Hypertension In Rural District Research Articles

Adherence to antihypertensive medications in rural Lao PDR: a prospective observational study

BackgroundAlthough hypertension is becoming more prevalent among the adult population of the Lao People’s Democratic Republic (PDR), with a prevalence of approximately 20% in 2013, treatment adherence of patients with hypertension, especially those in rural areas, remains poorly understood. The objective of the present study was to examine the rate of medication adherence to antihypertensive medicines among outpatients with hypertension in rural districts of the Savannakhet.MethodsA prospective observational study was conducted in Xepon, Phin, and Nong districts. The study population was outpatients aged 18 years or older who were prescribed antihypertensive medicines at three district hospitals between February and August 2017. Data were collected on the first day of treatment (day 0) and the day of follow-up (around day 7) through interviews with the patients and outpatient registration books. The medication adherence rate was determined using the four-item Morisky Medication Adherence Scale. The level of adherence was evaluated by the sum of the scale, with scores ranging from 0 to 4 points. The adherent group, namely those with a score of 0, and the non-adherent group, namely those with scores of 1 to 4 points, were compared. Fisher’s exact test was used to identify factors associated with medication adherence.ResultsOf the 68 patients examined, 38.2% newly began treatment. Half of the patients (n = 34, 50.0%, 95% CI 0.38 to 0.62) adhered to medication instructions. The adherent group was more likely to have received written instructions when prescribed medication, compared to the non-adherent group (79.4% vs 55.9%, p = 0.068). Those who perceived that hypertension needs lifelong treatment were significantly more likely to adhere to the medication regimen (p = 0.028).ConclusionsMedication adherence was present among 50% of outpatients with hypertension who visited a district hospital. Therefore, providing written instructions to patients would be effective for improving medication adherence.

Prevalence and associated risk factor of hypertension among individuals of age 18-59 years in South-eastern Nepal: A cross-sectional study

Background: Hypertension is one of the major risk factors for the rising burden of cardiovascular diseases (CVDs) in developing region. It has also been recognized as one of the major public health problems in the developing countries since the early seventies and the rate is increasing not only in urban areas but in rural areas with low socio-economic condition. 
 Methods: A cross sectional study was conducted in Jogidaha Village Development Comittee(VDC) and Triyuga Municipality of Udaypur district of South-Eastern Nepal. A total of 430 participants of age 18-59 years were selected. Semi-structured questionnaire (WHO NCD STEPS instrument) was used to collect information on demographic variables and associated risk factors with use of show cards. Clinical and anthropometric measurement were done. Primary outcome was prevalence of hypertension. Bivariate and multivariate analysis were performed to show strength of association among various risk factors with hypertension. 
 Results: The prevalence of hypertension was found to be 25.1%. Prevalence of overweight and obesity was found to be 49.8%. Hypertension was significantly associated with age (AOR=1.09, CI=1.05-1.10) and gender (male >female; AOR= 2.12,CI =1.22-3.68). Similarly, increased waist-hip ratio(7.12; CI 2.87-17.67),alcohol consumption(OR=2.82,CI=1.77-4.52), and use of tobacco products (OR =1.8,CI=1.02-3.20) showed significant association with hypertension.
 Conclusion: There is high prevalence of hypertension in rural districts of South-Eastern Nepal. A community-based preventive approach with early detection and treatment and life-style modification is needed to reduce the burden of disease and make sustainable changes.

Association between family history and the risk of hypertension in rural districts of Hanzhong in Shaanxi province

Objective: To understand the prevalence of hypertension and quantitative relationship between family history and the risk of hypertension among rural residents living in Hanzhong District, Shaanxi province. Methods: A multistage random sampling survey was conducted. Data on the characteristics related to hypertension were collected and physical examination was conducted. Logistic regression was used to analyze the relationship between family history and hypertension. Results: A total number of 2 817 rural residents aged 18-80 with complete information were recruited. The crude prevalence of hypertension was 33.7%. Results from the logistic regression analysis showed that the OR was 2.06 (95% CI: 1.70-2.50) between family histories with or without hypertension. When the first-degree relatives were with the degrees of family history of hypertention as Ⅰ, Ⅱ or Ⅲ, the OR values of hypertension appeared as 1.83 (95% CI: 1.47-2.27), 2.94 (95% CI: 2.09-4.13) and 4.48 (95% CI: 2.17-9.27) respectively. Either father or mother having the positive family history of hypertension, the corresponding OR values appeared as 2.50 (95% CI: 1.84-3.40), 1.61(95% CI: 1.22-2.12) seen in mothers. However, when both father and mother having the family history of hypertention, the OR value was seen 2.82 (95%CI: 1.76-4.51) in the mothers. Conclusion: Family history appeared as a risk factor for hypertension. The number of first-degree relatives with positive family history showed a dose-response relationship to the occurrence of hypertension. Family history in both father or mother might further affect the incidence of hypertension.

Is hypertension the new HIV epidemic?

Is hypertension the new HIV epidemic?

Relationship between female menopause and hypertension/isolated systolic hypertension in rural districts of Hanzhong in Shaanxi province

To analyze the associations between menopause and hypertension/isolated systolic hypertension (ISH) among rural females in Hanzhong, Shaanxi Province, China. In this cross-sectional study, 3030 residents were selected by stratified random sampling and investigated by questionnaire survey and physical examinations. Data of the females were analyzed to explore the impact of menopause on blood pressure by quantile regression and to investigate the associations between menopause and hypertension, ISH, and isolated distolic hypertension (IDH) by logistic regression. The number of premenopausal and postmenopausal women was 965 and 998. The average age was (41.0 ± 8.07) years in the premenopausal group and (58.0±7.12) years in the postmenopausal group (P<0.001). The prevalence of hypertension among the premenopausal group and postmenopausal group was 21.9% and 49.3%, respectively. Quantiles regression analysis showed that the impact of menopause on systolic blood pressure increased as the percentile increased. The diastolic blood pressure (DBP) of the premenopausal group was significantly lower than that in the postmenopausal at q ≥ 0.40(DBP = 84 mmHg,1 mmHg = 0.133 kPa) percentile points (P<0.05), while the difference was not significant at q≤ 0.30 (DBP=80 mmHg) percentile points(P>0.05). After the potential confounders including age, education level, marriage, occupational, hyperlipidemia, family history, exercise, sleep, watching TV, smoking, passive smoking, alcohol consumption, body mass index, wealth index, waist circumference were controlled, positive associations were observed between menopause and hypertension/ISH in logistic regression models. Menopause is positively related with hypertension/ISH. More effective interventions should be taken to prevent hypertension and ISH among rural women.

Survey of of Hypertension in Rural District of Nagano Prefecture

Survey of of Hypertension in Rural District of Nagano Prefecture