Prevalence Of End-organ Damage Research Articles

Abstract 15917: Burden of End Organ Damage Among Patients With Hypertension and Associated Patient- and Facility-Level Factors in Ghana

End-organ damage (EOD) are a serious complication of uncontrolled hypertension stroke, kidney disease, retinopathy, cardiovascular disease, and neuropathy are the most prevalent. The studies of EOD and associated factors are scarce in Sub-Saharan Africa. We explored the burden of EOD and the associated patient- and facility-level factors among patients with hypertension in Ghana. Methods: We recruited 14 health facilities and 15 patients with hypertension from each facility. Health facilities with hypertension services and patients on hypertension treatment were eligible for inclusion. The outcome of interest was the self-report of one or more of the most prevalent EOD. The patient-level independent variables were adherence to hypertension treatment, alcohol consumption, employment, and education. At the facility level, we included the facility type, size, ownership, and availability of hypertension guidelines as independent variables. The mixed-effect logistic regression model was used. Results: The study included two hundred and nine (209) patients. 172 (82%) were female, and the mean (±SD) age of participants was 61 (±12.7). 80 (38%) participants reported having suffered at least one EOD, the most prevalent being retinopathy, 38 (18%), followed by cardiovascular complications, 24 (11%). Employment was associated with lower odds (Odds Ratio: 0.42, 95% CI: 0.19, 0.90) of EOD than unemployment and tertiary or higher education was associated with lower odds (Odds Ratio: 0.32, 95% CI: 0.14, 0.74) of EOD than primary or lower educational level. Higher adherence to hypertension treatment was associated with lower odds (Odds Ratio: 0.88, 95% CI: 0.79, 0.97) of EOD. Conclusion: The prevalence of EOD is high. Patient-level interventions to improve hypertension care are needed with a focus on socio-determinants of health. Largescale studies are recommended to explore the facility-level factors that impact the development of EOD in Ghana.

Prevalence of End-Organ Damage, Beta Cell Reserve, and Exocrine Pancreas Defect in Fibrocalculous Pancreatic Diabetes: An Eastern India Perspective.

Background:Data on prevalence and burden of end-organ damage in fibrocalculous pancreatic diabetes (FCPD) from eastern India is scant. This study investigated the burden of end-organ damage and exocrine pancreatic defect in FCPD patients in Eastern India.Materials and Methods:Consecutive FCPD patients underwent evaluation of glycemic control, C-peptide, fecal elastase, body fat percent, tests for cardiac autonomic neuropathy (CAN), neuropathy, nephropathy, and retinopathy which were compared with data from type-1 diabetes (T1DM) and type-2 diabetes (T2DM).Results:Data from 101 FCPD, 41 T1DM, 40 T2DM, and 40 controls were analyzed. Body fat percent was lowest in FCPD and T1DM. Similarly, fasting and stimulated C-peptide was significantly lowest in T1DM, followed by FCPD. Significant elevations in stimulated C-peptide were observed in FCPD. Fecal elastase was lowest in FCPD. Exocrine pancreas defect in FCPD, T1DM, and T2DM was 100%, 53.66%, 27.5%, respectively. HbA1c was worst in FCPD. About 40% of FCPD patients had CAN while 13.33% had borderline CAN. Isolated parasympathetic dysfunction was the commonest (66.67%) among them. FCPD patients with CAN had lower fecal elastase, higher HbA1c, microalbuminuria, steatorrhea, neuropathy, retinopathy, and nephropathy, compared to those without CAN. On binary logistic regression, diabetes duration was a significant predictor of end-organ damage in FCPD. Fecal elastase and body fat percent were independent predictors for insulin therapy in FCPD.Conclusion:CAN is common in FCPD while exocrine pancreas defect is most severe in FCPD followed by T1DM and T2DM. Fecal elastase has an important prognostic role for insulinization in FCPD. Role of pancreatic enzyme replacement on glycemic control in diabetes with exocrine pancreas defect needs investigation.

End Organ Damage in Hypertensive Geriatric Age Group: A Cross Sectional Study

Objective: Hypertension is one of the common risk factors for cardiovascular and cerebrovascular diseases/disorders A developing country like India faces the double burden of communicable and non-communicable diseases; of the which, hypertension is the most important treatable cause of mortality and morbidity with loss of functional capacity and decline in the quality of life. Aim: To study the prevalence of end organ damage in the hypertensive geriatric age group. Method: The present study was a cross sectional study, conducted in 150 elderly patients admitted in MGM Hospital, Navi Mumbai, India with the diagnosis of stage I or II hypertension from 2011 to 2013. Results: Data analysis of the present study showed that 68% of elderly population aged between 60 to 69 years were suffering from hypertension. Compared to males, females had a higher rate of target organ damage. This study found that out of all patients with total end organ damage, 54.6 % had CVS complications, 15.7 % had hypertensive retinopathy, 25.9 % and 18.51 had raised creatinine and proteinuria respectively. 19.4 % had cerebrovascular accident (CVA) complications. Among Cardiovascular related complications Coronary artery disease (CAD) was found in 21 patients, out of them 7 had Congestive cardiac Failure (CCF). Left Ventricular Hypertrophy (LVH) was the most common complication and seen in 38 patients. 13.8 % patients had Regional Wall Motion Abnormality (RWMA) Conclusion: The present study concluded that Isolated Systolic Hypertension (ISH) is the commonest type of hypertension in geriatric age group. This study concluded that the most common risk factors of HTN in the elderly are sedentary life style, dyslipidemia and extra salt intake while the most common end organ damage was observed to be Left Ventricular Hypertrophy followed by renal dysfunction.
 Keywords: Hypertension, Isolated Systolic Hypertension, Dyslipidemia.

Status of End Organs in Newly Detected Rural Essential Hypertensives: A Study from Southern India

Background: Hypertension is associated with end-organ damage (EOD). Since EOD is a risk factor for cardio- and cerebrovascular complications, it is a major requirement for these to be detected, prevented, and treated. Objective: The objectives of our study were to determine out the prevalence of EOD in newly detected rural essential hypertensives, identify the pattern of EOD involved, and also assess the interrelationship among them. Methods: A total of 147 consecutive patients with newly diagnosed essential hypertension and, attending the outpatient clinic, were included in this study based on a set of inclusion and exclusion criteria. Patients with comorbid illnesses were excluded from the investigation. The significance of a range of variables involved was evaluated using statistical software. Results: Amongst the cases, there were 79 males (M) and 68 females (F). Their mean and median ages were 55 (standard deviation (SD) = 9.90) and 54 years, respectively. Of these 86% (70 M and 56 F) had one or more EODs; an observation which was very close to statistically significant (P = .054). In our patients, microalbuminuria (35%), diastolic dysfunction (59%), increased left ventricular (LV) mass (68%) and retinopathy (69%) were particularly notable. Increased LV mass had a strong association with retinopathy, microalbuminuria, and diastolic dysfunction. Conclusion: The presence of one or more EODs in newly detected hypertension indicates widespread vascular damage that carries a high risk for cardio- and cerebrovascular morbidity and mortality. Hence, there is an urgent requirement not only for complete evaluation but also to stimulate an increased awareness amongst physicians and the general public, regarding the control of blood pressure.

PREVALENCE OF ARTERIAL HYPERTENSION, ASSOCIATED DISEASES AND END-ORGAN DAMAGES IN REPUBLIC OF BASHKORTOSTAN

Aim. To estimate arterial hypertension (AH) prevalence among population of Republic of Bashkortostan (RB), prevalence of end-organ damages and the associated clinical conditions in hypertensive patients. Material and methods. 1648 people from 10 regions of RB were examined. Standard questionnaires were used - socially-demographic, health con???dition, WHO cardiologic questionnaire, women’s health. Results. The urban and rural AH prevalence, AH prevalence in men and women, as well as AH comorbidities prevalence is studied. There is a high fre???quency of myocardial infarction and cerebral strokes in AH patients. Prevalence of end-organ damage and the associate clinical conditions is various in men and in women. С onclusion. Available data will help to develop primary and secondary AH prevention taking into account risk factors.

Perfil del hipertenso adulto mayor tratado

There is concern about the consequences that hypertension has on the well being and mortality of elderly people.To compare the morbidity and mortality of young and old treated hypertensive subjects.Retrospective analysis of hypertensive subjects treated and followed for a period of 10 +/- 9 years. Subjects that started treatment at an age of less than 65 years and those that started treatment after 65 years of age, were analyzed separately. The antihypertensive drugs used for treatment and blood pressure reduction were similar in both groups.Subjects that started treatment after 65 years of age (157 females and 133 males) had lower serum cholesterol levels and a higher prevalence of end organ damage than their younger counterparts. Women over 65 had a higher body mass index than women of less than 65. Males over 65 years had a higher prevalence of diabetes than younger males. Mortality and complications of hypertension were higher in subjects that started treatment after 65 years of age.The higher mortality of subjects that start hypertensive treatment after 65 years of age, is indicative of the need to detect and treat hypertension at the earliest possible moment.

Management of neonatal candidiasis. Neonatal Candidiasis Study Group.

To identify areas of consensus and controversy in the management of neonatal candidiasis. A questionnaire was distributed to US-based members of the Pediatric Infectious Diseases Society and a sampling of US neonatologists. Three hundred eighty evaluable questionnaires were returned (42% of those mailed). Ninety-five percent of respondents have cared for an infant with systemic candidiasis in the past 2 years. Fluconazole and liposomal amphotericin are used to some extent by 90 and 69% of respondents, respectively. A single blood culture positive for Candida led to a recommendation for immediate treatment by 99%; amphotericin B was the preferred therapy for candidemia (88%). More than 80% of respondents would request cerebrospinal fluid, urine and repeat blood cultures and ophthalmologic examination in the evaluation of candidemia. If a cerebrospinal fluid culture is positive, 25% would use amphotericin B alone whereas 62% would add flucytosine. For candiduria Society members chose fluconazole therapy more often than did neonatologists, 23% vs. 3.4% (P<0.001). There was no consensus concerning duration of therapy, use of an amphotericin B test dose or management of a central catheter in place during candidemia. Systemic candidiasis in neonates is a frequently encountered clinical problem. There is agreement that prompt therapy with amphotericin B is required if a blood culture is positive for Candida and that such infants require additional evaluations. Other antifungals (fluconazole, liposomal amphotericin B) are used to some extent in this population. Many issues in management have no clear consensus and warrant further research.