Cross-sectional Health Examination Survey Research Articles

Tobacco exposure and alcohol drinking prevalence and associations with hypertension in rural southwest China: A cross-sectional study.

This study examined the prevalence of tobacco exposure and drinking and ascertained the relationships between tobacco exposure, alcohol drinking, concurrent smoking and drinking, and hypertension in rural southwestern China. Data were collected from a cross-sectional health interview and examination survey, which included 7572 adults aged ≥35 years, in rural China. Participant demographic characteristics, smoking habits, exposure to secondhand smoke (SHS), and alcohol drinking habits were obtained using a standard questionnaire. Blood pressure (BP), height, weight, and waist circumference were measured for each participant. The overall prevalence of smoking, SHS exposure, drinking, concurrent smoking and drinking, concurrent exposure to SHS and drinking, and hypertension was 37.7%, 27.4%, 16.2%, 12.6%, 1.6%, and 41.3%, respectively. Males had a significantly higher prevalence of smoking (74.1% vs 2.2%, p<0.01), drinking (31.1% vs 1.7%, p<0.01), and concurrent smoking and drinking than females (25.3% vs 0.3%, p<0.01). However, females had a higher prevalence of SHS exposure than males (30.2% vs 20.6%, p<0.01). Ethnic minorities had a higher prevalence of SHS exposure, drinking, and concurrent smoking and drinking, than Han participants (p<0.01). Participants with a higher education level had a higher prevalence of smoking, drinking, and concurrent smoking and drinking than their counterparts (p<0.01). In contrast, participants with a lower education level had a higher prevalence of SHS exposure than their counterparts (p<0.01). Multivariate logistic regression analysis found that smokers (AOR=1.31; 95% CI: 1.13-1.51), individuals exposed to SHS (AOR=1.24; 95% CI: 1.11-1.43), drinkers (AOR=1.31; 95%: CI: 1.15-1.50), and concurrent smokers and drinkers (AOR=1.45; 95% CI: 1.25-1.67) all had a higher probability of having hypertension (p<0.01). Additionally, concurrent smoking and drinking had the strongest association with the prevalence of hypertension (AOR=1.45; 95% CI: 1.25-1.67; p<0.01). Socioeconomic factors play an important role in influencing the prevalence of smoking, exposure to SHS, and drinking in rural southwest China. Interventions to prevent and reduce hypertension should, in particular, focus on smokers, individuals exposed to SHS, drinkers, and, in particular, concurrent smokers and drinkers.

Non-linear relationship of serum albumin-to-globulin ratio and cognitive function in American older people: a cross-sectional national health and nutrition examination survey 2011-2014 (NHANES) study.

Inflammation and liver function are associated with cognitive decline and dementia. Little is known about the serum albumin-to-globulin ratio on cognitive function. The objective of this study was to investigate the association between albumin-to-globulin ratio and cognitive function among the American older people. The public data available on the US National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014 was used for this cross-sectional study. Participants aged ≥60 years completed the cognitive function assessments, including word learning and recall modules from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the animal fluency (AF) test, and the digit symbol substitution test (DSST). A composite cognition score was calculated to evaluate global cognition. The univariate and multivariate linear regression analysis, curve fitting, a threshold effect, along with a subgroup analysis and interaction tests were conducted. Serum albumin-to-globulin ratio (per 0.1 unit) was positively associated DSST score (β = 0.36, 95% CI: 0.21, 0.51), AF score (β = 0.1, 95% CI: 0.04, 0.16) and global cognition score (β = 0.05, 95% CI: 0.02, 0.07), after being fully adjusted, while albumin-to-globulin ratio was not related to CERAD score (β = 0.05, 95% CI: -0.02, 0.12). A non-linear was observed in the dose-response relationship between albumin-to-globulin ratio and global cognition (P for non-linearity < 0.001). The subgroup analysis was overall stable, yet the interaction test was significant for age on global cognition (P for interaction = 0.036). The findings of this cross-sectional study suggested a positive and non-linear association between albumin-to-globulin ratio and cognitive function in the American older people. Maintaining albumin-to-globulin ratio with an appropriate range may be one of the therapeutic strategies to limit the progression of cognitive decline for the older people.

Age and sex differences in comorbidities in adult temporomandibular disorders: A cross-sectional study using Korea National Health and Nutrition Examination Survey (KNHANES).

To investigate the relationship between Temporomandibular disorder (TMD) and associated comorbidities in groups matched according to age and sex. Using data from the cross-sectional fifth Korea National Health and Nutrition Examination Survey (KNHANES). Of the 25,534 eligible KNHANES, 17,762 adults aged ≥19 years who responded to survey questionnaire on TMD and comorbidities. Subjects were classified into eight groups according to age and sex. Logistic regression analyses were performed to evaluate the association between TMD and comorbidities according to age and sex. Of the enrolled participants, 2,107 (11.86%) complained of ≥1 TMD symptoms. In all groups, odds ratios (ORs) for prevalence of TMD were >1 in those with tinnitus. Rhinitis was closely associated with TMD in 6 groups. ORs for TMD with comorbidities according to age and sex were as follows: hypertension, men aged 50-64 years (OR 0.62; CI 0.41-0.94); ischemic heart disease, men aged 35-49 years (4.38; 1.54-12.47); osteoarthritis, women aged 50-64 years (1.38; 1.03-1.86); diabetes mellitus, men aged 35-49 years (0.21; 0.05-0.88); depression, men aged 50-64 years (1.68; 1.00-2.83), women aged 35-49 years (1.39; 1.05-1.85) and women aged 65-80 years (2.01; 1.46-2.77); migraine, men aged 50-64 years (1.60; 1.14-2.25), women aged d35-49 years (1.44; 1.14-1.81) and women aged 35-49 years (1.43; 1.07-1.90); cold hypersensitivity in the hands and feet, men aged 19-34 years (1.64; 1.05-2.58), men aged 35-49 years (1.68; 1.04-2.70), men aged 65-80 years (1.74; 1.09-2.75) and women aged 35-49 years (1.45; 1.15-1.84); olfaction disorder, men aged 50-64 years (2.49; 1.39-4.43); voice disorder, men aged 50-64 years (2.25; 1.28-3.96) and women aged 65-80 years (1.69; 1.09-2.63). This study confirmed that the types and effects of comorbidities related to prevalence of TMD may differ according to the patient's age and sex and this result will increase the predictability of the onset of TMD.

Novel, computational IgE-clustering in a population-based cross-sectional study: Mapping the allergy burden.

Even though the prevalence of allergies is increasing, population-based data are still scarce. As a read-out for chronic inflammatory information, new methods are needed to integrate individual biological measurements and lifestyle parameters to mitigate the consequences and costs of allergic burden for society. More than 480.000 data points were collected from 1462 Luxembourg adults during the representative, cross-sectional European Health Examination Survey, spanning health and lifestyle reports. Deep IgE-profiles based on unsupervised clustering were correlated with data of the health survey. 42.6% of the participants reported a physician-diagnosed allergy and 44% were found to be IgE-positive to at least one allergen or extract. The main sensitization sources were tree pollens followed by grass pollens and mites (52.4%, 51.8% and 40.3% of sensitized participants respectively), suggesting seasonal as well as perennial burden. The youngest group of participants (25-34years old) showed the highest burden of sensitization, with 18.2% of them having IgE to 10 or more allergen groups. Unsupervised clustering revealed that the biggest cluster of 24.4% of participants was also the one with the highest medical need, marked by their multi-sensitization to respiratory sources. Our novel approach to analyzing large biosample datasets together with health information allows the measurement of the chronic inflammatory disease burden in the general population and led to the identification of the most vulnerable groups in need of better medical care.

P14-091-23 Dietary Quality and Their Composition at Different Diabetes Status in US Adults: Cross-Sectional Analysis National Health and Nutrition Examination Survey 2005–2018

P14-091-23 Dietary Quality and Their Composition at Different Diabetes Status in US Adults: Cross-Sectional Analysis National Health and Nutrition Examination Survey 2005–2018

Trends in the Prevalence of Chronic Non-Communicable Diseases and Multimorbidity across Socioeconomic Gradients in Rural Southwest China.

This study aimed to determine the changing prevalence of five chronic non-communicable diseases (NCDs)- hypertension, coronary heart disease (CHD), stroke, chronic obstructive pulmonary disease (COPD), and asthma-- and its multimorbidity (refers to the co-existence of two or more chronic diseases in an individual) across socioeconomic spectra in rural southwest China. Two cross-sectional health interviews and examination surveys were conducted among individuals aged ≥35 years in rural China. An individual socioeconomic position (SEP) index was constructed using principal component analysis. Anthropometric measurements, blood pressure, and post-bronchodilator spirometry tests were recorded for each participant. The mean age and proportion of men was 56.1 years and 48.4% in 2011, while was 56.6 years and 49.4% in 2021. From 2011 to 2021, the overall prevalence of hypertension, stroke and COPD increased from 26.1%, 1.1%, and 8.7% to 40.4%, 2.4%, and 12.8%, respectively (P < 0.01), while prevalence of CHD (2.1% vs. 2.2%) and asthma (1.4% vs. 1.5%) did not differ between the two study years (P > 0.05). The prevalence of NCDs multimorbidity increased from 2.3% to 9.7%, and was also observed among subgroups categorized by sex, age, ethnicity, level of education, income, and SEP (P < 0.01). In addition, the relative increases in the prevalence of multimorbidity were greater among men, old individuals, ethnic minorities, and those with low level of education and low SEP. Both in 2011 and 2021, ethnic minorities and individuals with lower level of education and low SEP had a higher prevalence of multimorbidity of the five studied chronic NCDs than their counterparts (P <0.01). The prevalence of NCDs multimorbidity increased substantially across all socioeconomic gradients in rural southwest China. Future interventions to further manage NCDs and their multimorbidity must be tailored to address socioeconomic factors.

Rural-urban differentials of prevalence and lifestyle determinants of pre-diabetes and diabetes among the elderly in southwest China

BackgroundDiabetes has become a major public health problem in China. A better understanding of diabetes determinants and urban-rural differences is essential to crafting targeted diabetes prevention measures for the elderly living in both urban and rural areas. This study aimed to compare rural-urban differentials in prevalence and lifestyle determinants of pre-diabetes and diabetes among the elderly in southwest China.MethodsA cross-sectional health interview and examination survey was conducted among individuals aged ≥ 60 years in both a rural and urban area of China. Anthropometric measurements, including height, weight, and waist circumference, as well as blood pressure and fasting blood glucose measurements were taken. Associated risk factors for pre-diabetes and diabetes were evaluated using multivariate logistic regression analysis.ResultsIn total, 1,624 urban residents and 1,601 rural residents consented to participate in the study. The urban prevalence of pre-diabetes and diabetes (46.8% and 24.7%, respectively), was higher than the rural prevalence (23.4% and 11.0%, respectively, P<0.01). Urban elderly participants had markedly higher prevalence of obesity, central obesity, and physical inactivity than their rural counterparts (15.3%, 76.0%, and 9.2% vs. 4.6%, 45.6%, and 6.1%, P<0.01). In contrast, rural elderly adults had higher prevalence of smoking than urban ones (23.2% vs. 17.2%, P<0.01). Obese (OR 1.71, 95% CI 1.27–2.30 vs. OR 1.73, 95% CI 1.30–3.28) and centrally obese participants (OR 1.59, 95% CI 1.18–2.15 vs. OR 1.83, 95% CI 1.32–2.54) were more likely to suffer from diabetes in both urban and rural regions. Furthermore, urban current smokers had a higher probability of suffering from diabetes (OR 1.58, 95% CI 1.11–2.25), while hypertension was positively associated with the prevalence of diabetes in the rural area (OR 2.13, 95% CI 1.54–2.95). Obese participants in the rural area were more likely to suffer from pre-diabetes (OR 2.50, 95% CI 1.53–4.08), while physical inactivity was positively associated with prevalence of pre-diabetes in the urban area (OR 1.95, 95% CI 1.37–2.80).ConclusionPre-diabetes and diabetes are more prevalent among urban older adults than their rural counterparts in southwest China. The identified rural-urban differentials of lifestyle factors have significant impacts on prevalence of pre-diabetes and diabetes. Thus, tailored lifestyle interventions are needed to improve diabetes prevention and management among the elderly in southwest China.

Socioeconomic differentials of trends in the prevalence and economic burden of chronic obstructive pulmonary disease in rural southwest China

BackgroundChronic obstructive pulmonary disease (COPD) is a leading cause of mortality and morbidity, and imposes a substantial financial burden on society. However, few studies have examined the role of individual socioeconomic status (SES) in temporal trends of COPD prevalence and economic cost. This study aimed to uncover the changing prevalence and economic burden of COPD across socioeconomic gradients in rural southwest China.MethodsData were collected from two cross-sectional health interviews and examination surveys administered 10 years apart among individuals aged ≥ 35 years in rural China. A prevalence-based cost-of-illness method was used to estimate the cost of COPD. The individual socioeconomic position (SEP) index was constructed using principal component analysis. Post-bronchodilator spirometry tests were performed for each participant.ResultsFrom 2011 to 2021, the prevalence of COPD increased from 8.7% to 12.8% (P < 0.01), while the economic cost of COPD increased 1.9-fold. Unit hospital costs and outpatient costs increased 1.57–fold and 1.47–fold, while unit medication costs fell by 10.6%. Increasing prevalence was also observed when the data were stratified by sex, age, ethnicity, level of education, level of income, and SEP (P < 0.05). Men, ethnic minorities, and those with a lower educational level, lower income, or lower SEP had a higher prevalence of COPD than their counterparts both in 2011 and 2021 (P < 0.05). Unit outpatient costs and medication costs increased with patients’ SEP in both survey years (P < 0.05).ConclusionsThe prevalence and economic costs of COPD increased substantially across all socioeconomic gradients in rural southwest China in the decade from 2011 and 2021. Future COPD prevention and management interventions as well as efforts to improve access to affordable COPD medication and treatment should focus in particular on ethnic minority and low SEP populations.

Trends of blood pressure, raised blood pressure, hypertension and its control among Italian adults: CUORE Project cross-sectional health examination surveys 1998/2008/2018

ObjectivesTo assess in the Italian general adult population the trends of blood pressure (BP) and prevalence of raised BP (RBP), hypertension and its control in order to evaluate population health...

Development of non-communicable disease risk factors in Finland: projections up to 2040.

Non-communicable diseases are a major cause of mortality and morbidity worldwide. They share the same behavioural risk factors (smoking, sedentary behaviour, alcohol consumption and an unhealthy diet), all of which are modifiable risk factors, and biological consequences (hypertension, elevated total cholesterol, obesity and diabetes). Using data from a series of cross-sectional health examination surveys conducted among the adult population in Finland from 1997 to 2017, a projection of risk factor development (smoking, leisure time sedentary behaviour, hypertension, elevated total cholesterol, overweight and obesity, and diabetes) up to the year 2040 was made. The projections were estimated using a multiple imputation method. Smoking prevalence is estimated to continue to decline up to 2040, similar to hypertension and elevated total cholesterol. By contrast, obesity and diabetes will develop unfavourably, with an increase in prevalence. The increase in obesity is mainly due to polarisation - that is, normal-weight people remain of a normal weight, but overweight people tend to gain more weight and become obese. The observed and estimated changes for leisure time sedentary lifestyle were not statistically significant. Projections of risk factors for non-communicable diseases are needed to guide public health policies and programmes, decision-making and the allocation of health care resources for prevention and care. In Finland, favourable developments have been seen in many of the risk factors, but obesity and diabetes show unfavourable development. There is a need to continue regular, systematic monitoring of the development of risk factors through health examination surveys and to set national goals and programmes to tackle the existing problems.

Study protocol for an epidemiological study ‘Multimorbidity − identifying the most burdensome patterns, risk factors and potentials to reduce future burden (MOLTO)’ based on the Finnish health examination surveys and the ongoing register-based follow-up

IntroductionMultimorbidity, defined as the co-occurrence of two or more long-term medical conditions, is an increasing public health concern worldwide causing enormous burden to individuals, healthcare systems and societies. The most...

Dietary total antioxidant capacity is associated in Polish men and women with the prevalence of cardiovascular diseases and their risk factors

Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiovascular diseases (CVD) are the main cause of mortality in the Polish population. Improper diet and lifestyle are among the risk factors for CVD. Previous studies have suggested that dietary total antioxidant capacity (DTAC) is a measure of diet quality. Purpose The aim of the study was to investigate the relationship between diet quality measured by DTAC and the prevalence of CVD and CVD risk factors in the representative sample of men and women in Poland. Methods The study evaluated participants (2594 men, 3136 women) of the population-based cross-sectional Polish National Multicenter Health Examination Survey (WOBASZ II), which was conducted in 2013-2014. Dietary data were collected using a single 24-hour dietary recall method. The database on dietary antioxidants was compiled from published and own experimental data. DTAC was calculated taking into account the antioxidant capacity of individual foods and the amount of food intake. Men and women were divided into quartiles of CVD prevalence and its risk factors (diabetes; hypertension; BMI≥25; central obesity, CO; low level of leisure-time physical activity, LTPA) according to DTAC. Statistical calculations were performed using the Statistical Analysis System (SAS), version 9.4 (SAS Institute Inc., Cary, NC, USA). Results DTAC in men ranged from 0.47 to 95.69 mmol/day, while in women it was 0.32-191.82 mmol/day. In men, the prevalence of CVD was 23.7% in the lowest DTAC quartile (Q1) versus 14.9% in the highest quartile (Q4) (p&amp;lt;0.0001), while in women it was 23.4% (Q1) and 17.4% (Q4), respectively (p&amp;lt;0.0002). In women, but not in men, DTAC was inversely associated with diabetes (p&amp;lt;0.0002), hypertension (p&amp;lt;0.0001), CO (p&amp;lt;0.02) and low LTPA (p&amp;lt;0.0006). Conclusions DTAC is inversely related to the prevalence of CVD in both genders. In women, but not in men, there is a significant inverse association of DTAC with CVD risk factors such as metabolic diseases, central obesity and lower physical activity. In order to reduce the risk of CVD, Polish men and women should be advised to improve the quality of their diet by increasing the dietary intake of antioxidants.

Association between oral health and frailty: results from the Korea National Health and Nutrition Examination Survey

BackgroundPrevious research has suggested that poor oral health is positively associated with frailty. The objective of this study was to explore associations of key oral diseases (periodontal disease, tooth loss), and oral hygiene and management behaviors with the level of frailty in community-dwelling older Korean adults using national representative survey data.MethodsThis study used cross-sectional, 6th and 7th Korea National Health and Nutrition Examination Survey (KNHANES VI, VII) data. Adults aged 50+ years were included. Frailty was measured using frailty phenotype (FP) and frailty index (FI). FP was determined using five frailty criteria, i.e., weight loss, weakness, exhaustion, slowness, or low physical activity, and the level of frailty was classified with the number of criteria present (robust, none; pre-frail, 1–2; frail, 3+). FI was determined using a 44-item FI constructed according to a standard protocol, and the level of frailty was classified as robust (FI: ≤ 0.08), pre-frail (FI: 0.08–0.25), and frail (FI: ≥ 0.25). Multiple ordinal regression analyses were conducted with each type of frailty as the outcome variable. Independent variables of interest were the periodontal status, number of teeth, and practices on oral hygiene and management. Analyses were additionally adjusted for participants’ socioeconomic, diet, and behavioral characteristics. ResultsThe prevalence of frailty was 4.38% according to the FP classification (n = 4156), 10.74% according to the FI classification (n = 15,073). In the final adjusted model, having more teeth and brushing after all three meals were significantly associated with lower odds of being more frail (in both frailty models); no significant association was observed between periodontal disease and frailty.ConclusionsFindings from this study show having more teeth and practicing adequate brushing are significantly associated with frailty. Due to limitations of the study design, well-designed longitudinal studies are needed to confirm these findings.

Health Inequities Exist in Europe: Are Spatial Health Inequities Present in the Small State of Malta?

Targeting and reducing health inequities is a requisite for public health. The Maltese Islands are divided into six geographical districts with a total area of 316 km2. It is anticipated that the close geographical proximity and social integration would result in similar population health status. This study aims to identify whether geographical health inequities exist despite the small country area. A cross-sectional health examination survey was conducted. Participants with type 2 diabetes (T2DM) and impaired fasting blood glucose (IFG) were identified, depending on their medical and drug history and fasting blood glucose levels. Those with body mass index ≥30 kg/m2 were labeled as obese. Different health status was compared between the residents in the different districts according to demographic, socioeconomic, lifestyle, and medical history. Regression analysis was carried out to identify links between the different districts, BMI, IFG, and T2DM diagnosis, while adjusting for confounders. Geographical inequities were evident despite the close proximity. The Gozo district exhibited distinctive metabolic inequities compared to the other districts. An independent relationship was present between IFG diagnosis and residence in Gozo and Northern districts. Obesity was linked to residing in Gozo. Health inequities were evident between the close districts of the Maltese Islands despite similar socioeconomic, lifestyle, and healthcare provision. Psychosocial factors might be the underlying causes for these inequities. Public health officials and government should work to enhance public education and set up local policies and interventions to target these inequities.

Secular trends in diet-related greenhouse gas emission estimates since 2000 - a shift towards sustainable diets in Sweden.

This study examines secular changes in diet-related greenhouse gas emissions (GHGE) in younger and older Swedish adults, since the turn of this century. Two cross-sectional health examination surveys were conducted in 2001-2004 (T1) and 2014-2018 (T2). At both times, an eighty-six-item FFQ was embedded in the survey. From the food frequencies and age-standardised portion sizes, GHGE estimates (kg CO2e/year) were calculated. GHGE was modelled as a function of time period and covariates, for five distinct age groups. The municipality of Gothenburg, in western Sweden. Women and men aged 25-34, 35-44, 45-54, 55-64 and 65-75 years were randomly selected from the population registry and recruited for examinations. After exclusion of participants with incomplete dietary data, the analytic sample consisted of 2569 individuals at T1 and 2119 at T2. Lower dietary GHGE scores were observed at T2 compared with T1, in each age group, adjusting for sex, BMI and education. The largest differences in GHGE were observed in the youngest age group (approximately 30 % reduction). Decreasing trends in GHGE from animal-based foods were observed at all ages and were accompanied by smaller increases from plant-based sources in younger groups only. At all ages, GHGE from discretionary foods decreased, and prevalence of overweight remained stable. Optimal dietary trends should support both human health and planetary health. Our results suggest that Swedish adults have moved in this direction, e.g. through less intake of red meat products and stable weight status.

Dietary intake of plant sterols in cardiovascular diseases: a population-based study of Polish adults

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Cardiology, Warsaw, Poland Introduction. Cardiovascular diseases (CVD) are a major cause of premature mortality and disability in developed countries. Among various risk factors, disorders of lipid metabolism are prevalent. Scientific evidence shows that plant sterols have a positive effect on dyslipidemia. The primary mechanism of hypolipemic effect of plant sterols is inhibition of cholesterol absorption in the small intestine, and this effect depends on the dose. Purpose. The aim of the study was to determine the intake of plant sterols, which was never studied in the Polish population. Methods. In total, 5690 participants of the population-based cross-sectional Polish National Multicenter Health Examination Survey WOBASZ II (2013-2014), aged 20+, were evaluated in the study (1). Nutritional data were collected using a single 24-hour dietary recall method. A dietary plant sterol database was compiled from available experimental data including total and individual plant sterols such as β-sitosterol, campesterol and stigmasterol. Plant sterol intakes were calculated taking into account plant sterol contents in individual food products and the volume of food consumption. Statistical calculations were performed using Statistical Analysis System (SAS), version 9.4 (SAS Institute Inc., Cary, NC, USA). Results. The dietary plant sterol intake (DPSI) for the general population, 283 mg/day, was dependent on the age and gender. The intake of sterols among people over 65 years of age (264 mg/day in men and 208 mg/day in women) was lower than in younger age groups (20-44 years) of participants (343 mg/day in men and 259 mg/day in women). The main dietary plant sterol for both genders was β-sitosterol (∼62% of intake), followed by campesterol (∼21%) and stigmasterol (∼9%). Overall, men and women with cardiovascular disease had significantly lower DPSI (p &amp;gt; 0.002) than men and women without cardiovascular disease, 298.6 and 237.8 vs. 326.1 and 255.9 mg/d, respectively, and men but not women with diabetes had significantly (p &amp;gt; 0.04) lower DPSI than men without diabetes, 301.7 vs. 323.3, respectively. Conclusions. In the view of current recommendations to lower cholesterol, this research confirms findings for other populations, that the dietary intake of plant sterols in the Polish population is insufficient to beneficially modulate lipid metabolism, especially in CVD and diabetic patients.

Socioeconomic differentials in trends in the prevalence of hypertension and pre-hypertension and hypertension awareness, treatment, and control in rural Southwestern China

BackgroundThis study examines the socioeconomic differentials in trends in the prevalence of hypertension and pre-hypertension and hypertension awareness, treatment, and control in rural Southwestern China.MethodsTwo cross-sectional interviews and health examination surveys were administered in rural Yunnan Province, including 6,350 consenting participants in 2009 and 6,359 consenting participants in 2016 (aged ≥ 35 years). Participant demographics, socioeconomic status (SES), and ethnicity, along with information about hypertension awareness, treatment, and control, were collected using similar questionnaires in the two surveys. The participants’ blood pressure levels were also measured.ResultsFrom 2009 to 2016, the prevalence of hypertension substantially increased from 28.4% to 39.5% (P < 0.01), and awareness and control rose from 42.2 and 25.8% to 53.1 (P < 0.01) and 30.6% (P < 0.05), respectively. Although people with a higher education level also had higher awareness and control rates than the lower education level ones, there were no conspicuous differences in the improvement of awareness and control between publics with different education levels over the 7 years studied. Increases were observed in both rates of awareness and control in people with a high level of income (P < 0.01). However, only the awareness rate increased in participants with a low level of income. Furthermore, the prevalence (P < 0.01) and treatment (P < 0.05) of hypertension were higher in the Han people than in ethnic minorities.ConclusionsIndividual SES has clear associations with trends in the prevalence, awareness, and control of hypertension. Future interventions to improve hypertension prevention and control should be tailored to address individual SES.

Factors associated with high sedentary behaviour among adolescents and adults with psychological distress in South Africa

The aim of this study was to estimate factors associated with high sedentary behaviour (SB) in adolescents and adults who have psychological distress in South Africa. Data used in this analysis were derived from the cross-sectional South African National Health and Nutrition Examination Survey – 2012. The sample consisted of 2306 participants (42 years median age) who had psychological distress. In all, 16.2% of the study participants engaged in ⩾8 hr SB/day. In unadjusted analysis, functional disability, older age, bodily pain, hypertension, and cognitive impairment was significantly more frequent among those with high SB. In adjusted logistic regression, functional disability and aged 65 years and above were positively associated with high SB. Results seem to suggest that interventions aimed at reducing SB among South Africans who have psychological distress may target the risk groups that were identified.

Inequalities by education and marital status in the co-occurrence of cardiovascular risk factors in Finland persisted between 1997\u20132017

Understanding on sociodemographic variation of the co-occurrence of cardiovascular disease risk factors is crucial for planning future prevention strategies. We aimed at examining (1) the co-occurrence of smoking, obesity, hypertension and elevated serum cholesterol by education and marital status, and (2) its trends in different sociodemographic groups in Finland. We used data from cross-sectional health examination surveys among the general population (25–64 years): for 1997–2012 the National FINRISK Study and for 2017 the FinHealth 2017 Survey (n = 25036). A risk factor accumulation score with categories (1) zero, (2) one, (3) two, and (4) three or four elevated risk factors was the outcome in multinomial logistic regression. The risk factor score was more favourable among women, among high education groups, and slightly among participants living with a spouse. Among men, the lowest risk factor score class became more prevalent especially in the intermediate education group, which approached the highest education group over time. Our results indicate an overall transition towards a more favourable risk factor distribution. However, risk factor accumulation among the least educated remained emphasizing the need to develop and implement more targeted prevention interventions and public health policies to decrease the risk factor burden particularly in this group.

The silent epidemic of obesity in The Gambia: evidence from a nationwide, population-based, cross-sectional health examination survey.

ObjectivesNon-communicable diseases account for 70% of global deaths; 80% occur in low-income and middle-income countries. The rapid increase of obesity in sub-Saharan Africa is a concern. We assessed generalised and abdominal obesity and their associated risk factors among adults in The Gambia.DesignNationwide cross-sectional health examination survey using the WHO STEPwise survey methods.SettingThe Gambia.ParticipantsThis study uses secondary analysis of a 2010 nationally representative random sample of adults aged 25–64 years (78% response rate). The target sample size was 5280, and 4111 responded. Analysis was restricted to non-pregnant participants with valid weight and height measurements (n=3533).Primary and secondary outcome measuresThe primary outcome variable was generalised obesity, using WHO body mass index (BMI) thresholds. Analyses used non-response weighting and adjusted for the complex survey design. We conducted multinomial logistic regression analysis to identify factors associated with BMI categories. The secondary outcome variable was abdominal obesity, defined as high waist circumference (using the International Diabetes Federation thresholds for Europeans).ResultsTwo-fifths of adults were overweight/obese, with a higher obesity prevalence in women (17%, 95% CI 14.7 to 19.7; men 8%, 95% CI 6.0 to 11.0). 10% of men and 8% of women were underweight. Urban residence (adjusted relative risk ratio 5.8, 95% CI 2.4 to 14.5), higher education (2.3, 1.2 to 4.5), older age, ethnicity, and low fruit and vegetable intake (2.8, 1.1 to 6.8) were strongly associated with obesity among men. Urban residence (4.7, 2.7 to 8.2), higher education (2.6, 1.1 to 6.4), older age and ethnicity were associated with obesity in women.ConclusionThere is a high burden of overweight/obesity in The Gambia. While obesity rates in rural areas were lower than in urban areas, obesity prevalence was higher among rural residents in this study compared with previous findings. Preventive strategies should be directed at raising awareness, discouraging harmful beliefs on weight, and promoting healthy diets and physical activity.