects on BMI (p = 0.011, d = -0.48, 95% CI: -0.84 to 0.11), WC (p = 0.043, d = -0.37, 95% CI: -0.74 to -0.01), low-density lipoprotein (p = 0.003, d = -0.57, 95% CI: -0.93 to -0.19), HOMA-IR (p = 0.026, d = -0.42, 95% CI: -0.78 to -0.05) and fasting insulin (p = 0.035, d = -0.40, 95% CI: -0.76 to -0.03). Regression analysis showed that only the percentage change of HDL was associated with the change of MVPA (b = 0.326, p = 0.015) and TPA (b = 0.480, p = 0.001). Conclusion: From the findings of the study we can conclude that 12-week low-volume Tabata-style functional HIIT was highly effective for university female students to improve cardiorespiratory fitness, body fat, some cardiometabolic health outcomes and habitual PA.
Collapse
Affiliation(s)
- Yining Lu
- Faculty of Sport Science, Ningbo University, Ningbo, China.,Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Huw D Wiltshire
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Julien Steven Baker
- Centre for Population Health and Medical Informatics, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Qiaojun Wang
- Faculty of Sport Science, Ningbo University, Ningbo, China
| | - Shanshan Ying
- Faculty of Sport Science, Ningbo University, Ningbo, China
| |
Collapse
|
9
|
Lokpo SY, Ametefe CY, Osei-Yeboah J, Owiredu WKBA, Ahenkorah-Fondjo L, Agordoh PD, Acheampong E, Duedu KO, Adejumo EN, Appiah M, Asiamah EA, Ativi E, Kwadzokpui PK. Performance of Body Adiposity Index and Relative Fat Mass in Predicting Bioelectric Impedance Analysis-Derived Body Fat Percentage: A Cross-Sectional Study among Patients with Type 2 Diabetes in the Ho Municipality, Ghana. BIOMED RESEARCH INTERNATIONAL 2023; 2023:1500905. [PMID: 37101689 PMCID: PMC10125734 DOI: 10.1155/2023/1500905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 01/02/2023] [Accepted: 02/21/2023] [Indexed: 04/28/2023]
Abstract
Objective The study sought to determine the diagnostic accuracy of body adiposity index (BAI) and relative fat mass (RFM) to predict BIA-derived BFP among patients with type 2 diabetes in the Ho municipality. Materials and Method. This hospital-based cross-sectional study involved 236 patients with type 2 diabetes. Demographic data, including age and gender were obtained. Height, waist circumference (WC), and hip circumference (HC) were measured using standard methods. BFP was estimated on a bioelectrical impedance analysis (BIA) scale. The validity of BAI and RFM as alternative estimates for BIA-derived BFP was evaluated based on mean absolute percentage error (MAPE), Passing-Bablok regression, Bland-Altman plots, receiver-operating characteristic curve (ROC), and kappa statistics analyses. A p value less than 0.05 was considered statistically significant. Results BAI showed systematic bias in estimating BIA-derived BFP in both genders, but this was not evident between RFM and BFP among females (t = -0.62; p = 0.534). While BAI showed "good" predictive accuracy in both genders, RFM exhibited "high" predictive accuracy for BFP (MAPE: 7.13%; 95% CI: 6.27-8.78) among females according to MAPE analysis. From the Bland-Altman plot analysis, the mean difference between RFM and BFP was acceptable among females [0.3 (95% LOA: -10.9 to 11.5)], but both BAI and RFM recorded large limits of agreement and low Lin's concordance correlation coefficient with BFP (Pc < 0.90) in the two gender populations. The optimal cut-off, sensitivity, specificity, and Youden index for RFM were >27.2, 75%, 93.75%, and 0.69, respectively, while those of BAI were >25.65, 80%, 84.37%, and 0.64, respectively, among males. Among females, the values for RFM were >27.26, 92.57%, 72.73%, and 0.65, whereas those of BAI were >29.4, 90.74%, 70.83%, and 0.62, respectively. The accuracy of discriminating between BFP levels was higher among females [BAI (AUC: 0.93) and RFM (AUC: 0.90)] compared to males [BAI (AUC: 0.86) and RFM (AUC: 0.88)]. Conclusion RFM had a better predictive accuracy of BIA-derived BFP in females. However, both RFM and BAI failed as valid estimates for BFP. Furthermore, gender-specific performance in the discrimination of BFP levels for RFM and BAI was observed.
Collapse
Affiliation(s)
- Sylvester Yao Lokpo
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Cephas Yao Ametefe
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - James Osei-Yeboah
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - William K. B. A. Owiredu
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Linda Ahenkorah-Fondjo
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Percival Delali Agordoh
- Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwabena Obeng Duedu
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Esther Ngozi Adejumo
- Department of Medical Laboratory Science, School of Public and Allied Health, Babcock University, Ilishan-Remo, Ogun State, Nigeria
| | - Michael Appiah
- Department of Medical Laboratory Sciences, Accra Technical University, Accra, Greater Accra Region, Ghana
| | - Emmanuel Akomanin Asiamah
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Emmanuel Ativi
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
- Medical Laboratory Department, Ho Teaching Hospital, Ho, Ghana
| | - Precious Kwablah Kwadzokpui
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
- Medical Laboratory Department, Ho Teaching Hospital, Ho, Ghana
| |
Collapse
|
10
|
Wang Y, Min C, Song X, Zhang H, Yuan C, Chen L, Zhang H. The dose-response relationship between BMI and hypertension based on restricted cubic spline functions in children and adolescents: A cross-sectional study. Front Public Health 2022; 10:870568. [PMID: 36600935 PMCID: PMC9806353 DOI: 10.3389/fpubh.2022.870568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022] Open
Abstract
Background A high body mass index (BMI) is a major risk factor for hypertension. The purpose of this study was to investigate the association between the BMI and hypertension in children and adolescents. Methods We analyzed physical examination data from 29,810 students aged 6-14 years old. A restricted cubic spline (RCS) function was used to investigate the dose-response relationship between the BMI and hypertension. Results The prevalence of hypertension was 9.91%, followed by 11.71% in males and 7.9% in females, respectively. Compared to the normal weight group, the odds risk (OR) for hypertension in the overweight group was 1.729, and the OR for hypertension in the obesity group was 3.089. After adjusting for potential confounders, the adjusted ORs were 1.620 [95% confidence interval (CI): 1.457-1.800] in the overweight group and 3.092 (95% CI: 2.824-3.385) in the obesity group. According to the multivariate RCS regression analysis, there was a significant non-linear dose-response association between the BMI and the risk of hypertension (all P-values for non-linear < 0.001). Conclusion The dose-response relationship analysis showed that the association strength of hypertension increased non-linearly along with the continuous change of BMI in children and adolescents.
Collapse
Affiliation(s)
- Yani Wang
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Congcong Min
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaoyan Song
- Health Management Center, Qingdao Central Hospital, Qingdao University, Qingdao, China
| | - Heyue Zhang
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Chen Yuan
- Health Management Center, Qingdao Central Hospital, Qingdao University, Qingdao, China
| | - Lizhen Chen
- Department of Infectious Disease, Qingdao Municipal Hospital, Qingdao University, Qingdao, China,*Correspondence: Lizhen Chen
| | - Haiying Zhang
- Health Management Center, Qingdao Central Hospital, Qingdao University, Qingdao, China,Haiying Zhang
| |
Collapse
|
11
|
Geng X, Zhou Y, Gao X, Li F, Gu G, Bai L, Cui W. The overestimated prevalence of hypertension in a population survey: a cross-sectional study from Hebei province, China. BMC Cardiovasc Disord 2022; 22:542. [PMID: 36510119 PMCID: PMC9743587 DOI: 10.1186/s12872-022-02994-y] [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: 08/18/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Currently, the prevalence of hypertension is mainly ascertained using a one-visit population survey, which may lead to overestimation. The purpose of this study was to assess the accuracy of hypertension prevalence determined by a one-visit population survey. METHODS For this cross-sectional study, we continuously enrolled 1116 volunteers without a hypertension history in Hebei province from January 2018 to December 2019. The study population included 511 (45.80%) males and 605 (54.20%) females with a mean age of 48 years. The hypertension prevalence was assessed using two methods: one-visit screening and daytime ambulatory blood pressure (BP) monitoring. We directly compared the performances of daytime ambulatory BP monitoring and one-visit screening in the same group of subjects. In addition, we explored possible thresholds to improve the detection of hypertension. RESULTS During the one-visit survey, the mean BP value was about 8 mmHg higher than that determined by daytime ambulatory BP monitoring. The prevalence of hypertension was 29.84% and 14.07% during the one-visit and daytime multiple visit surveys, respectively. The risk factors for overestimated hypertension were female sex, body mass index < 24.00 kg/m2, and diastolic BP of 100 mmHg. The positive predictive value of the one-visit population survey for diagnosing hypertension was 36.34%. Furthermore, receiver operating characteristic analysis showed that in males, the best diagnostic threshold for hypertension diagnosis was 148/96 mmHg. CONCLUSION The hypertension prevalence was likely overestimated by 2-fold in the one-visit survey group compared to the daytime ambulatory BP monitoring group. Thus, the threshold for one-visit BP screening should be raised to 148/96 mmHg to improve the accuracy of hypertension diagnosis.
Collapse
Affiliation(s)
- Xue Geng
- grid.452702.60000 0004 1804 3009Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, No. 215, He Ping West Road, 050000 Shijiazhuang, China
| | - Yaqing Zhou
- grid.452702.60000 0004 1804 3009Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, No. 215, He Ping West Road, 050000 Shijiazhuang, China
| | - Xiaoli Gao
- Department of Cardiology, North China Petroleum General Hospital, Cangzhou, China
| | - Feng Li
- grid.452702.60000 0004 1804 3009Department of Quality Control, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guoqiang Gu
- grid.452702.60000 0004 1804 3009Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, No. 215, He Ping West Road, 050000 Shijiazhuang, China
| | - Long Bai
- grid.452702.60000 0004 1804 3009Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, No. 215, He Ping West Road, 050000 Shijiazhuang, China
| | - Wei Cui
- grid.452702.60000 0004 1804 3009Department of Cardiology, The Second Hospital of Hebei Medical University and Institute of Cardiocerebrovascular Disease of Hebei Province, No. 215, He Ping West Road, 050000 Shijiazhuang, China
| |
Collapse
|
12
|
Nguyen TT, Nguyen MH, Nguyen YH, Nguyen TTP, Giap MH, Tran TDX, Pham TTM, Pham KM, Nguyen KT, Le VTT, Su CT, Duong TV. Body mass index, body fat percentage, and visceral fat as mediators in the association between health literacy and hypertension among residents living in rural and suburban areas. Front Med (Lausanne) 2022; 9:877013. [PMID: 36148456 PMCID: PMC9485490 DOI: 10.3389/fmed.2022.877013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background Hypertension is a major cause of death and disability worldwide. Enhancing health literacy (HL) may help to alleviate the risk of hypertension and its burden. However, evidence on the association between HL and hypertension and potential mechanisms remain to be explored. Objectives This study examined the association between HL and hypertension; and explored whether body mass index (BMI), body fat percentage (PBF), and visceral fat (VF) were mediators of this association in people who resided in rural and suburban areas in Vietnam. Methods A cross-sectional survey was conducted from 1st July to 31st December 2019, involving 1655 residents and exploring participants' sociodemographic characteristics, HL, health-related behaviors, comorbidities, body composition, and blood pressure (BP). People with systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg or using antihypertensive medication were classified as having hypertension. Multiple logistic regression and mediation analyses were used to explore associations. Results The hypertension prevalence was 41.9% (694/1,655). In adjusted models, a higher HL score was associated with a lower hypertension likelihood (OR = 0.96; 95%CI = 0.95–0.97; p < 0.001). Factors associated with a higher odd of hypertension were overweight/obese (OR = 1.69; 95%CI = 1.24–2.29; p = 0.001), high PBF (OR = 2.35; 95%CI = 1.85–2.99; p < 0.001), and high VF (OR = 2.27; 95%CI = 1.63–3.16; p < 0.001). Notably, PBF significantly mediated the association between HL and hypertension (indirect effect, OR = 0.99; 95%CI = 0.98–0.99; p = 0.009; percent mediated = 8.56%). The mediating roles of BMI and VF were not found. Conclusion The prevalence of hypertension was relatively high. People with better HL were less likely to have hypertension. The association between HL and hypertension was partially explained by PBF. Strategic approaches are required to improve people's HL and body fat which further help to manage hypertension in rural and suburban areas.
Collapse
Affiliation(s)
- Tham T. Nguyen
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Minh H. Nguyen
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yen H. Nguyen
- Department of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
- Department of Pharmacy, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam
- Ph.D. Program in School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Thao T. P. Nguyen
- Health Personnel Training Institute, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Manh H. Giap
- Emergency Department, Bai Chay Hospital, Hạ Long, Vietnam
| | - Tung D. X. Tran
- Stem Cell Unit, Van Hanh Hospital, Ho Chi Minh, Vietnam
- Hi-Tech Institute, Nguyen Tat Thanh University, Ho Chi Minh, Vietnam
| | - Thu T. M. Pham
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Khue M. Pham
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Kien T. Nguyen
- Department of Health Promotion, Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Vinh-Tuyen T. Le
- Department of Pharmacognosy - Traditional Pharmacy - Pharmaceutical Botanic, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
- Ph.D. Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Chien-Tien Su
- School of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Tuyen Van Duong
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
- *Correspondence: Tuyen Van Duong
| |
Collapse
|
13
|
Boro B, Banerjee S. Decomposing the rural-urban gap in the prevalence of undiagnosed, untreated and under-treated hypertension among older adults in India. BMC Public Health 2022; 22:1310. [PMID: 35799143 PMCID: PMC9264707 DOI: 10.1186/s12889-022-13664-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 06/20/2022] [Indexed: 12/30/2022] Open
Abstract
Background Although awareness and treatment rates of hypertension have significantly improved in recent years, the prevalence of undiagnosed and untreated hypertension remains a major public health concern for Indian policymakers. While the urban–rural variation in the prevalence, diagnosis, control, and treatment of hypertension is reasonably well-documented, the explanation behind such variation remains poorly understood given the dearth of studies conducted on exploring the determinants of the rural–urban gap in the prevalence of undiagnosed, untreated, and uncontrolled hypertension in India. In view of this research gap, our paper aims to decompose the inter-group differences between rural and urban areas in undiagnosed, untreated, and undertreated hypertension among older adults in India into the major contributing factors. Methods Nationally representative data collected in the Longitudinal Ageing Study of India, Wave-1 (2017–18), was utilized for this study. Maximum-likelihood binary logistic-regression models were employed to capture the crude and adjusted associations between the place of residence and prevalence of undiagnosed, untreated, and undertreated hypertension. Fairlie’s decomposition technique was used to decompose the inter-group differences between rural and urban residents in the prevalence of undiagnosed, untreated, and undertreated hypertension among the older population in India, into the major contributing factors, in order to explore the pathways through which these differences manifest. Results The overall prevalence rates of undiagnosed, untreated, and undertreated hypertension among older adults were 42.3%, 6%, and 18.7%, respectively. However, the prevalence of undiagnosed and untreated hypertension was higher in rural areas, by 12.4 and 1.7 percentage-points, respectively, while undertreated hypertension was more prevalent in the urban areas (by 7.2 percentage-points). The decomposition analysis explained roughly 41% and 34% of the urban advantage over rural areas in the case of undiagnosed and untreated hypertension, while it explained 51% of the urban disadvantage in respect of undertreated hypertension. The rural–urban differentials in education and comorbidities accounted for the majority of the explained rural disadvantage in the prevalence of undiagnosed hypertension, explaining 13.51% and 13.27% of the gap, respectively. The regional factor was found to be the major driver behind urban advantage in the prevalence of untreated hypertension, contributing 37.47% to the overall gap. In the case of undertreated hypertension, education, comorbidities, and tobacco consumption were the major contributors to the urban–rural inequality, which accounted for 12.3%, 10.6%, and 9.8% of the gap, respectively. Conclusion Socio-economic and lifestyle factors seemed to contribute significantly to the urban–rural gap in undiagnosed, untreated and undertreated hypertension in India among older adults. There is an urgent need of creating awareness programmes for the early identification of hypertensive cases and regular treatment, particularly in under-serviced rural India. Interventions should be made targeting specific population groups to tackle inequality in healthcare utilization.
Collapse
Affiliation(s)
- Bandita Boro
- Centre for the Study of Regional Development, School of Social Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Shreya Banerjee
- Centre for the Study of Regional Development, School of Social Sciences, Jawaharlal Nehru University, New Delhi, India.
| |
Collapse
|
14
|
Yao P, Xue N, Yin S, You C, Guo Y, Shi Y, Liu T, Yao L, Zhou J, Sun J, Dong C, Liu C, Zhao M. Multi-Dimensional Feature Combination Method for Continuous Blood Pressure Measurement Based on Wrist PPG Sensor. IEEE J Biomed Health Inform 2022; 26:3708-3719. [PMID: 35417358 DOI: 10.1109/jbhi.2022.3167059] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The cuffless blood pressure monitoring method based on photoplethysmogram (PPG) makes it possible for long-term blood pressure monitoring to prevent and treat cardiovascular and cerebrovascular events. However, the traditional feature extraction is based on two separate sensors, which is inconvenient. In a single sensor measurement, the prediction model based on a single feature group usually does not perform well. This paper presents an artificial neural network (ANN) model for predicting blood pressure based on feature combinations. The robustness of the model is improved from three aspects. Firstly, an adaptive peak extraction algorithm is used to improve the accuracy of peaks and troughs detection. Secondly, multi-dimensional features are extracted and fused, including three groups of PPG-based features and one group of demographics-based features. Finally, a two-layer feedforward artificial neural networks algorithm is used for regression. Thirty-three subjects distributed in three blood pressure groups were recruited. The proposed method passes the European Society of Hypertension International Protocol revision 2010 (ESP-IP2). Experimental results show that the proposed method exhibits good accuracy for a diverse population with an estimation error of 0.03 4.27 mmHg for SBP and 0.01 3.38 for DBP. Moreover, the model can track blood pressure in a long-term range, which demonstrates the robustness of the algorithm. This work will contribute to the long-term wellness management and rehabilitation process, enabling timely detection and improvement of the user's physical health.
Collapse
|
15
|
Liu G, Fang Q, Ji X, OuYang J, Zhu Y, Wang L, Wang X. Medical expenditure and its influencing factors of patients with hypertension in Shanxi Province, China: a study based on 'System of Health Accounts 2011' and multiple-layer perceptron neural network. BMJ Open 2022; 12:e048396. [PMID: 35241463 PMCID: PMC8895933 DOI: 10.1136/bmjopen-2020-048396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES To study the medical expenditure and influencing factors of patients with hypertension in Shanxi Province, China. DESIGN A cross-sectional study. SETTING 1088 medical institutions, including general hospitals, traditional Chinese medicine hospitals, special hospitals, basic medical institutions and public health institutions. PARTICIPANTS 180 441 hypertensive outpatients and 14 763 inpatients from 1 January to 31 December 2017. PRIMARY AND SECONDARY OUTCOME MEASURES Curative care expenditure for hypertension (CCEht) was measured based on System of Health Accounts 2011. Influenced factors were analysed by univariate analysis and multiple layer perceptron neural network. RESULTS In 2017, CCEht was US$307.71 million, accounting for 3.63% of total CCE and 0.14% of gross domestic product (GDP) in Shanxi Province of China. CCE of hypertensive outpatients (CCEht-out) and inpatients (CCEht-in) accounted for 44.49% and 55.51% of CCEht. Drug fee accounted for 81.55% of CCEht-out and 22.50% of CCEht-in, respectively. The top three influencing factors were drug fee, surgical fee and hospitalisation days for inpatients, and drug fee, examination fee and test fee for outpatients. CONCLUSIONS The medical expenditure of hypertension is still heavy for individuals and society. The diagnosis and treatment capacities of primary healthcare system has been enhanced. New rural cooperation medical insurance and urban employee basic medical insurance have a trend of overusing, and the burden of family healthcare expenditure is still heavy. To ease the economic burden of patients with hypertension and improve the efficiency of social resources utilisation, policymakers should pay more attention to key groups, further increase support for primary healthcare system, standardise the treatment and reimbursement of hypertension and incline the reimbursement policy to outpatient service.
Collapse
Affiliation(s)
- Guojie Liu
- School of Forensic Medicine, China Medical University, Shenyang, China
| | - Quan Fang
- College of Health Management, China Medical University, Shenyang, China
| | - Xinyu Ji
- First Hospital of China Medical University, Shenyang, China
| | - Jing OuYang
- Humanity and Management College, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Yalan Zhu
- College of Health Management, China Medical University, Shenyang, China
| | - Leying Wang
- First Clinical Department, China Medical University, Shenyang, China
| | - Xin Wang
- College of Health Management, China Medical University, Shenyang, China
- School of Public Health, Xin Jiang Medical University, Urumqi, China
| |
Collapse
|
16
|
Cao Y, Sathish T, Haregu T, Wen Y, de Mello GT, Kapoor N, Oldenburg B. Factors Associated With Hypertension Awareness, Treatment, and Control Among Adults in Kerala, India. Front Public Health 2021; 9:753070. [PMID: 34790643 PMCID: PMC8591131 DOI: 10.3389/fpubh.2021.753070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/11/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Hypertension, the most significant risk factor for cardiovascular disease, is an increasing contributor to global health burden, particularly in low- and middle-income countries (LMICs) such as India. While the rates of hypertension awareness, treatment, and control in India have been reported in several studies, the factors associated with these rates are less well-understood. Existing studies are predominantly cross-sectional, and the factors examined are limited. Understanding the predictors associated with these rates, using more rigorous study designs, is crucial for the development of strategies to improve hypertension management. Aims: To examine a range of factors associated with hypertension awareness, treatment, and control using both cross-sectional and longitudinal analyses. Methods: Data was derived from a population-based sample of 1,710 participants from Kerala, aged 30–60 years. We examined a comprehensive range of factors, including demographic, behavioral factors, anthropometric, clinical measures, psychosocial factors and healthcare utilization. Multilevel mixed effects logistic regression was used for both cross-sectional and longitudinal analyses (repeated measures for all variables across 2 years) to determine the factors associated with awareness, treatment, and control of hypertension. Results: A total of 467 (27.3%) participants had hypertension at baseline. Among those, the rates of awareness, treatment, and control of hypertension were 54.4, 25.5, and 36.4%, respectively. Being male (OR 0.27, 95% CI 0.14–0.53) and consumption of alcohol (OR 0.49, 95% CI 0.31–0.80) were significant predictors of poorly controlled hypertension (longitudinal analysis). Depression (OR 2.04, 95% CI 1.15–3.61) and fair-to-poor self-perceived health status (OR 1.87, 95% CI 1.15–3.04) were associated with increased hypertension awareness, whereas anxiety (OR 1.97, 95% CI 1.04–3.71) was associated with increased hypertension treatment (cross-sectional analysis). Seeking outpatient service in the past 4 weeks was associated with higher awareness (OR 1.09, 95% CI 1.27–2.87), treatment (OR 1.73, 95% CI 1.20–2.50) and control (OR 1.96, 95% CI 1.37–2.80) (longitudinal analysis). Conclusion: Our findings suggest the importance of considering psychosocial factors and better engagement with health services in hypertension management, as well as giving more attention to body fat control and largely male-related behaviors such as alcohol consumption, taking into account of some Indian specific attributes.
Collapse
Affiliation(s)
- Yingting Cao
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.,Implementation Science Lab, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Thirunavukkarasu Sathish
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.,Population Health Research Institute (PHRI), McMaster University, Hamilton, ON, Canada
| | - Tilahun Haregu
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.,Implementation Science Lab, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Yu Wen
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.,Implementation Science Lab, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Gabrielli Thais de Mello
- Research Centre for Physical Activity and Health (NuPAF), Federal University of Santa Catarina, Florianópolis, Brazil
| | - Nitin Kapoor
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.,Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
| | - Brian Oldenburg
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia.,Implementation Science Lab, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,School of Psychology and Public Health, LaTrobe University, Melbourne, VIC, Australia
| |
Collapse
|
17
|
He C, Wang W, Chen Q, Shen Z, Pan E, Sun Z, Lou P, Zhang X. Factors associated with stroke among patients with type 2 diabetes mellitus in China: a propensity score matched study. Acta Diabetol 2021; 58:1513-1523. [PMID: 34125293 DOI: 10.1007/s00592-021-01758-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/05/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE This study aimed to examine the prevalence of stroke and associated factors of stroke in patients with type 2 diabetes(T2DM) in China. METHODS Participants were 18,013 T2DM patients recruited with stratified random cluster sampling method from December 2013 to January 2014 in China. Propensity score matching was used to eliminate confounding effects between groups and logistic regression analysis was used to examine factors associated with stroke among T2DM patients. RESULTS Overall, the prevalence of stroke in the subjects with T2DM was 9.5%. After nearest neighbor matching, smoking (OR = 1.60, 95%CI: 1.26-2.03), hypertension (OR = 2.96, 95%CI: 2.55-3.43), dyslipidemia (OR = 2.00, 95%CI: 1.71-2.33), family history of stroke (OR = 2.02, 95%CI: 1.61-2.54), obesity (OR = 1.21, 95%CI: 1.01-1.45) and sleep duration < 6 h/day (OR = 1.44, 95%CI: 1.20-1.73) or > 8 h/day (OR = 1.22, 95%CI: 1.05-1.42) were positively associated with stroke, whereas drinking 1-3 days/week (OR = 0.64, 95%CI: 0.45-0.90) or daily (OR = 0.45, 95%CI: 0.33-0.60), effective exercise (OR = 0.65, 95%CI: 0.57-0.73) and underweight (OR = 0.30, 95%CI: 0.13-0.71) were negatively related to stroke. Besides, the risk of stroke increased substantially with accumulation of above seven modified risk factors. The odds ratio values of stroke in patients having ≥ 5 of the above seven risk factors was 14.39 (95% CI: 8.87-23.26). CONCLUSIONS The prevalence of stroke was high among T2DM in China. It is of great significance to strengthen comprehensive management of health-related behaviors including smoking cessation, moderate alcohol consumption, effective exercise, 6-8 h of sleep duration, keeping normal weight and the prevention of hypertension and dyslipidemia to have sustained beneficial effects on improvements of stroke risk factors.
Collapse
Affiliation(s)
- Chenlu He
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Wei Wang
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
| | - Qian Chen
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Ziyuan Shen
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Enchun Pan
- Huai´an Center for Disease Control and Prevention, Huai´an, 223001, Jiangsu, China
| | - Zhongming Sun
- Huai´an Center for Disease Control and Prevention, Huai´an, 223001, Jiangsu, China
| | - Peian Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou, 221000, Jiangsu, China
| | - Xunbao Zhang
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
| |
Collapse
|
18
|
Zhang Z, Hu Z, Wang H, Zhou Q, Li C, Hao M. Changes of Multisectoral Collaboration and Service Delivery in Hypertension Prevention and Control before and after the 2009 New Healthcare Reform in China: An Interrupted Time-Series Study. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:8976625. [PMID: 34589192 PMCID: PMC8476259 DOI: 10.1155/2021/8976625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/20/2021] [Accepted: 08/23/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES There is a need to assess the 2009 new healthcare reform in China on hypertension prevention. It helps to control from the perspectives of multisectoral participation, government responsibility assignment, performance assessment, and service delivery. DESIGN Interrupted time-series study. Setting. 31 provinces in mainland China. Primary and Secondary Outcome Measures. Based on the content analysis of publicly available policy documents from 31 provinces regarding hypertension prevention and control, we analyzed the changes brought by the 2009 new healthcare reform through four quantitative indicators, including multisector participation (MP), main department responsibility coverage (MDRC), primary department assessment indicator coverage (MDAIC), and service type coverage (STC). We compared the changing trends of four indicators before and after 2009. RESULTS Nationally, MP, MDRC, and STC grew rapidly and increased to 88.9%, 96.4%, and 77.8%, respectively, in 2017, higher than MDAIC (36.9%). This growth was accelerated by the new healthcare reform, with the highest acceleration in MP (β3 = 6.345, p < 0.001), followed by MDRC (β3 = 3.829, p < 0.01), STC (β3 = 3.799, p < 0.001), and MDAIC (β3 = 3.585, p < 0.001). The MP and MDRC trend changes were higher in the central and western regions than in the east after the reform. CONCLUSIONS Our research showed that the new healthcare reform had a positive effect in promoting multisectoral participation in preventing and controlling hypertension in China, improving the responsibility mechanism, and expanding the types of services provided. The government should lead the coordination and implementation of multidepartmental responsibilities and mobilize nonhealth departments to continuously participate in the prevention and control of chronic diseases by improving incentive and evaluation mechanisms.
Collapse
Affiliation(s)
- Zhifan Zhang
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China
| | - Zhi Hu
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China
- Anhui Medical University, Hefei, Anhui 230032, China
| | - Hua Wang
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China
- Jiangsu Preventive Medicine Association, Nanjing, Jiangsu 210009, China
| | - Qingyu Zhou
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China
| | - Chengyue Li
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China
| | - Mo Hao
- Research Institute of Health Development Strategies, Fudan University, Shanghai 200032, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai 200032, China
| |
Collapse
|
19
|
Yu P, Ning Y, Gao Y, Zhao Y, Tie L, Wu L, Zhang L, Zhang R, Cui M, Pang H, Wu Q, Wang Z, Chen L, Zhao L. Hypertension among Mongolian adults in China: A cross-sectional study of prevalence, awareness, treatment, control, and related factors: Hypertension among Mongolian adults in China. J Clin Hypertens (Greenwich) 2021; 23:1786-1801. [PMID: 34399030 PMCID: PMC8678733 DOI: 10.1111/jch.14348] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/09/2021] [Accepted: 07/28/2021] [Indexed: 11/28/2022]
Abstract
The objectives of the study were to comprehend the prevalence of hypertension (HTN) and prehypertension (PHT), awareness, treatment, and control of HTN and its distribution in urban, agricultural, pastoral, and semi-agricultural/semi-pastoral areas, and to explore the related factors of HTN among Mongolian adults in China. From August 2018 to August 2020, a multi-stage stratified cluster random sampling method was conducted to investigate the prevalence of HTN among Mongolian adults aged ≥18 years living in China (n = 2558). Inclusion criteria for HTN were systolic blood pressure ≥ 140 mm Hg and/or diastolic blood pressure ≥ 90 mm Hg and/or had hypertensive history and/or taking antihypertensive drugs for HTN. The prevalence rates of HTN and PHT were 44.77% and 32.03%, respectively. The prevalence rates of PHT in urban, agricultural, pastoral, and semi-agricultural/semi-pastoral areas were 34.93%, 34.73%, 26.03%, and 33.44%, respectively, and the prevalence rates of HTN were 35.97%, 40.15%, 49.68%, and 48.07%, respectively. The awareness, treatment and control rates of HTN were 66.48%, 58.93%, and 16.48%, respectively. In this survey, the overweight, obesity, and central obesity rates were 34.30%, 30.67%, and 58.08%, respectively. Compared with Chinese adults ≥18 years, the prevalence rate of HTN among Mongolian adults in China aged ≥ 18 years was relatively high; the prevalence rate of PHT and HTN awareness, treatment, and control rates were similar. The prevalence of HTN and the rates of obesity and central obesity were higher in pastoral regions than in the other three types of regions, and the rate of overweight was highest in agricultural regions.
Collapse
Affiliation(s)
- Peiyao Yu
- Inner Mongolia Medical UniversityHohhotChina
| | - Yuzhen Ning
- Affiliated Hospital of Inner Mongolia Medical UniversityHohhotChina
| | - Yumin Gao
- Inner Mongolia Medical UniversityHohhotChina
- Laboratory for Molecular Epidemiology in Chronic DiseasesInner Mongolia Medical UniversityHohhotChina
| | - Yanping Zhao
- Affiliated Hospital of Inner Mongolia Medical UniversityHohhotChina
| | - Lin Tie
- Health Center of BayanmanghaDaolaodu SumuJarud BannerTongliaoChina
| | - Lijitu Wu
- Health Center of BayanmanghaDaolaodu SumuJarud BannerTongliaoChina
| | - Lili Zhang
- Community Health Service Center of Shangdu TownZhenglan BannerXilingol LeagueChina
| | - Ru Zhang
- XilinhotCommunity Health Service Center of ChugulanXilingol LeagueChina
| | - Meng Cui
- Shanxi Medical UniversityTaiyuanChina
| | - Hui Pang
- Inner Mongolia Medical UniversityHohhotChina
- Laboratory for Molecular Epidemiology in Chronic DiseasesInner Mongolia Medical UniversityHohhotChina
| | - Qian Wu
- Inner Mongolia Medical UniversityHohhotChina
| | - Zhidi Wang
- Inner Mongolia Medical UniversityHohhotChina
| | - Le Chen
- Inner Mongolia Medical UniversityHohhotChina
| | - Lingyan Zhao
- Inner Mongolia Medical UniversityHohhotChina
- Laboratory for Molecular Epidemiology in Chronic DiseasesInner Mongolia Medical UniversityHohhotChina
| |
Collapse
|
20
|
Severe hypertension in China: results from the China PEACE million persons project. J Hypertens 2021; 39:461-470. [PMID: 33038086 PMCID: PMC7928212 DOI: 10.1097/hjh.0000000000002675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/03/2020] [Accepted: 09/15/2020] [Indexed: 01/13/2023]
Abstract
INTRODUCTION People with severe hypertension have high risk of target organ damage, yet few studies focus specifically on this population. We sought to assess the characteristics, prevalence, awareness, and treatment patterns of severe hypertension among middle-aged adults in China. METHODS We enrolled 2 660 666 participants aged 35-75 years from 31 provinces between 2014 and 2018 in the cross-sectional China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project. Severe hypertension was defined as SBP of at least 160 mmHg or DBP of at least 100 mmHg. Awareness and treatment were defined as self-reported diagnosis of hypertension and current use of antihypertensive medication, respectively. Analyses were completed in 2019. RESULTS Our sample included 2 618 757 adults with a mean age of 55.6 years (SD 9.8), 59.6% of whom were women. A total of 378 457 (14.5%) participants had severe hypertension, of whom 222 533 (58.8%) were untreated. The age--sex-standardized rate of severe hypertension was 11.6% based on the 2010 Chinese Census data. Advanced age, female sex, current drinking, obesity, lower income, diabetes, and prior cardiovascular events were associated with higher risk of severe hypertension (all P < 0.01). Of untreated participants with severe hypertension, only 60 484 (27.1%) were aware of their conditions. Among participants with severe hypertension despite treatment, 84.7% reported taking one class of antihypertensive medication; only 15% reported taking guideline-recommended combination therapy. CONCLUSION Many millions of people in China have severe hypertension and the vast majority are unaware of their condition and undertreated. There are immense opportunities to improve outcomes in this high-risk group.
Collapse
|
21
|
Wei J, Mi Y, Li Y, Xin B, Wang Y. Factors associated with awareness, treatment and control of hypertension among 3579 hypertensive adults in China: data from the China Health and Nutrition Survey. BMC Public Health 2021; 21:423. [PMID: 33648483 PMCID: PMC7919311 DOI: 10.1186/s12889-021-10417-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 02/09/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The prevalence of hypertension is high and rising in China, but most people with hypertension do not have their blood pressure under control. This study investigated hypertension awareness, treatment, and control and their associated factors among Chinese adults. METHODS Data collected from the 2011 China Health and Nutrition Survey (CHNS) from 12,991 Chinese adults were used. Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, self-reported prior diagnosed hypertension, or taking antihypertensive medications. Hypertension awareness, treatment, and control were defined as a self-reported diagnosis of hypertension, current use of antihypertensive medication, and blood pressure < 140/90 mmHg, respectively. Multivariate logistic regression was performed to examine factors associated with hypertension awareness, treatment, and control. RESULTS Overall, 3579 (27.6%) of the CHNS adult participants had hypertension, of whom 55.7% were aware of their diagnosis, 46.5% were treated with antihypertensive medications, but only 20.3% had their blood pressure under control. Higher hypertension treatment was associated with older age (OR = 2.57; 95%CI, 1.65-4.02), urban residency (1.50; 1.14-1.97), living in the Eastern region (1.52; 1.14-2.01), and being overweight/obese (1.99; 1.39-2.84). Hypertension awareness was associated with similar factors as hypertension treatment but was also associated with being female (1.37, 1.12-1.66). Poor hypertension control was associated with being overweight/obese (0.56; 0.42-0.76) and minority ethnicity (0.52; 0.31-0.86). CONCLUSION Hypertension is a major public health challenge in China. The prevalence of hypertension awareness, treatment, and control are still low despite existing public health policies and programs to reduce the burden of hypertension. More intensive hypertension screening and treatment programs are warranted in China.
Collapse
Affiliation(s)
- Junxiang Wei
- Department of Obstetrics, Northwest Women's and Children's Hospital, Xi'an, 710061, Shaanxi, China.
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
| | - Yang Mi
- Department of Obstetrics, Northwest Women's and Children's Hospital, Xi'an, 710061, Shaanxi, China
| | - Yan Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bo Xin
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Youfa Wang
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| |
Collapse
|
22
|
Akl C, Akik C, Ghattas H, Obermeyer CM. The cascade of care in managing hypertension in the Arab world: a systematic assessment of the evidence on awareness, treatment and control. BMC Public Health 2020; 20:835. [PMID: 32493255 PMCID: PMC7268748 DOI: 10.1186/s12889-020-08678-6] [Citation(s) in RCA: 12] [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: 05/06/2019] [Accepted: 04/08/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Hypertension is a leading risk factor for mortality and morbidity globally and in the Arab world. We summarize the evidence on awareness, treatment, and control of hypertension, to assess the extent of gaps in the hypertension continuum of care. We also assess the influence of gender and other social determinants at each level of the cascade of care. METHODS We searched MEDLINE and SSCI databases for studies published between 2000 and 2017, reporting the rates of awareness, treatment or control of hypertension and/or their determinants in the Arab region. We included sources on both general populations and on clinical populations. The review process was based on the PRISMA guidelines. We present rates on the three stages of the care cascade corresponding to (1) awareness (2) treatment and (3) control of blood pressure, and estimated the losses that occur when moving from one stage to another. We also take stock of the evidence on social determinants and assess the statistical significance of gender differences in awareness, treatment and control. RESULTS Data from 73 articles were included. Substantial proportions of hypertensives were lost at each step of the hypertension care continuum, with more missed opportunities for care resulting from lack of awareness of hypertension and from uncontrolled blood pressure. More than 40% and 19% of all hypertensive individuals were found to be unaware and to have uncontrolled blood pressure, respectively, but among individuals diagnosed with hypertension, less than 21% were untreated. Awareness rates were higher among women than men but this advantage was not consistently translated into better blood pressure control rates among women. CONCLUSIONS This analysis of the cascade of care indicates that barriers to proper diagnosis and adequate control are greater than barriers to delivery of treatment, and discusses potential factors that may contribute to the gaps in delivery.
Collapse
Affiliation(s)
- Christelle Akl
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, P.O. Box: 11-0236, Riad El Solh, Beirut, 1107-2020 Lebanon
| | - Chaza Akik
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, P.O. Box: 11-0236, Riad El Solh, Beirut, 1107-2020 Lebanon
| | - Hala Ghattas
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, P.O. Box: 11-0236, Riad El Solh, Beirut, 1107-2020 Lebanon
| | - Carla Makhlouf Obermeyer
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, P.O. Box: 11-0236, Riad El Solh, Beirut, 1107-2020 Lebanon
| |
Collapse
|
23
|
Prevalence and Determinants of Hypertension Awareness, Treatment, and Control in Botswana: A Nationally Representative Population-Based Survey. Int J Hypertens 2020; 2020:8082341. [PMID: 32550019 PMCID: PMC7281842 DOI: 10.1155/2020/8082341] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/29/2020] [Accepted: 05/01/2020] [Indexed: 12/30/2022] Open
Abstract
Introduction Hypertension is a leading risk factor for cardiovascular mortality and an emerging public health concern in sub-Saharan Africa. Few studies have examined performance on the management of hypertension in this region, where the context may be distinct from other developing regions. Objectives We aimed to determine the prevalence and correlates of hypertension, awareness, treatment, and control among adults in Botswana, a middle-income African country undergoing rapid demographic transition and with high HIV burden. Methods In this 2014 cross-sectional survey of adults aged 15–69 years, information on sociodemographic characteristics, lifestyle behavior, and medical history was collected through in-person interviews and physical measurements (body mass index and triplicate blood pressure (BP)). Hypertension was defined as self-report of use of antihypertensives in the previous two weeks and/or having elevated BP (≥140/90 mmHg). Multivariable logistic regression was employed to explore factors associated with hypertension, awareness (report of previous diagnosis), treatment (antihypertensives), and control (BP < 140/90). Results Our analysis (N = 4,007) yielded an age-standardized hypertension prevalence of 30% (95% CI: 28%–32%, N = 1,393). Among hypertensives, 54% (50–58%) were unaware of their condition, 45% (40–50%) of those aware were untreated, and 63% (55–70%) of those on medications were suboptimally treated (BP ≥ 140/90 mmHg). A fifth of hypertensives who were diagnosed but not on medications had BP ≥ 180/110 mmHg. Diabetes was the strongest correlate of hypertension and awareness (aOR 4.00, 1.86–8.59; aOR 3.30, 1.44–7.55, respectively). Males were less likely to be aware (aOR 0.62, 0.41–0.94) or controlled (aOR 0.36, 0.16–0.83). Obese individuals were more likely to be treated (aOR 2.17, 1.12–4.22), yet less likely to be controlled (aOR 0.32, 0.15–0.66). Conclusions We report the first nationally representative estimates of the hypertension care cascade performance in Botswana, which will support planning and future policy evaluations. Findings contribute to the relatively sparse evidence on this subject and may inform development of innovations that improve quality of hypertension management and adherence support in similar settings.
Collapse
|
24
|
Yang L, Wu H, Jin X, Zheng P, Hu S, Xu X, Yu W, Yan J. Study of cardiovascular disease prediction model based on random forest in eastern China. Sci Rep 2020; 10:5245. [PMID: 32251324 PMCID: PMC7090086 DOI: 10.1038/s41598-020-62133-5] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 02/28/2020] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death worldwide and a major public health concern. CVD prediction is one of the most effective measures for CVD control. In this study, 29930 subjects with high-risk of CVD were selected from 101056 people in 2014, regular follow-up was conducted using electronic health record system. Logistic regression analysis showed that nearly 30 indicators were related to CVD, including male, old age, family income, smoking, drinking, obesity, excessive waist circumference, abnormal cholesterol, abnormal low-density lipoprotein, abnormal fasting blood glucose and else. Several methods were used to build prediction model including multivariate regression model, classification and regression tree (CART), Naïve Bayes, Bagged trees, Ada Boost and Random Forest. We used the multivariate regression model as a benchmark for performance evaluation (Area under the curve, AUC = 0.7143). The results showed that the Random Forest was superior to other methods with an AUC of 0.787 and achieved a significant improvement over the benchmark. We provided a CVD prediction model for 3-year risk assessment of CVD. It was based on a large population with high risk of CVD in eastern China using Random Forest algorithm, which would provide reference for the work of CVD prediction and treatment in China.
Collapse
Affiliation(s)
- Li Yang
- Zhejiang Provincial Center for Cardiovascular Disease Control and Prevention, Zhejiang Hospital, Hangzhou, 310013, China
- Key Laboratory of Public Health Safety, Ministry of Education, Health Communication Institute, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Haibin Wu
- Ewell Technology Co., Ltd, Tower D of Oriental Communication Technology City, Hangzhou, 310000, China
| | - Xiaoqing Jin
- Chinese Acupuncture Department, Zhejiang Hospital, Hangzhou, 310013, China
| | - Pinpin Zheng
- Key Laboratory of Public Health Safety, Ministry of Education, Health Communication Institute, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Shiyun Hu
- Zhejiang Provincial Center for Cardiovascular Disease Control and Prevention, Zhejiang Hospital, Hangzhou, 310013, China
| | - Xiaoling Xu
- Zhejiang Provincial Center for Cardiovascular Disease Control and Prevention, Zhejiang Hospital, Hangzhou, 310013, China
| | - Wei Yu
- Zhejiang Provincial Center for Cardiovascular Disease Control and Prevention, Zhejiang Hospital, Hangzhou, 310013, China
| | - Jing Yan
- Zhejiang Provincial Center for Cardiovascular Disease Control and Prevention, Zhejiang Hospital, Hangzhou, 310013, China.
| |
Collapse
|
25
|
Li R, Tian Z, Wang Y, Liu X, Tu R, Wang Y, Dong X, Wang Y, Wei D, Tian H, Mao Z, Li L, Huo W, Wang C, Bie R. The Association of Body Fat Percentage With Hypertension in a Chinese Rural Population: The Henan Rural Cohort Study. Front Public Health 2020; 8:70. [PMID: 32266195 PMCID: PMC7103629 DOI: 10.3389/fpubh.2020.00070] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/24/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Obesity is an important risk factor for hypertension. Previous studies have explored the association between body fat percentage (BFP) and hypertension, but evidence on the consistency of the association remains uncertain and limited. The aim of this study was to explore the relationship between BFP and hypertension in a Chinese rural population. Methods: The present cross-sectional study including 38,913 eligible individuals was conducted in rural areas of Henan province. BFP was measured by bioelectrical impedance methods using Omron body fat and weight measurement device. Logistic regression models and restricted cubic spline regression models were performed to investigate the relationship between BFP and hypertension. Receiver operating characteristic (ROC) analyses were used to compare the discriminating power of adiposity indices. Results: The age-standard prevalence of hypertension was 23.74 and 17.87% in males and females, respectively. Compared with the first quartile of BFP, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for hypertension in the highest BFP quartile were 3.30 (95% CI: 2.85, 3.83) in males and 2.66 (95% CI: 2.36, 2.99) in females, and the adjusted ORs increased along with increasing BFP levels. The areas under ROC and 95% CIs of BFP were 0.673 (0.665, 0.682) in males and 0.696 (0.689, 0.703) in females, respectively. Conclusions: BFP was significantly positively associated with the prevalence of hypertension in both males and females in the Chinese rural population. Controlling of body fat should be emphasized in rural areas of China. Clinical Trial Registration: Registration number: ChiCTR-OOC-15006699. http://www.chictr.org.cn/showproj.aspx?proj=11375
Collapse
Affiliation(s)
- Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhongyan Tian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yanhua Wang
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Runqi Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yan Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaokang Dong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yikang Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Dandan Wei
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Huiling Tian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Linlin Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Ronghai Bie
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| |
Collapse
|
26
|
Effects of social support and depression on problematic drinking among trauma-exposed Chinese adults: A population-based study. Heliyon 2020; 6:e03405. [PMID: 32099926 PMCID: PMC7031303 DOI: 10.1016/j.heliyon.2020.e03405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 03/26/2019] [Accepted: 02/07/2020] [Indexed: 11/23/2022] Open
Abstract
Background Alcohol consumption is prevalent and alcohol-related problems are a considerable social issue in China. Over 17% of Chinese consume alcohol regularly. Exposure to potentially traumatic events (PTE) is associated with increased alcohol-related problems. Social support often buffers this association. This study examined the relationship between exposure to PTE and alcohol misuse and explored the moderating effect of social support on this relationship in a Chinese context. Methods Data were collected through face-to-face computer assisted interviews in a stratified cluster sample of 753 Chinese adults living in Guangzhou, China. The Life Events Checklist-5 (LEC-5), World Health Organization Alcohol Use Disorders Identification Test (WHO-AUDIT), and Social Support Rating Scale (SSRS) were used to measure trauma exposure, problematic alcohol use, and social support. Results Univariable logistic regression analyses indicated that trauma exposure (OR = 3.18; compared to non-exposure), increased depression (OR = 1.06), and perceived friend support (OR = 1.21), were associated with higher odds of problematic drinking. Multivariable models adjusting for potential confounders demonstrated that PTE and depression were associated with problematic drinking, but this was not the case for perceived friend support. Perceived friend support modified the effect of trauma exposure and was associated with increased odds of problematic drinking among those who reported high levels of depressive symptoms. Conclusion Social support may not always be a beneficial resource among those who experienced PTEs in a Chinese context. Further research is needed to better understand the role and function of different types of support, and for whom these associations are beneficial.
Collapse
|
27
|
Du X, Fang L, Xu J, Chen X, Zhang J, Bai Y, Wu J, Ma J, Yu M, Zhong J. Prevalence, awareness, treatment and control of hypertension and sodium intake in Zhejiang Province, China: A cross-sectional survey in 2017. PLoS One 2019; 14:e0226756. [PMID: 31869377 PMCID: PMC6927602 DOI: 10.1371/journal.pone.0226756] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 12/03/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In recent decades, hypertension has become a popular public health problem in China. In 2017, a cross-sectional survey about hypertension and sodium intake measured by 24-hour (24-h) urine was launched in Zhejiang Province, to provide the basis of the Chinese population to develop a salt reduction intervention and prevention of hypertension strategy. METHODS Cross-sectional data were obtained from 7512 participants aged 18 to 69 years in Zhejiang Province of China by complex, multistage sampling methods. The survey included face-to-face questionnaires and physical examination among all participants. Blood pressures and the use of anti-hypertension medications were used to determine hypertension. One thousand five hundred participants of them were asked to collect 24-h urine to measure sodium and potassium levels to assess intake. All rates and means were weighted by sampling weight and population structure of the province. RESULTS The weighted means of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 127.78 mm Hg (95% confidence interval [CI], 127.21-128.36) and 79.40 mm Hg (95%CI, 79.04-79.76). The weighted hypertension prevalence was 30.41% (95%CI, 28.91-31.91). Among those classified as having hypertension, 43.55% (95%CI, 40.77-46.34) were aware of the fact that they were suffering from hypertension, 32.05% (95%CI, 29.49-34.61) of them reported taking anti-hypertension medications, only 14.48% (95%CI, 12.54-16.42) had their blood pressure controlled. The weighted means of 24-h urinary sodium was 165.52 mmol (standard deviation [SD], 2.92), representing that the mean intake of sodium chloride was 9.68g (SD, 0.17) through conversion. CONCLUSION These cross-sectional survey results show that hypertension and excessive sodium intake in adults are prevalent in Zhejiang Province, China. Salt reduction and prevention of hypertension is still an urgent public health work.
Collapse
Affiliation(s)
- Xiaofu Du
- Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P. R. China
| | - Le Fang
- Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P. R. China
| | - Jianwei Xu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, P. R. China
| | - Xiangyu Chen
- Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P. R. China
| | - Jie Zhang
- Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P. R. China
| | - Yamin Bai
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, P. R. China
| | - Jing Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, P. R. China
| | - Jixiang Ma
- Division of Non-communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, P. R. China
| | - Min Yu
- Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P. R. China
| | - Jieming Zhong
- Department of Non-Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P. R. China
| |
Collapse
|
28
|
Wu Y, Zhang Y, Gao J, Man S, Xing J, Cao Z, Song S, Wu S, Gao W. Effect of brachial-ankle pulse wave velocity combined with blood pressure on cardio-cerebrovascular events. Exp Ther Med 2019; 18:4555-4566. [PMID: 31807146 PMCID: PMC6878894 DOI: 10.3892/etm.2019.8149] [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: 11/20/2018] [Accepted: 07/19/2019] [Indexed: 01/19/2023] Open
Abstract
The aim of the present study was to evaluate the effect of brachial-ankle pulse wave velocity (baPWV) combined with blood pressure (BP) on cardio-cerebrovascular events. Participants who received health examinations during the periods 2010-2011, 2012-2013 and 2014-2015 were recruited. The participants were divided into four groups according to their BP and baPWV levels as follows: Normotension + low baPWV, normotension + high baPWV, hypertension + low baPWV, and hypertension + high baPWV. The cumulative incidence of cardio-cerebrovascular events was calculated using life-table analysis, and the associations of BP and baPWV with cardio-cerebrovascular events were analyzed using a multivariate Cox proportional hazards regression model. Receiver operating characteristic curves were used to calculate the predictive values of baPWV combined with BP, baPWV alone or BP alone for cardio-cerebrovascular events by comparing their area under the curve (AUC) using the normal approximation method. There were 20,310 participants with a mean age of 50.13±0.09 years in the present study, including 13,240 males. A total of 278 participants developed a cardio-cerebrovascular event after a mean follow-up period of 3.34±1.82 years. The cumulative incidence of cardio-cerebrovascular events in the normotension + low baPWV, normotension + high baPWV, hypertension + low baPWV and hypertension + high baPWV groups was 0.2, 0.9, 0.8 and 3.1%. Multivariate Cox proportional hazards regression analysis showed that compared with the normotension + low baPWV group, the risks of cardio-cerebrovascular events in the normotension + high baPWV, hypertension + low baPWV and hypertension + high baPWV groups were increased after adjusting for confounding factors, and their hazard ratios (95% CI) were 4.18 (2.23-7.83), 3.00 (1.39-6.47) and 9.34 (5.14-16.96), respectively. The AUC values for the predictive values of baPWV combined with BP, baPWV alone and BP alone on cardio-cerebrovascular events were calculated to be 0.744, 0.677 and 0.698, respectively. In conclusion, high baPWV accompanied by hypertension could increase the risk of cardio-cerebrovascular events. The predictive value of baPWV combined with BP on cardio-cerebrovascular events is superior compared with that of either baPWV or BP alone.
Collapse
Affiliation(s)
- Yuntao Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, P.R. China.,Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Yajing Zhang
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China.,Graduate School, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Jingsheng Gao
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Shuli Man
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, P.R. China
| | - Jianong Xing
- Department of Cardiology, The Third People's Hospital, Tangshan, Hebei 063000, P.R. China
| | - Zhiwei Cao
- Department of Cardiology, The People's Hospital of Luanxian, Tangshan, Hebei 063000, P.R. China
| | - Shaomin Song
- Department of Cardiology, Linxi Hospital of Kailuan, Tangshan, Hebei 063000, P.R. China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Wenyuan Gao
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, P.R. China
| |
Collapse
|
29
|
Hoang VM, Tran QB, Vu THL, Nguyen TKN, Kim BG, Pham QN, Nguyen TL, Lai DT, Nakagawa J, Shin HR, Kim WJ, Riley L, Wadhwani C, Truong DB, Tran DP. Patterns of Raised Blood Pressure in Vietnam: Findings from the WHO STEPS Survey 2015. Int J Hypertens 2019; 2019:1219783. [PMID: 31871783 PMCID: PMC6913158 DOI: 10.1155/2019/1219783] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 09/15/2019] [Accepted: 11/06/2019] [Indexed: 12/03/2022] Open
Abstract
This study aims to describe the prevalence of raised blood pressure and the situation of management for raised blood pressure among the adult population in Vietnam. It also aims to examine the association between diversified socioeconomic and behavioral factors of raised blood pressure and awareness of raised blood pressure. Data were obtained from the STEPS survey conducted in Vietnam in 2015. Survey sample was nationally representative with a total of 3,856 people aged 18-69 years old. The study outcomes included raised blood pressure and awareness of and control of raised blood pressure. Multiple logistic regression was used to examine the association of socioeconomic and behavior risk factors with the outcome variables. The overall prevalence of raised blood pressure in Vietnam in 2015 was 18.9% (95% CI: 17.4%-20.6%). The prevalence of raised blood pressure was higher among men. Significantly correlated factors with raised blood pressure were age, sex, body mass index, and diabetes status. Levels of awareness of raised blood pressure were higher among the older age group and overweight people and lower among ethnic minority groups. Raised blood pressure in Vietnam is a serious problem due to its magnitude and the unacceptably high unawareness rate in the population. Public health actions dealing with the problems of raised blood pressure are urgent, while taking into account its relationship with sex and socioeconomic status. It is clear that the interventions should address all people in society, with a focus on disadvantaged groups which are the rural and ethnic minority peoples.
Collapse
Affiliation(s)
- Van Minh Hoang
- Hanoi University of Public Health (HUPH), Hanoi, Vietnam
| | - Quoc Bao Tran
- Division of Non-Communicable Diseases, General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | | | | | | | - Quynh Nga Pham
- World Health Organization Country Office, Hanoi, Vietnam
| | | | - Duc Truong Lai
- World Health Organization Country Office, Hanoi, Vietnam
| | - Jun Nakagawa
- World Health Organization Country Office, Hanoi, Vietnam
| | - Hai-Rim Shin
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Warrick Junsuk Kim
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Leanne Riley
- World Health Organization, HQ Office, Geneva, Switzerland
| | | | - Dinh Bac Truong
- Division of Non-Communicable Diseases, General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | - Dac Phu Tran
- Division of Non-Communicable Diseases, General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| |
Collapse
|
30
|
Yang L, Jin X, Yan J, Jin Y, Xu S, Xu Y, Liu C, Yu W, Zheng P. Comparison of prevalence and associated risk factors of cognitive function status among elderly between nursing homes and common communities of China: A STROBE-compliant observational study. Medicine (Baltimore) 2019; 98:e18248. [PMID: 31804354 PMCID: PMC6919412 DOI: 10.1097/md.0000000000018248] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Dementia among elderly is a serious problem worldwide. This study was conducted to estimate the prevalence and associated risk factors of dementia and mild cognitive impairment (MCI) in nursing homes (NHs) and common communities (CCs) among elderly in China.A cross-sectional survey was conducted in 4 communities across 12 cities in Southern China from May to November of 2014. Qualified psychiatrists and trained nurses carried out relevant diagnosis, assessments, interviews, and information collection. Screening test of mini-mental state examination was conducted among participants firstly, then confirmed diagnosis was carried out among the ones with positive results. Student t test, χ test, univariate, and multivariate logistic regression analysis were conducted to analyze data.A total of 2015 participants aged 65 or older were included in the final analysis; 908 came from NHs while 1107 came from CCs. The crude prevalence rates of dementia and MCI were 22.0% and 15.8%, respectively among all the participants. Dementia prevalence was 42.4% among those living in NHs, which was significantly higher than that of 5.3% in CCs (P < .0001). There were more moderate and severe dementia in NHs compared with CCs (P < .0001). It showed that older age, illiterate compared with high level of education (adjusted odds ratio, AOR = 3.32, 95% CI: 1.53-7.21), heavy drinking (AOR = 1.51 (1.00-2.24), having a medical history of diabetes (AOR = 1.41, 95% CI: 1.02-2.33), and stroke (AOR = 1.21, 95% CI: 1.01-1.23) were associated with dementia in NHs, and middle socioeconomic status might be a protective factor for dementia (AOR = 0.33, 95% CI: 0.21-0.51).The problem of senile dementia in NHs is much more serious than our estimation, and there are not enough trained nursing staffs in NHs. More population-based strategies in NHs, including conducting cognitive screening accompanied with routine physical examination among elderly population, carrying out related primary prevention policies and public health services, and paying attention to some modifiable associated risk factors such as heavy smoking and drinking are needed.
Collapse
Affiliation(s)
- Li Yang
- Key Laboratory of Public Health Safety, Ministry of Education, Health Communication Institute, Fudan University, Shanghai
- Zhejiang Provincial Center for Cardiovascular Disease Control and Prevention, Zhejiang Hospital, Hangzhou, China
| | - Xiaoqing Jin
- Zhejiang Provincial Center for Cardiovascular Disease Control and Prevention, Zhejiang Hospital, Hangzhou, China
| | - Jing Yan
- Zhejiang Provincial Center for Cardiovascular Disease Control and Prevention, Zhejiang Hospital, Hangzhou, China
| | - Yu Jin
- Zhejiang Provincial Center for Cardiovascular Disease Control and Prevention, Zhejiang Hospital, Hangzhou, China
| | - Shanhu Xu
- Zhejiang Provincial Center for Cardiovascular Disease Control and Prevention, Zhejiang Hospital, Hangzhou, China
| | - Ying Xu
- Zhejiang Provincial Center for Cardiovascular Disease Control and Prevention, Zhejiang Hospital, Hangzhou, China
| | - Caixia Liu
- Zhejiang Provincial Center for Cardiovascular Disease Control and Prevention, Zhejiang Hospital, Hangzhou, China
| | - Wei Yu
- Zhejiang Provincial Center for Cardiovascular Disease Control and Prevention, Zhejiang Hospital, Hangzhou, China
| | - Pinpin Zheng
- Key Laboratory of Public Health Safety, Ministry of Education, Health Communication Institute, Fudan University, Shanghai
| |
Collapse
|
31
|
Gao J, Chen G, He H, Liu C, He Q, Li J, Wang J. The effect of auricular therapy on blood pressure: A systematic review and meta-analysis. Eur J Cardiovasc Nurs 2019; 19:20-30. [PMID: 31583887 PMCID: PMC6927068 DOI: 10.1177/1474515119876778] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Although a number of clinical studies have investigated the effectiveness and safety of auricular therapy for treating hypertension, the overall evidence remains uncertain. Aims: We aimed to evaluate the evidence for the effect of auricular therapy on blood pressure using meta-analysis methodology. Methods: We searched PubMed, Embase, Cochrane Library databases, Clinicalkey, China National Knowledge Infrastructure, China Scientific Journal Database and Wanfang Database and Chinese Biomedicine for trials that compared the effects of auricular therapy to that of sham auricular therapy, antihypertensive drugs, or no intervention on blood pressure. Blood pressure values before and after treatment, magnitude of blood pressure change between baseline and post-intervention, and the efficacy rate, as outcomes, were synthesized by RevMan 5.3. Continuous outcomes were expressed as weighted mean differences, and dichotomous data were expressed as relative risks with 95% confidence intervals. Results: We systematically reviewed 44 randomized controlled trials (involving 5022 patients through June 2018). Auricular acupressure plus antihypertensive drugs might be more effective than antihypertensive drugs alone in both reducing systolic blood pressure value after treatment (n=464 patients; mean difference, −5.06 mm Hg; 95% confidence interval, –6.76– −3.36, p<0.00001; I2=32%), decreasing diastolic blood pressure after treatment (n=464 patients; mean difference, −5.30 mm Hg; 95% confidence interval, –6.27– −4.33, p<0.00001; I2=0%) and the efficacy rate (relative risk, 1.22; 95% confidence interval, 1.17–1.26; p<0.00001; I2=0%). Conclusion: Auricular therapy could be provided to patients with hypertension as an adjunct to antihypertensive drugs for lowering blood pressure value and achieving blood pressure targets.
Collapse
Affiliation(s)
- JiaLiang Gao
- Department of Cardiology, Guang'anmen Hospital, China
| | - Guang Chen
- Department of Cardiology, Guang'anmen Hospital, China.,Beijing University of Chinese Medicine, China
| | - HaoQiang He
- Department of Cardiology, Guang'anmen Hospital, China.,Beijing University of Chinese Medicine, China
| | - Chao Liu
- Department of Cardiology, Guang'anmen Hospital, China.,Beijing University of Chinese Medicine, China
| | - QingYong He
- Department of Cardiology, Guang'anmen Hospital, China
| | - Jun Li
- Department of Cardiology, Guang'anmen Hospital, China
| | - Jie Wang
- Department of Cardiology, Guang'anmen Hospital, China
| |
Collapse
|
32
|
Awareness of hypertension and related factors in northeastern China: a cross-sectional study. J Hum Hypertens 2019; 34:43-50. [PMID: 31548618 DOI: 10.1038/s41371-019-0263-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/26/2019] [Accepted: 07/17/2019] [Indexed: 12/13/2022]
Abstract
Timely awareness of hypertension is among the most crucial components in reducing the burden of hypertension. However, there is limited information about the awareness of hypertension in northern China. Therefore, in this cross-sectional study, we aimed to investigate the awareness of hypertension and its associated factors in the Jilin province in China; the study was conducted between July 2014 and December 2015 in four cities and four rural counties in the Jilin province as part of a national study. A stratified multistage random-sampling method was used to select a representative sample: a total of 15,206 participants aged ≥15 years were initially recruited, among which 14,956 were finally included in the survey. The awareness of hypertension in the Jilin province was found to be 42.3%. Moreover, the awareness of hypertension was associated with age, sex, region, marital status, body mass index, and family history of hypertension or coronary artery disease. Employment was associated with a lower awareness in rural areas, whereas high education was associated with a higher awareness in urban areas. Policies targeting specific subgroups may be helpful in increasing the awareness of hypertension in the Jilin province.
Collapse
|
33
|
Zhao Y, Oldenburg B, Zhao S, Haregu TN, Zhang L. Temporal Trends and Geographic Disparity in Hypertension Care in China. J Epidemiol 2019; 30:354-361. [PMID: 31327817 PMCID: PMC7348077 DOI: 10.2188/jea.je20190029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND This study examines trends and geographic disparities in the diagnosis, treatment, and control of hypertension in China and investigates the association between regional factors and hypertension care. METHODS Blood pressure data and data relating to health care for hypertension were used for this study. The data were sourced from baseline and follow-up surveys of the China Health and Retirement Longitudinal Study, which was conducted in 2011, 2013, and 2015. To estimate the geographical disparities in diagnosis, treatment, and control of hypertension, random-effects models were also applied after controlling for sociodemographic characteristics. RESULTS Among hypertensive individuals in China, the trends showed decreases in undiagnosed, untreated, and uncontrolled hypertension: 44.1%, 51.6%, and 80.7% in 2011; 40.0%, 47.4%, and 77.8% in 2013; and 31.7%, 38.0%, and 71.4% in 2015, respectively. The number of undiagnosed, untreated, and uncontrolled hypertensive residents living in urban areas in 2015 was more than 10% lower than the number in rural areas and among rural-to-urban immigrant individuals in China. The poorest socio-economic regions across China were 8.5 times more likely to leave their residents undiagnosed, 2.8 times more likely to leave them untreated, and 2.6 times more likely to leave hypertension uncontrolled. CONCLUSIONS Although China has made impressive progress in addressing regional inequalities in hypertension care over time, it needs to increase its effort to reduce geographic disparities and to provide more effective treatments and higher quality care for patients with hypertension.
Collapse
Affiliation(s)
- Yang Zhao
- Melbourne School of Population and Global Health, The University of Melbourne.,WHO Collaborating Centre on Implementation Research for Prevention & Control of NCDs
| | - Brian Oldenburg
- Melbourne School of Population and Global Health, The University of Melbourne.,WHO Collaborating Centre on Implementation Research for Prevention & Control of NCDs
| | - Siqi Zhao
- Yantaishan Hospital of Yantai.,Yantai Sino-French Friendship Hospital
| | | | - Luwen Zhang
- School of Health Services Management, Southern Medical University
| |
Collapse
|
34
|
Shen T, Xing G, Zhu J, Cai Y, Zhang S, Xu G, Feng Y, Li D, Rao J, Shi R. Effects of 12-Week Supplementation of a Polyherbal Formulation in Old Adults with Prehypertension/Hypertension: A Randomized, Double-Blind, Placebo-Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:7056872. [PMID: 31391860 PMCID: PMC6662493 DOI: 10.1155/2019/7056872] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/24/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Uncontrolled blood pressure is the leading cause of mortality and disability due to associated cerebral and cardiovascular diseases and kidney failure. More than one-third of the old adult population have hypertension or prehypertension and many of their blood pressure are poorly controlled. OBJECTIVE We hypothesized that plant extracts-based antioxidants may benefit those with prehypertension/hypertension. METHOD One hundred age- and gender-matched healthy older adults were randomly assigned to receive HyperBalance capsules (n=50) or placebo (n=50) at Tang-Qiao Community Health Service Center, Shanghai. Blood pressure and severity scores of hypertension treatment-related symptoms (dizziness, headache, ringing/buzzing in ears, rapid heart rate, and chest tightness) were evaluated before and after the 12-week intervention. RESULTS Ninety-eight people completed the study, with 2 dropouts in the placebo group before the end of the study. Forty-one subjects (82%) of the HyperBalance group and 40 subjects (83.3%) of the placebo group had prehypertension (systolic blood pressures (SBP) between 130-139 and diastolic blood pressure (DBP) between 85-89mmHg), and 9 subjects (18%) in the HyperBalance group and 8 subjects (16.7%) in the placebo group had hypertension (≥140/90mmHg) before the intervention. HyperBalance significantly (P<0.01) reduced SBP from 136.18±4.38 to 124.14±3.96 mmHg and reduced DBP from 82.45±2.91 to 80.24±2.41mmHg, respectively, and reversed all 9 hypertension people to normotension or prehypertension state, whereas the placebo moderately reduced SBP from 135.79±4.22 to 132.35±4.656mmHg and reduced DBP from 82.90±3.07 to 82.27±3.01mmHg. All symptom severity scores became significantly lower in the HyperBalance group than in the placebo group after HyperBalance intervention: dizziness (0.82±0.44; vs 2.02±0.64, P<0.01); headache (0.46±0.50; vs 1.81±0.61, P<0.01); ringing/buzzing in ears (0.44±0.50; vs 1.04±0.29, P<0.01); and rapid heart rate and chest tightness (0.30±0.46; vs 0.92±0.28, P<0.01). CONCLUSION Polyherbal supplementation such as HyperBalance could benefit old adults with prehypertension/hypertension and improve treatment-related symptoms. Further studies are needed to validate the current findings.
Collapse
Affiliation(s)
- Tian Shen
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Guoqiang Xing
- The Affiliated Hospital and the Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong 637000, China
- Lotus Biotech.com LLC, John Hopkins University-MCC, 9601 Medical Center Drive, Rockville, MD 20850, USA
| | - Jingfen Zhu
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Shuxian Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Gang Xu
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Yi Feng
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Donghua Li
- Tang Qiao Community Health Service Center, Pudong New District, Shanghai 200127, China
| | - Jianyu Rao
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Rong Shi
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| |
Collapse
|
35
|
Impact of evacuation on trends in the prevalence, treatment, and control of hypertension before and after a disaster. J Hypertens 2019; 36:924-932. [PMID: 29227375 DOI: 10.1097/hjh.0000000000001626] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE After the Great East Japan Earthquake in 2011, the prevalence of cardiovascular disease risk factors increased in victims. We examined the trends in the prevalence, treatment, and control of hypertension before and after the disaster, as well as the impact of evacuation. METHODS Study participants were approximately 10 000 men and 12 000 women aged 40-74 years in each year from 2008 to 2014. All of the participants had lived in radiation evacuation zones prior to the Fukushima nuclear crisis. The age-standardized prevalence, treatment, and control of hypertension were calculated using the direct method. In a comparison of evacuees with nonevacuees, the proportion ratios and 95% confidence intervals for hypertension, treatment, and control were calculated by Poisson regression with robust error variance adjusted for covariates in each year after the disaster. RESULTS The age-standardized prevalence of hypertension peaked in 2012 at 48.8% in men and 39.0% in women. By 2014, the treatment and control of hypertension had increased to 66.3 and 67.1% in men, and 70.6 and 68.1% in women, respectively. The multiadjusted proportion ratios for the prevalence, treatment, and control of hypertension in any given year were 1.02-1.03, 0.99-1.05, and 0.93-1.06 in men, and 0.96-1.00, 0.99-1.05, and 1.06-1.11 in women, respectively. CONCLUSION The prevalence of hypertension peaked 1 year after the disaster, while the treatment and control of hypertension increased thereafter. These results indicate that evacuation had little to no impact on the prevalence, treatment, and control of hypertension in the population of Fukushima Prefecture.
Collapse
|
36
|
Song H, Zhang D, Chen Z, Wang R, Tang S, Bishwajit G, Chen S, Feng D, Wu T, Wang Y, Su Y, Feng Z. Utilisation of national community-based blood pressure monitoring service among adult Chinese and its association with hypertension treatment and blood pressure control-a mediation analysis. BMC Geriatr 2019; 19:162. [PMID: 31182039 PMCID: PMC6558874 DOI: 10.1186/s12877-019-1176-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 05/31/2019] [Indexed: 12/20/2022] Open
Abstract
Background Community-based blood pressure (BP) monitoring plays an important role in national hypertension management in China. However, the utilisation of this service, together with its associations on hypertension treatment and BP control has not been fully investigated. Methods The study population was from the China Health and Retirement Longitudinal Study (CHARLS) in 2015. Cross-sectional data of 2487 hypertensive persons were included as subjects. Stratified sample households were selected from 450 villages or communities of 150 counties from 28 provinces. Finally, 21,097 individuals were interviewed successfully. The main outcome was hypertension control (having average BP under 140-90 mmHg). The main independent variable was utilisation of community-based BP monitoring service (having BP examination once a season or more). The mediators were hypertension treatment (currently taking any antihypertensive medicine) and lifestyle factors (alcohol intake, physical activity, smoke). We performed chi-square and binary logistic regression to analyse associations of BP monitoring with hypertension treatment and blood pressure control. The mediation model was examined by the Sobel test. Results Mean age of the population was 64.2 (0.24). The percentage of males was 42.8%. Prevalence of community-based BP monitoring was 32.1%. Patients who used this service had higher odds of hypertension treatment (β = 1.259, P < 0.01, OR = 3.52, CI = 2.467–5.030), and BP control (β = 0.220, P < 0.05, OR = 1.246, CI = 1.035–1.499). Medication treatment played a complete mediating role between monitoring and hypertension control in this study (t = 4.51, P < 0.001). Those who underwent BP monitoring tended to be those who did not finish primary school education (χ2 = 30.300, P < 0.001), had poorer household income (χ2 = 18.298, P < 0.05), and lived in rural areas rather than in urban areas (χ2 = 40.369, P < 0.001). Conclusions Although the use of BP monitoring service had no direct effect on BP control, it had a positive effect on BP control through the full mediation effect of hypertension treatment. Termly BP monitoring by community-based health expertise among hypertensive persons, for instance, once a season, can be recommended to public health policymakers for BP control through instructions on medication treatment and health behaviours.
Collapse
Affiliation(s)
- Hongxun Song
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China
| | - Donglan Zhang
- College of Public Health, University of Georgia, 305B Wright Hall, Health Sciences Campus, 100 Foster Road, Athens, Georgia
| | - Zhuo Chen
- College of Public Health, University of Georgia, 305B Wright Hall, Health Sciences Campus, 100 Foster Road, Athens, Georgia
| | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China
| | - Shangfeng Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China
| | - Ghose Bishwajit
- School of International Development and Global Studies, University of Ottawa, 75 Laurier Avenue East, Ottawa, ON, Canada
| | - Shanquan Chen
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Sha Tin, N.T, Hong Kong, SAR, China
| | - Da Feng
- School of Pharmacy, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China
| | - Tailai Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China
| | - Yang Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China
| | - Yanwei Su
- School of Nursing, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, 13 Hangkong Road, Wuhan, Hubei, China.
| |
Collapse
|
37
|
2018 Chinese Guidelines for Prevention and Treatment of Hypertension-A report of the Revision Committee of Chinese Guidelines for Prevention and Treatment of Hypertension. J Geriatr Cardiol 2019; 16:182-241. [PMID: 31080465 PMCID: PMC6500570 DOI: 10.11909/j.issn.1671-5411.2019.03.014] [Citation(s) in RCA: 242] [Impact Index Per Article: 48.4] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
|
38
|
Hua Q, Fan L, Li J. 2019 Chinese guideline for the management of hypertension in the elderly. J Geriatr Cardiol 2019; 16:67-99. [PMID: 30923539 PMCID: PMC6431598 DOI: 10.11909/j.issn.1671-5411.2019.02.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Qi Hua
- Hypertension Branch of Chinese Geriatrics Society
- National Clinical Research Center of the Geriatric Diseases-Chinese Alliance of Geriatric Cardiovascular Disease
| | - Li Fan
- Hypertension Branch of Chinese Geriatrics Society
- National Clinical Research Center of the Geriatric Diseases-Chinese Alliance of Geriatric Cardiovascular Disease
| | - Jing Li
- Hypertension Branch of Chinese Geriatrics Society
- National Clinical Research Center of the Geriatric Diseases-Chinese Alliance of Geriatric Cardiovascular Disease
| |
Collapse
|
39
|
Jurić D, Pavličević I, Marušić A, Malički M, Buljan I, Šarotić V, Mrduljaš-Đujić N, Komparak A, Vujević M, De Micheli-Vitturi D, Šušnjar P, Puljiz T, Jerčić M, Leskur D, Marušić M. Effectiveness of treatment of newly diagnosed hypertension in family medicine practices in South Croatia. BMC FAMILY PRACTICE 2019; 20:10. [PMID: 30642264 PMCID: PMC6330736 DOI: 10.1186/s12875-019-0902-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 01/02/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Uncontrolled blood pressure remains an urgent issue in clinical practice worldwide. This study aimed to compare the characteristics and effectiveness of hypertension control in family medicine pratice in the first treatment year, in relation to the geographical position, socio-economic standard, and access to medical services and public pharmacies in urban, rural and island environments (city of Split vs. Dalmatian Hinterland vs. islands in Southern Croatia). METHODS A historical cohort study included 213 patients diagnosed from 2008 to 2014 with essential arterial hypertension (AH) and without related complications or diabetes mellitus. Each patient was followed up for 365 days from the visit when the diagnosis of hypertension was ascertained. Normotension was defined as arterial pressure < 140/90 mmHg. The annual cost of drugs prescribed for treating newly diagnosed hypertensive patient and the total price for defined daily dose per patient were also evaluated. RESULTS More than half patients achieved normotension within a year from the initial diagnosis in all family medicine practices (57.3%), without significant differences among the three geographic regions (P = 0.981). Higher initial systolic blood pressure was a positive predictive prognostic factor on achieveing normotension (odds ratio (OR) 0.96, 95% confidence interval 0.95-0.98). ACE inhibitors were the most commonly prescribed antihypertensive agents in monotherapy (35.1%), as well as considering overall prescriptions (25.2%). Calcium channel blockers were the most commonly prescribed initial BP-lowering single agents in urban areas (28.6%), whereas angiotensin-converting enzyme inhibitors were more common in rural (28.0%) and island areas (22.7%) (P = 0.037). The median annual antihypertensive drug cost was 169.4 (95% CI 151.5-201.8) Croatian kunas and was similar across the study sites. CONCLUSION Multiple antihypertensive drugs, prescribed in accordance with the guidelines, lead to similar pharmacological effects. Primary care physicians seem to be able to overcome potential interfering socio-economic factors and successfully achieve normotension in newly diagnosed patients with uncomplicated AH after 1 year of treatment.
Collapse
Affiliation(s)
- Diana Jurić
- Department of Pharmacology, University of Split School of Medicine, Šoltanska 2, Split, Croatia
| | - Ivančica Pavličević
- Department of Family Medicine, University of Split School of Medicine, Split, Croatia
- Family medicine practice, Split, Croatia
| | - Ana Marušić
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
| | - Mario Malički
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
| | - Ivan Buljan
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
| | | | - Nataša Mrduljaš-Đujić
- Department of Family Medicine, University of Split School of Medicine, Split, Croatia
- Family medicine practice, Postira, Croatia
| | | | | | | | | | | | | | - Dario Leskur
- Department of Pharmacy, University of Split School of Medicine, Split, Croatia
| | - Matko Marušić
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
| |
Collapse
|
40
|
Lv X, Niu H, Qu Y, Li M, Li L, Ma X, Jiang S, Gao C, Wang R, Zhang P, Li B. Awareness, treatment and control of hypertension among hypertensive patients aged 18 to 59 years old in the northeast of China. Sci Rep 2018; 8:17019. [PMID: 30451878 PMCID: PMC6243001 DOI: 10.1038/s41598-018-34923-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 10/26/2018] [Indexed: 01/22/2023] Open
Abstract
Hypertension not only has a high prevalence, but also brings disease burden to the affected patients. To assess the level of awareness, treatment and control of hypertension in the northeast of China, we investigated the rates of awareness, treatment and control of hypertension and identified its related factors among hypertensive patients aged 18 to 59 years old in Jilin, China. The data (n = 4632) for the present study were extracted from a cross-sectional study in Jilin. Among individuals with hypertension, the standardized rates of awareness, treatment and control of hypertension were 44.9%, 36.5%, 24.3%, respectively. The rates of awareness and treatment of hypertension among middle aged patients were higher than those among young patients. Compared to patients with normal Body Mass index (BMI), obese hypertensive patients had a higher rate of treatment (43.7% vs. 25.9%) and a lower rate of control (18.9% vs. 29.6%). Compared to patients with normal BMI, patients who were obese were more likely to take measures to treat hypertension (OR = 2.50, 95%CI: 2.05-3.05); but were less likely to have well-controlled blood pressure (OR = 0.55, 95%CI: 0.40-0.78). BMI is one of the influencing factors of hypertension awareness, treatment and control among patients 18 to 59 years old with hypertension.
Collapse
Affiliation(s)
- Xin Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
- Jilin Women and Children Health Hospital, Changchun, 130061, China
| | - Huikun Niu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Yangming Qu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Meiqi Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Lu Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Xiaoyu Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Shan Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Chunshi Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Rui Wang
- Department of Thoracic Surgery, the First Hospital of Jilin University, Changchun, 130021, China
| | - Peng Zhang
- Department of Neurology, Stroke Center, the First Hospital of Jilin University, Changchun, 130021, China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China.
| |
Collapse
|
41
|
Song J, Chen X, Zhao Y, Mi J, Wu X, Gao H. Risk factors for prehypertension and their interactive effect: a cross- sectional survey in China. BMC Cardiovasc Disord 2018; 18:182. [PMID: 30219041 PMCID: PMC6139180 DOI: 10.1186/s12872-018-0917-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/06/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Individuals with prehypertension are at higher risk of developing hypertension and cardiovascular diseases, while the interaction between factors may aggravate prehypertension risk. Therefore, this study aimed to evaluate the risk factors for prehypertension in Chinese middle-aged and elderly adults, and explore the potentially interactive effect of evaluated factors. METHODS All the participants that came from a community based cross-sectional survey were investigated in Bengbu, China, by being interviewed with a questionnaire. Body mass index (BMI), Waist circumference (WC) and lipid accumulation product (LAP) that reflect participants' obesity were also calculated. In addition, logistic regression model was applied to explore the risk factors of prehypertension, followed by the assessment of the interactive effects between risk factors on prehypertension by the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). RESULTS A total of 1777 participants were enrolled in this study, among which the prevalence of normtension, prehypertension and hypertension were 41.70%, 33.93% and 24.37% respectively. According to the multivariate logistic regression analysis, age (OR: 1.01, 95%CI: 1.00-1.02), smoking (OR: 1.67, 95%CI: 1.22-2.29), family history of cardiovascular diseases (OR: 1.52, 95%CI: 1.14-2.02), general obesity (OR: 1.51, 95%CI: 1.15-1.97) and LAP (OR: 2.58, 95%CI: 1.76-3.80) were all defined as the major factors that significantly related with the risk of prehypertension. When identifying prehypertension risk, the receiver-operating characteristics (ROC) curves (AUC) analysis indicated that LAP performed better than BMI in males (Z = 2.05, P = 0.03) and females (Z = 2.12, P = 0.03), but was superior to WC only in females (Z = 2.43, P = 0.01). What is more, there were significant interactive effects of LAP with family history of cardiovascular diseases (RERI: 1.88, 95%CI: 0.25-3.51; AP: 0.44, 95%CI: 0.20-0.69; SI: 2.37, 95%CI: 1.22-4.60) and smoking (RERI: 1.99, 95%CI: 0.04-3.93; AP: 0.42, 95%CI: 0.17-0.67; SI: 2.16, 95%CI: 1.68-4.00) on prehypertension risk. The value of AP (0.40, 95%CI: 0.03-0.77) also indicated a significant interaction between family history of cardiovascular diseases and smoking on prehypertension. CONCLUSION Prehypertension is currently prevalent in Chinese adults. This study indicated that age, family history of cardiovascular diseases, smoking, general obesity and LAP were significantly related with prehypertension risk. Furthermore, interactive effects on risk of prehypertension had been demonstrated in this study as well, which would help researchers to build strategy against prehypertension more comprehensively and scientifically.
Collapse
Affiliation(s)
- Jian Song
- School of public health, Bengbu medical college, 2600 Donghai Road, Bengbu, 233000 Anhui Province China
| | - Xue Chen
- School of public health, Bengbu medical college, 2600 Donghai Road, Bengbu, 233000 Anhui Province China
| | - Yingying Zhao
- Bengbu health board, 568 Nanhu Road, Bengbu, 233000 Anhui Province China
| | - Jing Mi
- School of public health, Bengbu medical college, 2600 Donghai Road, Bengbu, 233000 Anhui Province China
| | - Xuesen Wu
- School of public health, Bengbu medical college, 2600 Donghai Road, Bengbu, 233000 Anhui Province China
| | - Huaiquan Gao
- School of public health, Bengbu medical college, 2600 Donghai Road, Bengbu, 233000 Anhui Province China
| |
Collapse
|
42
|
Ruan Y, Huang Y, Zhang Q, Qin S, Du X, Sun Y. Association between dietary patterns and hypertension among Han and multi-ethnic population in southwest China. BMC Public Health 2018; 18:1106. [PMID: 30200909 PMCID: PMC6131804 DOI: 10.1186/s12889-018-6003-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 08/30/2018] [Indexed: 12/22/2022] Open
Abstract
Background Different dietary patterns and the risks of hypertension in various diet exposures among multi-ethnic population in southwest China remain extremely scarce. The aim of this study is to identify dietary patterns and explore the association between dietary patterns and the risk of hypertension among Han and multi-ethnic population in southwest China. Methods A representative sample of 3591 participants of Han, and multi-ethnic population were recruited by stratified cluster sampling in Diqing of Yunnan Province, southwest China from September 2012 to January 2013. Participants who were under 18 years old or who could not clearly answer the questions and those who used the anti-hypertensive medication were excluded from this survey. All participants reported their dietary intakes using validated food frequency questionnaires (FFQ), and their blood pressures were measured by standardized procedures. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg. Dietary patterns were identified by factor analysis with principal component. Logistic regression was used to explore the association between dietary patterns and hypertension. Results The overall prevalence of hypertension was 30.5% among Han and multi-ethnic population in Diqing, Yunnan Province. Three dietary patterns were identified in this study, defined as ‘Grassland healthy’, ‘Tuber and meat’, and ‘Fruit and vegetable’. Participants in the 5th quintile of the three dietary patterns were at a lower risk of hypertension compared with those in the 1st quintile. The odds ratio (OR) for the 5th quintile of ‘Grassland healthy’ pattern, ‘Tuber and meat’ and ‘Fruit and vegetable’ was 0.693 (95% CI: 0.537–0.893, p = 0.005), 0.678 (95% CI: 0.530–0.868, p = 0.002), 0.759 (95% CI: 0.593–0.970, p = 0.028), respectively. After further adjustment of participants’ age, the negative association between the ‘Grassland healthy’ pattern and the prevalence of hypertension persisted (OR = 0.703, 95% CI: 0.535–0.924, p = 0.012). However, the significant associations between the other two dietary patterns and hypertension disappeared. Conclusions The ‘Grassland healthy’ dietary pattern is associated with lower risk of hypertension, whereas there is no significant associations between the other two dietary patterns and hypertension among Han and multi-ethnic population in Diqing of Yunnan province, southwest China. Electronic supplementary material The online version of this article (10.1186/s12889-018-6003-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Yuan Ruan
- Department of nutrition and food hygiene, Centre for Disease Control and Prevention (CDC), No.158 Dongsi Street, Kunming, 650022, Yunnan, China.
| | - Yongshou Huang
- People's hospital of Diqing Tibetan Autonomous Prefecture, No. 19 Chicika Street, Shangri-la, Diqing, 674400, Yunnan, China
| | - Qiang Zhang
- Department of nutrition and food hygiene, Centre for Disease Control and Prevention (CDC), No.158 Dongsi Street, Kunming, 650022, Yunnan, China
| | - Shu Qin
- CDC of Diqing Tibetan Autonomous Prefecture, No. 88 Ren'an Road, Shangri-la, Diqing, 674400, Yunnan, China
| | - Xiaoxia Du
- CDC of Diqing Tibetan Autonomous Prefecture, No. 88 Ren'an Road, Shangri-la, Diqing, 674400, Yunnan, China
| | - Yongxin Sun
- People's hospital of Diqing Tibetan Autonomous Prefecture, No. 19 Chicika Street, Shangri-la, Diqing, 674400, Yunnan, China
| |
Collapse
|
43
|
Zhao L, Sun W, Wang J, Wu J, Zhang Y, Liu Y, Liu B. Differences in the treatment and control of hypertension in urban and rural residents of the northeastern region of the People's Republic of China: a cross-sectional study. Clin Exp Hypertens 2018; 41:366-372. [PMID: 29939765 DOI: 10.1080/10641963.2018.1489544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Hypertension is a significant global public health problem and an important risk factor for cardiovascular diseases. We aimed to determine treatment and control rates of hypertension and to explore related risk factors by urban and rural areas. METHODS A cross-sectional survey of 14,956 participants (≥ 15 years) was conducted in Jilin Province, China from July 2014 to December 2015 using questionnaire forms and physical measurements. RESULTS Total rates of hypertension treatment, control, and controlled blood pressure among treated subjects were 31.7%, 8.8%, and 27.9% in the Jilin Province. Rates of hypertension treatment, control, and controlled blood pressure among treated subjects were 35.9%, 13.7%, and 38.3% in urban areas and 28.4%, 5.0%, and 17.5% in rural areas, respectively. Higher treatment of hypertension was associated with older age, female sex, other races (except Han), and higher body fat percentage in both areas. Among urban residents, higher education was additionally associated with higher treatment of hypertension; among rural residents, a family history of coronary artery disease and unemployment were associated with higher treatment of hypertension. Higher control of hypertension was associated with unemployment, married status, higher education, healthy body mass index, lower abdominal waist circumference, non-smoking status, and lower visceral adiposity index in urban residents; higher control of hypertension was associated with younger age in rural residents. CONCLUSION Treatment and control rates of hypertension in urban and rural areas were lower than the national average; blood pressure control in patients taking antihypertensive drugs needs further improvement.
Collapse
Affiliation(s)
- Lei Zhao
- a Department of Cardiology , the Second Hospital of Jilin University , Changchun , China
| | - Wei Sun
- a Department of Cardiology , the Second Hospital of Jilin University , Changchun , China
| | - Junnan Wang
- a Department of Cardiology , the Second Hospital of Jilin University , Changchun , China
| | - Junduo Wu
- a Department of Cardiology , the Second Hospital of Jilin University , Changchun , China
| | - Yangyu Zhang
- b Department of Epidemiology and Biostatistics, School of Public Health , Jilin University , Changchun , China
| | - Yingyu Liu
- b Department of Epidemiology and Biostatistics, School of Public Health , Jilin University , Changchun , China
| | - Bin Liu
- a Department of Cardiology , the Second Hospital of Jilin University , Changchun , China
| |
Collapse
|
44
|
Wang J, Sun W, Wells GA, Li Z, Li T, Wu J, Zhang Y, Liu Y, Li L, Yu Y, Liu Y, Qi C, Lu Y, Liu N, Yan Y, Liu L, Hui G, Liu B. Differences in prevalence of hypertension and associated risk factors in urban and rural residents of the northeastern region of the People's Republic of China: A cross-sectional study. PLoS One 2018; 13:e0195340. [PMID: 29621328 PMCID: PMC5886571 DOI: 10.1371/journal.pone.0195340] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 03/20/2018] [Indexed: 02/01/2023] Open
Abstract
Background Hypertension is a significant global public health problem and recognized as an important risk factor for cardiovascular diseases. This study was designed to assess the current prevalence of hypertension and to explore risk factors associated with hypertension by urban and rural status to guide the prevention and control of hypertension in Jilin province. Methods A multi-stage stratified random cluster sampling method was used to obtain data on hypertension, which was investigated by physical examination and face-to-face questionnaire in July 2014-December 2015. Sample data were analyzed by complex weighted statistical analysis to estimate blood pressure levels and prevalence of hypertension in the province. Multivariable logistic regression analysis was used to identify factors influencing hypertension rates. Results The prevalence of hypertension was significantly higher in rural areas than urban areas (25.93% versus 22.73%, respectively). The rates of hypertension known (46.7% versus 38.1%, respectively), control (13.7% versus 5.0%, respectively), and controlled among treated subjects (38.3% versus 17.5%, respectively) were higher in urban areas than in rural areas (all p < 0.001), while the treatment rate was not statistically significantly different between urban and rural areas (35.9% versus 28.4%, respectively). After adjusting for demographic covariates, hypertension prevalence in rural areas was still significantly greater than in urban areas (adjusted OR = 1.22; 95%CI: 1.10, 1.36; p < 0.001). Common risk factors for hypertension among urban and rural residents included older age; male; married; employed; less education; overweight/obese; greater abdominal waist circumference; family history of hypertension, stroke, or coronary heart disease; current smoker; alcohol consumption; higher visceral adiposity index; and higher body fat percentage. Conclusions This study identified an increased risk for hypertension in rural regions of Jilin province, suggesting that rural hypertension screening and treatment guidelines should receive greater attention.
Collapse
Affiliation(s)
- Junnan Wang
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Wei Sun
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - George A. Wells
- Department of Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Zhibo Li
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Tianyi Li
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Junduo Wu
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Yangyu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yingyu Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Longbo Li
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Yunpeng Yu
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Yihang Liu
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Chao Qi
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Yang Lu
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Ning Liu
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Youyou Yan
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Lulu Liu
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Gang Hui
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Bin Liu
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
- * E-mail:
| |
Collapse
|
45
|
Tu R, Inoue Y, Yazawa A, Hao X, Cai G, Li Y, Lin X, He F, Yamamoto T. Social participation and the onset of hypertension among the middle-aged and older population: Evidence from the China Health and Retirement Longitudinal Study. Geriatr Gerontol Int 2018; 18:1093-1099. [PMID: 29602268 DOI: 10.1111/ggi.13317] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/12/2018] [Accepted: 02/21/2018] [Indexed: 11/30/2022]
Abstract
AIM While previous studies have examined the association between health-related behaviors and hypertension, comparatively little attention has been paid to the role of social participation (i.e. participating in community organizations). The aim of the present study was to investigate the longitudinal association between social participation and hypertension among the middle-aged and older population (aged ≥45 years) in China where the prevalence of hypertension has been increasing rapidly in the past few decades. METHODS Data came from the China Health and Retirement Longitudinal Study waves 2011 and 2013. Information was obtained from 5483 participants on blood pressure, social participation and covariates. A sex-stratified Poisson regression model with a robust variance estimator was used to examine the associations. RESULTS During the period between 2011 and 2013, 20.6% of men and 17.2% of women developed hypertension. A Poisson regression model showed that participating in community organizations once a week or more frequently was inversely associated with the onset of hypertension in women (incidence rate ratio 0.80, 95% confidence interval 0.67-0.95, P = 0.012). Among men, no such association was found. CONCLUSION The present study suggests that promoting social participation might help mitigate the disease burden associated with hypertension in China, particularly among women. Geriatr Gerontol Int 2018; 18: 1093-1099.
Collapse
Affiliation(s)
- Raoping Tu
- Department of International Health, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yosuke Inoue
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Aki Yazawa
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Xiaoning Hao
- China National Health and Development Research Center, Beijing, China
| | - Guoxi Cai
- Department of International Health, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,Nagasaki Prefectural Institute of Environment and Public Health, Nagasaki, Japan
| | - Yueping Li
- Department of Health Management, School of Public Health, Fujian Medical University, Fujian, China
| | - Xiuquan Lin
- Department for Chronic and Non-communicable Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fujian, China
| | - Fei He
- Department of Epidemiology, School of Public Health, Fujian Medical University, Fujian, China
| | - Taro Yamamoto
- Department of International Health, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| |
Collapse
|
46
|
Tian Z, Li Y, Li L, Liu X, Shi Y, Yang K, Liu R, Zhang H, Qian X, Yin L, Zhao J, Wang C. Dose-response relationship between visceral fat index and untreated hypertension in Chinese rural population: the RuralDiab study. ACTA ACUST UNITED AC 2018; 12:448-456.e1. [PMID: 29678423 DOI: 10.1016/j.jash.2018.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 03/14/2018] [Indexed: 01/10/2023]
Abstract
The study aimed to explore the association of visceral fat index (VFI) with untreated hypertension in different genders and evaluate the practicability of VFI as a marker for discriminating untreated hypertension in Chinese rural population. A total of 12,536 eligible participants aged 35 years and older were derived from the RuralDiab study in China. VFI was assessed with bioelectrical impendence methods and divided into sex-specific quartiles. Logistic regression and restricted cubic spline regression were performed. Receiver operating characteristic curve was applied to analyze the discriminating performance of VFI. Meanwhile, a meta-analysis was conducted to validate the result of this study. Compared with the lowest VFI quartile, the adjusted odds ratios (ORs) and 95% confidence interval (95% CI) in the highest VFI quartile were 3.68 (2.91-4.66) in male and 2.63 (2.12-3.25) in female (Ptrend < .01). Nonlinear increasing trends about the risk of untreated hypertension were observed with the continuously increasing VFI in both genders (Plinearity < .01). The sensitivity and specificity in the optimal cutoff values for VFI were 58.37% and 62.26% in male, and 49.09% and 66.67% in female. The area under the curves (95% CI) were 0.64 (0.63-0.66) in male and 0.61 (0.60-0.62) in female. Meta-analysis results displayed the pooled odds ratios (95% CI) of 2.65 (1.79-3.93) in male and 2.27 (1.74-2.95) in female. VFI was significantly positively correlated with the risk of untreated hypertension, and dose-response relationships were observed in both genders in Chinese rural population. However, VFI as a marker had limited potential for discriminating untreated hypertension.
Collapse
Affiliation(s)
- Zhongyan Tian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yuqian Li
- Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Linlin Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yuanyuan Shi
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Kaili Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruihua Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Honglei Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xinling Qian
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Lei Yin
- Department of Prevention and Health care, Military Hospital of Henan Province, Zhengzhou, Henan, PR China
| | - Jingzhi Zhao
- Department of Prevention and Health care, Military Hospital of Henan Province, Zhengzhou, Henan, PR China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| |
Collapse
|
47
|
Wu J, Li T, Song X, Sun W, Zhang Y, Liu Y, Li L, Yu Y, Liu Y, Qi C, Liu B. Prevalence and distribution of hypertension and related risk factors in Jilin Province, China 2015: a cross-sectional study. BMJ Open 2018; 8:e020126. [PMID: 29599392 PMCID: PMC5875623 DOI: 10.1136/bmjopen-2017-020126] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 02/15/2018] [Accepted: 02/21/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the prevalence and distribution of hypertension and its related factors in Jilin province, China. DESIGN A cross-sectional study in four cities and four rural counties in Jilin as part of a national Chinese study. PARTICIPANTS AND SETTING A total of 15 206 participants who were ≥15 years old and were selected using a stratified multistage random sampling method. MAIN OUTCOME MEASURES The prevalence of hypertension. RESULTS The prevalence of hypertension in Jilin province was 24.7%. Moreover, the prevalence of hypertension increased with age in both sexes, and was higher in men than in women. The modifiable factors that were associated with hypertension were body mass index, smoking and alcohol drinking. The risk factors identified are similar to those in southern China, except smoking, which has no association with hypertension prevalence in the South. CONCLUSIONS Age, sex, body mass index, smoking and alcohol drinking were risk factors of hypertension. Control of these related risk factors, especially smoking, may be helpful in the treatment and management of hypertension in Jilin province.
Collapse
Affiliation(s)
- Junduo Wu
- Department of Cardiology, The Second Hospital of Jilin University, Changchun, China
| | - Tianyi Li
- Department of Cardiology, The Second Hospital of Jilin University, Changchun, China
| | - Xianjing Song
- Department of Cardiology, The Second Hospital of Jilin University, Changchun, China
| | - Wei Sun
- Department of Cardiology, The Second Hospital of Jilin University, Changchun, China
| | - Yangyu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yingyu Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Longbo Li
- Department of Cardiology, The Second Hospital of Jilin University, Changchun, China
| | - Yunpeng Yu
- Department of Cardiology, The Second Hospital of Jilin University, Changchun, China
| | - Yihang Liu
- Department of Cardiology, The Second Hospital of Jilin University, Changchun, China
| | - Chao Qi
- Department of Cardiology, The Second Hospital of Jilin University, Changchun, China
| | - Bin Liu
- Department of Cardiology, The Second Hospital of Jilin University, Changchun, China
| |
Collapse
|
48
|
Zhou H, Wang K, Zhou X, Ruan S, Gan S, Cheng S, Lu Y. Prevalence and Gender-Specific Influencing Factors of Hypertension among Chinese Adults: A Cross-Sectional Survey Study in Nanchang, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E382. [PMID: 29473870 PMCID: PMC5858451 DOI: 10.3390/ijerph15020382] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 02/09/2018] [Accepted: 02/20/2018] [Indexed: 01/23/2023]
Abstract
Hypertension has become the leading cause of death worldwide; data on hypertension among Nanchang adults are sparse. The aim of this study was to investigate the prevalence and gender-specific influencing factors of hypertension in adults in Nanchang, China. A cross-sectional survey was conducted with a representative sample of 2722 Chinese residents aged 18 years and above between May and September 2016, with a response rate of 92.4% (2516/2722). A stratified cluster sampling method was adopted in this study. Data on prevalence and influencing factors were obtained from a standard questionnaire and physical measurements. Univariate and multivariate logistic regressions were performed to analyze the influencing factors. The age-standardized prevalence was 19.8% (18.2-21.3) (male: 19.5% (18.0-21.1); female, 20.01% (18.5-21.6)). Factors positively associated with hypertension prevalence were past smoking, diabetes mellitus (DM), and overweight and obesity in both genders. Abdominal obesity and family history of cardiovascular diseases (CVD) were risk factors only in males; sleeping time and consumption of fresh vegetables and fruits were related to the prevalence of hypertension only in females. These findings will form the baseline information for the development of more effective approaches to enhance current prevention and control management of hypertension.
Collapse
Affiliation(s)
- Hui Zhou
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, Jiangxi 330006, China.
| | - Kai Wang
- School of Medicine, Nanchang University, Nanchang, Jiangxi 330006, China.
| | - Xiaojun Zhou
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, Jiangxi 330006, China.
| | - Shiying Ruan
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, Jiangxi 330006, China.
| | - Shaohui Gan
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, Jiangxi 330006, China.
| | - Siyuan Cheng
- Department of Public Health Sciences, University of Hawaii at Mānoa, Honolulu, HI 96822, USA.
| | - Yuanan Lu
- Department of Public Health Sciences, University of Hawaii at Mānoa, Honolulu, HI 96822, USA.
| |
Collapse
|
49
|
Bâ HO, Camara Y, Menta I, Sangaré I, Sidibé N, Diall IB, Coulibaly S, Kéita MA, Millogo GRC. Hypertension and Associated Factors in Rural and Urban Areas Mali: Data from the STEP 2013 Survey. Int J Hypertens 2018; 2018:6959165. [PMID: 29610681 PMCID: PMC5828104 DOI: 10.1155/2018/6959165] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 11/24/2017] [Accepted: 12/20/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Our study aims to estimate hypertension (HTN) prevalence and its predictors in rural and urban area. METHODS We conducted a cross-sectional population-based study involving subjects aged 15 to 65 years. Collected data (sociodemographic, blood pressure, weight, height, and blood glucose) were analyzed using SPSS version 20. A logistic regression was conducted to look for factors associated with HTN. RESULTS Mean was 47 years. High blood pressure (HBP) prevalence was 21.1 and 24.7%, respectively, in rural and urban setting. In rural area age group significantly predicted hypertension with age of 60 years having more-than-4-times risk of hypertension, whereas, in urban area age group, sex and body mass index were predictors with OR: HTN raising from 2.06 [1.24-3.43] for 30-44 years old to 7.25 [4.00-13.13] for 60 years and more using <30 years as reference. Female sex was protective with OR of 0.45 [0.29-0.71] and using normal weight as reference OR for overweight was 1.54 [1.04-2.27] and 2.67 [1.64-4.36] for obesity. CONCLUSION Hypertension prevalence is high and associated factors were age group in rural area and age group, female sex, and body mass index in urban area.
Collapse
|
50
|
Ybarra Sagarduy JL, Camacho Mata DY, Moral de la Rubia J, Piña López JA, Yunes Zárraga JLM. Psychological, interpersonal, and clinical factors predicting time spent on physical activity among Mexican patients with hypertension. Patient Prefer Adherence 2018; 12:89-96. [PMID: 29379276 PMCID: PMC5757987 DOI: 10.2147/ppa.s147943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND It is widely known that physical activity is the key to the optimal management and clinical control of hypertension. PURPOSE This research was conducted to identify factors that can predict the time spent on physical activity among Mexican adults with hypertension. METHODS This cross-sectional study was conducted among 182 Mexican patients with hypertension, who completed a set of self-administered questionnaires related to personality, social support, and medical adherence and health care behaviors, body mass index, and time since the disease diagnosis. Several path analyses were performed in order to test the predictors of the study behavior. RESULTS Lower tolerance to frustration, more tolerance to ambiguity, more effective social support, and less time since the disease diagnosis predicted more time spent on physical activity, accounting for 13.3% of the total variance. The final model shows a good fit to the sample data (pBS =0.235, χ2/gl =1.519, Jöreskog and Sörbom's Goodness of Fit Index =0.987, adjusted modality =0.962, Bollen's Incremental Fit Index =0.981, Bentler-Bonett Normed Fit Index =0.946, standardized root mean square residual =0.053). CONCLUSION The performance of physical activity in patients with hypertension depends on a complex set of interactions between personal, interpersonal, and clinical variables. Understanding how these factors interact might enhance the design of interdisciplinary intervention programs so that quality of life of patients with hypertension improves and they might be able to manage and control their disease well.
Collapse
Affiliation(s)
- José Luis Ybarra Sagarduy
- Unit of Social Work and Human Development, Autonomous University of Tamaulipas, Ciudad Victoria
- Correspondence: José Luis Ybarra Sagarduy, Unit of Social Work and Human Development, Autonomous University of Tamaulipas, University Center “Adolfo López Mateos”, Ciudad Victoria 87000, Tamaulipas, Mexico, Tel +52 834 318 1800, Email
| | | | | | | | - José Luis Masud Yunes Zárraga
- Institute of Health and Safety Services for State Workers, Clinic for the Study and Prevention of the Chilhood Obesity, Ciudad Victoria, Mexico
| |
Collapse
|