Hypertension OR Research Articles

Secondhand smoking increased the possibility of hypertension with a significant time and frequency dose-response relationship

In this research, we investigated whether secondhand smoking (SHS) increases the possibility of hypertension. We used data from the Shaanxi baseline survey of the Regional Ethnic Cohort Study in Northwest China (RECS). Active smoking and SHS were determined by questionnaires. Hypertension was defined as self-reported or objectively measured. Multivariable logistic regression model was performed to estimate the risk of hypertension under active smoking and SHS. Compared to never-smokers, exposure to SHS had a 9% (P = 0.005) higher possibility of hypertension. The adjusted OR for exposure time of ≤ 3 h/week, 3–12 h/week, and > 12 h/week were 1.03 (P = 0.545), 1.10 ( P = 0.040), and 1.15 (P = 0.015), respectively. The adjusted OR for frequency of SHS of 1–2 times/week, 3–5 times/week, and nearly every day were 0.94 (P = 0.421), 1.01 (P = 0.846), and 1.14 (P < 0.001), respectively. Compared to smokers, additional exposure to SHS had a more than threefold increased possibility of having hypertension. The adjusted OR for hypertension was 1.07 (P = 0.254), and 1.23 (P = 0.007) in only smokers and smokers with SHS, respectively. Our study provided evidence that SHS could be a risk factor for hypertension, and additional exposure of active smokers to SHS significantly increases the possibility of hypertension. Reducing the frequency or time of SHS may be effective in preventing hypertension.

Associations of artificial sweetener intake with cardiometabolic disorders and mortality: a population-based study.

Artificial sweeteners are generally used and recommended to alternate added sugar for health promotion. However, the health effects of artificial sweeteners remain unclear. In this study, we included 6371 participants from the National Health and Nutrition Examination Survey with artificial sweetener intake records. Logistic regression and Cox regression were applied to explore the associations between artificial sweeteners and risks of cardiometabolic disorders and mortality. Mendelian randomisation was performed to verify the causal associations. We observed that participants with higher consumption of artificial sweeteners were more likely to be female and older and have above medium socio-economic status. After multivariable adjustment, frequent consumers presented the OR (95 % CI) for hypertension (1·52 (1·29, 1·80)), hypercholesterolaemia (1·28 (1·10, 1·50)), diabetes (3·74 (3·06, 4·57)), obesity (1·52 (1·29, 1·80)), congestive heart failure (1·89 (1·35, 2·62)) and heart attack (1·51 (1·10, 2·04)). Mendelian randomisation confirmed the increased risks of hypertension and type 2 diabetes. Moreover, an increased risk of diabetic mortality was identified in participants who had artificial sweeteners ≥ 1 daily (HR = 2·62 (1·46, 4·69), P = 0·001). Higher consumption of artificial sweeteners is associated with increased risks of cardiometabolic disorders and diabetic mortality. These results suggest that using artificial sweeteners as sugar substitutes may not be beneficial.

Polymorphism of ADAMTS-13 gene rs28503257 in Iraqipatients with Hypertension

The aim of this study was to investigate the association of polymorphism of ADAMTS-13 gene to the susceptibility of hypertension in patients with hypertension in an Iraqi population. Forty-five hypertensive patients (23 males and 22 females), their age 40-70 years and 35 healthy controls (18 males and 17 females), their age range between 40-70 years. were selected from Wasit Province using a convenient sampling method. Genetic polymorphism of ADAMTS13) rs28503257 A/G was carried out using TaqMan -PCR. In patients and controls, the genotypic and allelic distributions of adisentgrine and metallopeptedase with a thrombospondin type1 motife13(ADAMTS13) rs28503257 A/G of the study populations were consistent with Hardy-Weinberg equilibrium. The genotypes frequecies of ADAMTS-13 rs 28503257 A/G of patients with hypertension manifested non-significant differences when compared with healthy control group AA =40(89%), AG =5(11) in patients vs. 30(86), 5(14) P=0.67 in controls for each genotype respectively. There were no hypertensive patients or controls carrying the genotype GG in the study sample. The A and G allele frequencies in SNP rs28503257 A/G were not significantly different between the two groups (P&gt;0.05). The A allele was the major one in studied groups with a percent of (0.9286) and (0.9444) in control and patients groups respectively. Whereas the A allele was the minor one with a percent of (0.0714) and (0.0556) in these groups respectively. The association analysis revealed that individuals carrying the homozygous AA genotype were assocaited with hypertension OR=1.3333 (CI95% 0.3537 to 5.0259) and P= 0.6709 indicating that a positive association with the disease.However,the individuals with a hetrozygous AG genotype showed negative association with the disease OR= 0.7500 (CI95% 0.1990 to 2.8271) ,P=0.6709. Although no individuals carrying the genotype GG were observed in patients and controls, the odds ratio can be calculated in the presence of other genotypes OR= 0.7802 (CI95% 0.0151 to 40.2986), P= 0. 9019.These results suggest that the A allele may be considered as a risk allele in hypertension whereas the G allele is a protective allele agianst hypertension. The genetic model for ADAMTS-13 in comparison between hypertensive patients and controls .The dominant model indicated that patients of(AG+GG/AA) genotypes decreased the association with hypertension comparing with control with OR=1.333 CI95%0.3537 to 5.025: patients (40/5 and 0.00) in patients vs.(30/5 and 0.00) with OR== 0.7500(CI95%0.1990 to 2.8271) , P =0.6709,P=0.6709.The recessive model revealed that patients carrier the genotype(AA+AG/GG) increased the association with the disease (0.0/40 and 5) in patients compared with controls(0.00/30 and 5) with OR=1.2817(CI95% 0.0248 to 66.199), P=0. 9019.The Over dominant model revealed that patients carrier the genotype (AA+GG/AG) increased the association with the disease (0.040 and 5) in patients compared with controls (0.00/30 and 5) with OR=1.3333(CI95%0.3537 to5.0259),P=0.6709. In coclusion, the polymorphisms ADAMTS-13 rs28503257 variant A/G with are associated with the susceptibility of hypertension.

Postoperative urinary retention - prevalence and risk factors: prospective, cohort study

Introduction Ensuring perioperative urination maintenance can often be challenging, as postoperative urinary retention is frequently overlooked in favor of more clearly defined goals such as successful surgery, comprehensive postoperative pain control, reducing the risk of postoperative cardiorespiratory complications and shortening the patient's overall hospital stay. However, the inability to initiate urination and empty the bladder in the early postoperative period may negatively affect each of the listed success criteria. Material and methods A single-center, prospective, observational, cohort study was conducted, enrolling elderly patients without severe comorbidities. A total of 127 complete datasets were analyzed. Anthropometric parameters, type of surgery, duration of anesthesia and surgery; and several parameters previously reported as risk factors for postoperative urinary retention were recorded. The main objective wasto identify the prevalence of postoperative urinary retention in a surgical group in the Republic of Moldova. The secondary objective was to test the predictive value of a series of parameters (modifiable and non-modifiable) related to the patient or surgical treatment received as risk factors for urinary retention in the first 24 hours postoperatively. Statistical software used: Social Science Statistics (https://www.socscistatistics.com). Results The studied surgical population was homogeneous in terms of body mass, height, duration of surgery and anesthesia; heterogeneous by gender (62.2% male) and type of anesthesia (64% general anesthesia). Depending on the definition criteria, the prevalence of postoperative urinary retention varied between 5.5% and 7.9%. The preoperative unmodifiable risk factors for postoperative urinary retention: positive history for hypertension OR = 9.0 (X2 (1, N = 127) = 5.6, p = 0.017), diabetes mellitus OR = 5.1 (X2 (1, N = 127) = 5.36, p = 0.021) and stroke OR = 4.83 (X2 (1, N = 127) = 2.098, p = 0.148). Conclusions The prevalence of postoperative urinary retention in a single-center surgical population from the Republic of Moldova varies between 5.5% and 7.9%, depending on the criteria for postoperative urinary retention applied. This variation highlights the need for a consensus on diagnostic criteria for postoperative urinary retention is needed. Patients with hypertension and diabetes mellitus were more likely to develop postoperative urinary retention. Patients with pre-existing neurological disorders such as positive history for stroke and diabetic polyneuropathy were more susceptible for postoperative urinary retention.

Analysis of MTHFR C677T genotype and related factors in H-type hypertension in Tibet, China

Background and aimsH-type hypertension is essential hypertension combined with high homocysteine, and both synergistically increase the risk of cardiovascular and cerebrovascular events. The aim of this study was to investigate the risk factors of H-type hypertension in Tibetan plateau population and correlation with MTHFR C677T gene.Methods and resultsA multi-stage cluster random sampling method was used to select the research subjects in Tibet Autonomous Region from June 2020 to November 2021. Among Tibetans, the incidence of H-type hypertension accounted for 84.31% of hypertensive patients. The logistic regression analysis demonstrated that age, uric acid (UA), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) were risk factors for the prevalence of H-type hypertension, the OR (95% CI) was 1.083(1.073–1.094), 1.002(1.001–1.004), 1.240(1.050–1.464) and 2.274(1.432–3.611), respectively. MTHFR C677T TT genotype patients with H-type hypertension OR (95% CI) was 1.629(1.004–2.643). Based on this, a nomogram model was established, and the reliability of the model was proved by area under ROC curve, Brier score and average absolute error. The model’s results indicate that for every five years of age, the score increases by 6 points; for a 2mmol/L increase in TG, the score increases by 5.5 points; for a 1mmol/L increase in LDL-C, the score increases by 10 points; and individuals with the TT genotype receive 8 points. The higher the score, the greater the risk of disease.ConclusionThe MTHFR C677T TT genotype is a risk locus for Tibetan patients with H-type hypertension, with age, TG, and LDL-C were identified as risk factors for the disease.

Evaluating A Multicomponent Chronic Disease Management Pilot Intervention among Korean Patients with Hypertension and Diabetes.

A local clinic-based chronic disease management intervention including care planning, education about disease management, monitoring, and evaluation of the achievement of objects was introduced in Korea in 2019. We evaluated the effect of the intervention on medication adherence in patients with hypertension and diabetes. In 2019, a one-year retrospective case-control group study design was performed using data from the National Health Insurance Service in Korea. Propensity score matching was used to control for selection bias. Medication adherence, calculated by medication possession rate, was the dependent variable. We conducted multivariate logistic regression analyses to examine the association between participation in the intervention and medication adherence, adjusting for covariates. A control group was set as a reference for participation in the full/partial component intervention. The proportions of participants in the full component intervention in the experimental group were 43.2% and 42.6% for patients with hypertension or diabetes, respectively. Both these groups tended to be more medication adherent than their counterparts (hypertension OR: 1.23, 95% CI 1.03-1.45, diabetes OR: 1.64, 95% CI: 1.24-2.17). Institutionalizing a comprehensive chronic disease management program using multidisciplinary teams in the primary care context is crucial. Also, it is necessary to refine reimbursement payment systems.

A SYSTEMATIC REVIEW AND META-ANALYSIS: RISK FACTORS OF MORTALITY COVID-19

Background: COVID-19 is still a threat throughout the world because of its high morbidity and mortality. Comorbid diseases like hypertension, diabetes mellitus, and heart disease are some of the factors in the high severity and mortality of COVID-19 patients. Purpose: The study aims to analyze the effect of risk factors on COVID-19 mortality using a systematic review and meta-analysis. Methods: Articles were taken from online journal portals Pubmed, Garuda, and Google Cendekia, and all were published from October 2019 to December 2021 in full text and with an observational study design. The keywords used in searching the articles were "COVID-19", "sars cov 2", "2019-nCoV", "2019 novel coronavirus", "COVID-19 deaths", and "COVID-19 mortality". The articles were collected using a PRISMA diagram; then, data extraction was carried out in a systematic review. The data was synthesized by using a meta-analysis technique using the RevMan application. Results: This study analyzed 59 articles and found that age, hypertension OR=3.09 (2.69-3.56), sex OR= 1.29 (1.08-1.53), and diabetes mellitus OR=3.03 (2.66-3.44) are the risk factors for COVID-19 death. Conclusion: The death in COVID-19 patients is influenced by elderly age, gender, and comorbid disease (diabetes and hypertension). These COVID-19-death-related factors can help health workers recognize and prevent a more severe stage of the disease through more appropriate handling and treatment.

Association between a metabolic score for insulin resistance and hypertension: results from National Health and Nutrition Examination Survey 2007-2016 analyses.

The Metabolic Score for Insulin Resistance (METS-IR) offers a promising and reliable non-insulin-based approach to assess insulin resistance and evaluate cardiometabolic risk. However, evidence for the association between METS-IR and hypertension was still limited. Participants from the National Health and Nutrition Examination Survey (NHANES) database from 2007-2016 were selected for weighted multivariable regression analyses, subgroup analyses and restricted cubic spline (RCS) modeling to assess the association between the METS-IR and hypertension, as well as systolic blood pressure (SBP) and diastolic blood pressure (DBP). This study enrolled 7,721 adults aged ≥20 years, 2,926 (34.03%) of whom was diagnosed as hypertension. After adjusting for all potential covariates, an increased METS-IR (log2 conversion, denoted as log2METS-IR) was independently associated with a higher prevalence of hypertension (odd ratio [OR] 3.99, 95% confidence interval [CI] 3.19~5.01). The OR for hypertension in subjects with the highest quartile of METS-IR was 3.89-fold (OR 3.89, 95% CI 3.06~4.94) higher than that in those with the lowest quartile of METS-IR. This positive correlation became more significant as METS-IR increased (p for trend < 0.001). Log2METS-IR was significantly correlated with increase in SBP (β 6.75, 95% CI 5.65~7.85) and DBP (β 5.59, 95% CI 4.75~6.43) in a fully adjusted model. Consistent results were obtained in subgroup analyses. Hypertension, SBP and DBP all exhibited a non-linear increase with the rise in METS-IR. The minimal threshold for the beneficial association of METS-IR with hypertension, SBP and DBP were all identified to be 46.88. The findings of this study revealed a significant positive association between METS-IR and hypertension among US adults, suggesting METS-IR as a potential tool for assessing hypertension risk.

The ALDH2 gene rs671 polymorphism is associated with cardiometabolic risk factors in East Asian population: an updated meta-analysis.

Acetaldehyde dehydrogenase 2 (ALDH2) had reported as a prominent role in the development of cardiometabolic diseases among Asians. Our study aims to investigate the relationship between ALDH2 polymorphism and cardiometabolic risk factors in East Asian population. We searched databases of PubMed, Web of Science, and Embase updated to Oct 30th, 2023. We extracted data of BMI, Hypertension, SBP, DBP, T2DM, FBG, PPG, HbA1c, TG, TC, LDL-C and HDL-C. In total, 46 studies were finally included in our meta-analysis, containing, 54068 GG and, 36820 GA/AA participants. All outcomes related to blood pressure revealed significant results (hypertension OR=0.83 [0.80, 0.86]; SBP MD=-1.48 [-1.82, -1.14]; DBP MD=-1.09 [-1.58, -0.61]). FBG showed a significant difference (MD=-0.10 [-0.13, -0.07]), and the lipid resulted significantly in some outcomes (TG MD=-0.07 [-0.09, -0.04]; LDL-C MD=-0.04 [-0.05, -0.02]). As for subgroups analysis, we found that in populations without severe cardiac-cerebral vascular diseases (CCVDs), GG demonstrated a significantly higher incidence of T2DM (T2DM OR=0.88 [0.79, 0.97]), while the trend was totally opposite in population with severe CCVDs (T2DM OR=1.29 [1.00, 1.66]) with significant subgroup differences. Our updated meta-analysis demonstrated that ALDH2 rs671 GG populations had significantly higher levels of BMI, blood pressure, FBG, TG, LDL-C and higher risk of hypertension than GA/AA populations. Besides, to the best of our knowledge, we first report GG had a higher risk of T2DM in population without severe CCVDs, and GA/AA had a higher risk of T2DM in population with severe CCVDs.Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023389242.

Exploring the risk factors associated with hypertension in children: A systematic review

Introduction: Hypertension in children is increasingly becoming a global concern due to its impact on long-term health. This is influenced by several risk factors that can favor the occurrence of hypertension in children. The purpose of this systematic review is to determine the risk factors that can affect the occurrence of hypertension in children.Methods: Searching articles using Medical Subject Heading (MeSH) with keywords of risk factor AND hypertension OR high blood pressure AND children OR child. This research used academic databases, including Scopus, CINAHL, ScienceDirect, and Google Scholar with inclusion criteria. The article discusses the risk factors for hypertension in children aged 6-19 years, no history of autoimmune and hematological disease, articles published in 2018-2023, studies using observational and quasi-experimental designs in English and using The Joanna Briggs Institute (JBI) Critical Appraisal method.Results: This research analyzed a total of seven articles. The risk factors for hypertension that often occur in children include excessive nutritional status, lack of physical activity, family history of hypertension, smoking habits in children, excess sodium consumption, and male gender have a higher risk of hypertension.Conclusion: Obesity has become the dominant factor in hypertension in children. It is recommended that children and adolescents exercise regularly, follow examinations at school or the nearest health facility, and maintain a healthy and regular diet. Keywords: children; hypertension; risk factor

Prevalence of somatic diseases in adults with attention deficit hyperactivity disorder in Japan is highest in people aged ≥40 years with mental disorders: a cross-sectional study of a Japanese health insurance claims database.

Studies have reported an association between attention deficit hyperactivity disorder (ADHD) and somatic diseases; however, the correlation of mental disorders with the association between ADHD and somatic diseases remains uninvestigated. This study investigated and compared the prevalence of somatic diseases among adults with/without ADHD, stratified by the presence or absence of mental disorders. This cross-sectional study (October 2020-September 2021), using data (June 2013-September 2021) from a Japanese health insurance claims database, included adult participants with a medical record of and receiving medication for ADHD (ADHD group); the control group (matched 1:5 by age/sex) comprised participants without ADHD. The prevalence and odds ratio (OR; ADHD versus control) of type 2 diabetes mellitus (T2DM), diabetes complications, hypertension, cardiovascular disease (CVD), dyslipidemia, gout and hyperuricemia, chronic obstructive pulmonary disease (COPD), non-alcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD/NASH), and atopic dermatitis were investigated. Pooled ORs for stratified analysis were calculated using the Mantel-Haenszel method. In the matched analysis sets, the ORs for all somatic diseases were significantly higher for the ADHD group (n=15,028) versus the control group (n=74,796). On stratified analysis, the Mantel-Haenszel ORs were significant for NAFLD/NASH (1.53; 95% confidence interval [CI]: 1.34, 1.73), diabetes complications (1.39; 95% CI: 1.09, 1.77), and gout and hyperuricemia (1.34; 95% CI: 1.19, 1.51). Furthermore, the stratum-specific ORs for T2DM, hypertension, and dyslipidemia were >1 and <1 in the presence and absence of mental disorders, respectively. The prevalence of all somatic diseases except atopic dermatitis increased with age. For participants aged ≥40 years, the Mantel-Haenszel ORs were significant for all somatic diseases except CVD, COPD, and atopic dermatitis. The prevalence of several somatic diseases, including chronic disorders, was high among adults with ADHD, particularly in those aged ≥40years and those with mental disorders.

Meta-Analysis the Effects of Hypertension, High Density Lipoprotein, and Diabetes Mellitus on the Risk of Stroke

Background: Stroke is defined as an interruption of the blood supply to the brain which is usually caused by a blockage by a blood clot. This causes disruption of the supply of oxygen and nutrients to the brain resulting in damage to brain tissue. This study aims to analyze and estimate the effect of hypertension, high-density lipoprotein, and diabetes mellitus on the risk of stroke. Subjects and Method: This study is a systematic review and meta-analysis using the PRISMA flow chart and the PICO model. Population: adults. Intervention: hypertension, high-density lipoprotein, and diabetes mellitus. Comparison: normal blood pressure, normal HDL, and normal blood sugar. Outcome: strokes. The databases used were PubMed, Google Scholar, Science Direct, and Proquest with keywords (hypertension OR "diabetes mellitus" OR "high-density lipoprotein") AND stroke AND ("cross-sectional" OR "case-control") AND aOR. There were 9 Case-Control studies and 4 Cross-Sectional studies published in 2013-2023 that met the inclusion criteria. Analysis was performed with RevMan 5.3. Results: 13 studies from Oman, Iran, Lebanon, Ghana, Finland, Nigeria, China, Japan, and Saudi Arabia were selected for meta-analysis. Total sample was 71,037. Had history of hypertension (aOR= 5.48; 95% CI = 2.26 to 13.32; p= 0.002) and diabetes mellitus (aOR = 1.93; 95% CI= 1.45 to 2.57; p&lt; 0.001) increased the risk of stroke. High HDL levels reduced the risk of stroke (aOR = 0.46; 95% CI = 0.27 to 0.79; p= 0.004). Conclusion: History of hypertension and diabetes mellitus increase the risk of stroke. However, high HDL levels reduce the risk of stroke. Keywords: hypertension, high-density lipoprotein, diabetes mellitus, stroke.

Associations between dietary magnesium intake and hypertension, diabetes, and hyperlipidemia.

Hypertension, diabetes, and hyperlipidemia significantly impact chronic diseases and mortality. Magnesium is an essential nutrient for maintaining critical physiological functions, and magnesium deficiency is often associated with adverse health outcomes. In a cross-sectional study of US adults, we aimed to explore dietary magnesium intake and its association with the prevalence of hypertension, diabetes, and hyperlipidemia in US adults over 20 years of age in NHANES 2007-2018. We obtained data on 24,171 samples of hypertension, 9950 samples of diabetes, and 12,149 samples of hyperlipidemia. We used multivariable logistic regression models adjusted for multiple sociodemographic, anthropometric, and lifestyle factors, with participants subdivided into five groups based on quintiles of daily dietary magnesium. After adjusting for the major lifestyle and dietary variables, an independent and significant inverse relationship between dietary magnesium and hypertension, diabetes, and hyperlipidemia was observed. Compared with the lowest quintile of magnesium intake, the prevalence of hypertension, diabetes, and hyperlipidemia was significantly reduced in the highest magnesium quintile. The OR of hypertension in the highest quintile was 0.66 (95% CI: 0.51-0.87; P trend < 0.001), the OR of diabetes was 0.56 (95% CI: 0.39-0.81; P trend < 0.001), and the OR of hyperlipidemia was 0.68 (95% confidence interval: 0.53-0.86; P trend = 0.007). In the subgroup analysis, most of the inverse relationships persisted. Our findings highlight the potential of magnesium-rich foods to prevent hypertension, diabetes, and hyperlipidemia in US adults. This article summarizes and discuss recent findings on: 1) A high dietary magnesium intake was associated with a lower prevalence of hypertension; 2) An inverse relationship between dietary magnesium with diabetes hyperlipidemia; 3) Monitoring and management of magnesium was important.

Maternal Factors Associated with Low Birth Weight Among Neonates Born at Thika Level 5 Hospital in Kiambu County, Kenya

Purpose: To determine maternal factors associated with low birth weight among neonates born at Thika Level Five Hospital in Kiambu County, Kenya.&#x0D; Methodology: Cross sectional convergent design was employed. The target group composed of mothers who delivered in the hospital during the study period (July-August, 2019). Census method was used to recruit participants for a quantitative study. Purposive sampling was used to select participants for FGDs and KIIs. Sample size was determined using the Cochran formula. Desired sample size was 210 mothers which was adjusted to 215 participants. Independent variables included: socio-demographic, socio-economic, socio-cultural, behavioral, and health of the mothers. Dependent variable was LBW which was classified further into LBW, very LBW, extremely LBW. (UNICEF, 2010). Quantitative and qualitative data were analyzed using Stata statistical version 14, logistic regression and NVivo version 14 respectively,&#x0D; Findings: ≥35 years of mothers OR=13.67, p=0.018, CL [1.55-120.12] and the second born children OR=2.98; p=0.025; CL [1.15-7.73] were associated with the overall LBW. Secondary level education OR=0.35; p=0.03; CL [0.14-0.91] was a protection against LBW. Meru OR=17.429, p=0.016, CI [1.7162-176.991] and other tribes OR=10.479, p=0.048, CI [1.025-107.124] were associated with low birth weight. Hypertension OR=3.59; p=0.038; CL [0.14-0.91] and malaria (OR=51.250, p=0.005, CL [3.185-822.132]) were associated with very LBW. ANC-attendance (OR=0.068, p=0.37, CL [0.0055-0.845]) was a protection against extremely LBW OR= 0.07; p=0,037; CL [0.01-0.85].&#x0D; Unique Contribution to Theory, Policy and Practice: ≥35 years of mothers are risk factors for low birth weight. Second child is at risk of being low birth weight. Neonates of Meru origin and other minority ethnic groups in Thika are at risk of being LBW. Secondary level education is a protection against low birth weight. Hypertension and malaria are risk factors for very low birth weight. ANC-attendance is a protection against extremely low birth weight. The County Government of Kiambu should develop suitable strategies of strengthening maternal and child services at level one.

Declined prevalence, improved awareness and control of hypertension are associated with spousal educational attainment: A mega-data study

Cardiovascular diseases, including hypertension, have posed a serious threat to human health in recent decades. Family-centered health promotion and disease control for the management of hypertension is gaining attention. In this study, we assessed the association between spousal educational attainment (SEA) and hypertension prevalence, awareness, and control, intending to provide new directions for family health care. A total of 71 211 191 reproductive-aged participants from the National Free NFPCP during 2013–2019 were included in the current study. Inverse probability weighting (IPW) via propensity models were used to adjust for the imbalance by SEA. Both multivariable-adjusted ORs and inverse-probability-weighted ORs were used to assess the association between SEA and the prevalence, awareness, and control of hypertension. ORs of prevalence, awareness, and control of hypertension with SEA stratified by sex, age, and residency type were also reported. Compared with participants with SEA of compulsory education, the inverse-probability-weighted ORs for hypertension were 0.97 (0.96–0.97), 0.99 (0.98–1.00), and 0.91 (0.88–0.93) for participants with SEA of senior high, college, and postgraduate, respectively. The corresponding ORs for hypertension awareness were 1.12 (1.10–1.13), 1.15 (1.13–1.16), and 1.38 (1.34–1.41). The increment of hypertension control associated with SEA was only identified in urban areas. Modification analyses revealed that urban participants were observed to have more healthy benefits associated with SEA; additional decreased prevalent hypertension and increased hypertension awareness associated with SEA were observed in wives and husbands respectively. Thus, SEA was associated with decreased prevalent hypertension and increased awareness and control of hypertension. Our findings call for increased participation of spouses in family-centered healthcare, with consideration of modified effects by gender, age, and residency type, to improve chronic disease prevention and control including hypertension.

COVID-19 in multiple myeloma patients: frequencies and risk factors for hospitalization, ventilatory support, intensive care admission and mortality –cooperative registry from the Grupo Brasileiro de Mieloma Multiplo (GBRAM)

IntroductionThis study evaluated outcomes and risk factors for COVID-19 in 91 Brazilian multiple myeloma (MM) patients between April 2020 and January 2022. ResultsOf the 91 MM patients diagnosed with COVID-19, 64% had comorbidities and 66% required hospitalization due to COVID-19, with 44% needing ventilatory support and 37% intensive care. Age (OR 2.02; 95%CI 1.02 – 7.7) and hypertension OR 4.5; 95%CI 1.3 – 15.5) were independently associated with hospitalization and certain MM therapies (corticosteroids and monoclonal drugs) were associated with ventilatory support (OR 4.3; 95%CI 1.3 – 14 and OR 5.7; 95%CI 1.8 – 18, respectively), while corticosteroids and immunomodulatory drugs were linked to ICU admission (OR 5.1; 95% CI 1.4 – 18 and OR 3.4; 95%CI 1.1 – 10, respectively). The overall mortality rate was 30%, with the highest rate observed in the ICU (73%). Additionally, the ECOG performance status was linked to increased mortality (OR 11.5; 95%CI 1.9 – 69). The MM treatment was delayed in 63% of patients who recovered from COVID-19. ConclusionsThe findings highlight the need for preventing COVID-19 and prioritizing vaccination among MM patients, as they have high rates of severe outcomes in the event of COVID-19. It is also essential to monitor the potential clinical impacts of COVID-19 on MM patients in the long-term. Given the limited resources available in treating MM patients in Brazil during the COVID-19 pandemic, outcomes might be worse in this population.

The Effect of Progressive Muscle Relaxation (PMR) Exercise on Blood Pressure Reduction in Hypertensive Clients: A Literature Review

Compliance with taking antihypertensive drugs is low amongst patients with hypertension. Uncontrolled blood pressure causes heart disease, kidney failure, diabetes, and stroke. It is necessary to have alternative support in controlling blood pressure by using progressive muscle relaxation exercises. This study aimed to determine the effect of progressive muscle relaxation on reducing blood pressure in patients with hypertension. The research design used was a literature study with a sample size of 20 journals: Pubmed (n=2), Proquest (n=4), Science Direct (n=8) and Biomed Central (n=6). By using the keyword search data “Progressive Muscle Relaxation AND Blood Pressure AND Hypertension OR Hypertensive” and using analysis techniques with thematic analysis, 95% of the results of the study reported that there was a decrease in systolic and diastolic values in hypertensive patients before and after the progressive muscle relaxation intervention and 5% reported that there was no change. Progressive muscle relaxation is effective for lowering blood pressure in hypertensive patients.&#x0D; Keywords: Progressive Muscle Relaxation, Blood Pressure, Hypertension

Long-term trajectories of community integration: identification, characterization, and prediction using inpatient rehabilitation variables

ABSTRACT Background Community integration (CI) is often regarded as the foundation of rehabilitation endeavors after stroke; nevertheless, few studies have investigated the relationship between inpatient rehabilitation (clinical and demographic) variables and long-term CI. Objectives To identify novel classes of patients having similar temporal patterns in CI and relate them to baseline features. Methods Retrospective observational cohort study analyzing (n = 287) adult patients with stroke admitted to rehabilitation between 2003 and 2018, including baseline Functional Independence Measure (FIM) at discharge, follow-ups (m = 1264) of Community Integration Questionnaire (CIQ) between 2006 and 2022. Growth mixture models (GMMs) were fitted to identify CI trajectories, and baseline predictors were identified using multivariate logistic regression (reporting AUC) with 10-fold cross validation. Results Each patient was assessed at 2.7 (2.2–3.7), 4.4 (3.7–5.6), and 6.2 (5.4–7.4) years after injury, 66% had a fourth assessment at 7.9 (6.8–8.9) years. GMM identified three classes of trajectories: Lowest CI (n=105, 36.6%): The lowest mean total CIQ; highest proportion of dysphagia (47.6%) and aphasia (46.7%), oldest at injury, largest length of stay (LOS), largest time to admission, and lowest FIM. Highest CI (n=63, 21.9%): The highest mean total CIQ, youngest, shortest LOS, highest education (27% university) highest FIM, and Intermediate CI (n=119, 41.5%): Intermediate mean total CIQ and FIM scores. Age at injury OR: 0.89 (0.85–0.93), FIM OR: 1.04 (1.02–1.07), hypertension OR: 2.86 (1.25–6.87), LOS OR: 0.98 (0.97–0.99), and high education OR: 3.05 (1.22–7.65) predicted highest CI, and AUC was 0.84 (0.76–0.93). Conclusion Novel clinical (e.g. hypertension) and demographic (e.g. education) variables characterized and predicted long-term CI trajectories.

Underweight and Normal Weight Central Obesity Among Filipinos and its Association with Cardiovascular Risks and Diseases

In most epidemiological studies underweight and normal weight central obesity groups are either underrepresented, excluded, or merged to the normal weight category. This study aims to compare underweight and normal weight central obesity groups and possible age and gender differences in association with cardiovascular risk and diseases using a previous local study. Methods: Participants were Filipinos aged 20 years or older who had participated in and completed the desired data in the National Nutrition and Health Survey 2008. Participants were categorised into two groups: underweight and normal weight central obesity. The profiles of the groups were compared and their association with cardiovascular risks and diseases determined, using adjustment models for age and sex. Results: A total of 3,009 participants were included in this study: 684 (22.7%) underweight and 2,325 (77.3%) normal weight central obesity. The mean age for underweight participants was 47.8 years versus 43.2 years for normal weight central obesity; 56.6% of the participants were female and 43.4% were male. In comparison to normal weight central obesity using adjustment models for age and sex, ORs were as follows: hypertension OR 1.49, diabetes OR 1.71, and dyslipidaemia OR 1.8. Using a sex stratified model there were significant differences in diastolic blood pressure (mean, male 78 versus female 75), triglycerides (mean, male 117 versus female 106), HDL level (mean, male 40.3 versus female 41.6) and LDL level (mean, male 99 versus female 115). Using an age stratified model, coronary artery disease ORs were 25th percentile (OR 2), 50th percentile (OR 2.4) and 75th percentile (OR 1.9); cerebrovascular accident 75th percentile (OR 2.5) and peripheral artery disease 50th percentile (OR 3.4). Hypertension 25th percentile (OR 2.0), 50th percentile (OR 2.4) and 75th percentile (OR 1.9); diabetes 25th percentile (OR 6.7), 75th percentile (OR 1.7) and dyslipidaemia 25th percentile (OR 1.2) were significantly higher in the underweight group. Conclusion: Greater association in hypertension and coronary artery disease in all age groups, stroke among the older age group, and diabetes among the younger and older age groups were seen among underweight participants compared to normal weight central obesity among Filipinos.

Targeted care coordination towards patients with a history of multiple readmissions effectively reduces readmissions.

To decrease hospital readmission rates, clinical practices create a transition of care (TOC) process to assess patients and coordinate care postdischarge. As current evidence suggests lack of universal benefit, this study's objectives are to determine what patient and process factors associate with hospital readmissions, as well as construct a model to decrease 30-day readmissions. Three months of retrospective discharged patient data (n = 123) were analysed for readmission influences including: patient-specific comorbidities, admission-specific diagnoses, and TOC components. A structured intervention of weekly contact, the Care Coordination Cocoon (CCC), was created for multiply readmitted patients (MRPs), defined as ≥2 readmissions. Three months of postintervention data (n = 141) were analysed. Overall readmission rates and patient- and process-specific characteristics were analysed for associations with hospital readmission. Standard TOC lacked significance. Patient-specific comorbidities of cancer (odds ratio [OR] 6.27; 95% confidence interval [CI] 1.73-22.75) and coronary artery disease (OR 6.71; 95% CI 1.84-24.46), and admission-specific diagnoses within pulmonary system admissions (OR 7.20; 95% CI 1.96-26.41) were associated with readmissions. Post-CCC data demonstrated a 48-h call (OR 0.21; 95% CI 0.09-0.50), answered calls (OR 0.16; CI 0.07-0.38), 14-day scheduled visit (OR 0.20; 95% CI 0.07-0.54), and visit arrival (OR 0.39; 95% CI 0.17-0.91) independently associated with decreased readmission rate. Patient-specific (hypertension-OR 3.65; CI 1.03-12.87) and admission-specific (nephrologic system-OR 3.22; CI 1.02-10.14) factors associated with readmissions which differed from the initial analysis. Targeting a practice's MRPs with CCC resources improves the association of TOC components with readmissions and rates decreased. This is a more efficient use of TOC resources.