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Shahrestanaki E, Mohammadian Khonsari N, Seif E, Baygi F, Ejtahed HS, Sheidaei A, Djalalinia S, Magliano DJ, Qorbani M. The worldwide trend in diabetes awareness, treatment, and control from 1985 to 2022: a systematic review and meta-analysis of 233 population-representative studies. Front Public Health 2024; 12:1305304. [PMID: 38827607 PMCID: PMC11140097 DOI: 10.3389/fpubh.2024.1305304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 03/06/2024] [Indexed: 06/04/2024] Open
Abstract
Background With the rapid increase in the prevalence of DM, studies on the awareness, treatment, and control of this condition are essential. Therefore, this study aimed to review the literature and pool the awareness, treatment, and control of diabetes at the global, regional, and national levels. Methods In this systematic review and meta-analysis, several databases, including MEDLINE/PubMed, Institute of Scientific Information (ISI), Scopus, and Google Scholar, were searched using appropriate keywords up to June 2022. Observational studies investigating the awareness, treatment, and control of glucose levels among diabetic individuals were included. Awareness, treatment, and control were defined as the proportion of participants who were aware of their diabetes condition, treated pharmacologically, and achieved adequate glucose control, respectively. Two investigators independently conducted the study selection, data extraction, and quality assessment. Heterogeneity among studies was calculated using Chi-square, and a random-effect meta-analysis was used to pool the rates. Results A total of 233 studies published between 1985 and 2022 met the inclusion criteria. The included studies had a combined population of 12,537,968. The pooled awareness of DM was 60% (95%CI: 56-63) and ranged from 41% (25-57) in low-income countries to 68% (64-72) in high-income countries, with no significant trend observed over the assessed periods at the global level. The pooled treatment of DM globally was 45% (42-48) and varied from 37% (31-43) in lower-middle-income countries to 53% (47-59) in high-income countries, showing variation over the examined time period. Before 2000, the proportion of adequate DM control was 16% (12-20), which significantly improved and reached 22% (19-25) after 2010. The pooled awareness, treatment, and control of DM were higher in females, high-income countries, and urban areas compared to males, upper and lower-middle-income countries, and rural areas, respectively. The older adults population had higher awareness and treatment rates than the adult population, but their DM control did not differ significantly. Conclusion Despite the high level of awareness and treatment among the diabetic population, treatment success (control) is considerably low, particularly in low-income countries and rural areas. It is crucial to improve awareness, treatment, and control by strengthening the primary care system in all countries.
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Affiliation(s)
- Ehsan Shahrestanaki
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ehsan Seif
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Fereshteh Baygi
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Deputy of Research & Technology, Ministry of Health & Medical Education, Tehran, Iran
| | - Dianna J. Magliano
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Collazos-Huamán LDC, Guerreros-Espino C, Herrera-Añazco P, Benites-Zapata VA. Association between glycemic control and albuminuria among Peruvian adults with diabetes mellitus 2: a cross-sectional analytical study. SAO PAULO MED J 2022; 140:767-774. [PMID: 35858014 PMCID: PMC9671563 DOI: 10.1590/1516-3180.2021.0448.r2.07022022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 02/07/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Albuminuria is a risk factor for microvascular and macrovascular complications in the diabetic population. However, few studies have correlated poor glycemic control and albuminuria prevalence in Hispanic populations. OBJECTIVE To evaluate the association between glycemic control and albuminuria among Peruvian adults with type 2 diabetes mellitus (T2DM). DESIGN AND SETTING Cross-sectional analytical study among adults with T2DM in Lima, Peru. METHODS We included adults over 18 years old who were in a clinical follow-up program at a private clinic in Lima in 2018. Poor glycemic control was defined as a serum value of glycosylated hemoglobin A1C (HbA1C) ≥ 7%. Albuminuria was defined as albumin values > 30 mg/dl in the first morning urine. We generated generalized linear regression models from the Poisson family with robust variance. We calculated the crude and adjusted prevalence ratios (PRs) with their 95% confidence interval (CI). RESULTS We analyzed 907 participants of median age 58 years (interquartile range, IQR 49 to 66), and 62.8% were males. The prevalence of poor glycemic control was 39.8%, and the prevalence of albuminuria was 22.7%. The prevalences of albuminuria in groups with poor glycemic control and adequate glycemic control were 32.7% and 16.1%, respectively. In the adjusted regression analysis, we found a statistically significant association between poor glycemic control and albuminuria (annual percentage rate, aPR = 1.70; 95% CI: 1.28-2.27). CONCLUSIONS The prevalence of poor glycemic control and albuminuria was high in our study population. Moreover, Peruvian T2DM adults with poor glycemic control were more likely to have albuminuria.
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Affiliation(s)
| | - Camila Guerreros-Espino
- Undergraduate Student, Faculty of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - Percy Herrera-Añazco
- MD, MHEd. Researcher, Universidad Privada San Juan Bautista (UPSJB), Lima, Peru; and Assistant Manager, EsSalud, Instituto de Evaluación de Tecnologías en Salud e Investigación, Lima, Peru
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Khafaji MA, Al Ghalayini KW, Sait MK, Alorri RA, Garoub T, Alharbi EA, Magadmi T, Fatani F, Jan HF, Jawhari AA. Prevalence of Diabetes and Hypertension Among King Abdulaziz University Employees: Data From First Aid and Cardiopulmonary Resuscitation Training Program. Cureus 2021; 13:e20097. [PMID: 35003953 PMCID: PMC8723699 DOI: 10.7759/cureus.20097] [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] [Accepted: 12/01/2021] [Indexed: 11/06/2022] Open
Abstract
Objectives Saudi Arabia has a very high rate of chronic illnesses, especially hypertension (HTN) and diabetes. This study aimed to investigate the prevalence and control of diabetes and hypertension among employees at a university in Saudi Arabia, including the associated risk factors, and to evaluate the need for early screening among these individuals. Methods This retrospective study used data from the first aid training program. In total, there were 3964 employees who completed the program, and only 1000 employees were enrolled. The program was conducted at King Abdulaziz University (KAU), Jeddah, Saudi Arabia. Blood pressure (BP), random blood sugar, and body mass index (BMI) were measured in all employees. Descriptive data, including mean, standard deviation (SD), crosstab, chi-square, and linear regression, were analyzed. Categorical variables were described using frequencies and percentages. Results The prevalence of hypertension and diabetes was 31% and 5%. There were 365 males and 635 females. Employees with risk factors such as gender, age, and body mass index had significant effects on having high blood pressure and random blood glucose measurements. Of the employees who reported being free from chronic diseases, 2.9% had abnormal random blood glucose readings (prediabetic and diabetic ranges), while 37.4% had abnormal blood pressure readings (prehypertensive and hypertensive ranges). Conclusion The high prevalence of hypertension and diabetes reflects the crucial role of early screening in diabetes and hypertension protocols and raising awareness regarding protocol implementation in Saudi Arabia to improve quality of life (QoL) at the individual and community levels.
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Affiliation(s)
- Mawya A Khafaji
- Radiology, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
| | | | - Maram K Sait
- Internal Medicine, King Abdullah Medical City, Jeddah, SAU
| | | | - Tasneem Garoub
- Preventive Medicine, King Khalid University Hospital, Jeddah, SAU
| | - Esrra A Alharbi
- Internal Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, SAU
| | - Talah Magadmi
- Internal Medicine, King Abdulaziz University, Jeddah, SAU
| | - Falwah Fatani
- Internal Medicine, King Abdulaziz University, Jeddah, SAU
| | - Hussain F Jan
- Family Medicine, King Abdulaziz University, Jeddah, SAU
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Rosário EVN, Severo M, Francisco D, Brito M, Costa D. Examining the relation between the subjective and objective social status with health reported needs and health-seeking behaviour in Dande, Angola. BMC Public Health 2021; 21:979. [PMID: 34034701 PMCID: PMC8152355 DOI: 10.1186/s12889-021-11003-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 05/06/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Assessing subjective social status (SSS) may be easily accommodated in the context of a Health and Demographic Surveillance System (HDSS). To our knowledge, no prior studies have examined the association of SSS and health in Angola. Subjective socioeconomic measures may provide a rapid assessment of a relevant social status construct, important for studying health inequalities. In this study, we addressed social determinants of health by examining the relationship between the subjective and objective social status, reported health and healthcare-seeking behaviour. METHODS This research results from a cross-sectional study performed during 2015 in the Dande HDSS, in Angola. We tested the application of the MacArthur scale as a measure of SSS in a developing setting, in a sample of 12,246 households. First, we investigated its relation to objective socioeconomic indicators, and then we explored how subjective and objective social status associate with health reported needs and health-seeking behaviour of the surveyed population. Chi-square, ANOVA tests, and Receiver Operating Characteristics (ROC) Curves analysis were computed for testing relationships between subjective status ladder quartiles, sociodemographic and household characteristics. Logistic regression was used to examine the influence of subjective perception of status in self-reported health and health-seeking behaviour. RESULTS Our findings suggest that the SSS follows a gradient distribution obtained with more objective socioeconomic indicators. Additionally, we found that subjective perception of status influence health needs reporting and health-seeking behaviour and its significant effect remained after controlling for the objective socioeconomic markers. Individuals standing in the second quartile of the social ladder have more odds of reporting illness and those in the highest quartiles of the ladder were twice more likely (OR = 2.23, 95% CI = 1.52-3.26) to seek help from formal health services than those at the bottom of the ladder. CONCLUSIONS The MacArthur Scale is a valuable tool to measure SSS in the Dande HDSS, relevant for studying socioeconomic disparities and health inequalities. It is also an easier alternative to traditional measures such as income, usually difficult to measure in developing settings. The social perception of status should be considered as a complement with objective indicators when exploring social determinants of health.
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Affiliation(s)
- Edite Vila Nova Rosário
- CISA - Centro de Investigação em Saúde de Angola (Health Research Centre of Angola), Hospital Geral do Caxito, Rua Direita, Caxito, Angola.
- Instituto de Saúde Pública da Universidade do Porto (ISPUP), Oporto, Portugal.
| | - Milton Severo
- Instituto de Saúde Pública da Universidade do Porto (ISPUP), Oporto, Portugal
| | - Diogo Francisco
- CISA - Centro de Investigação em Saúde de Angola (Health Research Centre of Angola), Hospital Geral do Caxito, Rua Direita, Caxito, Angola
| | - Miguel Brito
- CISA - Centro de Investigação em Saúde de Angola (Health Research Centre of Angola), Hospital Geral do Caxito, Rua Direita, Caxito, Angola
- Health and Technology Research Centre (H&TRC), Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisbon, Portugal
| | - Diogo Costa
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
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Gonçalves MAA, Pedro JM, Silva C, Magalhães P, Brito M. Normal limits of the electrocardiogram in Angolans. J Electrocardiol 2020; 63:68-74. [PMID: 33142184 DOI: 10.1016/j.jelectrocard.2020.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/11/2020] [Accepted: 10/16/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Studies on the normal electrocardiogram limits in African populations are limited, especially in sub-Saharan Africa. There is no literature describing normal ECG limits in Angolans. OBJECTIVES The aim of this study is to establish the normal ECG limits for adult Angolans, without established heart disease, stratified by gender and age. METHODS A cross-sectional study was performed, involving 2179 participants from a population in northern Angola, without established heart disease, aged between 15 and 74 years. A 12‑lead ECG and a rhythm strip were recorded for all participants and analysed and processed by the University of Glasgow software and encoded by the Minnesota Code. The normal range of the electrocardiographic parameters were established as the 2nd and 98th percentiles of the measurement distribution per age group and gender. Mann-Whitney and Kruskal-Wallis tests were used for two independent groups and Bonferroni adjustments were used for multiple testing. GAMLSS models were used to obtain the continuous age-dependent percentile curves. RESULTS The normal range of the ECG differed between men and women: heart rate 49 to 100 bpm vs. 55 to 108 bpm, P wave duration 81 to 130 ms vs. 84 to 130 ms, PR interval 119 to 210 ms vs. 120 to 202 ms, QRS duration 74 to 110 ms vs. 70 to 104 ms, QT interval 324 to 441 ms vs. 314 and 438 ms, P-wave axis - 29 to 850 vs. -18 to 810, QRS-wave axis - 13 to 850 vs. -180 and 820, T-wave axis 0 to 720 vs. -8 to 730, Sokolow-Lyon index 2.13 to 6.21 mV vs. 1.60 to 4.87 mV, Cornell index 0.17 to 6.24 mV vs. 0.14 mV to 4.35 mV. CONCLUSIONS The values described for the electrocardiographic measurements above can act as a reference framework for Angolan adults without established heart disease. Our study suggests that the normal range of most ECG parameters vary according to age and sex and the ECG diagnostic criteria must therefore be specific for these demographic measures.
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Affiliation(s)
- Mauer A A Gonçalves
- Centro de Estudos Avançados em Educação e Formação Médica (CEDUMED), Luanda, Angola; Faculty of Medicine from University Agostinho Neto, Luanda, Angola; Centro de Investigação em Saúde de Angola (CISA), Caxito, Bengo, Angola
| | - João Mário Pedro
- Centro de Investigação em Saúde de Angola (CISA), Caxito, Bengo, Angola; EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Portugal
| | - Carina Silva
- Health and Technology Research Center (H&TRC), Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Portugal; CEAUL - Centro de Estatística e Aplicações, Faculdade de Ciências, Universidade de Lisboa, Portugal
| | - Pedro Magalhães
- Faculty of Medicine from University Agostinho Neto, Luanda, Angola
| | - Miguel Brito
- Centro de Investigação em Saúde de Angola (CISA), Caxito, Bengo, Angola; Health and Technology Research Center (H&TRC), Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Portugal.
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Robbiati C, Putoto G, Da Conceição N, Armando A, Segafredo G, Atzori A, Cavallin F. Diabetes and pre-diabetes among adults reaching health centers in Luanda, Angola: prevalence and associated factors. Sci Rep 2020; 10:4565. [PMID: 32165677 PMCID: PMC7067759 DOI: 10.1038/s41598-020-61419-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 02/18/2020] [Indexed: 11/25/2022] Open
Abstract
With the lack of surveys, surveillance program and/or statistical data, epidemiologic studies can provide a better understanding of diabetes in Sub-Saharan Africa. This was a cross-sectional survey to determine prevalence of diabetes and impaired fasting glucose (IFG) among adults attending six health centres in six different districts of Luanda (Angola) during August-November 2018, followed by a case-control study to assess the risk factors for IFG and diabetes in a subgroup of subjects not receiving treatment for diabetes. Factors associated with diabetes/IFG were assessed using a generalized ordered logit model and the effects were expressed as odds ratios (OR1 for IFG/diabetes vs. no IFG/diabetes; OR2 for diabetes vs. no diabetes) with 95% CI (confidence interval). Some 1,803 participants were included in the survey. Prevalence of diabetes was 12.0% (95%CI 10.5% to 13.5%) and prevalence of IFG was 9.0% (95%CI 7.7% to 10.4%). Older age (OR1 = OR2 1.03, 95%CI 1.02 to 1.04), higher weight (OR1 = OR2 1.01, 95%CI 1.01 to 1.03), having measured glycaemia before (OR2 2.07, 95%CI 1.29 to 3.31), feeling polyuria (OR1 1.93, 95%CI 1.13 to 3.28; OR2 2.18, 95%CI 1.32 to 3.59), feeling polydipsia (OR1 1.92, 95%CI 1.16 to 3.18), feeling weakness (OR1 = OR2 2.22, 95%CI 1.39 to 3.55), consumption of free-sugars food/beverages (OR1 = OR2 2.34, 95%CI 1.44 to 3.81) and time spent seated (OR1 1.80, 95%CI 1.17 to 2.76) were associated with increased likelihood of diabetes and/or IFG, while eating vegetables was associated with decreased likelihood of IFG or diabetes (OR1 = OR2 0.69, 95%CI 0.47 to 0.99). In conclusion, the high prevalence of diabetes and IFG, with common unawareness of the disease, calls for appropriate interventions in Angolan urban settings. Further research may evaluate the impact of context-specific factors to enhance intervention strategies and feed the results into local health policies. In addition, such information may be useful for selecting high-risk subjects to test.
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Affiliation(s)
| | | | - Natália Da Conceição
- National Directory of Public Health, Ministry of Health of Angola, Luanda, Angola
| | - António Armando
- National Directory of Public Health, Ministry of Health of Angola, Luanda, Angola
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Safari-Faramani R, Rajati F, Tavakol K, Hamzeh B, Pasdar Y, Moradinazar M, Najafi F. Prevalence, Awareness, Treatment, Control, and the Associated Factors of Diabetes in an Iranian Kurdish Population. J Diabetes Res 2019; 2019:5869206. [PMID: 31565657 PMCID: PMC6745166 DOI: 10.1155/2019/5869206] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/25/2019] [Accepted: 08/17/2019] [Indexed: 12/18/2022] Open
Abstract
AIMS This study is aimed at estimating the prevalence, awareness, treatment, and glycemic control of diabetes mellitus (DM) and its associated factors in an Iranian Kurdish population. METHODS Baseline data of the Ravansar Non-communicable Disease (RaNCD) cohort study, consisting of adults aged 35-65 years, were used. Diabetes was defined as a fasting plasma glucose (FPG) of 126 mg/dl or higher, being on diabetes medication, and/or diabetes confirmed by a health practitioner. RESULTS Nine thousand nine hundred ninety-nine participants were assigned to this study. The prevalence of DM, awareness, treatment, and glycemic control of DM were 8.19, 74.97, 74.75, and 32.68, respectively. Based on the adjusted models, increased age (p < 0.01); obesity or overweight (p < 0.01); being ex-smoker (p < 0.05); suffering from dyslipidemia (p < 0.01), hypertension (p < 0.01), or both of them (p < 0.01); and positive family history in the first-degree relatives (p < 0.01) were strongly associated with a high risk of DM, while engagement in regular physical activity (p < 0.05) was a protective factor. Female gender (p < 0.01), being older than 55 years, positive family history in the first-degree relatives (p < 0.01), suffering from both hypertension and dyslipidemia (p < 0.01), and obesity or overweight (p < 0.005) were negatively associated with DM awareness. Being married and widowed (p < 0.05 and <0.05) and a high BMI (p < 0.01) were strong predictors of receiving treatment for DM. Six to nine years of schooling (p < 0.05) and suffering from hypertension (p < 0.05) increased the probability of DM being controlled. CONCLUSIONS When the prevalence of DM is notable, awareness and probability of receiving treatment and controlling FPG are of particular importance. A considerable proportion of the patients were aware and on treatment, which may partly be due to improving primary health care services in Iran.
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Affiliation(s)
- Roya Safari-Faramani
- Department of Epidemiology, Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Rajati
- Department of Health Promotion, Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kamran Tavakol
- School of Medicine, Howard University, Washington, DC, USA
| | - Behrooz Hamzeh
- Department of Health Promotion, Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Department of Nutrition, Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradinazar
- Department of Epidemiology, Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Department of Epidemiology, Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Rosário EVN, Costa D, Francisco D, Brito M. HDSS Profile: The Dande Health and Demographic Surveillance System (Dande HDSS, Angola). Int J Epidemiol 2018; 46:1094-1094g. [PMID: 28541528 PMCID: PMC5837639 DOI: 10.1093/ije/dyx072] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Edite Vila Nova Rosário
- Health Research Centre of Angola (CISA), Caxito, Bengo, Angola.,Institute of Public Health, University of Porto (ISPUP), Porto, Portugal
| | - Diogo Costa
- Health Research Centre of Angola (CISA), Caxito, Bengo, Angola.,EPIUnit - Institute of Public Health, University of Porto (ISPUP), Porto, Portugal
| | - Diogo Francisco
- Health Research Centre of Angola (CISA), Caxito, Bengo, Angola
| | - Miguel Brito
- Health Research Centre of Angola (CISA), Caxito, Bengo, Angola.,Lisbon School of Health Technology (ESTeSL), Lisboa, Portugal
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Cardiovascular Risk Assessment in Angolan Adults: A Descriptive Analysis from CardioBengo, a Community-Based Survey. Int J Hypertens 2018; 2018:2532345. [PMID: 30258655 PMCID: PMC6146561 DOI: 10.1155/2018/2532345] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 08/05/2018] [Accepted: 08/26/2018] [Indexed: 01/13/2023] Open
Abstract
From a community-based survey conducted in Angola, 468 individuals aged 40 to 64 years and not using drug therapy were evaluated according to the World Health Organisation STEPwise Approach to Chronic Disease Risk Factor Surveillance. Using data from tobacco use, blood pressure, blood glucose, and total cholesterol levels, we estimated the 10-year risk of a fatal or nonfatal major cardiovascular event and computed the proportion of untreated participants eligible for pharmacological treatment according to clinical values alone and total cardiovascular risk. The large majority of participants were classified as having a low (<10%) 10-year cardiovascular risk (87.6%), with only 4.5% having a high (≥ 20%) cardiovascular risk. If we consider the single criteria for hypertension, 48.7% of the population should be considered for treatment. This value decreases to 22.0% if we apply the risk prediction chart. The use of hypoglycaemic drugs does not present any differences (19.0% in both situations). The use of lipid-lowering drugs (3.8%) is only recommended by the risk prediction chart. This study reveals the need of integrated approaches for the treatment of cardiovascular disorders in this population. Risk prediction charts can be used as a way to promote a better use of limited resources.
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