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Zare P, Poustchi H, Mohammadi Z, Mesgarpour B, Akbari M, Kamalipour A, Abdipour-Mehrian SR, Hashemi ES, Ghamar-Shooshtari A, Hosseini SA, Malekzadeh R, Bazrafshan Drissi H, Malekzadeh F, Molavi Vardanjani H. Polypharmacy and medication usage patterns in hypertensive patients: Findings from the Pars Cohort Study. Res Social Adm Pharm 2024; 20:1038-1046. [PMID: 39098543 DOI: 10.1016/j.sapharm.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 05/19/2024] [Accepted: 07/31/2024] [Indexed: 08/06/2024]
Abstract
Polypharmacy, defined here as the concomitant use of five or more medications, is a significant health issue, particularly affecting individuals with chronic diseases like hypertension (HTN). To compare individuals with and without HTN in term of polypharmacy, and to investigate correlates of polypharmacy and medication use patterns in individuals with HTN in southwest Iran. This cross-sectional study used the baseline data of 9270 participants of the Pars Cohort Study (PCS) with a mean age of 52.6 ± 9.7 years. Poisson multivariable modeling was applied to identify correlates of polypharmacy, and Lexicomp® was used to assess drug-drug interactions. Anatomical Therapeutic Chemical classification was used to describe the pattern of medication use. The prevalence of polypharmacy in individuals without hypertension was 4.7 % (4.2%-5.2 %) vs. 23.7 % (22.1%-25.3 %) in individuals with hypertension (P < 0.001). Individuals with hypertension from middle-high socioeconomic status (SES) had a 1.51-fold higher prevalence of polypharmacy than vs. low SES. Those with more than three comorbidities had a 5.18 times higher prevalence of polypharmacy than those with isolated hypertension. Calcium channel blockers were the most common antihypertensives (20.9 %). In terms of drug-drug interactions, type C interactions were most prevalent among participants with hypertension and polypharmacy (76.0 %). Our findings imply a fairly high prevalence of polypharmacy and drug-drug interactions among individuals with hypertension; to tackle this issue, we recommend a national pharmacovigilance system, training programs for primary care physicians, public education and awareness campaigns, drug-checking campaigns, targeted screenings to alter modifiable risk factors, and the use of safe combination pills.
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Affiliation(s)
- Pooria Zare
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Mesgarpour
- Research and Technology, National Institute for Medical Research and Development (NIMAD), Tehran, Iran
| | - Mohammadreza Akbari
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Alireza Kamalipour
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, CA, USA
| | | | - Elham-Sadat Hashemi
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arash Ghamar-Shooshtari
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Ophtalmology Resident of Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Hosseini
- Postdoctoral Researcher, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Malekzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Bazrafshan Drissi
- Department of Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Malekzadeh
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Molavi Vardanjani
- MPH Department, School of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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2
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Mobasseri K, Matlabi H, Allahverdipour H, Kousha A. Home-based supportive and health care services based on functional ability in older adults in Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:124. [PMID: 38784273 PMCID: PMC11114482 DOI: 10.4103/jehp.jehp_422_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/22/2023] [Indexed: 05/25/2024]
Abstract
BACKGROUND Home-based care is affordable due to population aging, increased chronic disease, and higher hospitalization costs. The objective was to evaluate home-based supportive and health care services provided to older adults and identify possible associations between activities of daily living (ADLs), instrumental ADL (IADLs) classifications, sociodemographic variables, clinical characteristics, and perceived social support among older adults. MATERIALS AND METHODS In this cross-sectional study, 700 people aged 60 years and older were selected by stratified cluster sampling. Areas of Tabriz City were selected as clusters, and 55 comprehensive urban health centers were selected as stratifies. Chi-square, Pearson's and Spearman's tests, and multiple linear regression were used for statistical analyses. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS 24.0, SPSS Inc., Chicago, USA). The study instrument included demographic characteristics of older adults and caregivers, health services provided at home, and two valid questionnaires, including the KATZ index of independence in (instrumental) activities of daily living and a multidimensional scale of perceived social support. Scores on scales and demographic variables were collected during telephone interviews. The study lasted from April 25, 2022, to October 30, 2022. RESULTS A high level of perceived social support was 56.6%. The study found that 51.3% of participants had family caregivers. Most participants had ADL independence (85.4%), while 22.9% and 24.3% were dependent and needed assistance with IADL, respectively. Women had a lower ADL score and a higher IADL score than men (P < 0.05). The obtained results of multiple regression analysis revealed a negative and significant association between unemployment, illiteracy, increasing age, five and more medications, and ADL and IADL dependency (P < 0.05). CONCLUSION Empowering older adults to reduce dependency, and designing a formal home-based care system is recommended.
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Affiliation(s)
- Khorshid Mobasseri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Geriatric Health, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Matlabi
- Department of Geriatric Health, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Department of Health Education and Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Kousha
- Department of Health Education and Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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3
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Mansouri A, Khosravi Farsani A, Mohammadifard N, Nouri F, Jozan M, Tabatabaei GA, Salehidoost R, Rafiee H. Self-rated health and its determinants in patients with hypertension in Isfahan in 2019. BMC Public Health 2024; 24:480. [PMID: 38360624 PMCID: PMC10870428 DOI: 10.1186/s12889-024-17887-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/25/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Self-rated health (SRH) serves as an assessment of contentment regarding one's social, mental, and physical well-being and has been linked to both cardiovascular mortality and morbidity. Nonetheless, the relationship between SRH and medical outcomes in individuals with hypertension unsettled. This research endeavors to pinpoint the determinants that affect SRH in Iranian patients with hypertension. MATERIALS AND METHODS This cross-sectional study took place in Isfahan, Iran, from November 2018 to August 2019 and involved 886 patients with essential HTN. The data collection methods included a checklist for demographic information and risk factors, blood pressure measurements (systolic and diastolic), the Persian version of the 8-Item Morisky Medication Adherence scale, and a self-rated health questionnaire recommended by the World Health Organization. Independent sample T-test and chi squared test were used for comparison of variables between two groups of SRH. Additionally, multivariable logistic regression was used to analyze the factors influencing self-rated health status. RESULTS Among 886 participants (mean age 57.8 ± 8.8 years, 71.9% women), 89.62% reported good SRH. Comorbid conditions were significantly associated with poorer SRH (p < 0.05). Notably, higher education (odd ratio (OR) = 1.88, 95% confidence interval (CI) = 1.13-3.11, p = 0.015) and increased income (OR = 4.34, 95% CI = 1.43-13.18, p = 0.010) were identified as positive determinants of good SRH. CONCLUSION We concluded that socioeconomic factors (education and income) and comorbid conditions (diabetes, hyperlipidemia, and pulmonary diseases) are risk factors for poor SRH among hypertensive patients. These findings could help planning of health enhancement initiative.
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Affiliation(s)
- Asieh Mansouri
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi Farsani
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nouri
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnaz Jozan
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ghazaal Alavi Tabatabaei
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Rezvan Salehidoost
- Centre for Endocrinology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Hamed Rafiee
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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4
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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.
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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
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Lamloum D, Fassio F, Osetinsky B, Tediosi F. Care Cascades for Hypertension in Low-Income Settings: A Systematic Review and Meta-Analysis. Int J Public Health 2023; 68:1606428. [PMID: 37901590 PMCID: PMC10600349 DOI: 10.3389/ijph.2023.1606428] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Objective: High blood pressure is the leading risk factor for cardiovascular disease. The hypertension care cascade (HCC) is increasingly being used to evaluate the effectiveness of interventions. This systematic review aims to examine HCC in low-income settings. Methods: The search strategy included articles published between January 2010 and April 2023. We excluded studies with incomplete HCC, on fragile patients or aged <18 years, reviews. We used the MOOSE guideline. Five researchers retrieved data on the survey year, country, population, HCC and diagnostic methods for hypertension. We used JBI Critical Appraisal Tools for quality assessment. Results: Ninety-five articles were analyzed. Average hypertension prevalence was 33% (95% CI: 31%-34%), lower in LICs than in LMICs (25% vs. 34%). The overall mean awareness of hypertension was 48% (95% CI: 45%-51%), its treatment was 35% (95% IC: 32%-38%) and its control 16% (95% CI: 14%-18%). In almost all steps, percentages were lower in LICs and in Sub-Saharan Africa. Conclusion: Trends in HCC vary between countries, with poorer performance in LICs. This review highlights the need for interventions tailored to low-income settings in order to improve hypertension care.
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Affiliation(s)
- Demetrio Lamloum
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Bern, Switzerland
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Federico Fassio
- Department of Public Health, Experimental and Forensic Medicine, Section of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, Italy
| | - Brianna Osetinsky
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Fabrizio Tediosi
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Karami B, Azimi A, Rahimi Z, Mahmoudi S, Jalilian N. Contribution of NOS3AS Variants to Susceptibility to Essential Hypertension: A Study in Kermanshah Province, Western Iran. Biochem Genet 2023; 61:2149-2158. [PMID: 36966459 DOI: 10.1007/s10528-023-10364-2] [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: 01/25/2023] [Accepted: 03/09/2023] [Indexed: 03/27/2023]
Abstract
Hypertension (HTN) is a global health challenge and increase the risk of cardiovascular disease. Hypertension has a multifactorial course of evolution, with both genetic and environmental factors playing an important role. To date, a number of genes and pathways have been proposed to be associated with HTN, among which is Nitric Oxide pathway. NO levels can be regulated by reactive oxygen species (ROS), superoxide and post-transcriptional mechanisms, including sense-anti sense interactions. NOS3AS gene encodes an antisense RNA (sONE) which is complementary to NOS3 transcript in 662 nucleotides and may regulate NOS3 in a post-transcriptional manner. In this study, we sought to define the role of NOS3AS in the pathophysiology of essential HTN. A total of 131 cases with hypertension and 115 controls were enrolled in the study. Peripheral blood was drawn from all study participants after signing the informed consent form. Three variants (rs71539868, rs12666075 and rs7830) were investigated by Tetra-ARMS PCR method. The results were then statistically analyzed. We found statistically significant association between rs7830 TT genotype, rs12666075 GT and TT genotypes with susceptibility to HTN. We failed to observe association between rs71539868 and susceptibility to HTN. The present study showed a strong association between NOS3AS variants and susceptibility to hypertension in the population of Kermanshah province. Our results may shed more light on the mechanisms of disease development and may also help to better identify genetic predispositions and individuals at risk.
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Affiliation(s)
- Bahareh Karami
- Department of Clinical Biochemistry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Azam Azimi
- Medical Genetics Laboratory, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zohreh Rahimi
- Department of Clinical Biochemistry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sousan Mahmoudi
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nazanin Jalilian
- Department of Clinical Biochemistry, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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7
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Ostovar A, Sepanlou S, Shariati M, Mahdavi Hezaveh A, Yousefi E, Hodjatzadeh A, Afkar M, Pariani A, Moghisi A, Khalagi K, Najmi M, Bashti S, Aghamohammadi S, Bagherzade yazdi M, Atefi A, Joneidi A, Barakati H, Heshmat R, Peykari N, Ranjbar M, Hammelman C, Mendis S, Pariyanzeitooni M, Mohammadi N, Noemani K, Barati H, Alborzinia R, Mirshfiee P, Khaligh N, Anvari M, Morsali A, Shirzadian A, Hasani M, Zakeri M, Alizadeh Barzian K, Azadmehr H, Ghasemi A, Delshad A, Hajiuni R, Shafieinia MA, Dolatabad M, Soltani M, Azizi A, Izadi M, Rokhshad H, Sadeghi G, Rahmani MH, Sedaghat SM, Sadeghzade H, Mirmoieni R, Golmohammadi A, Najafi Moghadam T, Ehsanzadeh A, Parvin A, Ahmadian M, Hosseinkhani R, Shadmand S, Shahrokhi F, Panje Shahi M, Shafiei bafti M, Shahabadi S, Shaddel S, Bayat Asghari A, Talebi E, Sharafi S, Kooshki M, Asadiyan F, Sadeghi MJ, Eghbali B, Norouzinezhad G, Farrokhzad S, Mirheidari M, Nejadghaderi M, Iran nezhad N, Mehri SM, Rahimzadeh A, Etminanbakhsh H, Dalili A, Aminforghani H, Rahbar MN, Rostampour S, Fateh M, Moradi F, Mousavi SA, Pourabazari G, Sharbafi J, Aminmanesh A, Karimi A, Sarbazi M, Farbakhsh F, Alinezhad J, Parishan Kordiani T, Dalili N, Parisay Z, Sadeghian MR, Bazishad A, Sartipi M, Seydi A, Raeisi A. The Iranian blood pressure measurement campaign, 2019: study protocol and preliminary results. J Diabetes Metab Disord 2023; 22:899-911. [PMID: 37255819 PMCID: PMC10225367 DOI: 10.1007/s40200-022-01126-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/05/2022] [Accepted: 09/06/2022] [Indexed: 06/01/2023]
Abstract
Purpose Hypertension is one of the most important risk factors for premature mortality and morbidity in Iran. The objective of the Iranian blood pressure (BP) measurement campaign was to identify individuals with raised blood pressure and providing appropriate care and increase the awareness among the public and policymakers of the importance of tackling hypertension. Methods The campaign was conducted in two phases. The first (communication) phase started on May 17th (International Hypertension Day). The second phase started on June 8th, 2019, and lasted up to July 7th during which, blood pressures were measured. The target population was Iranians aged ≥ 30 years. Participants voluntarily referred to health houses in rural and health posts and comprehensive health centers in urban areas in the setting of the Primary Health Care network. Additionally, over 13,700 temporary stations were set up in highly visited places in urban areas. Volunteer healthcare staff interviewed the participants, measured their BP, and provided them with lifestyle advice and knowledge of the risks and consequences of high blood pressure. They referred participants to physicians in case their BP was high. Participants immediately received a text message containing the relevant advice based on their measured BP and their past history. Results Blood pressure was measured for a total of 26,678,394 participants in the campaign. A total of 13,722,148 participants (51.4%) were female. The mean age was 46 ± 14.1 years. Among total participants, 15,012,693 adults (56.3%) with no past history of hypertension had normal BP, 7,959,288 participants had BP in the prehypertension range (29.8%), and finally, 3,706,413 participants (13.9%) had either past medical history of hypertension, used medications, or had high BP measured in the campaign. Conclusion The campaign was feasible with the objective to increase the awareness among the public and policymakers of the importance of tackling hypertension in Iran.
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Affiliation(s)
- Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute,, Tehran University of Medical Sciences, 1411713137, No 10, Jalale Al Ahmad St., next to Dr. Shariati Hospital Complex, Tehran, Iran
- Center for Non-communicable Disease Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Sadaf Sepanlou
- Digestive Disease Research institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Alireza Mahdavi Hezaveh
- Center for Non-communicable Disease Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Elham Yousefi
- Center for Non-communicable Disease Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Alieh Hodjatzadeh
- Center for Non-communicable Disease Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Mehdi Afkar
- Center for Non-communicable Disease Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Abbas Pariani
- Center for Non-communicable Disease Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Alireza Moghisi
- Center for Non-communicable Disease Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Kazem Khalagi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute,, Tehran University of Medical Sciences, 1411713137, No 10, Jalale Al Ahmad St., next to Dr. Shariati Hospital Complex, Tehran, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Najmi
- Center for Non-communicable Disease Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Shahnaz Bashti
- Center for Non-communicable Disease Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Saeideh Aghamohammadi
- Center for Health Network Management, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | | | - Azizollah Atefi
- Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Ahmad Joneidi
- Center for Environmental & Occupational Health, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Hamed Barakati
- Center for Population, Family, and School Health, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Peykari
- Iranian Non-communicable Diseases Committee (INCDC), Deputy for Education, Ministry of Health and Medical Education, Tehran, Iran
| | - Mansour Ranjbar
- WHO Country Office for Iran (Islamic Republic of), Tehran, Iran
| | | | | | | | - Nahid Mohammadi
- Deputy of Public Health, Abadan University of Medical Sciences, Abadan, Iran
| | - Kourosh Noemani
- Deputy of Public Health, Jondishapour Ahwaz University of Medical Sciences, Ahwaz, Iran
| | - Hojatollah Barati
- Deputy of Public Health, Alborz University of Medical Sciences, Karaj, Iran
| | - Reza Alborzinia
- Deputy of Public Health, Alborz University of Medical Sciences, Karaj, Iran
| | - Pari Mirshfiee
- Deputy of Public Health, Arak University of Medical Sciences, Arak, Iran
| | - Naghmeh Khaligh
- Deputy of Public Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mostafa Anvari
- Deputy of Public Health, Asadabad University of Medical Sciences, Asadabad, Iran
| | - Ali Morsali
- Deputy of Public Health, Asadabad University of Medical Sciences, Asadabad, Iran
| | | | - Mahnaz Hasani
- Deputy of Public Health, Bam University of Medical Sciences, Bam, Iran
| | - Maryam Zakeri
- Deputy of Public Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | | | - Hamid Azadmehr
- Deputy of Public Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Ali Ghasemi
- Deputy of Public Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Afshin Delshad
- Deputy of Public Health, North Khorasan University of Medical Sciences, Bojnourd, Iran
| | - Razieh Hajiuni
- Deputy of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Mostafa Dolatabad
- Deputy of Public Health, Esfarayen University of Medical Sciences, Esfarayen, Iran
| | - Maryam Soltani
- Deputy of Public Health, Esfarayen University of Medical Sciences, Esfarayen, Iran
| | - Abdollah Azizi
- Deputy of Public Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Mohsen Izadi
- Deputy of Public Health, Gerash University of Medical Sciences, Gerash, Iran
| | - Hasan Rokhshad
- Deputy of Public Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Gholamreza Sadeghi
- Deputy of Public Health, Guilan University of Medical Sciences, Rasht, Iran
| | | | | | - Hamide Sadeghzade
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Ali Golmohammadi
- Deputy of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Asad Ehsanzadeh
- Deputy of Public Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Abdolmohsen Parvin
- Deputy of Public Health, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Mahshid Ahmadian
- Deputy of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ramesh Hosseinkhani
- Deputy of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shapour Shadmand
- Deputy of Public Health, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Fateme Shahrokhi
- Deputy of Public Health, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Morteza Panje Shahi
- Deputy of Public Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Mehdi Shafiei bafti
- Deputy of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Sara Shahabadi
- Deputy of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Soleiman Shaddel
- Deputy of Public Health, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Abbas Bayat Asghari
- Deputy of Public Health, Khomeyn University of Medical Sciences, Khomeyn, Iran
| | - Esmaeel Talebi
- Deputy of Public Health, Khoy University of Medical Sciences, Khoy, Iran
| | - Sajjad Sharafi
- Deputy of Public Health, Larestan University of Medical Sciences, Larestan, Iran
| | - Maryam Kooshki
- Deputy of Public Health, Lorestan University of Medical Sciences, Khoramabad, Iran
| | - Faeghe Asadiyan
- Deputy of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | | | - Babak Eghbali
- Deputy of Public Health, Khorasan Razavi University of Medical Sciences, Mashhad, Iran
| | | | - Solmaz Farrokhzad
- Non-Communicable Diseases Research Institute, Qazvin University of Medical Sciences, Qazvin, Iran
- Deputy of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mahdi Mirheidari
- Deputy of Public Health, Qom University of Medical Sciences, Qom, Iran
| | - Mohsen Nejadghaderi
- Deputy of Public Health, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Najme Iran nezhad
- Deputy of Public Health, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Seyed Mohsen Mehri
- Deputy of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ardeshir Rahimzadeh
- Deputy of Public Health, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Azita Dalili
- Deputy of Public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | | | | | - Sepinood Rostampour
- Deputy of Public Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mansoureh Fateh
- Deputy of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Fariba Moradi
- Deputy of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Ali Mousavi
- Deputy of Public Health, Shushtar University of Medical Sciences, Shushtar, Iran
| | | | - Jabraeil Sharbafi
- Deputy of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Aminmanesh
- Deputy of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azita Karimi
- Deputy of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Sarbazi
- Deputy of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Farbakhsh
- Deputy of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Javad Alinezhad
- Deputy of Public Health, Torbat Heydarieh University of Medical Sciences, Torbat Heydarieh, Iran
| | | | - Nourieh Dalili
- Deputy of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Zafar Parisay
- Deputy of Public Health, Kohkilouye Boyerahmad University of Medical Sciences, Yasouj, Iran
| | | | - Amir Bazishad
- Deputy of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Majid Sartipi
- Deputy of Public Health, Zahedan University of Medical Sciences, Zahedan, Iran
- Health Promotion Research Center, School of Public Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ali Seydi
- Deputy of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Alireza Raeisi
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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8
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Mahmoudi Kohi S, Mohammadifard N, Hassannejad R, Nouri F, Mansourian M, Sarrafzadegan N. Explaining the Decline in Coronary Heart Disease Mortality Rate Using IMPACT Model: Estimation of the Changes in Risk Factors and Treatment Uptake in Iran between 2007 and 2016. ARYA ATHEROSCLEROSIS 2023; 19:33-42. [PMID: 38881584 PMCID: PMC11066787 DOI: 10.48305/arya.2023.17203.2697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/25/2022] [Indexed: 06/18/2024]
Abstract
INTRODUCTION Coronary heart disease (CHD) contributes significantly to mortality and morbidity in Iran. A model was fitted in this study to determine changes in risk factors and treatment uptake to CHD mortality rate reduction in Isfahan between 2007 and 2016. METHOD The IMPACT model was fitted to determine how much the decrease in CHD death can be explained by treatment uptake and significant risk factors included in the analyses for adults aged 35 to 84 years. Body mass index (BMI), diabetes, and smoking were considered as the CHD risk factors in the model. Medical and interventional treatments were studied in four different groups of patients. The primary data sources were obtained from the Persian registry of cardiovascular disease (PROVE), The Isfahan healthy heart program (IHHP), and the impact of self-care management and adopted Iranian guidelines for hypertension treatment on improving the control rate of hypertension (IMPROVE CARE) study, death registration system, and the Isfahan province Cemetery. RESULTS The CHD mortality rate decreased by 14% between 2007 and 2016 in Iran for adults aged 35 to 84 years and prevented or delayed 212 CHD deaths in 2016. Treatment uptakes caused 99% postponed or prevented death. Treatment for heart failure in hospitals explained approximately half of the death prevented by treatment. Risk factors caused about 15% of excess death. It appears that the prevalence of CHD is increasing while the death rate is decreasing because of these observed changes. CONCLUSION Risk factors worsened in 2016 and, without treatment, could lead to an increase in CHD mortality in Iran. Preventive policies should control the risk factor and contribute to the decrease in CHD death.
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Affiliation(s)
- Shirin Mahmoudi Kohi
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Razieh Hassannejad
- Interventional Cardiology Research Center, Cardiovascular Research Institute. Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nouri
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Mansourian
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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9
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Self-Care Behaviors in Patients with Hypertension to Prevent Hypertensive Emergencies: a Qualitative Study Based on the Theory of Planned Behavior. JOURNAL OF CARDIOVASCULAR EMERGENCIES 2022. [DOI: 10.2478/jce-2022-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
Abstract
Background: Hypertension is a crucial general health issue. Severe and acute hypertension needs urgent medical intervention. Self-care behaviors can help patients with hypertension in controlling blood pressure and preventing hypertensive emergencies. This study aimed to determine the perception of hypertension towards self-care behaviors using constructs of the theory of planned behavior (TPB) in critically ill patients with hypertension to prevent hypertensive emergencies.
Material and Methods: This study was conducted based on the directed qualitative content analysis of 33 critically ill patients with hypertension who participated in semi-structured interviews and focus group discussions. Results: The data were analyzed based on the four main categories of TPB. The attitude category consisted of positive and negative subcategories. The subjective norms category consisted of authority of healthcare staff, family support and approval, and influence of friends subcategories. The perceived behavioral control category included discipline, self-control, receiving consultation, individual concerns, financial problems, access to medicine, food culture, and coronavirus limitations subcategories. The behavioral intention category had intention to perform the behavior and intention to continue a behavior subcategories.
Conclusion: The results revealed the requirement for a multidimensional approach to improve attitude, subjective norms, and behavioral control for performing self-care behaviors to reduce the number of hypertensive emergencies in critically ill patients with hypertension. Factors affecting self-care included socioeconomic status, family support, governmental organizations, and participants’ health condition.
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10
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Awareness, treatment, and practices of lifestyle modifications amongst diagnosed hypertensive patients attending the tertiary care hospital of Karachi: A cross-sectional study. Ann Med Surg (Lond) 2022; 82:104587. [PMID: 36268382 PMCID: PMC9577521 DOI: 10.1016/j.amsu.2022.104587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/31/2022] [Accepted: 09/04/2022] [Indexed: 11/22/2022] Open
Abstract
Background Methods Results Conclusion Data regarding the awareness of lifestyle modifications in the general hypertensive population of Pakistan is scarce. Out of 425 hypertensive patients, 70.7% had uncontrolled hypertension. Age and female gender were the only risk factors significantly associated with uncontrolled hypertension. Most of the patients are on treatment and still not controlled, and thus could be considered under treatment. Interventions should be considered and implemented to potentially increase the control rates.
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11
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Okati-Aliabad H, Ansari-Moghaddam A, Kargar S, Mohammadi M. Prevalence of hypertension and pre-hypertension in the Middle East region: a systematic review & meta-analysis. J Hum Hypertens 2022; 36:794-804. [PMID: 35031669 DOI: 10.1038/s41371-021-00647-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 11/22/2021] [Accepted: 12/01/2021] [Indexed: 10/19/2022]
Abstract
Hypertension is a leading cause of mortality and morbidity globally. This study aimed to obtain an overall regional estimate of the prevalence of hypertension and pre-hypertension and present the disease pattern based on the age and time in the Middle East region. We searched PubMed, Google Scholar, Medline for articles on the prevalence of hypertension, pre-hypertension among countries of the Middle East region from 1999 to 2019. STATA-14 was used to analyze the data. Data were pooled using a random-effects meta-analysis model, and heterogeneity between studies was assessed using I2 test and subgroup analysis. A total of eighty-three studies with 479816 participants met the criteria for inclusion in the meta-analysis process. The overall prevalence of hypertension and pre-hypertension in the Middle East region were 24.36% (95% CI: 19.06-31.14) and 28. 60% (95% CI: 24.19-33.80), respectively. An increasing trend in the prevalence of hypertension was observed with the increasing age. The prevalence of hypertension in the ≤ 49-year-old age group was 17.13% (95% CI: 13.79-21.27) and in people over 60 years was 61.24% (95% CI: 55.30-67.81) (P < 0.001). This pattern has been similar among both males and females. On the other hand, a decreasing trend in the prevalence of pre-hypertension was observed with the increasing age. The increasing trend in the prevalence of hypertension and decreasing trend in the prevalence of pre-hypertension with age are significant concerns in the Middle East region. Screening for the prevention and control of hypertension should prioritize public health programs.
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Affiliation(s)
- Hassan Okati-Aliabad
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Shiva Kargar
- Gerash University of Medical Sciences, Gerash, Iran.
| | - Mahdi Mohammadi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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12
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Pallangyo P, Komba M, Mkojera ZS, Kisenge PR, Bhalia S, Mayala H, Kifai E, Richard MK, Khanbhai K, Wibonela S, Millinga J, Yeyeye R, Njau NF, Odemary TK, Janabi M. Medication Adherence and Blood Pressure Control Among Hypertensive Outpatients Attending a Tertiary Cardiovascular Hospital in Tanzania: A Cross-Sectional Study. Integr Blood Press Control 2022; 15:97-112. [PMID: 35991354 PMCID: PMC9390787 DOI: 10.2147/ibpc.s374674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background Notwithstanding the availability of effective treatments, asymptomatic nature and the interminable treatment length, adherence to medication remains a substantial challenge among patients with hypertension. Suboptimal adherence to BP-lowering agents is a growing global concern that is associated with the substantial worsening of disease, increased service utilization and health-care cost escalation. This study aimed to explore medication adherence and its associated factors among hypertension outpatients attending a tertiary-level cardiovascular hospital in Tanzania. Methods The pill count adherence ratio (PCAR) was used to compute adherence rate. In descriptive analyses, adherence was dichotomized and consumption of less than 80% of the prescribed medications was used to denote poor adherence. Logistic regression analyses was used to determine factors associated with adherence. Results A total of 849 outpatients taking antihypertensive drugs for ≥1 month prior to recruitment were randomly enrolled in this study. The mean age was 59.9 years and about two-thirds were females. Overall, a total of 653 (76.9%) participants had good adherence and 367 (43.2%) had their blood pressure controlled. Multivariate logistic regression analysis showed; lack of a health insurance (OR 0.5, 95% CI 0.3-0.7, p<0.01), last BP measurement >1 week (OR 0.6, 95% CI 0.4-0.8, p<0.01), last clinic attendance >1 month (OR 0.4, 95% CI 0.3-0.6, p<0.001), frequent unavailability of drugs (OR 0.6, 95% CI 0.3-0.9, p = 0.03), running out of medication before the next appointment (OR 0.6, 95% CI 0.4-0.9, p = 0.01) and stopping medications when asymptomatic (OR 0.6, 95% CI 0.4-0.8, p<0.001) to be independent associated factors for poor adherence. Conclusion A substantial proportion of hypertensive outpatients in this tertiary-level setting had good medication adherence. Nonetheless, observed suboptimal blood pressure control regardless of a fairly satisfactory adherence rate suggests that lifestyle modification plays a central role in hypertension management.
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Affiliation(s)
- Pedro Pallangyo
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Makrina Komba
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Zabella S Mkojera
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Peter R Kisenge
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Smita Bhalia
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Henry Mayala
- Directorate of Clinical Support Services, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Engerasiya Kifai
- Directorate of Clinical Support Services, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Mwinyipembe K Richard
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Khuzeima Khanbhai
- Unit of Research and Training, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Salma Wibonela
- Directorate of Nursing, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Jalack Millinga
- Directorate of Nursing, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Robert Yeyeye
- Directorate of Nursing, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Nelson F Njau
- Directorate of Clinical Support Services, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Thadei K Odemary
- Directorate of Clinical Support Services, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Mohamed Janabi
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
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13
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Hadian Z, Fatemeh S, Reihani S, Mirmoghtadaie L, Tan TC. Survey of the salt (NaCl) Contents of Traditional Breads in Tehran, 2016‒2018: Implication for Public Health. Int J Prev Med 2022; 13:91. [PMID: 35958365 PMCID: PMC9362750 DOI: 10.4103/ijpvm.ijpvm_338_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/08/2020] [Indexed: 11/13/2022] Open
Abstract
Background Considering the importance of non-communicable diseases (NCDs) in Iran, the aim of this study is to identify the trend in the salt (NaCl) levels of various types of traditional bread (sangak, barbari, taftoon, and lavash breads) in Tehran in 2016 and 2018 and its implication for public health. Methods A total of 777 samples of various traditional breads were randomly collected from various districts located in Tehran in 2018. The salt content (expressed as g/100 g dry weight) in these breads were determined according to Volhard method. Results from this study were compared with those reported in 2016. Results The present study indicated that the mean salt content in traditional breads in 2018 was significantly higher than that reported in 2016. Salt content in traditional breads collected in 2018 ranged from 0.03 to 6.52/100 g dry weight, with mean value of 1.43 g/100 g dry weight. When comparing with the permitted limit set by Institute of Standards and Industrial Research of Iran (ISIRI), there was an increase in the percentage of samples complying with the permitted limit; 50.8% (2016) vs 54.1% (2018). Conclusions The daily salt intake increased from 1.56 g per person in 2016 to 2.31 g per person in 2018. Considering the high bread per capita consumption in Iran, it seems that half of the daily recommended salt intake could be reached exclusively through breads. Hence, the main strategies for salt intake reduction from bread could be achieved through evaluation of salt reduction programs and development of technological factors in bread baking.
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Affiliation(s)
- Zahra Hadian
- Department of Food Technology Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Address for correspondence: Dr. Zahra Hadian, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. E-mail:
| | - S. Fatemeh
- Department of Food Technology Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S. Reihani
- Department of Food Technology Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Mirmoghtadaie
- Department of Food Sciences and Technology, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Thuan Chew Tan
- Food Technology Division, School of Industrial Technology, Universiti Sains Malaysia 11800 Penang, Malaysia
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14
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Najafipour H, Nasri HR, Rostamzadeh F, Amirzadeh R, Shadkam M, Mirzazadeh A. Prevalence and incidence of pre-hypertension and hypertension (awareness/control) in Iran: findings from Kerman coronary artery diseases risk factors study 2 (KERCADRS). J Hum Hypertens 2022; 36:461-472. [PMID: 32929131 DOI: 10.1038/s41371-020-00392-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 07/09/2020] [Accepted: 07/29/2020] [Indexed: 12/22/2022]
Abstract
Hypertension (HTN) is an important cause of cardiovascular-related morbidity and mortality. The present study was conducted to investigate the prevalence and incidence rate of pre-HTN, diagnosed and undiagnosed HTN, as well as its control and associated factors in adult population in southeast Iran. In a randomized household survey, 9987 participants aged 15-80 years were recruited into the study. HTN was confirmed through examination or using antihypertensive drug(s). Pre-HTN and HTN were defined as 120-139/80-89 and ≥140/90 mmHg for systolic and diastolic BP, respectively. The prevalence of pre-HTN was 28.5%. The prevalence of HTN was 19.2% (13.9% diagnosed and 5.3% undiagnosed). HTN increased with age (from 4% in 15-24 to 67.8% in 75-80 years). Men had higher pre-HTN (35.6% vs. 23.4%) and undiagnosed HTN (7.5% vs. 3.8%) than women. Of those diagnosed, 46.5% had uncontrolled BP, in which, women had better conditions than men (45.6% vs. 47.4%). Obesity, positive family history of HTN, anxiety, and low physical activity were the most significant predictors of HTN. The prevalence of pre-HTN decreased but there was no change in the prevalence of HTN during the last 5 years. The 5-year incidence rate/100 person-years of pre-HTN and HTN was 6.6 and 3.7, respectively. Although there are some promising signs of reducing pre-HTN and slowing HTN rise, currently, almost one-fifth of the adult population suffers from HTN. Given the poor BP control in patients with diagnosed HTN, especially in men, alarms that more effective interventions and strategies are needed to reduce deleterious consequences of HTN.
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Affiliation(s)
- Hamid Najafipour
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.,Department of Physiology and Pharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Reza Nasri
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences and Department of Cardiology, Kerman University of Medical Sciences, Kerman, Iran.
| | - Farzaneh Rostamzadeh
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Raheleh Amirzadeh
- Social Determinants of Health Research Center, Institute of Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mitra Shadkam
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Mirzazadeh
- Institute for Health Policy Studies, University of California, San Francisco, CA, USA
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15
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Khoram K, Asghari-Jafarabadi M, Ebrahimi-Mamagani M, Shokrvash B, Hariri-Akbari M. The Magnitude of Salt Intake Behaviors and Its Predictors among Saqez Urban Population of Kurdistan District in Iran: A Cross-Sectional Study. Int J Hypertens 2022; 2022:8439517. [PMID: 35198241 PMCID: PMC8860568 DOI: 10.1155/2022/8439517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 01/12/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Controlling and reducing salt intake are one of the solutions to overcome hypertension. This study aimed at determining the predictors related to salt control methods in Saqez urban population. METHODS AND MATERIALS In the present cross-sectional study, the sample population was randomly selected through cluster sampling. Data collection was performed using valid questionnaires, demographic, family economic status, knowledge, perception, intention, salt intake behaviors, and salt control methods, along with measuring body mass index (BMI) and hypertension levels. Descriptive, analytical statistical methods and multivariate logistic regression analysis were used to determine the predictors of desirable salt control methods. The variables of sex, age, family economic status, knowledge, perception, perceived social support, self-efficacy, and intention were analyzed as independent variables. Data analysis was performed using SPSS software version 24 at a significance level of 0.05. RESULTS Out of 766 participants, 73% were women, with mean (M) 32.83, standard deviation (SD) 9.52 years, and 77.2% were married. There were significant sex differences in employment (P=0.01) and economic status (P=0.016). The M (SD) of blood pressure (systolic/diastolic) was 110.65 (0.0212) (P=0.441). The salt intake control methods between men and women did not show significant differences (P=0.368). Among totally 88.5%, 87.7% men and 88.9% women followed desirable behaviors. The predictors that determine the adoption of salt control methods were sex (man) (OR = 0.71, 95% CI (0.38-1.29)), age (OR = 1.02, 95% CI = (0.99-1.05)), SES/FAS (medium, high level) (OR = 1.37, 95% CI = (0.754-2.47); OR = 0.46, 95% CI = (0.047-4.55)), blood pressure (OR = 1.33, 95% CI = (0.16-11.23)), knowledge (have) (OR = 1.01, 95% CI = (0.39-1.63)), intent to reduce salt (OR = 1.047, 95% CI = (1.03-1.06)), perceived salt reduction importance (OR = 1.02, 95% CI = (1.01-1.04)), perceived emotional support (health staff) (OR = 1.02, 95% CI = (1.01-1.04)), media (OR = 1.01, 95% CI = 0.99-1.02), perceived practical support (spouse) (OR = 1.02, 95% CI = 0.99-1.04)), and perceived self-efficacy (OR = 1.01, 95% CI = (0.99-1.03)). CONCLUSION The support of health staff and spouse seems to be effective in controlling the salt intake behaviors of healthy individuals. In parallel with the development and change of people's lifestyles, new approaches (legal and services) for salt control based on the support of media and social media were expected.
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Affiliation(s)
- Kolsom Khoram
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari-Jafarabadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrangiz Ebrahimi-Mamagani
- Social Determinant of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Biochemistry & Diet Therapy, Faculty of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behjat Shokrvash
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maral Hariri-Akbari
- Department of Foreign Languages, Faculty of Education, Yildiz Technical University (YTU), Istanbul, Turkey
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16
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Rahimlou M, Grau N, Banaie-Jahromi N, Taheri M, Khosravi A, Mavrommatis Y, Mohammadifard N. Association of adherence to the dietary approach to stop hypertension and Mediterranean diets with blood pressure in a non-hypertensive population: Results from Isfahan Salt Study (ISS). Nutr Metab Cardiovasc Dis 2022; 32:109-116. [PMID: 34893410 DOI: 10.1016/j.numecd.2021.09.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Hypertension is among the major risk factors for cardiovascular events in the Iranian population. This cross-sectional study was designed to examine the association of adherence to the dietary approaches to stop hypertension (DASH) and Mediterranean (MED) dietary patterns with the distribution of blood pressure and pre-hypertension prevalence. METHODS AND RESULTS This cross-sectional study was carried out in 1363 non-hypertensive adults. Adherence to the DASH and MED diets was calculated using a semi-quantitative food frequency questionnaire (FFQ). Hypertension was measured by the standard method. Multiple logistic regression was applied to obtain the odds ratio of pre-hypertension in the tertiles of MED and DASH dietary patterns. Compared to the lowest, participants with the highest adherence to the DASH dietary pattern had significantly lower systolic blood pressure (SBP) (111.3 ± 11.8 vs. 112.8 ± 12.5; P = 0.010) and diastolic blood pressure (DBP) (70.7 ± 9.2 vs. 71.8 ± 9.8; 0.042). There was no significant difference in the mean SBP and DBP among the participants across tertiles of MED or diet adherence. Higher scores of the DASH and MED diets were inversely associated with lower SBP after adjustment for all potential confounders (OR = -0.04, 95% CI = -0.29, -0.01, P = 0.039) and (OR = -0.04, 95% CI = -0.72, -0.02, P = 0.044), respectively. Also, DASH and MED dietary patterns was associated with reduced OR of pre-hypertension occurrence by 13% (OR: 0.87; 95% CI: 0.70-0.98; P for trend = 0.042) and 16% ([OR: 0.84; 95% CI: 0.69-0.97; P trend = 0.035), respectively. CONCLUSION Adherence to the DASH and MED diets was inversely associated with the odds for pre-hypertension and SBP.
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Affiliation(s)
- Mehran Rahimlou
- Department of Nutrition, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Narges Grau
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrin Banaie-Jahromi
- Department of Nutrition, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Marzieh Taheri
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Yiannis Mavrommatis
- Faculty of Sport Health and Applied Science, St Mary's University Twickenham, TW14SX, UK
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
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17
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Farzad M, MitraMoodi, Sharifi F, Amirabadizadeh H, Amirabadizadeh A, Kazemi T, Javadi A, Nasiri M. Prevalence and factors connected with chronic diseases in the elderly residents of Birjand: a community - based study in Birjand, South Khorasan Province, Iran. J Diabetes Metab Disord 2021; 20:1655-1662. [PMID: 34900817 PMCID: PMC8630296 DOI: 10.1007/s40200-021-00918-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/12/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The rapid rise of non-communicable diseases (NCDs) across the elderly has attracted much attention in Iran due to the high rate of population aging in the country. The current survey intended to evaluate the prevalence of and factors associated with five NCDs in the elderly residents of Birjand, a metropolis of South Khorasan, Iran. METHODS Following an observational design, 1820 elderly dwellers of Birjand aged ≥ 60 years residing in urban or rural areas were explored. Data on the target NCDS and socio-demographic features, health behavioral factors, and objective assessment of height and weight were collected using interviews. RESULTS The prevalence of hypertension, diabetes mellitus, chronic obstructive pulmonary disease (COPD), stroke, and cancer was 55.2% (1004/1819), 25.5% (463/1819), 1.0% (18/1807), 4.4% (80/1810), and 1.8% (33/1816), respectively. There was no gender difference concerning the prevalence of COPD, whereas the prevalence of hypertension, diabetes mellitus, and cancer was higher in women than men. Stroke was conversely higher in males than females. The common correlations of the five main NCDs were locality of residence and low body mass index (BMI). Rural residents had higher odds of diabetes mellitus and hypertension and lower odds of stroke. Diabetes mellitus, hypertension, and stroke were associated with a low BMI. Gender, age, and occupation were found to be associated with some of the NCDs. Retired and housewives had more chance to have hypertension and diabetes mellitus than the unemployed elderly. CONCLUSION The findings demonstrated that hypertension, diabetes mellitus, and stroke are the three prevalent NCDs among elders in the area and warrant a specific focus on reducing the burden of diseases and aligning healthcare services to prepare the whole needs of this population.
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Affiliation(s)
- Marjan Farzad
- Cardiovascular Diseases Research Center, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran
| | - MitraMoodi
- Social Determinants of Health Research Center, School of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hasan Amirabadizadeh
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Alireza Amirabadizadeh
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Toba Kazemi
- Cardiovascular Diseases Research Center, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
- Clinical Research Development Unit of Razi Hospital, Birjand University of Medical Sciences, Birjand, Iran
| | - Abbas Javadi
- Social Determinants of Health Research Center, School of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Maziar Nasiri
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
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18
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Balouchi A, Rafsanjani MHAP, Al-Mutawaa K, Naderifar M, Rafiemanesh H, Ebadi A, Ghezeljeh TN, Shahraki-Mohammadi A, Al-Mawali A. Hypertension and pre-hypertension in Middle East and North Africa (MENA): A meta-analysis of prevalence, awareness, treatment, and control. Curr Probl Cardiol 2021; 47:101069. [PMID: 34843808 DOI: 10.1016/j.cpcardiol.2021.101069] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/11/2021] [Accepted: 11/21/2021] [Indexed: 01/03/2023]
Abstract
Hypertension (HTN) is one of the most important public health challenges, especially in developing countries. Despite individual studies, information on the exact prevalence of prehypertension (pre-HTN) and HTN in the Middle East and North Africa (MENA) is lacking. This meta-analysis was conducted to evaluate prevalence of pre-HTN and HTN, awareness, treatment, and control in the MENA region. PubMed, Web of Science, and Scopus databases were searched from inception to April 30, 2021. Keywords included hypertension, pre-hypertension, awareness, treatment, and control. The quality of the included studies was evaluated using the Hoy scale. A random-effects model was evaluated based on overall HTN. The heterogeneity of the preliminary studies was evaluated using the I2 test. A total of 147 studies involving 1,312,244 participants were included in the meta-analysis. Based on the results of the random-effects method (95% CI), the Prevalence of pre-HTN and HTN were 30.6% (95% CI: 25.2, 36.0%; I2 = 99.9%), and 26.2% (95% CI: 24.6, 27.9%; I2 = 99.8%), respectively. The prevalence of HTN awareness was 51.3% (95% CI: 47.7, 54.8; I2 = 99.0%). The prevalence of HTN treatment was 47.0% (95% CI: 34.8, 59.2; I2 = 99.9%). The prevalence of HTN control among treated patients was 43.1% (95% CI: 38.3, 47.9; I2 = 99.3%). Considering the high prevalence of HTN, very low awareness, and poor HTN control in the region, more attention should be paid to preventive programs for HTN reduction.
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Affiliation(s)
- Abbas Balouchi
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | | | - Kholoud Al-Mutawaa
- Senior consultant community Medicine, Head of Non-communicable Disease Department, Ministry of Public Health, Doha, Qatar
| | - Mahin Naderifar
- Department of Nursing, Zabol University of Medical Sciences, Zabol, Iran
| | | | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Tahereh Najafi Ghezeljeh
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Azita Shahraki-Mohammadi
- Assistant Professor of Medical Library and Information Sciences, Department of medical library and information sciences, Paramedical school, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Adhra Al-Mawali
- Director/Centre of Studies & Research, Ministry of Health, Oman.
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19
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Sadeghi-Gandomani H, Habibi Z, Eghbali-Babadi M, Khosravi A. Impact of Telenursing on Blood Pressure and Body Mass Index of People with Prehypertension: A Randomized Controlled Clinical Trial. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2021; 26:544-549. [PMID: 34900655 PMCID: PMC8607889 DOI: 10.4103/ijnmr.ijnmr_113_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 09/02/2019] [Accepted: 01/31/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Prehypertension is an important global health challenge. This study determines the effect of telenursing on Blood Pressure (BP) and Body Mass Index (BMI) in patients with prehypertension. MATERIALS AND METHODS This randomized controlled clinical trial study included 81 patients with prehypertension discharged from an emergency room at Isfahan University of Medical Sciences (Iran) in 2016. Participants joined a session about hypertension, risk factors, and lifestyle modification to reduce its risk. Using a random number table, 41 subjects were assigned to the experimental group and 40 subjects to the control group. Only the experimental group received four SMS messages each week and a 10-15 min phone call once a month to help them change their lifestyle and reinforce their health behaviors. Eventually, patients' information was collected, and the data were analyzed using independent t, paired t, and Chi-square tests. RESULTS The experimental group after the intervention had a significantly lower mean (Standard Deviation [SD]) of Systolic Blood Pressure (SBP) (from 126.67 [5.15] to 119.21 [5.72] [t 40 = 8.40, p < 0.001]) and Diastolic Blood Pressure (DBP) [from 85.28 (2.29) to 78.79 (4.16) (t 40 = 10.02, p < 0.001)]. However, the same means were not significantly different in the control group [SBP (p = 0.116) and DBP (p = 0.096)]. The mean (SD) of changes between BMI before and after the intervention was -0.75 (0.66) in the experimental and 0.042 (0.41) in the control group, which was significantly different between the two groups (t 79= -6.44, p < 0.001). CONCLUSIONS Telenursing can have potential benefits to maintain BP within the normal range and reduce BMI in patients with prehypertension.
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Affiliation(s)
| | - Zahra Habibi
- Global Health, Global Studies Institute, University Of Geneva, Geneva, Switzerland
| | - Maryam Eghbali-Babadi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi
- Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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20
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Mirzaei M, Mirzaei M, Gholami S, Abolhosseini H. Prevalence of hypertension and related risk factors in central Iran: Results from Yazd Health Study. ARYA ATHEROSCLEROSIS 2021; 17:1-9. [PMID: 34703488 PMCID: PMC8519624 DOI: 10.22122/arya.v17i0.2045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 06/02/2020] [Indexed: 12/02/2022]
Abstract
BACKGROUND The prevalence of hypertension (HTN) varies across countries due to differences in its related risk factors. This study aimed to investigate the prevalence of HTN and related risk factors among adults. METHODS This study was conducted on the data from the recruitment phase of Yazd Health Study. Using multi-stage random cluster sampling, 10000 adults of 20-69 years were selected. Self-reported HTN (diagnosed by a physician) was recorded in a home visit. Blood pressure (BP) was measured using a standard protocol and categorized based on the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and ýTreatment of High Blood Pressure (JNC-7) classification. T-test was used to examine the gender differences. Qualitative variables were presented as number (frequency). Chi-square test and bivariate logistic regression were carried out to determine the association between risk factors. RESULTS The response rate was 95% (n = 9975). The prevalence of positive history of HTN was 18.5%. The mean systolic and diastolic BP was 126.5 ± 18.4 and 80.2 ± 12.5 mmHg, respectively. The prevalence of HTN was 36.0% (95%CI: 35.1-36.9). Its prevalence reduced by high-education, physical activity, lower BMI, and lack of history of diabetes mellitus (DM) (P < 0.0001). HTN is less common in smokers (P < 0.0001). Logistic regression analysis showed that HTN was higher among men (OR: 1.83; 95%CI: 1.64-2.03), the elderly (OR: 5.15; 95%CI: 4.20-6.31), low-educated (OR: 1.40; 95%CI: 1.17-1.67), and diabetics (OR: 1.20; 95%CI: 1.05-1.38). The prevalence of HTN was 2 times higher in obeses. HTN did not have a significant relationship with inactivity, smoking, and hypercholesterolemia. CONCLUSION The prevalence of HTN was high. By identifying modifiable risk factors, health policymakers can prioritize intervention programs. It is necessary to inform younger adult groups how these factors can be managed through a healthy lifestyle and nutritional habits.
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Affiliation(s)
- Masoud Mirzaei
- Professor, Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohsen Mirzaei
- PhD Candidate, Yazd Cardiovascular Research Centre, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Somaye Gholami
- Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Abolhosseini
- PhD Candidate, School of Traditional Medicine, Kerman University of Medical Sciences, Kerman, Iran
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21
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Mohammadian Khonsari N, Shahrestanaki E, Ejtahed HS, Djalalinia S, Sheidaei A, Hakak-Zargar B, Heshmati J, Mahdavi-Gorabi A, Qorbani M. Long-term Trends in Hypertension Prevalence, Awareness, Treatment, and Control Rate in the Middle East and North Africa: a Systematic Review and Meta-analysis of 178 Population-Based Studies. Curr Hypertens Rep 2021; 23:41. [PMID: 34625888 DOI: 10.1007/s11906-021-01159-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW This study investigated and pooled the long-term trends in prevalence, awareness, treatment, and control of hypertension (HTN) in the Middle East and North Africa (MENA) region. In this systematic review and meta-analysis, we searched MEDLINE/PubMed, Web of Science, Google Scholar, EMBASE, and Scopus between database inception and November 2020. All cross-sectional studies that investigated the prevalence of pre-HTN, HTN, awareness, treatment, and control in the MENA counties were included. The selection study, data extraction, and quality assessment were conducted by two investigators independently. Heterogeneity between studies was assessed using Cochran's Q test and I-squared, and due to sever heterogeneity between studies, the random effect model was used to pool the estimates. Sensitivity analysis was performed to estimate the long-term trends in prevalence, awareness, treatment, and control rates of HTN according to definition of HTN as systolic blood pressure of 140 mm Hg or more, or diastolic blood pressure of 90 mm Hg or more, or being on pharmacological treatment for HTN. RECENT FINDINGS Overall, 178 studies met the inclusion criteria. Studies comprised 2,262,797 participants with a mean age of 45.72 ± 8.84 years. According to random effect model, the pooled prevalence of pre-HTN and HTN was 33% (95% CI 28, 39) and 26% (25, 27), respectively. Over the past three decades, prevalence of hypertension increased significantly in the region. The pooled awareness, treatment, and control rates were 50% (48, 53), 41% (38, 44), and 19% (17, 21), receptively. The pooled awareness, treatment, and control rates of HTN were lower significantly in men than women. According to definition of HTN as blood pressures above 140/90 mm Hg, over the past three decades, although the awareness and treatment rates did not change significantly, the control rates improved significantly in the region. The findings showed that HTN is a significant public health problem in the MENA region. Although there are low levels of pooled awareness, treatment, and control rates, the control rates improved over the past three decades in the region.
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Affiliation(s)
| | - Ehsan Shahrestanaki
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hanieh-Sadat Ejtahed
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Javad Heshmati
- Songhor Healthcare Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Armita Mahdavi-Gorabi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran. .,Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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22
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Eghbali-Babadi M, Khosravi A, Feizi A, Alikhasi H, Kheirollahi N, Sarrafzadegan N. Prevalence of pre-hypertension and hypertension, awareness, treatment, and control of hypertension, and cardiovascular risk factors in postmenopausal women. ARYA ATHEROSCLEROSIS 2021; 17:1-9. [PMID: 35686241 PMCID: PMC9137222 DOI: 10.22122/arya.v17i0.2181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 01/18/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pre-hypertension (HTN) and HTN are risk factors for cardiovascular disease (CVD). Despite its importance, HTN is often underestimated and undiagnosed, especially in women. This study was designed to determine the prevalence of pre-HTN and HTN among a large sample of Iranian menopausal women. METHODS This repeated cross-sectional study was conducted on 1013 menopausal women aged 41 to 85 years in Isfahan, Iran, in the years 2001, 2007, and 2016. The participants were selected through multistage cluster random sampling. Awareness, treatment, and control of HTN were assessed using a validated researcher-made questionnaire. Blood pressure was determined via an arm digital blood pressure monitor. RESULTS The prevalence of HTN in the years 2001, 2007, and 2016 was 52.6%, 49.0%, and 51.6%, respectively; no significant changes were observed (P > 0.05). The prevalence of pre-HTN in these years was 56.6%, 53.3%, and 42.2%, respectively. In 2001 and 2007, respectively, 28.8% and 50.4% of menopausal women had HTN controlled by medication, and in 2016, 86.6% of women were aware of their disease and 62% of them had controlled HTN (P < 0.001). CONCLUSION The results showed that HTN and pre-HTN were highly prevalent among Iranian menopausal women and markedly increased with age. Interventional population-based approaches are needed to improve knowledge and efficient practice that may help to lower the risk of HTN and CVD in this at-risk population.
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Affiliation(s)
- Maryam Eghbali-Babadi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi
- Professor, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hassan Alikhasi
- Interventional Cardiology Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narges Kheirollahi
- Instructor, Department of Critical Care Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Narges Kheirollahi; Instructor, Department of Critical Care Nursing, Nursing and Midwifery Care Research
Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran;
| | - Nizal Sarrafzadegan
- Professor, Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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23
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Sadeghi R, Masoudi MR, Patelarou A, Khanjani N. Predictive Factors for the Care and Control of Hypertension based on the Health Belief Model among hypertensive patients during the COVID-19 epidemic in Sirjan, Iran. Curr Hypertens Rev 2021; 18:78-84. [PMID: 34082684 DOI: 10.2174/1573402117666210603115309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/13/2021] [Accepted: 03/02/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Hypertension is a leading risk factor for morbidity and mortality around the world. Preventing this health problem is considered an important priority. The aim of this study was to investigate the predictive factors for care and control of hypertension (CCH) according to the health belief model (HBM) in patients with hypertension during the COVID-19 epidemic in Sirjan, Iran. METHODS In this cross-sectional study, participants were chosen by simple random sampling. Data were collected by a valid and reliable researcher-made questionnaire from 200 patients with high blood pressure aged 30-60 years. Data were analyzed by SPSS21 and analysis based on descriptive statistics, Pearson correlation coefficients and linear regression were conducted. RESULTS The results of Pearson correlation coefficients showed that there was a significant correlation between almost all constructs of Health Belief Model (HBM), but the strongest correlations were between self-efficacy and perceived susceptibility (r = 0.940, P ≤ 0.001), and between perceived barriers with perceived benefits (r = -0.615, P ≤ 0.001). According to linear regression, perceived barriers (β = -0.291), cues to action (β = -0.590), and knowledge (β = 0.973) predicted more than 26% of CCH variability. Knowledge had a stronger role than other variables. CONCLUSIONS The results of this study show that the constructs of the Health Belief Model can predict CCH in hypertensive patients. This model can be used as a tool for designing and implementing educational interventions to increase CCH among hypertensive patients.
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Affiliation(s)
- Reza Sadeghi
- Department of Public Health, Sirjan School of Medical Sciences, Sirjan. Iran
| | | | - Athina Patelarou
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, Heraklion. Greece
| | - Narges Khanjani
- Neurology Research Center, Kerman University of Medical Sciences, Kerman. Iran
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24
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Javanbakht S, Eghbali M, Bolourinejad P, Sherafat A, Khosravi A, Hashemi M, Sarrafzadegan N. Maternal or paternal history: Which one plays more important role in developing hypertension? ARYA ATHEROSCLEROSIS 2021; 17:1-6. [PMID: 35685825 PMCID: PMC9133712 DOI: 10.22122/arya.v17i0.2263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 10/27/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hypertension (HTN) is one of the most common non-communicable diseases (NCDs), which in 2017 accounted for 1.65% of all deaths, and 0.66% of disability-adjusted life years (DALYs). About 25% of the adult population are hypertensive in Iran. Prevalence of HTN is significantly higher in those with a family history of HTN. This study compares the impact of paternal and maternal history of HTN on the risk of HTN development. METHODS This cross-sectional study was conducted among 2107 adults of 18-84 years old residing in Isfahan, Iran, from August 2015 to March 2016. Blood pressure (BP) measurement standards were taken from World Health Organization (WHO) guidelines. We measured BP in the right arm for three times at 1-minute intervals and considered the mean of second and third measurements. Other data were collected by questionnaire. RESULTS Prevalence of HTN was higher in participants whose mother or both parents were hypertensive (P < 0.001). Diastolic BP (DBP) was affected by every side of parental history (P < 0.001), while systolic BP(SBP) was affected when both parents were hypertensive (P < 0.001). As a result, maternal family history increased the odds of HTN by 1.9 times [95% confidence interval (CI): 1.35-2.65] and both maternal and paternal history increased it by 3.1 times (95% CI: 2.01-4.78) compared to those with no family history. However, paternal history was not significantly related to the odds of HTN. CONCLUSION Our study results demonstrate that maternal history of HTN doubles the odds of HTN. Besides, if both parents are hypertensive, it will be tripled.
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Affiliation(s)
- Sahel Javanbakht
- General Practitioner, Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Eghbali
- Associate Professor, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Paria Bolourinejad
- General Practitioner, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Sherafat
- Medical Student, School of Medicine, University of Central Lancashire, Preston, Lancashire, United Kingdom
| | - Alireza Khosravi
- Professor, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hashemi
- Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Mohammad Hashemi; Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute,
Isfahan University of Medical Sciences, Isfahan, Iran;
| | - Nizal Sarrafzadegan
- Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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25
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The Effect of Cognitive-Behavioral Intervention on Self-Care Behaviors and Blood Pressure Control in Patients with Primary Hypertension. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2021. [DOI: 10.52547/jech.8.1.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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26
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Amini MR, Sheikhhossein F, Bazshahi E, Hajiaqaei M, Shafie A, Shahinfar H, Azizi N, Eghbaljoo Gharehgheshlaghi H, Naghshi S, Fathipour RB, Shab-Bidar S. The effects of capsinoids and fermented red pepper paste supplementation on blood pressure: A systematic review and meta-analysis of randomized controlled trials. Clin Nutr 2020; 40:1767-1775. [PMID: 33129596 DOI: 10.1016/j.clnu.2020.10.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/10/2020] [Accepted: 10/13/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND & AIMS The present systematic review and meta-analysis were conducted to investigate the effects of capsinoids and fermented red pepper paste (FRPP) supplementation on Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP). METHODS Relevant studies, published up to May 2020, were searched through PubMed/Medline, Scopus, ISI Web of Science, Embase, and Google Scholar. All randomized clinical trials investigating the effect of capsinoids and FRPP supplementation on blood pressure including SBP and DBP were included. RESULTS Out of 335 citations, 7 trials that enrolled 363 subjects were included. Capsinoids and FRPP resulted in significant reduction in DBP (Weighted mean differences (WMD): -1.90 mmHg; 95% CI, -3.72 to -0.09, P = 0.04) but no significant change in SBP (WMD: 0.55 mmHg, 95% CI: -1.45, 2.55, P = 0.588). FRPP had a significant reduction in SBP. Greater effects on SBP were detected in trials, lasted ≥12 weeks, and sample size >50. Capsinoids with dosage ≤200 and FRPP with dosage of 11.9 g significantly decreased DBP. CONCLUSION Overall, these data suggest that supplementation with FRPP may play a role in improving SBP and DBP but for capsinoids no effects detected in this analysis on SBP and DBP.
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Affiliation(s)
- Mohammad Reza Amini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Fatemeh Sheikhhossein
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Elham Bazshahi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mahdi Hajiaqaei
- Department of Physiology, Faculty of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Anahid Shafie
- Department of Physiology, Faculty of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hossein Shahinfar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Neda Azizi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hadi Eghbaljoo Gharehgheshlaghi
- Division of Food Safety and Hygiene, Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Naghshi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Raana Babadi Fathipour
- Department of Food Science and Technology, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Vatani Nezafat A, Tavakolifard N, Vaezi A. Adherence of General Practitioners to the National Hypertension Guideline, Isfahan, Iran. Int J Prev Med 2020; 11:130. [PMID: 33088458 PMCID: PMC7554564 DOI: 10.4103/ijpvm.ijpvm_379_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/08/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND High systolic blood pressure is the leading risk factor for global mortality. Applying effective strategies to control hypertension is a rising concern. Guidelines are approved to be effective in the management of patients with cost-effective interventions. The aim of this study is to evaluate the adherence of family physicians working in Isfahan health centers to the national hypertension guideline, in 2019. METHODS Using a cross-sectional study, the practice of 43 physicians selected by a multistage sampling method from the perspective of hypertension management was observed in 377 visits. The data gathering form was designed according to the national hypertension guideline. Adherence to the guideline was evaluated by dividing the earned score by the most score one can earn. Data were analyzed using Independent T-test, Pearson correlation and linear regression model. RESULTS The mean score of adherence to the national hypertension guideline was 33.6 ± 16.42%. There was a significant association between physician's sex, years passed from graduation, type of occupation contract, type of university of education, and attending empowerment class and adherence to the national hypertension guideline. CONCLUSIONS The results of our study show that family physicians just follow one-third of the recommendations in the national hypertension guideline.
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Affiliation(s)
- Amir Vatani Nezafat
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Negah Tavakolifard
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Atefeh Vaezi
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Mirzaei M, Mirzaei M, Bagheri B, Dehghani A. Awareness, treatment, and control of hypertension and related factors in adult Iranian population. BMC Public Health 2020; 20:667. [PMID: 32397990 PMCID: PMC7216488 DOI: 10.1186/s12889-020-08831-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 05/01/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Hypertension, known as the silent killer, is a major risk factor for cardiovascular disease. Awareness and treatment of hypertension is not appropriate in the world, and this has led to an increase in mortality and morbidity caused by uncontrolled hypertension. This study aims to estimate awareness, treated, and controlled hypertensive and relevant predictors in an adult Iranian population. METHODS This cross-sectional study was conducted on 10,000 adults aged 20-69 years in Yazd, Iran. They were selected through multi-stage random cluster sampling in 2015-2016. Blood pressure was measured three-time with standard protocol by trained health workers. Those with a positive history of hypertension and using anti-hypertensive drugs, prescribed by a physician, were considered hypertensive. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic BP of ≥90 mmHg. Uncontrolled hypertension was defined in accordance with recommended treatment targets by the Joint National Committee (JNC7). Logistic regression was used to assess the predictors of hypertension awareness, treatment and control. RESULTS The prevalence of hypertension was 37.3%, and the prevalence of pre-hypertension was 46.4%. 49.7% of People with hypertension were aware of their disease, and 71.5% of them were using antihypertensive drugs prescribed by physicians. Blood pressure was controlled in 38.9% of the treated patients. In the adjusted model, older age, female sex, and history of diabetes mellitus were positively associated with higher awareness. High physical activity, tobacco smoking, and diabetes are the only predictors of treated high blood pressure. Younger age, female sex, and higher education were determinants of controlled hypertension. Having health insurance was significantly correlated with awareness and control of hypertension. CONCLUSION Hypertension is a public health problem in this population, which is not well controlled. Half of the patients were unaware. Intervention for increased screening coverage is needed. It should plan to raise public awareness about hypertension and improve hypertension control under the supervision of physicians. Implement a family physician program is recommended in the health system.
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Affiliation(s)
- Mohsen Mirzaei
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Masoud Mirzaei
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Behnam Bagheri
- Shahediah Cohort Study, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ali Dehghani
- Department of Epidemiology and Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
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Mohammadi-Dolatabadi A, Vakhshoori M, Eghbali-Babadi M, Heidarpour M, Shafie D, Garakyaraghi M, Khosravi A. Comparison of multiple blood pressure frequency methods with optimum blood pressure measurement among Iranian individuals. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2020; 25:40. [PMID: 32582346 PMCID: PMC7306238 DOI: 10.4103/jrms.jrms_129_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/17/2019] [Accepted: 02/03/2020] [Indexed: 12/05/2022]
Abstract
Background: Proper blood pressure (BP) measurement frequency method is less evaluated to optimize hypertension (HTN) status among different nations due to cultural patience variations. The aim of this study was to compare the first (BP1), second (BP2), and the mean of first and second (BP1,2) and all the three (BP1,2,3) with the second and third BP measurements in Iranian individuals. Materials and Methods: This cross-sectional study was done on 2264 individuals aged 18 years or more living in Isfahan city, Iran. Their BPs were assessed from right arms by the standard tools and methods after 5 min of rest in a quiet room by a trained staff. The mean second and third readings were considered as reference, and the other aforementioned variables were compared with it. Results: The mean age of total population was 40.9 ± 16.1 years (males: 52%). Men had significant higher means of systolic BP (SBP) and diastolic BP (DBP) with any measurement frequency methods than women (P < 0.001 and P = 0.009). Considerable clinical significant (≥5 mmHg) ranges were mostly observed in BP1 compared with BP2,3. SBP2 and DBP2 indices showed insignificant differences compared with reference mean. Moreover, abnormal BP levels (≥140/90 mmHg) were mostly observed in terms of BP1 measurement with no remarkable variability in BP2 reading in comparison to the reference. Conclusion: Our considerable data suggested that BP2 could appropriately categorize BP status similar to BP2,3 and it may be rational for physicians considering this mean and excluding the first BP measurement as a sole criterion for HTN assessment in Iranian adults. Multiple researches are necessary quantifying appropriate frequencies of BP reading.
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Affiliation(s)
- Alireza Mohammadi-Dolatabadi
- Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrbod Vakhshoori
- Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Eghbali-Babadi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Heidarpour
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Davood Shafie
- Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Garakyaraghi
- Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi
- Interventional Cardiology Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Mirniam AA, Habibi Z, Khosravi A, Sadeghi M, Eghbali-Babadi M. A clinical trial on the effect of a multifaceted intervention on blood pressure control and medication adherence in patients with uncontrolled hypertension. ARYA ATHEROSCLEROSIS 2020; 15:267-274. [PMID: 32206070 PMCID: PMC7073804 DOI: 10.22122/arya.v15i6.1904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Hypertension (HTN) is the key risk factor for cardiovascular diseases (CVDs). The purpose of this study was to determine the effect of a multifaceted intervention on blood pressure (BP) control and medication adherence (MA) among patients with uncontrolled HTN. METHODS A randomized controlled clinical trial study was conducted on 72 patients in the emergency ward who were selected through convenience sampling method. They were randomly divided into intervention and control groups. The studied multifaceted intervention includes motivational interviews and 90 minutes of training sessions, use of a drug reminder box, family support, and 4 phone call follow-ups. The8-Item Morisky Medication Adherence Scale (MMAS-8) was used before and after the intervention. BP was measured in both groups before and after the intervention and compared between them. RESULTS No significant difference existed between the two groups in terms of MA and systolic and diastolic BP before the study. The differences between the mean changes in post-intervention systolic (-25.75 ± 19.39 vs. -2.88 ± 11.92 mmHG; P < 0.001) and diastolic (-6.18 ± 8.87 vs. -1.06 ± 8.70 mmHg; P = 0.010) BP in the intervention and control groups were statistically significant. The mean changes in post-intervention MA in the intervention and control group was 2.91 ± 1.64 and -0.36 ± 1.15, respectively; this difference was statistically significant (P < 0.001). CONCLUSION The studied multifaceted intervention promoted MA and reduced systolic and diastolic BP. Thus, the use of this method as a supplementary treatment is recommended after patient discharge.
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Affiliation(s)
- Azam-Alsadat Mirniam
- MSc Student, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Habibi
- MSc Student, Global Studies Institute, University of Geneva, Geneva, Switzerland
| | - Alireza Khosravi
- Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Eghbali-Babadi
- Assistant Professor, Nursing and Midwifery Care Research Center AND Department of Intensive Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Rezaianzadeh A, Jafari F, Sadeghi SE, Rahimikazerooni S. The prevalence and predictors of pre-hypertension and hypertension in Kherameh cohort study: a population based study on 10,663 persons in south of Iran. J Hum Hypertens 2020; 35:257-264. [PMID: 32203076 DOI: 10.1038/s41371-020-0330-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 03/04/2020] [Accepted: 03/09/2020] [Indexed: 01/11/2023]
Abstract
Hypertension (HTN) is an important risk factor for cardiovascular disease (CVD) mortality and morbidity among Iranians. The present study aimed to estimate the prevalence of pre-HTN and HTN and some of its related factors in south of Iran. This cross-sectional survey was conducted on the data of the Persian cohort study in Kherameh. The participants consisted of 10,663 people aged 40-70 years. HTN was defined as either systolic/diastolic blood pressure (SBP/DBP) ≥140/90 mmHg or taking medications. Pre-HTN was defined as SBP = 120-139 mmHg and/or DBP = 80-89 mmHg. The logistic regression method was used to identify the factors associated with pre-HTN and HTN. The age-standardized prevalence rate (ASPR) of pre-HTN was 19.66% (95% CI: 19.45-19.86%) and 18.59% (95% CI: 18.36-18.83%) in males and females, respectively. Also, the ASPR of HTN was 21.44 (95% CI: 21.22-21.65%) in males and 33.53% (95% CI: 33.22-33.85%) in females. Male gender, old age, being unemployed, low education level, high body mass index (BMI), no smoking, diabetes, cerebro-cardiovascular disease, suffering from another chronic disease, family history of CVD, and negative family history of cancer and other chronic diseases were independently associated with pre-HTN (p < 0.05). All variables, except for gender, smoking, and family history of cancer, were significantly associated with HTN. Drug abuse was also correlated to HTN (p < 0.05). This study revealed the increased prevalence of HTN in rural and urban areas. Therefore, the health system needs to develop strategies to raise the accessibility of screening and diagnostic services.
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Affiliation(s)
| | - Fatemeh Jafari
- MSc Candidate of Epidemiology in Shiraz University of Medical Sciences, Shiraz, Iran.
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Zabolypour S, Alishapour M, Behnammoghadam M, Abbasi Larki R, Zoladl M. A Comparison of the Effects of Teach-Back and Motivational Interviewing on the Adherence to Medical Regimen in Patients with Hypertension. Patient Prefer Adherence 2020; 14:401-410. [PMID: 32161450 PMCID: PMC7049851 DOI: 10.2147/ppa.s231716] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/22/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Arterial hypertension is considered a chronic medical problem and also a challenging condition. The present study aimed to compare the effects of motivational interviewing and teach-back on people with hypertension. MATERIALS AND METHODS In this clinical trial conducted in Yasuj in 2018 a total of 81 patients with essential hypertension were selected in terms of the inclusion criteria. Then, they were randomly divided into three groups: teach-back (Group 1), motivational interviewing (Group 2), and control (Group 3). Three teach-back sessions were held for the teach-back group, five sessions of motivational interviewing for the motivational interviewing group, and the routine care was provided for the control group. In addition, data were collected by the demographic form and scale of Adherence to Systemic Hypertension Treatment, which were completed by participants of all three groups at baseline and also two months from the intervention. Data were analyzed using SPSS 21 by applying descriptive statistics, one-way ANOVA, chi-squared test, Fisher's exact test, and Bonferroni test. FINDINGS Two months from the interventions, in Group 1, the score of adherence to the hypertension treatment regimen significantly increased by 816.38 points compared to the control group, in Group 2 by 1228.9 points compared to the control group, and in Group 2 by 412.6 points compared to Group 1 (p >0.05). CONCLUSION Both teach-back and motivational interviewing increased the adherence to the hypertension treatment regimen; however, motivational interviewing was more effective compared to teach-back in boosting adherence to the hypertension treatment regimen.
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Affiliation(s)
- Soheila Zabolypour
- Medical Surgical Nursing Department, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Maryam Alishapour
- Student Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | - Rozina Abbasi Larki
- Urology Department, Medicine Faculty, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Mohammad Zoladl
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
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Borumandnia N, Alavi Majd H, Khadembashi N, Heidary S. Clustering of the Deadliest Diseases among Iranian Men from 1990 to 2016: A Growth Mixture Model Approach. J Res Health Sci 2019; 19:e00457. [PMID: 31586378 PMCID: PMC7183556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/14/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Paying attention to men's health seems quite important for a variety of reasons. We evaluated the change of mortality rates due to various causes in Iranian men over the past decades. STUDY DESIGN A cross-sectional study. METHODS The mortality rates for deadliest causes of diseases among Iranian men during 1990-2016 were extracted from the Global Burden of Disease (GBD) study. Latent Growth Mixture Models (LGMM) were applied to determine subgroups' cause of death. In this way, the causes within each group showed similar trends of mortality rates over time. RESULTS The LGMM clustered causes into 4 classes. Diabetes mellitus, hypertensive heart disease and neurological disorders have had increasing trend. Causes in class 2, including diarrhea, lower respiratory and other common infectious diseases, ischemic heart disease, ischemic stroke, neonatal disorders, and other non-communicable diseases manifested a slow decreasing trend. Most causes were allocated to 3rd class with a slow increase in mortality rates over time. Finally, within the last class, transport injuries and unintentional injuries revealed a decreasing trend. CONCLUSION Most factors have rising trend, despite the fact that some have shown a very slight downward trend. Consequently, according to the four distinguished clusters resulting from LGMM, it is essential to provide programs to attain the goal of access to prevention, treatment, and support for high-risk mortality factors.
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Affiliation(s)
- Nasrin Borumandnia
- 1Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Alavi Majd
- 2Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Correspondence : Hamid Alavi Majd (PhD) Tel: +98 912 1483687 E-mail:
| | - Naghmeh Khadembashi
- 3Department of English Language, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Serveh Heidary
- 2Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Prevalence, awareness, treatment, and control of hypertension and their determinants: Results from the first cohort of non-communicable diseases in a Kurdish settlement. Sci Rep 2019; 9:12409. [PMID: 31455810 PMCID: PMC6711962 DOI: 10.1038/s41598-019-48232-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/25/2019] [Indexed: 12/21/2022] Open
Abstract
Hypertension is a public health issue in Iran. The study aimed to estimate the prevalence, awareness, treatment, and control of hypertension, and to explore their determinants among 10,040 Kurdish adults from Ravansar Non-Communicable Disease (RaNCD) cohort study in Iran. Univariate, and multivariate analyses were used for statistical analysis. Prevalence of hypertension was 15.7%. Among hypertensive patients, awareness, treatment, and control of hypertension were 80.7%, 73.2%, and 53.3%, respectively. In multivariate analysis, significant associations were found between awareness and female sex, older age, being married rather than being single, literacy, living in rural areas, having family history, and comorbidities, with a higher probability for those who had both diabetes and dyslipidemia. Being married, living in rural areas, being ex-smokers, having less physical activity and individuals who had diabetes and dyslipidemia had higher odds of receiving treatment. Being female had a statistically significant association with the control of hypertension. The Kurdish population had higher awareness, with a greater proportion of treated, and controlled patients compared to populations included in previous studies for the last 20 years in Iran. With the continuing health promotion programs in Iran, it is expected to observe a lower prevalence of hypertension, higher awareness and greater number of treated individuals with controlled hypertension.
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Afsargharehbagh R, Rezaie-Keikhaie K, Rafiemanesh H, Balouchi A, Bouya S, Dehghan B. Hypertension and Pre-Hypertension Among Iranian Adults Population: a Meta-Analysis of Prevalence, Awareness, Treatment, and Control. Curr Hypertens Rep 2019; 21:27. [PMID: 30949774 DOI: 10.1007/s11906-019-0933-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE OF REVIEW This meta-analysis and systematic review was conducted to evaluate hypertension and prehypertension prevalence, awareness, treatment, and control in Iranian adults population. RECENT FINDINGS In this study, six international and national databases were searched from inception until August 30, 2018. Forty-eight studies performed on 417,392 participants were included in the meta-analysis. Based on the results of random effect method (95% CI), the overall prevalence of pre-hypertension, hypertension, awareness, treatment, and control were 31.6% (95% CI 24.9, 38.3; I2 = 99.7%), 20.4% (95% CI 16.5, 24.4; I2 = 99.9%), 49.3% (95% CI 44.8, 53.8; I2 = 98.5%), 44.8% (95% CI 28.3, 61.2; I2 = 99.9%), 37.4% (95% CI 29.0, 45.8; I2 = 99.3%), respectively. Considering the increasing prevalence of pre-hypertension, hypertension, as well as more than half of the participants were unaware of their disease and were not treated, the results of the present study can help policy-makers to increase hypertension awareness, control, and treatment, especially in high-risk individuals.
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Affiliation(s)
| | | | - Hosien Rafiemanesh
- Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Balouchi
- Student Research Committee, Nursing and Midwifery School, Iran University of Medical Sciences, Tehran, Iran
| | - Salehoddin Bouya
- Internal Medicine and Nephrology, Clinical Immunology Research Center, Ali-Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.
- Zahedan University of Medical Sciences, Hesabi St, Zahedan, Iran.
| | - Behroz Dehghan
- Zahedan University of Medical Sciences, Hesabi St, Zahedan, Iran
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