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Kirsch DE, Grodin EN, Ray LA. Characterizing alcohol cue reactive and non-reactive individuals with alcohol use disorder. Addict Behav 2024; 155:108028. [PMID: 38640885 DOI: 10.1016/j.addbeh.2024.108028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/04/2024] [Indexed: 04/21/2024]
Abstract
PURPOSE Exposure to alcohol-related cues is thought to elicit a conditional response characterized by increased craving in individuals with alcohol use disorder (AUD). In the context of AUD research, it is important to consider that not all individuals with an AUD are alcohol cue reactive. This study systematically examined subjective alcohol cue reactivity and its clinical and drinking correlates in individuals with an AUD enrolled in a human laboratory pharmacotherapy trial. METHODS Individuals with current moderate-to-severe AUD (N = 52) completed a standard alcohol cue exposure paradigm and individual difference assessments as part of a human laboratory pharmacotherapy trial (NCT04249882). We classified participants as cue reactive (CR+) and cue non-reactive (CR-), as indicated by self-reported, subjective alcohol urge, and examined group differences in baseline clinical characteristics and drinking outcomes over the course of the trial. RESULTS Twenty participants (38%) were identified as CR+, while 32 participants (62%) were identified as CR-. The CR+ and CR- groups did not differ in baseline drinking and AUD clinical characteristics, but the groups differed in race composition (p = 0.02) and smoking prevalence (p = 0.04) such that the CR+ group had lower prevalence of smokers. The CR+, compared with the CR-, group drank more during the trial titration period (p = 0.03). Both groups reduced drinking across the trial (p's < 0.001), but the CR+ group exhibited a smaller reduction in drinking, compared with the CR- group (time x group, p = 0.029; CR-, p < 0.0001; CR+: p = 0.01). CONCLUSION Results indicate that cue reactivity is a heterogenous construct. Recognizing this heterogeneity, and the clinical factors associated with it, is critical to advancing this paradigm as an early efficacy marker in AUD research.
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Affiliation(s)
- Dylan E Kirsch
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA
| | - Erica N Grodin
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.
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2
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Chakrabarti S, Christopher A, Scott S, Kishore A, Nguyen PH. Effects of a large-scale alcohol ban on population-level alcohol intake, weight, blood pressure, blood glucose, and domestic violence in India: a quasi-experimental population-based study. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 26:100427. [PMID: 38827143 PMCID: PMC11140782 DOI: 10.1016/j.lansea.2024.100427] [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: 01/22/2024] [Revised: 05/01/2024] [Accepted: 05/08/2024] [Indexed: 06/04/2024]
Abstract
Background Globally, alcohol consumption is a leading risk factor for deaths and disability and a causal factor in over 200 diseases, injuries, and health conditions. In April 2016, the manufacture, transport, sale, and consumption of alcohol was banned in Bihar, a populous Indian state. We sought to estimate the impacts of this ban on health outcomes and domestic violence. Methods Data from the Indian National Family Health Surveys (2005-06, 2015-16, 2019-21), Annual Health Survey (2013), and District Level Household Survey (2012), were used to conduct difference-in-differences (DID) analysis, comparing Bihar (n = 10,733 men, n = 88,188 women) and neighbouring states (n = 38,674 men, n = 284,820 women) before and after the ban. Outcomes included frequent (daily or weekly) alcohol consumption, underweight, obesity, hypertension, diabetes, and intimate partner violence. A triple difference model adding male-female interaction to the DID model was also estimated. Attributable averted cases were calculated to estimate the impact of the ban. Findings Across all models, the ban led to reduced frequent alcohol consumption (DID: -7.1 percentage points (pp) (95% CI -9.6pp, -4.6pp), lower overweight/obesity (-5.6pp (-8.9, -2.2) among males, and reduced experiences of emotional (-4.8pp (-8.2pp, -1.4pp) and sexual (-5.5pp (-8.7pp, -2.3pp) violence among females. The ban prevented approximately 2.4 million cases of daily/weekly alcohol consumption and 1.8 million cases of overweight/obesity among males, and 2.1 million cases of intimate partner violence among females. Interpretation Strict alcohol regulation policies may yield significant population level health benefits for frequent drinkers and many victims of intimate partner violence. Funding No funding was received for this work.
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Affiliation(s)
- Suman Chakrabarti
- The International Food Policy Research Institute, Poverty, Health and Nutrition Division, Washington, DC, USA
| | - Anita Christopher
- The International Food Policy Research Institute, Development Support and Governance Division, Washington, DC, USA
| | - Samuel Scott
- The International Food Policy Research Institute, Poverty, Health and Nutrition Division, Washington, DC, USA
| | - Avinash Kishore
- The International Food Policy Research Institute, Development Support and Governance Division, Washington, DC, USA
| | - Phuong Hong Nguyen
- The International Food Policy Research Institute, Poverty, Health and Nutrition Division, Washington, DC, USA
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Argo A, Pitingaro W, Puntarello M, Buscemi R, Malta G, D’Anna T, Albano GD, Zerbo S. A Comprehensive Review on Alcohol Abuse Disorder Fatality, from Alcohol Binges to Alcoholic Cardiomyopathy. Diagnostics (Basel) 2024; 14:1189. [PMID: 38893715 PMCID: PMC11172201 DOI: 10.3390/diagnostics14111189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/20/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
Frequent and excessive consumption of alcohol, be it episodic or sustained misuse, ranks among the top causes of mortality globally. This comprehensive analysis seeks to elucidate how alcohol misuse precipitates death, with a particular focus on associated cardiac anomalies. Notably, the phenomenon of "Holiday Heart Syndrome", linked to binge drinking, is recognized for inducing potentially fatal cardiac arrhythmias. Moreover, persistent alcohol consumption is implicated in the development of alcoholic cardiomyopathy, a condition that underlies heart failure and arrhythmic disturbances of the heart. Additionally, individuals undergoing withdrawal from alcohol frequently exhibit disruptions in normal heart rhythm, posing a risk of death. This review further delves into additional alcohol-related mortality factors, including the heightened likelihood of hypertension, cerebrovascular accidents (strokes), and the connection between excessive alcohol use and Takotsubo syndrome.
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Affiliation(s)
- Antonina Argo
- Department of Health Promotion Sciences, Maternal and Child Care, Internal Medicine and Medical Specialties “Giuseppe D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (W.P.); (M.P.); (R.B.); (T.D.); (G.D.A.); (S.Z.)
| | | | | | | | - Ginevra Malta
- Department of Health Promotion Sciences, Maternal and Child Care, Internal Medicine and Medical Specialties “Giuseppe D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (W.P.); (M.P.); (R.B.); (T.D.); (G.D.A.); (S.Z.)
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Libby TE, Ilango SD, Leary CS, Semmens EO, Adam CE, Fitzpatrick AL, Kaufman JD, Hajat A. An assessment of the mediating role of hypertension in the effect of long-term air pollution exposure on dementia. Environ Epidemiol 2024; 8:e306. [PMID: 38799261 PMCID: PMC11115980 DOI: 10.1097/ee9.0000000000000306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/18/2024] [Indexed: 05/29/2024] Open
Abstract
Background Growing evidence links air pollution exposure to the risk of dementia. We hypothesized that hypertension may partially mediate this effect. Methods We previously documented an association between air pollution and dementia in the Ginkgo Evaluation of Memory Study, a randomized, placebo-controlled trial of 3069 adults ≥75 years across four US sites who were evaluated for dementia every 6 months from 2000-2008. We utilized a two-stage regression approach for causal mediation analysis to decompose the total effect of air pollution on dementia into its natural direct and indirect effect through prevalent hypertension. Exposure to air pollution in the 10 or 20 years before enrollment was assigned using estimates from fine-scale spatial-temporal models for PM2.5, PM10, and NO2. We used Poisson regression models for hypertension and Cox proportional hazard models for time-to-incident all-cause dementia, adjusting for a priori confounders. Results Participants were free of mild cognitive impairment at baseline (n = 2564 included in analyses); 69% had prevalent hypertension at baseline. During follow-up, 12% developed all-cause dementia (Alzheimer's disease [AD] = 212; vascular dementia with or without AD [VaD/AD mixed] = 97). We did not find an adverse effect of any air pollutant on hypertension. Hypertension was associated with VaD/AD mixed (HR, 1.92 [95% CI = 1.14, 3.24]) but not AD. We did not observe mediation through hypertension for the effect of any pollutant on dementia outcomes. Conclusions The lack of mediated effect may be due to other mechanistic pathways and the minimal effect of air pollution on hypertension in this cohort of older adults.
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Affiliation(s)
- Tanya E. Libby
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Sindana D. Ilango
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Cindy S. Leary
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, Montana
| | - Erin O. Semmens
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, Montana
| | - Claire E. Adam
- Center for Population Health Research, School of Public and Community Health Sciences, University of Montana, Missoula, Montana
| | - Annette L. Fitzpatrick
- Department of Epidemiology, University of Washington, Seattle, Washington
- Department of Family Medicine, University of Washington, Seattle, Washington
| | - Joel D. Kaufman
- Department of Epidemiology, University of Washington, Seattle, Washington
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington
- Department of Medicine, University of Washington, Seattle, Washington
| | - Anjum Hajat
- Department of Epidemiology, University of Washington, Seattle, Washington
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Masum M, Mamani DA, Howard JT. Alcohol and Binge Drinking Frequency and Hypertension: A National Cross-Sectional Study in the U.S. Am J Prev Med 2024:S0749-3797(24)00165-X. [PMID: 38762207 DOI: 10.1016/j.amepre.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/20/2024]
Abstract
INTRODUCTION The relationship between alcohol consumption and hypertension is multifaceted and a major public health concern. The association becomes even more complicated when hypertension is undiagnosed. This study investigates how alcohol consumption patterns are linked to measured, diagnosed, undiagnosed, and composite hypertension (any indications of hypertension from blood pressure readings, professional diagnosis, or reported medication use) in the United States. METHODS Data from the National Health and Nutrition Examination Survey 2015-2020, a nationally representative cross-sectional study, were analyzed in 2023-2024. The final analytic sample was 12,950 participants. Complex-survey weighted multivariable linear and logistic regression models estimated the effect of different alcohol consumption levels on hypertension. RESULTS Descriptive findings show that those who consumed alcohol more than 3 times weekly exhibited the highest prevalence of measured (52.5%), undiagnosed (27.0%), and composite hypertension (69.4%) compared to other levels of alcohol drinking. Multivariable linear regression analysis indicated a notable elevation in systolic (4.8 unit) and diastolic (2.46 unit) blood pressure among individuals with frequent binge drinking episodes compared to individuals with infrequent drinking. Logistic regression models estimated that drinking over 3 times weekly increases the odds of measured, undiagnosed, and composite hypertension by 64%, 70%, and 54%, respectively, while frequent binge drinking episodes raise these odds by 82%, 65%, and 47%. CONCLUSIONS Contrary to some studies suggesting moderate alcohol intake has protective cardiovascular effects, the findings did not corroborate a "J-shaped" curve. This underscores the importance of regular blood pressure monitoring among individuals with binge drinking episodes and emphasizes the need for public health interventions to mitigate alcohol consumption and its associated hypertension risks.
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Affiliation(s)
- Muntasir Masum
- Department of Epidemiology & Biostatistics, University at Albany, Rensselaer, New York.
| | - Daniel A Mamani
- Department of Demography, University of Texas at San Antonio, San Antonio, Texas
| | - Jeffrey T Howard
- Department of Public Health, University of Texas at San Antonio, San Antonio, Texas
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Weiner CM, Khan SE, Leong C, Ranadive SM, Campbell SC, Howard JT, Heffernan KS. Association of enterolactone with blood pressure and hypertension risk in NHANES. PLoS One 2024; 19:e0302254. [PMID: 38743749 PMCID: PMC11093351 DOI: 10.1371/journal.pone.0302254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 03/30/2024] [Indexed: 05/16/2024] Open
Abstract
The gut microbiome may affect overall cardiometabolic health. Enterolactone is an enterolignan reflective of dietary lignan intake and gut microbiota composition and diversity that can be measured in the urine. The purpose of this study was to examine the association between urinary enterolactone concentration as a reflection of gut health and blood pressure/risk of hypertension in a large representative sample from the US population. This analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) collected from January 1999 through December 2010. Variables of interest included participant characteristics (including demographic, anthropometric and social/environmental factors), resting blood pressure and hypertension history, and urinary enterolactone concentration. 10,637 participants (45 years (SE = 0.3), 51.7% (SE = 0.6%) were female) were included in analyses. In multivariable models adjusted for demographic, socioeconomic and behavioral/environmental covariates, each one-unit change in log-transformed increase in enterolactone was associated with a 0.738 point (95% CI: -0.946, -0.529; p<0.001) decrease in systolic blood pressure and a 0.407 point (95% CI: -0.575, -0.239; p<0.001) decrease in diastolic blood pressure. Moreover, in fully adjusted models, each one-unit change in log-transformed enterolactone was associated with 8.2% lower odds of hypertension (OR = 0.918; 95% CI: 0.892, 0.944; p<0.001). Urinary enterolactone, an indicator of gut microbiome health, is inversely associated with blood pressure and hypertension risk in a nationally representative sample of U.S. adults.
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Affiliation(s)
- Cynthia M. Weiner
- Department of Kinesiology, University of Maryland, College Park, Maryland, United States of America
| | - Shannon E. Khan
- Department of Kinesiology, University of Maryland, College Park, Maryland, United States of America
| | - Caleb Leong
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, Texas, United States of America
| | - Sushant M. Ranadive
- Department of Kinesiology, University of Maryland, College Park, Maryland, United States of America
| | - Sara C. Campbell
- Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey, United States of America
| | - Jeffrey T. Howard
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, Texas, United States of America
| | - Kevin S. Heffernan
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States of America
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Jensen GB, Grønbæk M, Jensen MT, Schnohr P, Nordestgaard BG, Lavie CJ, O'Keefe JH, Marott JL. Type of Alcohol and Blood Pressure: The Copenhagen General Population Study. Am J Med 2024:S0002-9343(24)00280-8. [PMID: 38750714 DOI: 10.1016/j.amjmed.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/24/2024] [Accepted: 05/06/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Most adults ingest alcoholic beverages. Alcohol shows strong and positive associations with blood pressure (BP). We hypothesized that intake of red wine, white wine, beer, and spirits and dessert wine show similar associations with BP in the general population. METHODS We included 104,467 males and females aged 20-100 years in the analysis of the Danish general population. Alcohol use and type of alcohol were assessed by questionnaire. Blood pressure was measured by automated digital BP manometer. Multivariable linear regression models were used when analyzing the association between number of drinks per week and BP, stratified by sex and adjusted for relevant confounders. Each alcohol type (red wine, white wine, beer, and spirits and dessert wine) was analyzed in similar models including adjustment for other alcohol types. RESULTS Most of the subjects (76,943 [73.7%]) drank more than 1 type of alcohol. However, 12,093 (12.6%) consumed red wine only, 4288 (4.5%) beer only, 1815 (1.9%) white wine only, and 926 (1.0%) spirits and dessert wine only. There was a dose-response association between total drinks per week and systolic and diastolic BP (SBP, DBP) (P < .001). The crude difference was 11 mmHg SBP and 7 mmHg DBP between high (>35 drinks per week) and low (1-2 drinks per week) alcohol intake. Overall, SBP was increased by 0.15-0.17 mmHG, and DBP was increased by 0.08-0.15 mmHg per weekly drink. After stratification for age and sex, effects were slightly higher among females and among individuals aged less than 60 years. CONCLUSION Alcohol intake is associated with highly significant increased SPB and DBP. The effect is similar for red wine, white wine, beer, and spirits.
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Affiliation(s)
- Gorm Boje Jensen
- The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark; National Institute of Public Health, University of Southern Denmark, Copenhagen.
| | - Morten Grønbæk
- The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark; National Institute of Public Health, University of Southern Denmark, Copenhagen
| | - Magnus T Jensen
- The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark; Steno Diabetes Center Copenhagen, Denmark
| | - Peter Schnohr
- The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark
| | - Børge Grønne Nordestgaard
- The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark; The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Denmark
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the UQ School of Medicine, New Orleans, Louisiana
| | - James H O'Keefe
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City
| | - Jacob Louis Marott
- The Copenhagen City Heart Study, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark; The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
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Bui H, Keshawarz A, Wang M, Lee M, Ratliff SM, Lin L, Birditt KS, Faul JD, Peters A, Gieger C, Delerue T, Kardia SLR, Zhao W, Guo X, Yao J, Rotter JI, Li Y, Liu X, Liu D, Tavares JF, Pehlivan G, Breteler MMB, Karabegovic I, Ochoa-Rosales C, Voortman T, Ghanbari M, van Meurs JBJ, Nasr MK, Dörr M, Grabe HJ, London SJ, Teumer A, Waldenberger M, Weir DR, Smith JA, Levy D, Ma J, Liu C. Association analysis between an epigenetic risk score and blood pressure. RESEARCH SQUARE 2024:rs.3.rs-4243866. [PMID: 38699335 PMCID: PMC11065078 DOI: 10.21203/rs.3.rs-4243866/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Background Epigenome-wide association studies have revealed multiple DNA methylation sites (CpGs) associated with alcohol consumption, an important lifestyle risk factor for cardiovascular diseases. Results We generated an alcohol consumption epigenetic risk score (ERS) based on previously reported 144 alcohol-associated CpGs and examined the association of the ERS with systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension (HTN) in 3,898 Framingham Heart Study (FHS) participants. We found an association of alcohol intake with the ERS in the meta-analysis with 0.09 units higher ERS per drink consumed per day (p < 0.0001). Cross-sectional analyses in FHS revealed that a one-unit increment of the ERS was associated with 1.93 mm Hg higher SBP (p = 4.64E-07), 0.68 mm Hg higher DBP (p = 0.006), and an odds ratio of 1.78 for HTN (p < 2E-16). Meta-analysis of the cross-sectional association of the ERS with BP traits in eight independent external cohorts (n = 11,544) showed similar relationships with blood pressure levels, i.e., a one-unit increase in ERS was associated with 0.74 (p = 0.002) and 0.50 (p = 0.0006) mm Hg higher SBP and DBP, but could not confirm the association with hypertension. Longitudinal analyses in FHS (n = 3,260) and five independent external cohorts (n = 4,021) showed that the baseline ERS was not associated with a change in blood pressure over time or with incident HTN. Conclusions Our findings provide proof-of-concept that utilizing an ERS is a useful approach to capture the recent health consequences of lifestyle behaviors such as alcohol consumption.
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Affiliation(s)
| | | | | | - Mikyeong Lee
- National Institute of Environmental Health Sciences
| | | | | | | | | | - Annette Peters
- Helmholtz Munich, German Research Center for Environmental Health
| | - Christian Gieger
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance
| | - Thomas Delerue
- Helmholtz Munich, German Research Center for Environmental Health
| | | | | | - Xiuqing Guo
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
| | - Jie Yao
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
| | - Jerome I Rotter
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
| | - Yi Li
- Boston University School of Public Health
| | - Xue Liu
- Boston University School of Public Health
| | - Dan Liu
- German Center for Neurodegenerative Diseases
| | | | | | | | | | | | | | | | | | | | - Marcus Dörr
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald
| | | | | | | | - Melanie Waldenberger
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance
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Bui H, Keshawarz A, Wang M, Lee M, Ratliff SM, Lin L, Birditt KS, Faul JD, Peters A, Gieger C, Delerue T, Kardia SLR, Zhao W, Guo X, Yao J, Rotter JI, Li Y, Liu X, Liu D, Tavares JF, Pehlivan G, Breteler MM, Karabegovic I, Ochoa-Rosales C, Voortman T, Ghanbari M, van Meurs JB, Nasr MK, Dörr M, Grabe HJ, London SJ, Teumer A, Waldenberger M, Weir DR, Smith JA, Levy D, Ma J, Liu C. Association analysis between an epigenetic alcohol risk score and blood pressure. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.29.24303545. [PMID: 38464320 PMCID: PMC10925472 DOI: 10.1101/2024.02.29.24303545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Background Epigenome-wide association studies have revealed multiple DNA methylation sites (CpGs) associated with alcohol consumption, an important lifestyle risk factor for cardiovascular diseases. Results We generated an alcohol consumption epigenetic risk score (ERS) based on previously reported 144 alcohol-associated CpGs and examined the association of the ERS with systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension (HTN) in 3,898 Framingham Heart Study (FHS) participants. We found an association of alcohol intake with the ERS in the meta-analysis with 0.09 units higher ERS per drink consumed per day (p < 0.0001). Cross-sectional analyses in FHS revealed that a one-unit increment of the ERS was associated with 1.93 mm Hg higher SBP (p = 4.64E-07), 0.68 mm Hg higher DBP (p = 0.006), and an odds ratio of 1.78 for HTN (p < 2E-16). Meta-analysis of the cross-sectional association of the ERS with BP traits in eight independent external cohorts (n = 11,544) showed similar relationships with blood pressure levels, i.e., a one-unit increase in ERS was associated with 0.74 (p = 0.002) and 0.50 (p = 0.0006) mm Hg higher SBP and DBP, but could not confirm the association with hypertension. Longitudinal analyses in FHS (n = 3,260) and five independent external cohorts (n = 4,021) showed that the baseline ERS was not associated with a change in blood pressure over time or with incident HTN. Conclusions Our findings provide proof-of-concept that utilizing an ERS is a useful approach to capture the recent health consequences of lifestyle behaviors such as alcohol consumption.
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Affiliation(s)
- Helena Bui
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Amena Keshawarz
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Mengyao Wang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Mikyeong Lee
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Scott M. Ratliff
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Lisha Lin
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Kira S. Birditt
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Jessica D. Faul
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Munich, German Research Center for Environmental Health, German
- Institute for Medical Informatics, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Christian Gieger
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
- Research Unit Molecular Epidemiology, Institute of Epidemiology, Helmholtz Munich, German Research Center for Environmental Health, Bavaria, Germany
| | - Thomas Delerue
- Research Unit Molecular Epidemiology, Institute of Epidemiology, Helmholtz Munich, German Research Center for Environmental Health, Bavaria, Germany
| | - Sharon L. R. Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Wei Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Xiuqing Guo
- The Institute for Translational Genomics and Populations, Department of Pediatrics, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Jie Yao
- The Institute for Translational Genomics and Populations, Department of Pediatrics, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Jerome I. Rotter
- The Institute for Translational Genomics and Populations, Department of Pediatrics, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
| | - Yi Li
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Xue Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Dan Liu
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Juliana F. Tavares
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Gökhan Pehlivan
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Monique M.B. Breteler
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Irma Karabegovic
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Carolina Ochoa-Rosales
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Centro de Vida Saludable de la Universidad de Concepción, Concepción, Chile
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Joyce B.J. van Meurs
- Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Mohamed Kamal Nasr
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Marcus Dörr
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine, Greifswald, Germany
- German Center of Neurodegenerative Diseases (DZNE), Rostock/Greifswald, site Greifswald, Germany
| | - Stephanie J. London
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Bialystok, Poland
| | - Melanie Waldenberger
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
- Research Unit Molecular Epidemiology, Institute of Epidemiology, Helmholtz Munich, German Research Center for Environmental Health, Bavaria, Germany
| | - David R. Weir
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Jennifer A. Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Daniel Levy
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Jiantao Ma
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Chunyu Liu
- Framingham Heart Study, Framingham, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
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Wood E, Pan J, Cui Z, Bach P, Dennis B, Nolan S, Socias ME. Does This Patient Have Alcohol Use Disorder?: The Rational Clinical Examination Systematic Review. JAMA 2024; 331:1215-1224. [PMID: 38592385 DOI: 10.1001/jama.2024.3101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Importance The accuracy of screening tests for alcohol use disorder (defined as a problematic pattern of alcohol use leading to clinically significant impairment or distress) requires reassessment to align with the latest definition in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5). Objective To assess the diagnostic accuracy of screening tools in identifying individuals with alcohol use disorder as defined in the DSM-5. Data Sources and Study Selection The databases of MEDLINE and Embase were searched (January 2013-February 2023) for original studies on the diagnostic accuracy of brief screening tools to identify alcohol use disorder according to the DSM-5 definition. Because diagnosis of alcohol use disorder does not include excessive alcohol use as a criterion, studies of screening tools that identify excessive or high-risk drinking among younger (aged 9-18 years), older (aged ≥65 years), and pregnant persons also were retained. Data Extraction and Synthesis Sensitivity, specificity, and likelihood ratios (LRs) were calculated. When appropriate, a meta-analysis was performed to calculate a summary LR. Results Of 4303 identified studies, 35 were retained (N = 79 633). There were 11 691 individuals with alcohol use disorder or a history of excessive drinking. Across all age categories, a score of 8 or greater on the Alcohol Use Disorders Identification Test (AUDIT) increased the likelihood of alcohol use disorder (LR, 6.5 [95% CI, 3.9-11]). A positive screening result using AUDIT identified alcohol use disorder better among females (LR, 6.9 [95% CI, 3.9-12]) than among males (LR, 3.8 [95% CI, 2.6-5.5]) (P = .003). An AUDIT score of less than 8 reduced the likelihood of alcohol use disorder similarly for both males and females (LR, 0.33 [95% CI, 0.20-0.52]). The abbreviated AUDIT-Consumption (AUDIT-C) has sex-specific cutoff scores of 4 or greater for males and 3 or greater for females, but was less useful for identifying alcohol use disorder (males: LR, 1.8 [95% CI, 1.5-2.2]; females: LR, 2.0 [95% CI, 1.8-2.3]). The AUDIT-C appeared useful for identifying measures of excessive alcohol use in younger people (aged 9-18 years) and in those older than 60 years of age. For those younger than 18 years of age, the National Institute on Alcohol Abuse and Alcoholism age-specific drinking thresholds were helpful for assessing the likelihood of alcohol use disorder at the lowest risk threshold (LR, 0.15 [95% CI, 0.11-0.21]), at the moderate risk threshold (LR, 3.4 [95% CI, 2.8-4.1]), and at the highest risk threshold (LR, 15 [95% CI, 12-19]). Among persons who were pregnant and screened within 48 hours after delivery, an AUDIT score of 4 or greater identified those more likely to have alcohol use disorder (LR, 6.4 [95% CI, 5.1-8.0]), whereas scores of less than 2 for the Tolerance, Worried, Eye-Opener, Amnesia and Cut-Down screening tool and the Tolerance, Annoyed, Cut-Down and Eye-Opener screening tool identified alcohol use disorder similarly (LR, 0.05 [95% CI, 0.01-0.20]). Conclusions and Relevance The AUDIT screening tool is useful to identify alcohol use disorder in adults and in individuals within 48 hours postpartum. The National Institute on Alcohol Abuse and Alcoholism youth screening tool is helpful to identify children and adolescents with alcohol use disorder. The AUDIT-C appears useful for identifying various measures of excessive alcohol use in young people and in older adults.
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Affiliation(s)
- Evan Wood
- British Columbia Centre on Substance Use, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Jeffrey Pan
- British Columbia Centre on Substance Use, Vancouver, Canada
| | - Zishan Cui
- British Columbia Centre on Substance Use, Vancouver, Canada
| | - Paxton Bach
- British Columbia Centre on Substance Use, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Brittany Dennis
- British Columbia Centre on Substance Use, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Seonaid Nolan
- British Columbia Centre on Substance Use, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - M Eugenia Socias
- British Columbia Centre on Substance Use, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
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John D, Johnson AR, Fathima FN, Mundackal R. Diabetes, hypertension, and other cardiovascular disease risk factors among adults in an urban underprivileged community in Bangalore city, India. J Family Med Prim Care 2024; 13:1440-1447. [PMID: 38827696 PMCID: PMC11141983 DOI: 10.4103/jfmpc.jfmpc_1256_23] [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: 08/01/2023] [Revised: 10/06/2023] [Accepted: 10/19/2023] [Indexed: 06/04/2024] Open
Abstract
Aim Diabetes and hypertension are major risk factors of cardiovascular disease, which is known to be the leading cause of global mortality in the world today. Studies have shown that the prevalence of these risk factors is on the rise, with the burden of diabetes alone increasing by 80% in the last two decades. Complications of diabetes and hypertension result in huge public health challenges for the country and catastrophic medical expenditures for families among the urban poor. Our study aims to estimate the prevalence of diabetes, hypertension, and other cardiovascular risk factors among adults in an urban underprivileged community of Bengaluru city. Objectives and Methods A cross-sectional study was conducted over a period of 6 months where 2245 individuals aged 30 or older were interviewed using a structured interviewer-administered questionnaire used to capture sociodemographic details that assessed modifiable risk factors for diabetes and hypertension. Inclusion criteria for diabetes were considered if the random blood sugar reading was ≥200 mg/dL, whereas a diagnosis of hypertension was taken into consideration if the systolic blood pressure reading was ≥140 mmHg and/or diastolic blood pressure was ≥90 mmHg. Results Among the 2245 participants that took part in the study, 15.5% were diabetics and 17.2% were hypertensive. There was a strong association of diabetes among consumers of alcohol, with more than one-third having a high prevalence of the disease (odds ratio (OR): 2.09, 95% confidence interval (95% CI): 1.1-3.9). More than half the population were consumers of junk food; the prevalence of diabetes in this group was 1.35 times higher than that in their counterparts (OR: 1.35, 95% CI: 1.0-1.8). A significant association of diabetes was also seen among those identified with central obesity (OR: 1.83, 95% CI: 1.4-2.5). One-third of the population who consumed alcohol were found to be diagnosed with hypertension (OR: 3.08, 95% CI: 1.6-5.9), and one-fifth of individuals who were regular consumers of junk food had a higher prevalence of hypertension (OR: 1.41, 95% CI: 1.1-1.8). A higher prevalence of hypertension was also seen among individuals with central obesity or a body mass index (BMI) of >30 (OR: 1.59, 95% CI: 1.2-2.1; OR: 1.92, 95% CI: 1.4-2.6). Conclusion The findings from our study conducted in an urban underprivileged area of Bengaluru city shed light on the significant associations between diabetes and hypertension and various demographic and lifestyle factors. Specifically, male gender and lower educational status were found to have a significant association with diabetes, whereas being unmarried and having a high BMI status were strongly linked to hypertension. In addition, the study revealed that elderly individuals, alcohol consumers, junk food eaters, and those with central obesity demonstrated an increased risk for both diabetes and hypertension. By identifying these risk factors, targeted interventions can be developed to address the unique challenges faced by this vulnerable section of society. Strategies can be designed to raise awareness, encourage healthier lifestyle choices, and improve access to healthcare services to effectively prevent and manage diabetes and hypertension in this community.
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Affiliation(s)
- David John
- Department of General Surgery, Basingstoke and North Hampshire Hosptial, United Kingdom
| | - Avita R. Johnson
- Department of Community Medicine, St Johns National Academy of Health Sciences, Bangalore, Karnataka, India
| | - Farah N. Fathima
- Department of Community Medicine, St Johns National Academy of Health Sciences, Bangalore, Karnataka, India
| | - Rose Mundackal
- Department of Community Medicine, St Johns National Academy of Health Sciences, Bangalore, Karnataka, India
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Tseng PY, Sung FC, Muo CH, Lan YC, Hser YI, Chien SHL, Wang JY. Risk of diabetes and hypertension in a population with alcohol use disorders. BMC Public Health 2024; 24:868. [PMID: 38515085 PMCID: PMC10956217 DOI: 10.1186/s12889-024-18318-y] [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: 12/06/2023] [Accepted: 03/10/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND A population-based follow-up study assessing the risk of developing hypertension and diabetes associated with alcohol use disorder (AUD) is crucial. We investigated this relationship by using insurance claims data from Taiwan. METHODS From the claims data, an AUD cohort (N = 60,590) diagnosed between 2000 and 2006 and a non-AUD comparison cohort (N = 60,590) without the diagnosis of hypertension or diabetes at baseline were established and matched by propensity scores estimated by baseline demographic status and the Charlson comorbidity index (CCI). We assessed the incidence rates of hypertension and/or diabetes at the end of 2016 and used Cox's method to estimate the related hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Relative to the comparison cohort, the AUD cohort had an approximately 1.70-fold higher incidence of hypertension (35.1 vs. 20.7 per 1,000 person-years), with an adjusted HR (aHR) of 1.72 (95% CI: 1.68-1.76), 2.16-fold higher incidence of diabetes (20.2 vs. 9.36 per 1,000 person-years), with an aHR of 2.18 (95% CI: 2.11-2.24), and 1.91-fold higher incidence of both diabetes and hypertension (10.3 vs. 5.38 per 1,000 person-years) with an aHR of 2.02 (95% CI: 1.94-2.10). The incidence rates of all outcomes were greater in men than in women, whereas the HRs were greater for AUD in women than for AUD in men relative to the respective comparison patients. The risk increased further for subjects with CCI ≥ 1, which was higher in the AUD cohort. CONCLUSIONS The increased risk of developing diabetes and hypertension in patients with AUD, especially the differences noted according to gender, indicates that clinicians should address potential comorbidities in these patients.
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Affiliation(s)
- Pei-Ying Tseng
- Department of Public Health, China Medical University, 406, Taichung, Taiwan
- Department of Medicine, Lee's General Hospital, 358, Yuanli, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, 404, Taichung, Taiwan
- Department of Health Services Administration, China Medical University College of Public Health, 406, Taichung, Taiwan
- Department of Food Nutrition and Health Biotechnology, Asia University, 413, Taichung, Taiwan
| | - Chih-Hsin Muo
- Management Office for Health Data, China Medical University Hospital, 404, Taichung, Taiwan
| | - Yu-Ching Lan
- Expert Labs, IBM Taiwan Corporation, 110, Taipei, Taiwan
| | - Yih-Ing Hser
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 90095, Los Angeles, CA, USA
| | - Sarina Hui-Lin Chien
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Jong-Yi Wang
- Department of Health Services Administration, China Medical University, 100 Jingmao Rd. Sec. 1, Beitun Dist, 406, Taichung, Taiwan.
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DeBlois JP, London AS, Heffernan KS. Hypertension at the nexus of veteran status, psychiatric disorders, and traumatic brain injury: Insights from the 2011 Behavioral Risk Factor Surveillance System. PLoS One 2024; 19:e0298366. [PMID: 38498456 PMCID: PMC10947695 DOI: 10.1371/journal.pone.0298366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 01/24/2024] [Indexed: 03/20/2024] Open
Abstract
Variable military service-related experiences, such as combat exposure, psychiatric disorders (PD), and traumatic brain injuries (TBI), may differentially affect the likelihood of having health care professional-identified high blood pressure (i.e., hypertension). PURPOSE Compare the odds of self-reported hypertension among non-combat and combat veterans with and without PD/TBI to non-veterans and each other. METHODS We used data from men from the 2011 Behavioral Risk Factor Surveillance System and distinguished: non-veterans (n = 21,076); non-combat veterans with no PD/TBI (n = 3,150); combat veterans with no PD/TBI (n = 1,979); and veterans (combat and non-combat) with PD and/or TBI (n = 805). Multivariable, hierarchical logistic regression models included exogenous demographic, socioeconomic attainment and family structure, health behavior and conditions, and methodological control variables. RESULTS One-third of men reported having been told at least once by a medical professional that they had high blood pressure. Bivariate analyses indicated that each veteran group had a higher prevalence of self-reported hypertension than non-veterans (design-based F = 45.2, p<0.001). In the fully adjusted model, no statistically significant differences in the odds of self-reported hypertension were observed between non-veterans and: non-combat veterans without PD/TBI (odds ratio [OR] = 0.92); combat veterans without PD/TBI (OR = 0.87); veterans with PD and/or TBI (OR = 1.35). However, veterans with PD and/or TBI had greater odds of reporting hypertension than both combat and non-combat veterans without PD/TBI (p<0.05). DISCUSSION Military service-related experiences were differentially associated with a survey-based measure of hypertension. Specifically, veterans self-reporting PD and/or TBI had significantly higher odds of self-reporting hypertension (i.e., medical provider-identified high blood pressure).
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Affiliation(s)
- Jacob P. DeBlois
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States of America
| | - Andrew S. London
- Department of Sociology, Syracuse University, Syracuse, NY, United States of America
| | - Kevin S. Heffernan
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States of America
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Adal AB, Kassa RN, Habte MH, Jebesa MG, Ademe S, Tiruneh CT, Andualem A, Aynalem ZB, Bewket B. Undiagnosed hypertension and associated factors among long-distance bus drivers in Addis Ababa terminals, Ethiopia, 2022: A cross-sectional study. PLoS One 2024; 19:e0292890. [PMID: 38359046 PMCID: PMC10868739 DOI: 10.1371/journal.pone.0292890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 10/01/2023] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Hypertension is a major public health problem that is often unrecognized, and its detection and control should be prioritized. The level of undiagnosed hypertension and its associated factors among long-distance bus drivers in Ethiopia is unknown. OBJECTIVE This study aimed to assess the magnitude of undiagnosed hypertension and its associated factors among long-distance bus drivers in Addis Ababa bus terminals. METHODS A facility-based cross-sectional study was conducted on 391 long-distance bus drivers from December 15, 2021, to January 15 2022 at five cross-country bus terminals in Addis Ababa. A standardized and structured questionnaire was adapted based on the WHO stepwise approach to a non-communicable disease study and translated into Amharic. Data were coded, cleaned, and entered using Epi-data version 4.6 and exported to SPSS version 26. Logistic regression analysis was performed. Variables with a P-value < 0.25 in the bivariable analysis were selected for multivariable logistic regression analysis. Independent variables with a P-value < 0.05 were considered statistically significant. The magnitude of association between independent and dependent variables was measured by odds ratio with a 95% confidence interval. RESULTS In this study, 391 study participants were involved with a response rate of 97.1%. The prevalence of undiagnosed hypertension was 22.5% (CI: 18.7%, 26.6%). Poor level of knowledge (AOR: 2.00, CI: 1.08, 3.70), long duration of driving per day (AOR: 2.50, 95% CI: 1.37-4.56), habit of chewing of chat (AOR: 2.61, 95% CI: 1.44, 4.73), regular alcohol consumption (AOR = 3.46; 95% CI: 1.70, 7.05), overweight (AOR:3.14, 95%CI: 1.54,6.42) obesity (AOR: 3.21, 95% CI 1.35, 7.61) and regular physical exercise (AOR: 0.16, 95% CI: 0.09, 0.29) were statistically significantly associated with undiagnosed hypertension. CONCLUSION This study revealed that the prevalence of undiagnosed hypertension among long-distance bus drivers was 22.5%, which was associated with modifiable behavioral factors, lack of regular physical exercise, lack of adequate awareness and high body mass index. RECOMMENDATION Stakeholders must implement the necessary preventive measures. These include increasing the level of awareness of hypertension among long-distance drivers and developing prevention of hypertension strategies and policies focusing on lifestyle and behavioral modifications.
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Affiliation(s)
- Abebaw Bires Adal
- College of Medicine and Health Science, Department of Nursing, Injibara University, Injibara, Ethiopia
| | - Rahel Nega Kassa
- Department of Nursing, St. Paul’s Millennium Medical College, Addis Ababa, Ethiopia
| | | | | | - Sewunet Ademe
- College of Medicine and Health Science, Department of Nursing, Injibara University, Injibara, Ethiopia
| | | | - Atsedemariam Andualem
- College of Medicine and Health Science, Department of Nursing, Injibara University, Injibara, Ethiopia
| | - Zewdu Bishaw Aynalem
- College of Medicine and Health Science, Department of Nursing, Injibara University, Injibara, Ethiopia
| | - Bekalu Bewket
- College of Medicine and Health Science, Department of Nursing, Injibara University, Injibara, Ethiopia
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Iddrisu A, Otoo D, Kwasi A, Gumedze F. Assessing the hazard of death, cardiac tamponade, and pericardial constriction among HIV and tuberculosis pericarditis patients using the extended Cox-hazard model: Intervention study. Health Sci Rep 2024; 7:e1892. [PMID: 38361809 PMCID: PMC10867395 DOI: 10.1002/hsr2.1892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/02/2024] [Accepted: 01/23/2024] [Indexed: 02/17/2024] Open
Abstract
Background and Aims Tuberculous (TB) pericarditis (TBP), a TB of the heart, is linked to significant morbidity and mortality rates. Administering glucocorticoid therapy to individuals with TBP might enhance overall results and lower the likelihood of fatality. However, the actual clinical effectiveness of supplementary glucocorticoids remains uncertain. This study specifically evaluated the effects of prednisolone, prednisolone-antiretroviral therapy (ART) interaction, and other potential risk factors in reducing the hazard of the composite outcome, death, cardiac tamponade, and constriction, among TBP and human immunodeficiency virus (HIV) patients. Methods The data used in this study were obtained from the investigation of the Management of Pericarditis trial, a multicentre international randomized double-blind placebo-controlled 2 × 2 factorial study that investigated the effects of two TB treatments, prednisolone and Mycobacterium indicus pranii immunotherapy in patients with TBP in Africa. This study used a sample size of 587 TBP and HIV-positive patients randomized into prednisolone and its corresponding placebo arm. We used the extended Cox-proportional hazard model to evaluate the effects of the covariates on the hazard of the survival outcomes. Models fitting and parameter estimation were carried out using R version 4.3.1. Results Prednisolone reduces the hazard of composite outcome (hazrad ratio [HR] = 0.32, 95% confidence interval [CI] = 0.19 , 0.54 , p < 0.001), cardiac tamponade (HR = 0.14, 95% CI = 0.05, 0.42, p < 0.001) and constriction (HR = 0.81, 95% CI = 0.41, 1.61, p = 0.55). However, prednisolone increases the hazard of death (HR = 1.58, 95% CI = 1.11, 2.24, p = 0.01). Consistent usage of ART reduces the hazard of composite outcome, death, and constriction but insignificantly increased the hazard of cardiac tamponade. Conclusion The study offers valuable insights into how prednisolone impact the hazard of different outcomes in patients with TBP and HIV. The findings hold potential clinical significance, particularly in guiding treatment decisions and devising strategies to enhance outcomes in this specific patient group. However, there are concerns about prednisolone potentially increasing the risk of death due to HIV-related death.
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Affiliation(s)
- Abdul‐Karim Iddrisu
- Department of Mathematics and StatisticsUniversity of Energy and Natural ResourcesSunyaniGhana
| | - Dominic Otoo
- Department of Mathematics and StatisticsUniversity of Energy and Natural ResourcesSunyaniGhana
| | - Afa Kwasi
- Department of Mathematics and StatisticsUniversity of Energy and Natural ResourcesSunyaniGhana
| | - Freedom Gumedze
- Department of Statistical SciencesUniversity of Cape TownRondeboschSouth Africa
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Di Fusco SA, Spinelli A, Castello L, Marino G, Maraschi I, Gulizia MM, Gabrielli D, Colivicchi F. Do Pathophysiologic Mechanisms Linking Unhealthy Lifestyle to Cardiovascular Disease and Cancer Imply Shared Preventive Measures? - A Critical Narrative Review. Circ J 2024; 88:189-197. [PMID: 34544961 DOI: 10.1253/circj.cj-21-0459] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Growing evidence has shown a bidirectional link between the cardiologic and oncologic fields. Several investigations support the role of unhealthy behaviors as pathogenic factors of both cardiovascular disease and cancer. We report epidemiological and research findings on the pathophysiological mechanisms linking unhealthy lifestyle to cardiovascular disease and cancer. For each unhealthy behavior, we also discuss the role of preventive measures able to affect both cardiovascular disease and cancer occurrence and progression.
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Affiliation(s)
| | | | - Lorenzo Castello
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital
| | - Gaetano Marino
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital
| | - Ilaria Maraschi
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital
| | | | | | - Furio Colivicchi
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital
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Chapp AD, Shan Z, Chen QH. Acetic Acid: An Underestimated Metabolite in Ethanol-Induced Changes in Regulating Cardiovascular Function. Antioxidants (Basel) 2024; 13:139. [PMID: 38397737 PMCID: PMC10886048 DOI: 10.3390/antiox13020139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/13/2024] [Accepted: 01/18/2024] [Indexed: 02/25/2024] Open
Abstract
Acetic acid is a bioactive short-chain fatty acid produced in large quantities from ethanol metabolism. In this review, we describe how acetic acid/acetate generates oxidative stress, alters the function of pre-sympathetic neurons, and can potentially influence cardiovascular function in both humans and rodents after ethanol consumption. Our recent findings from in vivo and in vitro studies support the notion that administration of acetic acid/acetate generates oxidative stress and increases sympathetic outflow, leading to alterations in arterial blood pressure. Real-time investigation of how ethanol and acetic acid/acetate modulate neural control of cardiovascular function can be conducted by microinjecting compounds into autonomic control centers of the brain and measuring changes in peripheral sympathetic nerve activity and blood pressure in response to these compounds.
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Affiliation(s)
- Andrew D. Chapp
- Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA
| | - Zhiying Shan
- Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI 49931, USA;
| | - Qing-Hui Chen
- Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI 49931, USA;
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Onalu C, Okah P, Okoye UO. A Focused Group Perspective of Risk Factors for Hypertension Among Middle-Aged Adults in Rural Areas of Anambra State, Nigeria. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2024; 21:1-17. [PMID: 37634142 DOI: 10.1080/26408066.2023.2252411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
PURPOSE Recent records by the World Health Organization show that hypertension is more prevalent in Africa than in other parts of the world, and remains the foremost common risk factor for cardiovascular-related diseases, stroke, renal diseases, and death. However, little is known about the risk factors for hypertension by people from rural areas, especially among middle-aged adults. Therefore, the study examined the knowledge of the risk factors for hypertension among middle-aged adults in rural areas of Anambra state, Nigeria. MATERIALS, AND METHOD Focus group discussions were used to collect data from 40 middle-aged adults (20 males and 20 females). Two key themes stood out from the data collection guides. These are "awareness of hypertension and its' symptoms" and "knowledge of risk factors of hypertension". RESULTS The findings showed that the participants were aware of hypertension but lacked in-depth knowledge of the risk factors for the disease. Most participants did not believe that intake of certain foods like starchy foods and excess alcohol consumption could lead to one being hypertensive. DISCUSSION AND CONCLUSION There is a need for social workers to sensitize and enlighten the middle-aged adults in the study area on the risk factors for the disease.
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Affiliation(s)
- Chinyere Onalu
- Department of Social Work, University of Nigeria, Nsukka, Nigeria
| | - Paulinus Okah
- Department of Social Work, University of Nigeria, Nsukka, Nigeria
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Allaire J, Lévesque B, Poirier P, Gagnon C, Auclair G, Lemire M, Ayotte P. Prevalence and determinants of hypertension in the adult Inuit population of Nunavik (northern Quebec, Canada). CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:168-179. [PMID: 37155001 PMCID: PMC10830977 DOI: 10.17269/s41997-023-00774-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/05/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVES To assess the prevalence of arterial hypertension among Inuit adults living in Nunavik (northern Quebec, Canada) in 2017 and identify its sociodemographic and lifestyle determinants. METHODS We used data obtained from 1177 Inuit adults aged ≥ 18 years who participated in the cross-sectional Qanuilirpitaa? Nunavik Inuit Health Survey during late summer-early fall of 2017. Resting blood pressure (BP) and anthropometric characteristics were measured during a clinical session, while sociodemographic characteristics and lifestyle habits were documented using validated questionnaires. Information on current medication was retrieved from medical files. Sex-stratified population-weighted log-binomial regressions were conducted to identify determinants of hypertension, adjusting for potential confounders. RESULTS Hypertension (systolic BP ≥ 140 mm Hg or diastolic BP ≥ 90 mmHg or taking antihypertensive medication) was present in 23% of the adult population and was more frequent in men than women (29% vs. 18%). About a third of hypertensive individuals (34%) were taking antihypertensive medication. These estimates are prone to biases due to the relatively low participation rate (37%). As expected, the prevalence of hypertension increased with age, but values were surprisingly elevated in 18 to 29-year-old men and women (18% and 8%, respectively) compared with 20 to 39-year-old adults of the general Canadian population (3% in both sexes, according to data from the Canadian Health Measures Survey, 2012-2015). Hypertension was associated with obesity and alcohol consumption in both men and women, and with higher socioeconomic status among men. CONCLUSION This survey revealed a high prevalence of hypertension among young Nunavimmiut adults in 2017 and the need to improve hypertension diagnosis and treatment in the region. Curbing obesity and alcohol consumption, two actionable determinants of hypertension, will require improving food security and addressing the consequences of historical trauma linked to colonization.
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Affiliation(s)
- Janie Allaire
- Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada
- Centre de recherche du CHU de Québec - Université Laval, Quebec City, QC, Canada
- Institut national de santé publique du Québec, Quebec City, QC, Canada
| | - Benoît Lévesque
- Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada
- Institut national de santé publique du Québec, Quebec City, QC, Canada
| | - Paul Poirier
- Institut universitaire de cardiologie et de pneumologie du Québec - Université Laval, Quebec City, QC, Canada
- Faculté de pharmacie, Université Laval, Quebec City, QC, Canada
| | - Claudia Gagnon
- Centre de recherche du CHU de Québec - Université Laval, Quebec City, QC, Canada
- Institut universitaire de cardiologie et de pneumologie du Québec - Université Laval, Quebec City, QC, Canada
- Département de médecine, Université Laval, Quebec City, QC, Canada
| | - Geneviève Auclair
- Inuulitsivik Health Centre, Inukjuak, QC, Canada
- Department of Family Medicine, McGill University, Montréal, QC, Canada
| | - Mélanie Lemire
- Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada
- Centre de recherche du CHU de Québec - Université Laval, Quebec City, QC, Canada
- Institut de biologie intégrative et des systèmes, Université Laval, Quebec City, QC, Canada
| | - Pierre Ayotte
- Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada.
- Centre de recherche du CHU de Québec - Université Laval, Quebec City, QC, Canada.
- Institut national de santé publique du Québec, Quebec City, QC, Canada.
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Wireko MB, Hendricks J, Bedu-Addo K, Van Staden M, Ntim EA, Larbi JA, Owusu IK. Association Between Alcohol Consumption and Blood Pressure Levels Among HIV Sero-Positive and Sero-Negative Cohorts: A Secondary Analysis of the Vukuzazzi Study. J Prim Care Community Health 2024; 15:21501319241235594. [PMID: 38477301 PMCID: PMC10938620 DOI: 10.1177/21501319241235594] [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: 12/25/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The effect of hypertension is aggravated by lifestyle factors such as alcohol consumption. This study sought to determine the association between alcohol consumption and the level of blood pressures among HIV seronegative and seropositive cohorts. METHODS This secondary analysis was performed on a cross-sectional survey data of 17 922 participants during the period between 2018 and 2020. A questionnaire was used to obtain participants' alcohol consumption history, which was categorized into non-alcohol consumers, non-heavy alcohol consumers, and heavy alcohol consumers. A linear regression model was used to establish relationships among participants with raised blood pressure (BP ≥ 140/90 mmHg). RESULTS Out of the total participants, 3553 (19.82%) were hypertensives. Almost 13% of the hypertensives (n = 458; 12.89%) were undiagnosed, and 12.44 % (442) had uncontrolled hypertension. About 14.52% of the hypertensives (3553) were not on any antihypertensive medication. Male non-consumers of alcohol had the highest systolic and diastolic BP; uncontrolled systolic BP (165.53 ± 20.87 mmHg), uncontrolled diastolic BP (102.28 ± 19.21mmHg). Adjusted for covariates, moderate alcohol consumption was associated with HTN among participants who were HIV seropositive [unadjusted (RR = 1.772, P = .006, 95% CI (1.178-2.665)], [RR = 1.772, P = .005, 95% CI (1.187-2.64)]. [unadjusted RR = 1.876, P = .036, 95% CI (1.043-3.378)], adjusted RR = 1.876, P = .041, 95% CI (1.024-3.437). Both moderate and heavy alcohol consumption were significantly related to hypertension among HIV sero-negative [unadjusted model, moderate consumption RR = 1.534 P = .003, 95% CI (1.152-2.044)], [adjusted model, moderate alcohol consumption RR = 1.535, P = .006, 95% CI (1.132-2.080)], [unadjusted model, heavy alcohol consumption, RR = 2.480, P = .030, 95% CI (1.091-5.638)], [adjusted model RR = 2.480, P = .034, 95% CI (1.072-5.738)]. CONCLUSION Alcohol consumption is significantly related to increase BP regardless of HIV infection.
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Affiliation(s)
- Manasseh B. Wireko
- Department of Applied and Theoretical Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jacobus Hendricks
- Department of Physiology and Environmental Health, University of Limpopo, South Africa
| | - Kweku Bedu-Addo
- Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Marlise Van Staden
- Department of Physiology and Environmental Health, University of Limpopo, South Africa
| | - Emmanuel A. Ntim
- Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - John A. Larbi
- Department of Applied and Theoretical Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Isaac K. Owusu
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Directorate of Medicine, Komfo Anokye Teaching Hospital. Kumasi, Ghana
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Chaimati S, Shantavasinkul PC, Sritara P, Sirivarasai J. Effects of AGT and AGTR1 Genetic Polymorphisms and Changes in Blood Pressure Over a Five-Year Follow-Up. Risk Manag Healthc Policy 2023; 16:2931-2942. [PMID: 38164294 PMCID: PMC10758254 DOI: 10.2147/rmhp.s442983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024] Open
Abstract
Purpose The renin-angiotensin system plays an important role in the central regulation of blood pressure (BP). Genetic variations of angiotensinogen (AGT) and angiotensin II type 1 receptor (AGTR1) may increase susceptibility to elevated BP and hypertension. This study investigated the effects of AGT rs699 and AGTR1 rs5186 single nucleotide polymorphisms (SNPs) on BP at baseline and at a 5-year follow-up. Paticipants and Methods The study population consisted of participants from the Electricity Generating Authority of Thailand cohort study (n=354); data were collected at baseline (2013) and 5 years later (2018). Genotyping of the two SNPs was performed using TaqMan® assay and statistical analyses were performed with SNPStats software. Results The frequencies of the two SNPs were within the Hardy-Weinberg equilibrium (p=0.22 for AGT rs699 and p=0.06 for AGTR1 rs5186). For each SNP, mutant genotypes were significantly associated with increased systolic BP and/or diastolic BP in the codominant and recessive models. Risk alleles of AGT rs699 and AGTR1 rs5186 were associated with increased odds of hypertension and hypertension with metabolic syndrome at follow-up. Conclusion Overall, our results suggest that polymorphisms of genes in the renin-angiotensin system increase susceptibility to the development and progression of hypertension and the development of the metabolic syndrome.
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Affiliation(s)
- Siwaphorn Chaimati
- Doctoral Program in Nutrition, Faculty of Medicine Ramathibodi Hospital and Institute of Nutrition, Mahidol University, Bangkok, 10400, Thailand
| | | | - Piyamitr Sritara
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
| | - Jintana Sirivarasai
- Nutrition Division, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand
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Edavettal JM, Harris NR, Cohen SE, Paloczi J, Chandrasekar B, Gardner JD. Abstinence Restores Cardiac Function in Mice with Established Alcohol-Induced Cardiomyopathy. Cells 2023; 12:2783. [PMID: 38132102 PMCID: PMC10742080 DOI: 10.3390/cells12242783] [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: 10/11/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
Alcohol-induced cardiomyopathy (ACM) has a poor prognosis with up to a 50% chance of death within four years of diagnosis. There are limited studies investigating the potential of abstinence for promoting repair after alcohol-induced cardiac damage, particularly in a controlled preclinical study design. Here, we developed an exposure protocol that led to significant decreases in cardiac function in C57BL6/J mice within 30 days; dP/dt max decreased in the mice fed alcohol for 30 days (8054 ± 664.5 mmHg/s compared to control mice: 11,188 ± 724.2 mmHg/s, p < 0.01), and the dP/dt min decreased, as well (-7711 ± 561 mmHg/s compared to control mice: -10,147 ± 448.2 mmHg/s, p < 0.01). Quantitative PCR was used to investigate inflammatory and fibrotic biomarkers, while histology was used to depict overt changes in cardiac fibrosis. We observed a complete recovery of function after abstinence (dP/dt max increased from 8054 ± 664 mmHg/s at 30 days to 11,967 ± 449 mmHg/s after abstinence, p < 0.01); further, both inflammatory and fibrotic biomarkers decreased after abstinence. These results lay the groundwork for future investigation of the molecular mechanisms underlying recovery from alcohol-induced damage in the heart.
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Affiliation(s)
- Joshua M. Edavettal
- Department of Physiology, LSU Health Sciences Center—New Orleans, New Orleans, LA 70112, USA; (J.M.E.); (N.R.H.); (S.E.C.); (J.P.)
| | - Nicholas R. Harris
- Department of Physiology, LSU Health Sciences Center—New Orleans, New Orleans, LA 70112, USA; (J.M.E.); (N.R.H.); (S.E.C.); (J.P.)
| | - Sarah E. Cohen
- Department of Physiology, LSU Health Sciences Center—New Orleans, New Orleans, LA 70112, USA; (J.M.E.); (N.R.H.); (S.E.C.); (J.P.)
| | - Janos Paloczi
- Department of Physiology, LSU Health Sciences Center—New Orleans, New Orleans, LA 70112, USA; (J.M.E.); (N.R.H.); (S.E.C.); (J.P.)
| | - Bysani Chandrasekar
- Department of Medicine, University of Missouri School of Medicine, Columbia, MO 65212, USA;
- Department of Medical Pharmacology and Physiology, Dalton Cardiovascular Research Center, and Harry S. Truman Memorial Veterans Hospital, Columbia, MO 65212, USA
| | - Jason D. Gardner
- Department of Physiology, LSU Health Sciences Center—New Orleans, New Orleans, LA 70112, USA; (J.M.E.); (N.R.H.); (S.E.C.); (J.P.)
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Shahidi S, Ramezani-Aliakbari K, Komaki A, Salehi I, Hashemi S, Asl SS, Habibi P, Ramezani-Aliakbari F. Effect of vitamin D on cardiac hypertrophy in D-galactose-induced aging model through cardiac mitophagy. Mol Biol Rep 2023; 50:10147-10155. [PMID: 37921981 DOI: 10.1007/s11033-023-08875-7] [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: 08/29/2023] [Accepted: 10/02/2023] [Indexed: 11/05/2023]
Abstract
BACKGROUND Cardiac apoptosis plays a key role in increased morbidity associated with aging-induced-cardiac disorder. Mitochondria play an important role in cardiac apoptosis, and dynamin-related protein 1 (Drp1), as a main mediator of mitochondrial fission, can trigger the mitophagy process to sustain the mitochondrial quality. The present study was done to determine the effect of vitamin D (VitD) treatment on cardiac hypertrophy through mitophagy regulation in aged animals induced by D-galactose (D-GAL). METHODS AND RESULTS Male Wistar rats were randomly divided into four groups: control, D-GAL (aging group), D-GAL co-injected with VitD (D-GAL ± VitD), and D-GAL plus ethanol (D-GAL ± Ethanol). Aging was induced by an intraperitoneal (i.p.) administration of D-GAL at 150 mg/kg daily for eight weeks and also VitD (400 IU/kg) or ethanol was injected (i.p.) into aging rats. Then, the levels of cardiac mitophagy and cardiac apoptosis were determined by measuring the expression of tensin homologue (PTEN)-induced putative kinase 1 (PINK1), Drp1, Bcl2-Associated X (Bax), and B-cell lymphoma 2 (Bcl2) genes. Aging in rats was associated with a reduction in mitophagy and also an increase in apoptosis of the heart through down-regulation of Drp1, PINK1, and Bcl2 genes and also up-regulation of Bax. However, VitD improved cardiac hypertrophy through cardiac mitophagy in D-GAL-induced aging rats. CONCLUSION VitD can inhibit cardiac hypertrophy by an increase in mitophagy and a decrease in apoptosis in the aging heart. The illustration of the suggested mechanism underlying of Vitamin D in cardiac hypertrophy induced by aging.
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Affiliation(s)
- Siamak Shahidi
- Department of Physiology, School of medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Neuroscience, School of Sciences and Advanced Technology in Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Alireza Komaki
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Neuroscience, School of Sciences and Advanced Technology in Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Iraj Salehi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Neuroscience, School of Sciences and Advanced Technology in Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Sara Soleimani Asl
- Anatomy Department, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Parisa Habibi
- Department of Physiology, School of medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Ramezani-Aliakbari
- Department of Physiology, School of medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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Abstract
PURPOSE The current review is to describe the definition and prevalence of resistant arterial hypertension (RAH), the difference between refractory hypertension, patient characteristics and major risk factors for RAH, how RAH is diagnosed, prognosis and outcomes for patients. MATERIALS AND METHODS According to the WHO, approximately 1.28 billion adults aged 30-79 worldwide have arterial hypertension, and over 80% of them do not have blood pressure (BP) under control. RAH is defined as above-goal elevated BP despite the concurrent use of 3 or more classes of antihypertensive drugs, commonly including a long-acting calcium channel blocker, an inhibitor of the renin-angiotensin system (angiotensin-converting enzyme inhibitor or angiotensin receptor blocker), and a thiazide diuretic administered at maximum or maximally tolerated doses and at appropriate dosing frequency. RAH occurs in nearly 1 of 6 hypertensive patients. It often remains unrecognised mainly because patients are not prescribed ≥3 drugs at maximal doses despite uncontrolled BP. CONCLUSION RAH distinctly increases the risk of developing coronary artery disease, heart failure, stroke and chronic kidney disease and confers higher rates of major adverse cardiovascular events as well as increased all-cause mortality. Timely diagnosis and treatment of RAH may mitigate the associated risks and improve short and long-term prognosis.
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25
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Wójcik M, Alvarez-Pitti J, Kozioł-Kozakowska A, Brzeziński M, Gabbianelli R, Herceg-Čavrak V, Wühl E, Lucas I, Radovanović D, Melk A, González Lopez-Valcarcel B, Fernández-Aranda F, Mazur A, Lurbe E, Borghi C, Drożdż D. Psychosocial and environmental risk factors of obesity and hypertension in children and adolescents-a literature overview. Front Cardiovasc Med 2023; 10:1268364. [PMID: 38054100 PMCID: PMC10694215 DOI: 10.3389/fcvm.2023.1268364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/24/2023] [Indexed: 12/07/2023] Open
Abstract
Childhood obesity has become a worldwide epidemic in the 21st century. Its treatment is challenging and often ineffective, among others due to complex, often not obvious causes. Awareness of the existence and meaning of psychosocial and environmental risk factors seems to be an essential element in the prevention and treatment of obesity and its complications, especially arterial hypertension. In this review, we will discuss the role of that risk factors linking obesity and increased cardiovascular disorders including the role of nutritional factors (including the role of unhealthy diet, inadequate hydration), unhealthy behaviors (e.g. smoking, alcohol and drugs, sedentary behavior, low physical activity, disrupted circadian rhythms, sleep disorders, screen exposure), unfavorable social factors (such as dysfunctional family, bullying, chronic stress, mood disorders, depression, urbanization, noise, and environmental pollution), and finally differences in cardiovascular risk in girls and boys.
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Affiliation(s)
- Małgorzata Wójcik
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College in Kraków, Kraków, Poland
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Kraków, Kraków, Poland
| | - Julio Alvarez-Pitti
- Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- INCLIVA Biomedical Research Institute, Hospital Clínico, University of Valencia, Valencia, Spain
| | - Agnieszka Kozioł-Kozakowska
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Kraków, Kraków, Poland
- Department of Pediatrics, Gastroenterology and Nutrition, Pediatric Institute, Jagiellonian University Medical College in Kraków, Kraków, Poland
| | - Michał Brzeziński
- Department of Pediatrics, Gastroenterology, Allergology and Pediatric Nutrition, Medical University of Gdansk, Kraków, Poland
| | - Rosita Gabbianelli
- Unit of Molecular Biology and Nutrigenomics, School of Pharmacy, University of Camerino, Camerino, Italy
| | - Vesna Herceg-Čavrak
- Faculty of Health Science, Libertas International University, Zagreb, Croatia
| | - Elke Wühl
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University, Heidelberg, Germany
| | - Ignacio Lucas
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Clinical Psychology Unit, University Hospital of Bellvitge, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Dragan Radovanović
- Department of Medical Sciences, Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Anette Melk
- Children’s Hospital, Hannover Medical School, Hannover, Germany
| | - Beatriz González Lopez-Valcarcel
- Department of Quantitative Methods for Economics and Management, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Artur Mazur
- Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Empar Lurbe
- Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- INCLIVA Biomedical Research Institute, Hospital Clínico, University of Valencia, Valencia, Spain
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Dorota Drożdż
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Kraków, Kraków, Poland
- Department of Pediatric Nephrology and Hypertension, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, Kraków, Poland
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Wang M, Li Y, Lai M, Nannini DR, Hou L, Joehanes R, Huan T, Levy D, Ma J, Liu C. Alcohol consumption and epigenetic age acceleration across human adulthood. Aging (Albany NY) 2023; 15:10938-10971. [PMID: 37889500 PMCID: PMC10637803 DOI: 10.18632/aging.205153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 10/04/2023] [Indexed: 10/28/2023]
Abstract
The alcohol-associated biological aging remains to be studied across adulthood. We conducted linear regression analyses to investigate the associations between alcohol consumption and two DNA methylation-based biological age acceleration metrics in 3823 Framingham Heart Study participants (24-92 years and 53.8% women) adjusting for covariates. We also investigated whether the two epigenetic aging metrics mediated the association of alcohol consumption with hypertension. We found that higher long-term average alcohol consumption was significantly associated with biological age acceleration assessed by GrimAge acceleration (GAA) and PhenoAge acceleration (PAA) in middle-aged (45-64 years, n = 1866) and older (65-92 years, n = 1267) participants while not in young participants (24-44 years, n = 690). For example, one additional standard drink of alcohol (~14 grams of ethanol per day) was associated with a 0.71 ± 0.15-year (p = 2.1e-6) and 0.60 ± 0.18-year (p = 7.5e-4) increase in PAA in middle-aged and older participants, respectively, but the association was not significant in young participants (p = 0.23). One additional standard serving of liquor (~14 grams of ethanol) was associated with a greater increase in GAA (0.82-year, p = 4.8e-4) and PAA (1.45-year, p = 7.4e-5) than beer (GAA: 0.45-year, p = 5.2e-4; PAA: 0.48-year, p = 0.02) and wine (GAA: 0.51-year, p = 0.02; PAA: 0.91-year, p = 0.008) in middle-aged participant group. We observed that up to 28% of the association between alcohol consumption and hypertension was mediated by GAA or PAA in the pooled sample. Our findings suggest that alcohol consumption is associated with greater biological aging quantified by epigenetic aging metrics, which may mediate the association of alcohol consumption with quantitative traits, such as hypertension.
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Affiliation(s)
- Mengyao Wang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Yi Li
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Meng Lai
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Drew R. Nannini
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Roby Joehanes
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Tianxiao Huan
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Daniel Levy
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
- Framingham Heart Study, Framingham, MA 01702, USA
| | - Jiantao Ma
- Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Chunyu Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
- Framingham Heart Study, Framingham, MA 01702, USA
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Adeyemi O, Bukur M, Berry C, DiMaggio C, Grudzen CR, Konda S, Adenikinju A, Cuthel A, Bouillon-Minois JB, Akinsola O, Moore A, McCormack R, Chodosh J. Substance use and pre-hospital crash injury severity among U.S. older adults: A five-year national cross-sectional study. PLoS One 2023; 18:e0293138. [PMID: 37878571 PMCID: PMC10599556 DOI: 10.1371/journal.pone.0293138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/06/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Alcohol and drug use (substance use) is a risk factor for crash involvement. OBJECTIVES To assess the association between substance use and crash injury severity among older adults and how the relationship differs by rurality/urbanicity. METHODS We pooled 2017-2021 cross-sectional data from the United States National Emergency Medical Service (EMS) Information System. We measured injury severity (low acuity, emergent, critical, and fatal) predicted by substance use, defined as self-reported or officer-reported alcohol and/or drug use. We controlled for age, sex, race/ethnicity, road user type, anatomical injured region, roadway crash, rurality/urbanicity, time of the day, and EMS response time. We performed a partial proportional ordinal logistic regression and reported the odds of worse injury outcomes (emergent, critical, and fatal injuries) compared to low acuity injuries, and the predicted probabilities by rurality/urbanicity. RESULTS Our sample consisted of 252,790 older adults (65 years and older) road users. Approximately 67%, 25%, 6%, and 1% sustained low acuity, emergent, critical, and fatal injuries, respectively. Substance use was reported in approximately 3% of the population, and this proportion did not significantly differ by rurality/urbanicity. After controlling for patient, crash, and injury characteristics, substance use was associated with 36% increased odds of worse injury severity. Compared to urban areas, the predicted probabilities of emergent, critical, and fatal injuries were higher in rural and suburban areas. CONCLUSION Substance use is associated with worse older adult crash injury severity and the injury severity is higher in rural and suburban areas compared to urban areas.
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Affiliation(s)
- Oluwaseun Adeyemi
- Ronald O Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York, New York, United States of America
| | - Marko Bukur
- Department of Surgery, New York University Grossman School of Medicine, New York, New York, United States of America
| | - Cherisse Berry
- Department of Surgery, New York University Grossman School of Medicine, New York, New York, United States of America
| | - Charles DiMaggio
- Department of Surgery, New York University Grossman School of Medicine, New York, New York, United States of America
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, United States of America
| | - Corita R. Grudzen
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Sanjit Konda
- Department of Orthopedics, New York University Grossman School of Medicine, New York, New York, United States of America
| | - Abidemi Adenikinju
- Department of Orthopedics, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Allison Cuthel
- Ronald O Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York, New York, United States of America
| | | | - Omotola Akinsola
- Department of Social Work, Minnesota State University, Mankato, Minnesota, United States of America
| | - Alison Moore
- Department of Medicine, University of California San Diego, San Diego, California, United States of America
| | - Ryan McCormack
- Ronald O Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York, New York, United States of America
| | - Joshua Chodosh
- Department of Medicine, New York University School of Medicine, New York, NY, United States of America
- Medicine Service, Veterans Affairs New York Harbor Healthcare System, New York, NY, United States of America
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Makukule A, Modjadji P, Thovhogi N, Mokgalaboni K, Kengne AP. Uncontrolled Hypertension, Treatment, and Predictors among Hypertensive Out-Patients Attending Primary Health Facilities in Johannesburg, South Africa. Healthcare (Basel) 2023; 11:2783. [PMID: 37893857 PMCID: PMC10606846 DOI: 10.3390/healthcare11202783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
Hypertension is a poorly controlled risk factor for cardiovascular disease in South Africa, particularly among patients receiving care in the public sector who are mostly from low socioeconomic backgrounds. This cross-sectional study investigated uncontrolled hypertension, treatment, and predictors among hypertensive out-patients attending primary health care facilities in Johannesburg, South Africa. The WHO STEPwise approach to the surveillance of non-communicable diseases was used to collect data, including sociodemographic and lifestyle factors, health status, and measurements for anthropometry and blood pressure along with self-reported adherence to treatment, estimated through the general medication adherence scale. Uncontrolled hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg in diagnosed patients receiving anti-hypertensive treatment. Overweight and obesity were defined as a body mass index ≥25 and ≥30 kg/m2, respectively. Logistic regression models were used to assess the predictors of uncontrolled hypertension. Four hundred (n = 400) hypertensive out-patients (mean age: 50 ± 8 years) participated in this study, with most living in poor sociodemographic environments. The prevalence rate of uncontrolled hypertension was 57%. Obesity (62% vs. 42%, p ≤ 0.0001), salt consumption (90% vs. 55%, p ≤ 0.0001), alcohol intake (42% vs. 19%, p ≤ 0.0001), a smoking habit (23% vs. 4%, p ≤ 0.0001), alternative medicine use (51% vs. 40%, p = 0.043), and comorbidities (64% vs. 36%, p ≤ 0.0001) were higher in the uncontrolled group than the controlled group, whereas the prevalence of physical activity (38% vs. 15%, p ≤ 0.0001) was high in the controlled group vs. the uncontrolled. Overall, 85% of the patients moderately adhered to treatment, only 2% exhibited high adherence, and 13% demonstrated low adherence; over half of the patients received tri-therapy treatment. The predictors of uncontrolled hypertension are a number of prescribed antihypertensive therapies [adjusted odds ration = 2.39; 95% confidence interval: 1.48-3.87], treatment adherence [0.46; 0.21-0.97], salt consumption [28.35; 7.87-102.04], physical activity [0.22; 0.13-0.37], current alcohol use [2.10; 1.22-3.61], and current cigarette smoking [4.79; 1.88-12.18]. The high prevalence of uncontrolled hypertension in this study suggests a need to optimize prescriptions, adherence to BP-lowering medications, and lifestyle modifications. The management of comorbidities such as diabetes could offer considerable benefits in controlling blood pressure.
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Affiliation(s)
- Amaziah Makukule
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, 1 Molotlegi Street, Ga-Rankuwa 0208, South Africa
| | - Perpetua Modjadji
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, 1 Molotlegi Street, Ga-Rankuwa 0208, South Africa
- Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Florida Campus, Roodepoort 1709, South Africa
| | - Ntevhe Thovhogi
- Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
| | - Kabelo Mokgalaboni
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Florida Campus, Roodepoort 1709, South Africa
| | - Andre Pascal Kengne
- Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
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Mahmoudinezhad G, Nishida T, Weinreb RN, Baxter SL, Chang AC, Nikkhoy N, Walker E, Liebmann JM, Girkin CA, Moghimi S. Associations of smoking and alcohol consumption with the development of open angle glaucoma: a retrospective cohort study. BMJ Open 2023; 13:e072163. [PMID: 37793935 PMCID: PMC10551939 DOI: 10.1136/bmjopen-2023-072163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 06/22/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVES To investigate the associations of alcohol consumption and smoking with the development of perimetric glaucoma in patients with suspected glaucoma. DESIGN A retrospective cohort study of patients suspected to have glaucoma enrolled in the Diagnostic Innovations in Glaucoma Study (DIGS) and the African Descent and Glaucoma Evaluation Study (ADAGES). SETTING Three tertiary glaucoma centres in the USA. PARTICIPANTS 825 eyes of 610 patients with glaucoma suspect eyes with normal visual fields (VF) at baseline were followed over an average of 9 years from the DIGS and ADAGES studies. OUTCOME MEASURES Development of glaucoma was defined as occurrence of three consecutive abnormal VF tests during follow-up. Univariable and multivariable Cox regression models were used to investigate lifestyle-related factors associated with development of VF loss over time. RESULTS VF tests were abnormal three times in a row in 235 (28.5%) eyes. Alcohol consumption was associated with a higher risk of developing glaucoma (HR 1.57, 95% CI 1.03 to 2.38, p=0.037). In men, the risk of developing glaucoma in alcohol drinkers (HR 1.92, 95% CI 1.00 to 3.68, p=0.048) was greater than non-alcohol drinkers. In individuals of African descent, the risk of developing glaucoma in alcohol drinkers (HR 1.79, 95% CI 1.02 to 3.15, p=0.043) was greater than non-alcohol drinkers. Age was a modifier of the relationship between smoking and glaucomatous VF defects (p=0.048). The risk of developing glaucoma in smokers (HR 1.73, 95% CI 1.10 to 2.72, p=0.019) was greater than never smokers after adjustment for confounding factors in older patients (age >61 years). CONCLUSION Alcohol consumption was associated with an increased risk of developing glaucoma, particularly in men and individuals of African descent. The risk of developing glaucoma among smokers suspected of having glaucoma was influenced by age, with older individuals having a higher risk than younger people. TRIAL REGISTRATION NUMBER NCT00221897 and NCT00221923.
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Affiliation(s)
- Golnoush Mahmoudinezhad
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Takashi Nishida
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Robert N Weinreb
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Sally L Baxter
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
- Department of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA
| | - Aimee C Chang
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Nicki Nikkhoy
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Evan Walker
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Jeffrey M Liebmann
- Department of Ophthalmology, Columbia University Medical Center, New York, New York, USA
| | - Christopher A Girkin
- Department of Ophthalmology, Bernard School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sasan Moghimi
- Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
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King SE, Waddell JT, Corbin WR. A preliminary investigation of salivary α-amylase as a novel biomarker of subjective response to alcohol: A brief report. Exp Clin Psychopharmacol 2023; 31:888-894. [PMID: 36757961 PMCID: PMC10409871 DOI: 10.1037/pha0000640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Alcohol misuse represents a universal public health concern that spans multiple demographics. As such, understanding shared, biological indicators of alcohol-related risk is vital to implementing targeted prevention and intervention efforts. Self-report measures of subjective response to alcohol (SR) capture both psychological and pharmacological effects of alcohol and robustly predict patterns of alcohol use, negative consequences, and the development of alcohol use disorders. Importantly, several biological markers of alcohol's sedating effects, including cortisol, have been identified and complement subjective response assessments. However, biological markers of alcohol's stimulating effects are less understood. Studies have implicated alcohol-induced changes in heart rate as a viable marker, but heart rate measurements are susceptible to measurement error. Salivary α-amylase, a reliable indicator of sympathetic nervous system activation, represents a promising alternative biomarker of alcohol-induced stimulation. Using data from a large, placebo-controlled alcohol administration study (N = 448), the present study examined the extent to which α-amylase is a viable marker of alcohol-induced stimulation. To test this, a measurement model was estimated in which baseline and ascending limb subjective stimulation latent variables were created using two validated measures of subjective response. Ascending self-reports of stimulation and levels of α-amylase were then regressed onto beverage conditions and allowed to correlate with each other. Findings indicated that α-amylase is sensitive to acute alcohol consumption and is positively, but not statistically reliably, related to the ascending limb stimulant SR. Future studies should consider including salivary α-amylase as a noninvasive physiological indicator of alcohol's stimulating effects. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Scott E King
- Department of Psychology, Arizona State University
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31
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Tse YH, Tuet CY, Lau KK, Tse HF. Dietary modification for prevention and control of high blood pressure. Postgrad Med J 2023; 99:1058-1067. [PMID: 37286197 DOI: 10.1093/postmj/qgad021] [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: 12/09/2022] [Revised: 01/16/2023] [Accepted: 01/31/2023] [Indexed: 06/09/2023]
Abstract
Hypertension (HT) remains the leading cause of cardiovascular and premature death around the world. Diet is one of the important factors that contributes to the development of HT. We review the current evidence of how different dietary factors may influence blood pressure (BP) and consequent development of HT. There is evidence that BP is positively associated with higher consumption of sodium, alcohol, animal-based protein such as red meat, low-quality carbohydrates such as sugar-sweetened beverages, and saturated fatty acids. On the contrary, other dietary constituents have BP-lowering effects. These include potassium, calcium, magnesium, yogurt, eggs, plant-based proteins such as soy and legumes, mono- and polyunsaturated fatty acids, and high-quality carbohydrates such as whole grain and fruits. Dietary fibre is unrelated to BP lowering, possibly due to the different mechanisms of various types of fibre. The effects of caffeine, hibiscus tea, pomegranate, and sesame on BP are also unclear as evidence is hard to assess due to the varying concentrations and different types of drinks used in studies. Implementing dietary changes such as the Dietary Approaches to Stop Hypertension (DASH diet) or adopting a Mediterranean diet has been shown to reduce and control BP. Although the effect of diet on BP control has been established, the optimal amount of each dietary component and consequent ability to devise a personalized diet for HT prevention and BP control for different populations still require further investigation.
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Affiliation(s)
- Yiu-Hei Tse
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Choi-Yee Tuet
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kui-Kai Lau
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
| | - Hung-Fat Tse
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Center for Translational Stem Cell Biology, Hong Kong, China
- Cardiac and Vascular Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, China
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Meredith LR, Burnette EM, Nieto SJ, Du H, Donato S, Grodin EN, Green R, Magill M, Baskerville WA, Ray LA. Testing pharmacotherapies for alcohol use disorder with cue exposure paradigms: A systematic review and quantitative synthesis of human laboratory trial methodology. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1629-1645. [PMID: 37423771 DOI: 10.1111/acer.15143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/30/2023] [Accepted: 06/24/2023] [Indexed: 07/11/2023]
Abstract
Alcohol cue exposure is a widely used experimental paradigm for screening pharmacotherapies for alcohol use disorder (AUD). Medication-related reductions in cue-reactivity signal early efficacy and inform medications development. Yet, across trials, the design of cue exposure, parameter testing, and outcome reporting is heterogeneous. This systematic review is a quantitative synthesis of trial methodologies and effect size estimation for AUD medication-related craving and psychophysiological outcomes under the cue exposure paradigm. A PubMed search was conducted on January 3, 2022 based on identified pharmacotherapies for peer-reviewed articles reported in English. Study-level characteristics, including sample descriptors, paradigm design, analytic approach, and Cochrane Risk of Bias, along with descriptive statistics for cue-exposure outcomes, were coded by two independent raters. Study-level effect sizes were estimated for craving and psychophysiological outcomes separately and sample-level effect sizes were calculated for each medication. Thirty-six trials, comprising 1640 participants and testing 19 different medications satisfied eligibility criteria. All studies reported on biological sex (71% male participants on average). The exposure paradigms implemented used in vivo (n = 26), visual (n = 8), and audio script (n = 2) cues. Some trials included means for craving by medication condition in text (k = 7) or figures (k = 18). The quantitative synthesis included 63 effect sizes (craving kes = 47; psychophysiological kes = 16) from 28 unique randomized trials testing 15 medications for effects on cue reactivity. For cue-induced craving, eight medications (kes range: 1-12) demonstrated small-to-medium effects (Cohen's d range: |0.24-0.64|) compared to placebo, with individuals randomized to receive medication reporting lower craving following cue exposure. Recommendations are provided to promote further consilience, so that the utility of cue exposure paradigms can be maximized in the development of effective AUD pharmacotherapies. Future work should explore the predictive utility of medication-related reductions in cue-reactivity on clinical outcomes.
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Affiliation(s)
- Lindsay R Meredith
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - Elizabeth M Burnette
- Brain Research Institute, University of California, Los Angeles, Los Angeles, California, USA
| | - Steven J Nieto
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - Han Du
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - Suzanna Donato
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - Erica N Grodin
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | - ReJoyce Green
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Molly Magill
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Wave-Ananda Baskerville
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
- Brain Research Institute, University of California, Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
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Martín-González C, Fernández-Alonso P, Pérez-Hernández O, Abreu-González P, Espelosín-Ortega E, Fernández-Rodríguez CM, Martín-Ponce E, González-Reimers E. Sarcopenic Obesity in People with Alcoholic Use Disorder: Relation with Inflammation, Vascular Risk Factors and Serum Vitamin D Levels. Int J Mol Sci 2023; 24:9976. [PMID: 37373124 DOI: 10.3390/ijms24129976] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
In recent years, the terms sarcopenia, sarcopenic obesity, and osteosarcopenic obesity (OSO) were coined to define a situation in elderly people strongly associated with frailty and increased mortality. Possibly, a complex interplay of several hormones and cytokines are involved in its development. Ongoing research detected that OSO may occur at any age and in several conditions. The prevalence of OSO in alcoholism was poorly analyzed. The aim of this study was to analyze the prevalence of OSO in alcoholism and its relationship with proinflammatory cytokines and/or common complications of alcoholism, such as cirrhosis, cancer, or vascular disease. We included 115 patients with alcoholic use disorder. Body composition analysis was performed by double X-ray absorptiometry. Handgrip strength was recorded using a dynamometer. We assessed liver function according to Child's classification, and determined serum levels of proinflammatory cytokines (TNF-α, IL-6, IL-8), routine laboratory variables, and vitamin D. People with alcoholic use disorder showed a high prevalence of OSO, especially regarding OSO obesity (60%), OSO osteopenia (55.65%), and OSO lean mass (60.17%). OSO handgrip was closely, independently, related to the presence of vascular calcification (χ2 = 17.00; p < 0.001). OSO handgrip was related to several proinflammatory cytokines and vitamin D. Vitamin D deficiency kept a close correlation with OSO handgrip (rho = -0.54, p < 0.001). Therefore, among people with alcohol use disorder, OSO prevalence was high. OSO handgrip is related to serum proinflammatory cytokine levels supporting the possible pathogenetic role of these cytokines on OSO development. Vitamin D deficiency is related to OSO handgrip suggesting its pathogenetic involvement in sarcopenia in patients with alcohol use disorder. The close association between OSO handgrip and vascular calcification is clinically relevant and suggests that OSO handgrip may constitute a prognostic tool in these patients.
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Affiliation(s)
- Candelaria Martín-González
- Departamento de Medicina Interna, Universidad de La Laguna, Servicio de Medicina Interna, Hospital Universitario de Canarias, Tenerife, Canary Islands, 38320 La Laguna, Spain
| | - Paula Fernández-Alonso
- Departamento de Medicina Interna, Universidad de La Laguna, Servicio de Medicina Interna, Hospital Universitario de Canarias, Tenerife, Canary Islands, 38320 La Laguna, Spain
| | - Onán Pérez-Hernández
- Departamento de Medicina Interna, Universidad de La Laguna, Servicio de Medicina Interna, Hospital Universitario de Canarias, Tenerife, Canary Islands, 38320 La Laguna, Spain
| | - Pedro Abreu-González
- Departamento de Ciencias Médicas Básicas, Unidad de Fisiología, Universidad de la Laguna, Tenerife, Canary Islands, 38320 La Laguna, Spain
| | - Elisa Espelosín-Ortega
- Servicio de Laboratorio, Hospital Universitario de Canarias, Tenerife, Canary Islands, 38320 La Laguna, Spain
| | - Camino María Fernández-Rodríguez
- Departamento de Medicina Interna, Universidad de La Laguna, Servicio de Medicina Interna, Hospital Universitario de Canarias, Tenerife, Canary Islands, 38320 La Laguna, Spain
| | - Esther Martín-Ponce
- Departamento de Medicina Interna, Universidad de La Laguna, Servicio de Medicina Interna, Hospital Universitario de Canarias, Tenerife, Canary Islands, 38320 La Laguna, Spain
| | - Emilio González-Reimers
- Departamento de Medicina Interna, Universidad de La Laguna, Servicio de Medicina Interna, Hospital Universitario de Canarias, Tenerife, Canary Islands, 38320 La Laguna, Spain
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Wamala D, Mutebi E, Kayima J. Prevalence and factors associated with suboptimal blood pressure among ambulatory patients with diabetic kidney disease attending a tertiary hospital in Uganda. Afr Health Sci 2023; 23:490-498. [PMID: 38223567 PMCID: PMC10782328 DOI: 10.4314/ahs.v23i2.57] [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] [Indexed: 01/16/2024] Open
Abstract
Background Kidney failure prevalence is increasing among diabetic kidney disease (DKD) patients in low-income countries. Suboptimal blood pressure (BP) drives kidney failure and mortality. The burden of suboptimal BP and its associated factors among these patients are not well documented. Objectives To determine the prevalence of suboptimal BP and associated factors among those with DKD attending Kiruddu National Referral Hospital. Methods In this cross-sectional study, recruited participants were screened for DKD using urine dipsticks from 6th May 2020 to 15th July 2020. A pretested questionnaire was administered, BP, height and weight were measured. Suboptimal BP was defined as systolic BP > 130mmHg and or diastolic BP > 80mmHg. A Poisson regression model analysed the associated factors. Results 250 participants with DKD, mean age of 52(11) years were included of whom 199 (79.6%) were female. Suboptimal BP prevalence was 84.4%, associated with past (p = 0.04) and current (p < 0.001) alcohol use, overweight (p < 0.001) and obesity (p < 0.001), wage earning (p < 0.001) and professionals (p = 0.048). Conclusion The prevalence of suboptimal BP was high among the overweight, obese, unemployed and alcohol users. Thus, there is a need for better BP control interventions.
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Affiliation(s)
- David Wamala
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - Edrisa Mutebi
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
| | - James Kayima
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda
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Anto EO, Boadu WIO, Korsah EE, Ansah E, Adua E, Frimpong J, Nyarkoa P, Tamakloe VCKT, Acheampong E, Asamoah EA, Opoku S, Afrifa-Yamoah E, Annani-Akollor ME, Obirikorang C. Unrecognized hypertension among a general adult Ghanaian population: An urban community-based cross-sectional study of prevalence and putative risk factors of lifestyle and obesity indices. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001973. [PMID: 37224164 DOI: 10.1371/journal.pgph.0001973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/05/2023] [Indexed: 05/26/2023]
Abstract
Hypertension (HTN) is the leading cause of cardiovascular diseases. Nevertheless, most individuals in developing countries are unaware of their blood pressure status. We determined the prevalence of unrecognized hypertension and its association with lifestyle factors and new obesity indices among the adult population. This community-based study was conducted among 1288 apparently healthy adults aged 18-80 years in the Ablekuma North Municipality, Ghana. Sociodemographic, lifestyle characteristics, blood pressure and anthropometric indices were obtained. The prevalence of unrecognized HTN was 18.4% (237 / 1288). The age groups 45-54 years [aOR = 2.29, 95% CI (1.33-3.95), p = 0.003] and 55-79 years [aOR = 3.25, 95% CI (1.61-6.54), p = 0.001], being divorced [aOR = 3.02 95% CI (1.33-6.90), p = 0.008], weekly [aOR = 4.10, 95% CI (1.77-9.51), p = 0.001] and daily alcohol intake [aOR = 5.62, 95% CI (1.26-12.236), p = 0.028] and no exercise or at most once a week [aOR = 2.25, 95% CI (1.56-3.66), p = 0.001] were independently associated with HTN. Among males, the fourth quartile (Q4) of both body roundness index (BRI) and waist to height ratio (WHtR) [aOR = 5.19, 95% CI (1.05-25.50), p = 0.043] were independent determinants of unrecognized HTN. Among females, the third quartile (Q3) [aOR = 7.96, 95% CI (1.51-42.52), p = 0.015] and Q4 [aOR = 9.87 95% CI (1.92-53.31), p = 0.007] of abdominal volume index (AVI), the Q3 of both BRI and WHtR [aOR = 6.07, 95% CI (1.05-34.94), p = 0.044] and Q4 of both BRI and WHtR [aOR = 9.76, 95% CI (1.74-54.96), p = 0.010] were independent risk factors of HTN. Overall, BRI (AUC = 0.724) and WHtR (AUC = 0.724) for males and AVI (AUC = 0.728), WHtR (AUC = 0.703) and BRI (AUC = 0.703) for females yielded a better discriminatory power for predicting unrecognized HTN. Unrecognized hypertension is common among the apparently healthy adults. Increased awareness of its risk factors, screening, and promoting lifestyle modification is needed to prevent the onset of hypertension.
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Affiliation(s)
- Enoch Odame Anto
- Faculty of Allied Health Sciences, Department of Medical Diagnostics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Medical and Health Sciences, Edith Cowan University, Joondalup Drive, Perth, Australia
- Centre for Precision Health, ECU Strategic Research Centre, Edith Cowan University, Perth, Australia
| | - Wina Ivy Ofori Boadu
- Faculty of Allied Health Sciences, Department of Medical Diagnostics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Ekow Korsah
- Faculty of Allied Health Sciences, Department of Medical Diagnostics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ezekiel Ansah
- Faculty of Allied Health Sciences, Department of Medical Diagnostics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eric Adua
- Rural Clinical School, Medicine and Health, University of New South Wales, Sydney, NSW Australia
| | - Joseph Frimpong
- Faculty of Allied Health Sciences, Department of Medical Diagnostics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Patience Nyarkoa
- Department of Physiology, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Emmanuel Acheampong
- Centre for Precision Health, ECU Strategic Research Centre, Edith Cowan University, Perth, Australia
| | - Evans Adu Asamoah
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Stephen Opoku
- Faculty of Allied Health Sciences, Department of Medical Diagnostics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Max Efui Annani-Akollor
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Christian Obirikorang
- Department of Molecular Medicine, School of Medicine and Dentistry, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Vallée A. Associations between smoking and alcohol consumption with blood pressure in a middle-aged population. Tob Induc Dis 2023; 21:61. [PMID: 37215190 PMCID: PMC10193384 DOI: 10.18332/tid/162440] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 03/20/2023] [Accepted: 03/23/2023] [Indexed: 05/24/2023] Open
Abstract
INTRODUCTION Inconsistent association between tobacco smoking, alcohol consumption and hypertension have been highlighted. The purpose of our study was to investigate the associations between smoking use and alcohol with systolic and diastolic blood pressure (SBP, DBP) and hypertension in a middle-aged population. METHODS Smoking status was based on smoking pack-years and cigarettes per day, and alcohol consumption was measured in units/day. Gender associations between smoking and alcohol consumption with BP and hypertension were estimated using multiple linear regressions. Synergistic effects between smoking and alcohol were investigating in both genders. RESULTS A total of 290913 individuals of the UK Biobank population were included (133950 men and 156963 women). Current smoking was significantly associated with lower SBP, DBP and lower hypertension prevalence, in both genders (p<0.001). However, cigarettes per day were associated with higher SBP in men current smokers [B=0.05 (0.02), p<0.001] with higher hypertension (p=0.001) but not with DBP (p=0.205). Similar results were observed in women current smokers [SBP: B=0.10 (0.02), p<0.001; DBP, p=0.217 and hypertension, p=0.019]. The number of smoking pack-years was only associated with higher levels in SBP in men (p=0.047) and in women (p<0.001). In both genders, alcohol consumption was associated with higher SBP, DBP and hypertension (p<0.001). Synergistic effects were observed for alcohol consumption on smoking pack-years and cigarettes per day with SBP and DBP. CONCLUSIONS Smoking and alcohol were associated with higher BP in current smokers with synergistic effects. The findings suggest the importance of considering smoking and alcohol consumption in BP control in addition to antihypertensive medication and public health practice.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation (DRCI), Foch Hospital, France
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Sakboonyarat B, Poovieng J, Srisawat P, Hatthachote P, Mungthin M, Rangsin R, Jongcherdchootrakul K. Prevalence, awareness, and control of hypertension and associated factors among Royal Thai Army personnel in Thailand from 2017 to 2021. Sci Rep 2023; 13:6946. [PMID: 37117457 PMCID: PMC10141845 DOI: 10.1038/s41598-023-34023-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/22/2023] [Indexed: 04/30/2023] Open
Abstract
Hypertension (HTN) is a potential risk factor for cardiovascular diseases. We aimed to determine the prevalence, awareness, and control of HTN among RTA personnel in Thailand. We conducted a series of cross-sectional studies from 2017 to 2021. HTN was defined by systolic blood pressure (BP) ≥ 140 mmHg or a diastolic BP ≥ 90 mmHg from a physical health examination, a history of HTN diagnosed by medical personnel, or taking antihypertensive medication. A total of 504,484 participants were included in the present study. The overall HTN prevalence was 29.4%. The prevalence of HTN among males was 30.5%, while it was 17.1% among females. Of the RTA personnel with HTN, 35.9% were aware of their condition. The overall control of HTN among RTA personnel with HTN was 15.8% in 2017 and 17.6% in 2021. Behavioral factors associated with HTN were current smoking, alcohol consumption, and sedentary behavior. A higher BMI was associated with higher HTN prevalence and HTN awareness but less likely to have controllable HTN. Male participants, younger individuals, current alcohol use, and sedentary behavior were associated with a lower prevalence of HTN awareness and controlled HTN. Current tobacco use was also associated with a lower prevalence of HTN awareness.
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Affiliation(s)
- Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Jaturon Poovieng
- Department of Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Phutsapong Srisawat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Panadda Hatthachote
- Department of Physiology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Mathirut Mungthin
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Kanlaya Jongcherdchootrakul
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand.
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Olatoye FJ, Akindele AJ, Balogun OE, Awodele O, Adejare AA. Antihypertensive Effect of Kolaviron, a Bioflavonoid From Garcinia kola, in L-NAME Induced Hypertension in Rats. Nat Prod Commun 2023. [DOI: 10.1177/1934578x221148608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
The antihypertensive effect of Kolaviron (KV) has been demonstrated in ethanol- and sucrose-model of hypertension in our previous studies. However, there remains a need to further confirm and validate this effect in other models of hypertension. This study was devised to appraise the antihypertensive action of KV in N(G)-nitro-L-arginine methyl ester (L-NAME) induced experimental format of hypertension. Thirty-six (36) male Wistar rats were divided into 6 groups of 6 animals each. Group I represents the control group while Group II animals received L-NAME 40 mg/kg only. Groups III to V animals received L-NAME 40 mg/kg and 50, 100, and 200 mg/kg KV, respectively. Group VI animals received L-NAME 40 mg/kg and 0.14 mg/kg Lisinopril (LIS). Treatment was done orally for 28 days after which blood pressure was determined via the invasive method. After this, vital organs and blood were retrieved for analysis. KV and LIS elicited significant contraction ( P < .01-.001) in blood pressure producing up to 27%, 24%, and 22% reduction in systolic blood pressure, diastolic blood pressure, and mean arterial pressure, respectively. In addition, KV elicited a notable rise ( P < .05-.001) in catalase, reduced glutathione, and superoxide dismutase in the blood and vital organs. Results from this study further demonstrate and confirm that KV possesses notable blood pressure-lowering effect possibly through its well-documented antioxidant effect. Additional studies are advocated to validate the results from this study and determine the precise mechanism for the antihypertensive action of KV.
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Affiliation(s)
- Francis J. Olatoye
- Department of Pharmacology, Therapeutics and Toxicology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Abidemi James Akindele
- Department of Pharmacology, Therapeutics and Toxicology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Okikioluwa E. Balogun
- Department of Pharmacology, Therapeutics and Toxicology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Olufunsho Awodele
- Department of Pharmacology, Therapeutics and Toxicology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Abdullahi A. Adejare
- Department of Physiology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
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Kapoor G. Association of Physical, Psychological and Psychosocial Attributes With Arterial Stiffness in Cardiovascular Disorders: A Systematic Literature Review. J Lifestyle Med 2023; 13:27-43. [PMID: 37250275 PMCID: PMC10210964 DOI: 10.15280/jlm.2023.13.1.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/05/2023] [Accepted: 02/17/2023] [Indexed: 05/31/2023] Open
Abstract
The prevalence of cardiovascular diseases is increasing exponentially in the industrialized world. According to the World Health Organization, 17.8 million people died in 2019 as a result of cardiovascular diseases (CVD), accounting for 31.0% of all fatalities worldwide. Even though CVD is more common in low and middle-income countries, it is responsible for three-quarters of all cardiovascular-related deaths worldwide. The most common attributes for the occurrence of CVD are the physical, psychological, and psychosocial factors. Arterial stiffness, which is a precursor of CVD, is most commonly affected by said factors and serves as a predictor for CVD diagnosis, treatment, and prevention. The purpose of this article is to learn more about the relationship between arterial stiffness and the physical, psychological, and psychosocial characteristics of cardiovascular diseases. In addition to proposed ways to lower the co-morbidities following CVD. PubMed, Medline, and Web of Science were used for the present review. Only articles published between 1988 and 2022 that discussed physical, psychological, and psychosocial characteristics were considered. A narrative discussion is used to extract and review the information from the selected articles. Several factors related to arterial stiffness and cardiovascular illness have been reviewed, and data has been compiled. This review proposed recommendations and a list of linked factors for prevention and to lower morbidity of cardiovascular illness.
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Affiliation(s)
- Gaurav Kapoor
- Department of Physiotherapy, Jayoti Vidyapeeth Women’s University, Rajasthan, India
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Alcohol Intake and Arterial Hypertension: Retelling of a Multifaceted Story. Nutrients 2023; 15:nu15040958. [PMID: 36839317 PMCID: PMC9963590 DOI: 10.3390/nu15040958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 02/17/2023] Open
Abstract
Alcoholic beverages are common components of diets worldwide and understanding their effects on humans' health is crucial. Because hypertension is the leading risk factor for cardiovascular diseases and all-cause mortality, the relationship of alcohol consumption with blood pressure (BP) has been the subject of extensive investigation. For the purpose of this review, we searched the terms "alcohol", "ethanol", and "arterial hypertension" on Pubmed MeSH and selected the most relevant studies. Short-term studies showed a biphasic BP response after ingestion of high doses of alcohol, and sustained alcohol consumption above 30 g/day, significantly, and dose-dependently, increased the risk for hypertension. These untoward effects of alcoholic beverages on BP can be mediated by a multiplicity of neurohormonal mechanisms. In addition to the effects on BP, excess alcohol intake might contribute to cardiac and renal hypertensive organ damage, although some studies suggest possible benefits of moderate alcohol consumption on additional cardiovascular risk factors, such as diabetes and lipoprotein(a). Some intervention studies and cumulative analyses support the evidence of a benefit of the reduction/withdrawal of alcohol consumption on BP and cardiovascular outcomes. This is why guidelines of scientific societies recommend avoidance or limitation of alcohol intake below one unit/day for women and two units/day for men. This narrative article overviews all these topics, providing an update of the current knowledge on the relationship between alcohol and BP.
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Attenuation by habitual alcohol drinking of the associations of obesity with blood pressure and pulse pressure. Blood Press Monit 2023; 28:17-23. [PMID: 36330757 DOI: 10.1097/mbp.0000000000000623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Obesity and alcohol drinking are known to be risk factors for hypertension. However, it remains to be determined whether alcohol affects the relationships of obesity with blood pressure and pulse pressure. METHODS The participants in this study were 29 171 men who had received annual health checkups. Relationships of BMI with blood pressure and pulse pressure were investigated in four subject groups divided by average daily alcohol consumption (grams of ethanol/day), non-, light (<22), moderate (≥22 and <44) and heavy (≥44) drinkers. RESULTS BMI was significantly correlated with SBP and DBP levels both in nondrinkers and drinkers. The strength of the correlations was significantly weaker in drinkers than in nondrinkers. Odds ratios for hypertension in subjects with vs. subjects without obesity tended to be lower with an increase in alcohol intake (odds ratios with 95% confidence intervals: 4.09 (3.69-4.52) in nondrinkers; 3.11 (2.62-3.68) in light drinkers; 2.87 (2.61-3.16) in moderate drinkers; 2.81 (2.49-3.18) in heavy drinkers). Pulse pressure was weakly but significantly associated with BMI and obesity, and these associations were significantly weaker in heavy drinkers than in nondrinkers. There were significant odds ratios for hypertension and high pulse pressure of the interaction term between obesity and alcohol drinking. CONCLUSION The associations of BMI with blood pressure and pulse pressure and the associations of obesity with hypertension and high pulse pressure were weaker in drinkers than in nondrinkers. Thus, alcohol drinking attenuates the associations of obesity with hypertension and high pulse pressure.
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Canfora F, Calabria E, Pecoraro G, Leuci S, Coppola N, Mazzaccara C, Spirito F, Aria M, D'Aniello L, Mignogna MD, Adamo D. Prevalence of hypertension and correlation with mental health in women with burning mouth syndrome: A case-control study. Front Cardiovasc Med 2023; 9:969148. [PMID: 36741839 PMCID: PMC9894887 DOI: 10.3389/fcvm.2022.969148] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/27/2022] [Indexed: 01/21/2023] Open
Abstract
Background The relationship between hypertension (HTN) and chronic pain is still a matter of debate, and its prevalence in patients with burning mouth syndrome (BMS) has never been evaluated. This study aimed to assess the prevalence of HTN in women with BMS and to evaluate its relationship with potential predictors such as risk factors for cardiovascular diseases, pain, and mental health status analyzing differences with healthy women. Methods In total, 250 women with BMS (WBMS) were prospectively recruited and compared with an equal number of healthy women (HW) matched for age. Education, body mass index, smoke and alcohol consumption, intensity and quality of pain, and psychological profile were further investigated to identify the potential predictors of HTN. Specifically, pain assessment [the Numeric Rating Scale (NRS) and Short-Form McGill Pain Questionnaire (SF-MPQ)] and psychological assessment [Hamilton Rating Scale for Depression and Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS)] was carried out for the participants. Results HTN was found in 128 (51.2%) WBMS and 76 (30.4%) HW (p < 0.001**). The scores of the NRS, SF-MPQ, HAM-D, HAM-A, and PSQI were statistically significantly higher in the WBMS than in the HW (p < 0.001**). A strongly linear correlation between HTN and employment status, systemic diseases, and education level (p < 0.001**) was found in WBMS, while a strong correlation between HTN and employment status, hypercholesterolemia, systemic diseases, and drug consumption was found in HW (p < 0.001**). No statistically significant correlation was found between HTN and pain, anxiety, depression, and sleep disturbances. Conclusion These results suggest that WBMS showed a higher prevalence of HTN compared with controls. Unemployed WBMS with lower education and other systemic comorbidities are at an increased risk of developing HTN. HTN is associated with alteration in the vascular structure and function of the brain, and these processes accelerate brain aging, which contributes to a reduction in intracortical connectivity, thus affecting the modulatory system of control of pain in patients with BMS, independently of their mental health assessment. Predictors that may underlie this association remain unclear, taking into account the differences found in HW, and should be further elucidated.
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Affiliation(s)
- Federica Canfora
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Elena Calabria
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy,*Correspondence: Elena Calabria ✉
| | - Giuseppe Pecoraro
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Stefania Leuci
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Noemi Coppola
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Cristina Mazzaccara
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy,CEINGE Advanced Biotechnologies, Naples, Italy
| | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Massimo Aria
- Department of Economics and Statistics, University of Naples Federico II, Naples, Italy
| | - Luca D'Aniello
- Department of Social Sciences, University of Naples Federico II, Naples, Italy
| | - Michele Davide Mignogna
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Daniela Adamo
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
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Melese M, Adera A, Ambelu A, Gela YY, Diress M. Occupational Noise-Induced Pre-Hypertension and Determinant Factors Among Metal Manufacturing Workers in Gondar City Administration, Northwest Ethiopia. Vasc Health Risk Manag 2023; 19:21-30. [PMID: 36687313 PMCID: PMC9851053 DOI: 10.2147/vhrm.s392876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
Introduction Cardiovascular disorders are one of the commonly recognized occupational diseases in the developed world. Individuals chronically exposed to noise at workplaces had a higher risk of developing elevated arterial blood pressure. There are limited studies in Ethiopia regarding this topic and thus this study determined the prevalence and determinant factors of occupational noise-induced pre-hypertension among metal manufacturing workers in Gondar city administration, Northwest Ethiopia. Methods An institution-based cross-sectional study design was carried out. In this study, 300 study participants were recruited by census sampling method. A sound level meter was used to measure the working area noise level. A semi-structured pre-tested interviewer-administered questionnaire was used to collect sociodemographic and clinical data. Blood pressure was measured in a quiet room in the morning using a mercurial sphygmomanometer. Both bivariable and multi-variable binary logistic regressions were used to identify factors associated with noise-induced prehypertension. Adjusted odds ratio with 95% confidence interval was reported, and variables with p < 0.05 were considered as statistically associated factors with pre-hypertension. Results The prevalence of noise-induced pre-hypertension was 27.7% (95% CI: 22.7-32.7). In multivariable logistic regression, working area noise level (AOR = 3.8, 95% CI: 6.8-8.9), 45-65 years' age (AOR = 9.8, 95% CI: 5.4-12.9), years of work experience ((6-10 years (AOR = 2.8, 95% CI: 1.98-5.90 and >10 years (AOR = 4.8, 95% CI: 7.8-9.75)), being a cigarette smoker (AOR = 3.6, 95% CI: 1.36-9.77), and alcohol consumption (AOR = 2.4, 95% CI: 1.06-1.04) were significantly associated with noise-induced prehypertension. Conclusion Workers in metal manufactures who were exposed to noise levels >85 dB developed elevated blood pressure. The odds of having prehypertension were increased by years of work experience, advanced age, smoking, and alcohol consumption. Our findings recommended that the real-world preventive strategies should be taken to lower the risk of noise-induced pre-hypertension hastened by occupational noise exposure.
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Affiliation(s)
- Mihret Melese
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Ayechew Adera
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Ambelu
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Yibeltal Yismaw Gela
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Mengistie Diress
- Department of Human Physiology, School of Medicine, University of Gondar, Gondar, Ethiopia,Correspondence: Mengistie Diress, University of Gondar, P. O. Box 196, Gondar, Ethiopia, Email
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Mediterranean Alcohol-Drinking Pattern and Arterial Hypertension in the "Seguimiento Universidad de Navarra" (SUN) Prospective Cohort Study. Nutrients 2023; 15:nu15020307. [PMID: 36678178 PMCID: PMC9865916 DOI: 10.3390/nu15020307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/27/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
Alcohol drinking patterns may determine the risk of hypertension and may also modify the detrimental effect of high alcohol intake. We prospectively evaluated the effect of the Mediterranean alcohol-drinking pattern and its interaction with the amount of alcohol consumed on the incidence of arterial hypertension. In the “Seguimiento Universidad de Navarra” (SUN) cohort, we followed-up 13,805 participants, all of them initially free of hypertension, during a maximum period of 16 years. Information about diet, chronic diseases, lifestyle and newly diagnosed hypertension was collected using validated questionnaires. We used a 7-item score (0 to 9 points) that jointly considered moderate alcohol consumption, distributed over the week, with meals, and a preference for red wine and avoidance of binge-drinking. During 142,404 person-years of follow-up, 1443 incident cases of hypertension were identified. Low adherence (score < 2) to the Mediterranean alcohol-drinking pattern was significantly associated with a higher incidence of hypertension (multivariable-adjusted hazard ratio 1.81, 95% confidence interval 1.09−2.99) as compared to the high-adherence (score > 7) category. Among alcohol consumers, a high adherence to the MADP is associated with a lower incidence of hypertension. Compared with abstinence, a high adherence did not seem to differ regarding its effect on hypertension risk.
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Hasegawa H, Tanaka T, Kondo M, Teramoto K, Nakayama K, Hwang GW. Blood vessel remodeling in the cerebral cortex induced by binge alcohol intake in mice. Toxicol Res 2023; 39:169-177. [PMID: 36726835 PMCID: PMC9839917 DOI: 10.1007/s43188-022-00164-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/23/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Ethanol is toxic to the brain and causes various neurological disorders. Although ethanol can directly exert toxicity on neurons, it also acts on other cell types in the central nervous system. Blood vessel endothelial cells interact with, and are affected by blood ethanol. However, the effects of ethanol on the vascular structures of the brain have not been well documented. In this study, we examined the effects of binge levels of ethanol on brain vasculature. Immunostaining analysis indicated structural alterations of blood vessels in the cerebral cortex, which became more tortuous than those in the control mice after ethanol administration. The interaction between the blood vessels and astrocytes decreased, especially in the upper layers of the cerebral cortex. Messenger RNA expression analysis revealed a unique downregulation of Vegfa mRNA encoding vascular endothelial growth factor (VEGF)-A among VEGF, angiopoietin, endothelin family angiogenic and blood vessel remodeling factors. The expression of three proteoglycan core proteins, glypican-5, neurocan, and serglycin, was also altered after ethanol administration. Thus, binge levels of ethanol affect the expression of VEGF-A and blood vessel-supporting proteoglycans, resulting in changes in the vascular structure of the cerebral cortex. Supplementary Information The online version contains supplementary material available at 10.1007/s43188-022-00164-y.
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Affiliation(s)
- Hiroshi Hasegawa
- Laboratory of Hygienic Sciences, Kobe Pharmaceutical University, 4-19-1 Motoyamakita-Machi, Higashinada-Ku, Kobe, 6588558 Japan
| | - Toshiya Tanaka
- Laboratory of Hygienic Sciences, Kobe Pharmaceutical University, 4-19-1 Motoyamakita-Machi, Higashinada-Ku, Kobe, 6588558 Japan
| | - Mari Kondo
- Laboratory of Hygienic Sciences, Kobe Pharmaceutical University, 4-19-1 Motoyamakita-Machi, Higashinada-Ku, Kobe, 6588558 Japan
| | - Koji Teramoto
- Laboratory of Hygienic Sciences, Kobe Pharmaceutical University, 4-19-1 Motoyamakita-Machi, Higashinada-Ku, Kobe, 6588558 Japan
| | - Kei Nakayama
- Laboratory of Hygienic Sciences, Kobe Pharmaceutical University, 4-19-1 Motoyamakita-Machi, Higashinada-Ku, Kobe, 6588558 Japan
| | - Gi-Wook Hwang
- Laboratory of Environmental and Health Sciences, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, 4-4-1 Komatsushima, Aoba-Ku, Sendai, Miyagi 9818558 Japan
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Tonetto S, Weikop P, Brudek T, Thomsen M. Behavioral and biochemical effects of alcohol withdrawal in female C3H/HeNRj and C57BL/6JRj mice. Front Behav Neurosci 2023; 17:1143720. [PMID: 36910126 PMCID: PMC9995974 DOI: 10.3389/fnbeh.2023.1143720] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/08/2023] [Indexed: 02/25/2023] Open
Abstract
Background Alcohol use disorder (AUD) is a major problem of our society and is often characterized and worsened by relapse. Prolonged alcohol exposure leads to numerous biochemical alterations that, upon cessation of alcohol intake, cause an array of immediate and lasting withdrawal symptoms. Acute withdrawal and neuroinflammation can be harmful in themselves, and lasting withdrawal symptoms contribute to relapse. Here, we conducted an initial feasibility study assessing several behavioral and neurochemical factors in female C3H/HeNRj (C3H) and C57BL/6JRj (B6) mice to determine which strain showed the clearest alcohol withdrawal symptoms during long-term abstinence and neurochemical alterations following re-exposure. Methods Female C3H and B6 mice (n = 12 per group/strain) were intermittently exposed to alcohol-containing or control liquid diets for 3 weeks. Acute and prolonged withdrawal symptoms were assessed over a period of 3 weeks using a battery of behavioral test, comprised of alcohol self-administration, anhedonia, hyperalgesia, anxiety-like and depressive-like disturbances. Brain inflammation was measured by multiplex cytokine assay. Monoamine levels in the hippocampus and striatum, as well as exploratory analyses of cations levels in the cerebellum, were assessed by High-Performance Liquid Chromatography (HPLC). Results Both C3H and B6 alcohol-exposed mice displayed decreased saccharin intake or preference and higher stress levels assessed by ultrasonic vocalizations (USVs) recordings. B6 but not C3H alcohol-exposed mice also exhibited a slower decline of alcohol oral self-administration (OSA), hyperalgesia, elevated brain TNF-α and elevated serotonin turnover. Conclusion Our findings highlight the suitability of the B6 strain to study the behavioral and neurochemical alterations caused by alcohol withdrawal and the potential efficacy of experimental treatments, not only in early detoxification, but also in prolonged abstinence. The feasibility of these assays is important because long-lasting withdrawal symptoms are often the main cause of relapse in alcohol-dependent patients.
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Affiliation(s)
- Simone Tonetto
- Laboratory of Neuropsychiatry, Psychiatric Center Copenhagen, University Hospital of Copenhagen, Copenhagen, Denmark.,Copenhagen Center for Translational Research, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark.,Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pia Weikop
- Center for Translational Neuromedicine, University of Copenhagen, Copenhagen, Denmark
| | - Tomasz Brudek
- Copenhagen Center for Translational Research, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark.,Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Morgane Thomsen
- Laboratory of Neuropsychiatry, Psychiatric Center Copenhagen, University Hospital of Copenhagen, Copenhagen, Denmark.,Copenhagen Center for Translational Research, Bispebjerg-Frederiksberg Hospital, University Hospital of Copenhagen, Copenhagen, Denmark.,Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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High burden of hypertension amongst adult population in rural districts of Northwest Ethiopia: A call for community based intervention. PLoS One 2022; 17:e0275830. [PMID: 36227880 PMCID: PMC9560483 DOI: 10.1371/journal.pone.0275830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 09/24/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Hypertension is a serious public health issue in Ethiopia, but there is a paucity of evidence in the country's rural areas. The aim of this study was to determine the prevalence of hypertension and its risk factors among adults in rural districts in northwest Ethiopia. METHODS A community-based cross-sectional study was conducted from June to October 2020. The 1177 study participants were chosen using a multistage sampling procedure. A face-to-face interview was conducted using an adapted version of the WHO STEPwise approach questionnaire. Blood pressure was measured three times using an aneroid sphygmomanometer, and the mean of the last two readings were used for the analysis. Data was entered using Epidata and analyzed using STATA-16. Multivariable logistic regression was used to identify risk factors associated with hypertension. RESULTS Of the total participants, 218 (18.5%) were found to be hypertensive. The prevalence of hypertension consistently increases with age. Hypertension was positively and significantly associated with female sex ((adjusted odd ratio (AOR) = 2.30, 95% CI: 1.53, 3.45)), age group 45-54 years (AOR = 4.63, 95% CI: 1.01, 21.37), 55-64 years (AOR = 14.40, 95% CI: 3.07, 67.63), ≥65 years (AOR = 19.37, 95% CI: 4.03, 93.09), having history of alcohol consumption (AOR = 3.25, 95% CI: 1.17, 9.02), used much amount of salt (AOR = 2.37, 95% CI: 1.53, 3.60) and too much amount of salt (AOR = 3.78, 95% CI: 1.85, 7.72), sleeping for a short duration (AOR = 2.05, 95%CI: 1.30, 3.24), and having family history of hypertension (AOR = 2.12, 95% CI; 1.32, 3.39). CONCLUSIONS Hypertension was significantly high among the rural population we studied and is emerging as a public health problem. Female sex, advanced age, ever used alcohol, excessive salt intake, insufficient sleep, and a family history of hypertension were factors that were positively and significantly associated with hypertension. We recommend local health authorities integrate promotion of hypertension health education, lifestyle modification intervention on salt and alcohol reduction, and hypertension detection, particularly for the female and elderly population, at the health post level to avert the problem.
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Kenore Y, Abrha S, Yosef A, Gelgelu TB. Determinants of Hypertension Among Patients with Diabetes mellitus in Public Hospitals of Kembata Tambaro Zone, South Nations Nationalities and Peoples Region, Ethiopia, 2021; A Case Control Study. J Multidiscip Healthc 2022; 15:2141-2152. [PMID: 36193190 PMCID: PMC9526505 DOI: 10.2147/jmdh.s379293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/16/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Hypertension is commonly defined as a persistently raised blood pressure in which systolic blood pressure reading (SBP) is greater than or equal to 140 mmHg and diastolic blood pressure (DBP) is greater than or equal to 90 mmHg. The comorbidity of hypertension and diabetes mellitus is complex and is associated with a high risk of complications. However, there are limited studies on determinants of hypertension among patients with diabetes in Ethiopia. Therefore this study aimed to identify the determinants of hypertension among patients with diabetes mellitus in public hospitals of the Kambata Tambaro Zone, Ethiopia. Methods and Materials A hospital-based unmatched case-control study was conducted among a total sample of 326 patients with diabetes from June 17, 2021 to August 17, 2021. This study was conducted in five public hospitals. The data were entered into EpiData version 3.1 software and exported to and analyzed using SPSS software version 25.0. Bivariable and multivariable binary logistic regression analyses were used to determine the association between the dependent and independent variables. Results Of the 336 study participants, 326 diabetic patients (163 cases and 163 controls) were interviewed resulting in a response rate of 97%. Age group ≥50 years (Adjusted Odds Ratio = 7.00, 95% CI = 1.69–28.9), inactivity in physical exercise (AOR = 5.84, 95% CI = 2.47–13.81), patients who have a history of drinking alcohol (AOR = 2.61, 95% CI = 1.35–5.03) and patients who had poor knowledge on diabetes (AOR = 3.04, 95% CI = 1.69–5.47) were more likely to develop hypertension among diabetic patients. Conclusion This study concluded that age, inactivity in physical exercise, history of alcohol intake and poor knowledge were determinants of hypertension among diabetic patients.
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Affiliation(s)
- Yeshialem Kenore
- Hawassa University Comprehensive Specialaized Hospital, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Solomon Abrha
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amanuel Yosef
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
- Correspondence: Amanuel Yosef, Tel +251 918451138, Email
| | - Temesgen Bati Gelgelu
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Sharma S, Singh H, Mehta K, Verma M, Goel S. Hypertension and its association with body mass index among the Indian population. Findings from a nationwide survey (NFHS-4), 2015-16. J Family Med Prim Care 2022; 11:5826-5833. [PMID: 36505572 PMCID: PMC9731076 DOI: 10.4103/jfmpc.jfmpc_168_22] [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: 01/21/2022] [Revised: 02/25/2022] [Accepted: 03/08/2022] [Indexed: 11/05/2022] Open
Abstract
Background Globally, hypertension (HTN) and obesity are two cardinal causes of morbidity and mortality. The Asian population shows comorbidities associated with obesity at a much lower body mass index (BMI) than the western population. Aim The primary objective of the present study was to evaluate the association between BMI and HTN among the adult population. Material and Methods We did a cross-sectional secondary data analysis of the NFHS-4 datasets, conducted during 2015-16. We included the adult population, that is, ≥19 years of age (93,040 men and 5,46,066 women), and excluded adolescents and pregnant women from our analysis. HTN was the primary dependent variable, while BMI was the primary predictor variable. Other covariates included age, education, place of residence, wealth index, use of alcohol and tobacco, and diabetes. Weighted analysis was done to depict our results. Results Around 18.7% of men and 13.5% of women were hypertensive, of which 53.86% of males and 38.7% females were either overweight or obese. The odds of living with HTN among obese men and women increased with age, wealth, use of alcohol and tobacco, and comorbidities such as diabetes. The prevalence of HTN was higher even among the underweight adults living with diabetes and those consuming alcohol and tobacco. Conclusion We reaffirm the significant association between BMI and HTN among adults. The use of the Asian classification of BMI for India and its neighboring countries to assess the burden of obesity would help in planning better interventions. A community-based targeted approach would help in controlling and reducing the prevalence of HTN.
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Affiliation(s)
- Shailja Sharma
- Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh, India
| | - Harshvardhan Singh
- Department of Community Medicine, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh, India
| | - Kedar Mehta
- Department of Community Medicine, GMERS Medical College, Gotri, Vadodara, Gujarat, India
| | - Madhur Verma
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Sonu Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Address for correspondence: Dr. Sonu Goel, Professor of Health Management, Department of Community Medicine and School of Public Health Post Graduate Institute of Medical Education and Research, Chandigarh - 160 012, India. Adjunct Clinical Associate Professor, Public Health Masters Program School of Medicine and Health Research Institute (HRI), University of Limerick, Ireland. E-mail:
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Saleem SM, Singh G, Zaidi I, Haq I, Singh I, Anjum S, Singh MP, Goel S. Geospatial epidemiology of hypertension and its risk factors in India: Findings from National Family Health Survey (2015-2016). J Family Med Prim Care 2022; 11:5730-5737. [PMID: 36505629 PMCID: PMC9730991 DOI: 10.4103/jfmpc.jfmpc_174_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/22/2022] [Accepted: 03/08/2022] [Indexed: 12/15/2022] Open
Abstract
Background The fourth round of National Family Health Survey (2015-2016) measured blood pressure for the first time and provided a unique opportunity of exploring trends in hypertension prevalence across states and districts for the first time. Aim This study will be the first in India to estimate the geospatial variation of hypertension among those in the 15-49 years age group in India. Materials and Methods Out of a total of 616,346 selected occupied households, 601,509 were successfully interviewed, giving a response rate of 98%. We adjusted the proportion of hypertension obtained by using national sample weights. We built a multivariable logistic regression model to assess the determinants of hypertension. Results The overall weighted prevalence of hypertension was 11.7%, and the prevalence was 11.1% in females and 11.0% in males. Urban areas had a higher prevalence (13.0%) compared to rural areas (11.0%). Those with no education (14.4%) and those who reported smoking (16.5%) had hypertension. Consumption of alcohol, fruits, and eggs was also found to be significantly related to hypertension. Conclusion Hypertension epidemic is spreading alarmingly in India across rural and urban populations. Disturbingly, the hypertension prevalence is now becoming more concentrated among the poor. This phenomenon has serious implications for the country's social and economic well-being. Urgent preventive measures need to be taken at a multidisciplinary level.
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Affiliation(s)
| | - Gurpreet Singh
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Ilham Zaidi
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Inaamul Haq
- Department of Community Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Ijyaa Singh
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Sahifa Anjum
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Mahendra P. Singh
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical and Education Research, Chandigarh, India
| | - Sonu Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical and Education Research, Chandigarh, India,Address for correspondence: Dr. Sonu Goel, Professor of Health Management, Department of Community Medicine and School of Public Health Post Graduate Institute of Medical Education and Research, Chandigarh - 160 012, India. Adjunct Clinical Associate Professor, Public Health Masters Program School of Medicine and Health Research Institute (HRI), University of Limerick, Ireland. E-mail:
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