Prevalence Of High Blood Pressure Research Articles

Incidence of Cardiovascular Disease Risk Factors Among Football Players in Ashanti Region of Ghana

Background: Sporting activity promotes healthy living, increases health benefits, mitigates some chronic disease conditions and prevents premature death. Cardiovascular disease risks during sports activities and exercises are low but in some instances of undiagnosed pathological cardiac conditions, players could be at the risk of tragic cardiovascular events. Objectives: The aim of the study was to determine the prevalence of high blood pressure, abnormal fasting blood sugar and lipid profiles, as probable cardiovascular disease risk factors among male soccer players. Methods: A cross-sectional study was used and 86 football players of the premier, 1st and 2nd divisions’ teams were used for the study. The blood pressure and biochemical markers such as fasting blood glucose and lipid profiles of the players were assessed. Results: Out of the 86 players, 8 (9.3%) were goalkeepers, 29 (33.7%) were defenders, 34 (39.5%) were midfielders, while 15 (17.4%) were strikers. The prevalence of hypertension and diabetes among the study population were 9.3% each. The most prevalent abnormality was reduced high density lipoprotein (38.4%), followed by hypercholesterolemia (27.9%) and (7.0%) high low density lipoprotein respectively. Conclusions: The incidence of high blood pressure, high blood glucose, reduced high density lipoprotein and hypercholesterolemia observed in the study indicate that the players are at increased risks of cardiovascular diseases.

Hypertension among health workers in Mahajanga : prevalence, knowledge

Introduction. Variations in the prevalence of hypertension according to the type of profession are evidenced due to the differences of constraints inside each professional activity. Our objective was to determine the prevalence of hypertension among health workers in Mahajanga. Patients and methods. We carried out a descriptive cross-sectional study during 6 months from january to june 2017 in Mahajanga. Our study population consisted of all people working in health establishments. The World Health Organization criteria were used to define hypertension: systolic blood pressure ≥ 140 mmHg and / or diastolic blood pressure ≥ 90 mmHg. Results. We enrolled 220 participants. The mean age was 39.4 years old. Participants worked in university hospitals in 42.3%, in basic health centers in 10%, in private hospitals and clinics in 42.3% and in private medical offices in 5.4% of cases. Thirty-four participants (15.5%) were hypertensive. The association of hypertension with older age and obesity was significant. The prevalence of hypertension was25.9% for physicians, 0 to 12.1% for servants, nursing assistants, laboratory technicians and nurses. Radiology technicians and anesthesiologists were affected in 60.0% and 33.3% of cases, respectively. The hypertensive patients were aware of their condition in 76.5% of the cases. Those who were already known to be hypertensive were treated in 96.2% of cases. Those who were treated had normal blood pressure in76.9% of the cases. Conclusion. The difference in the prevalence of high blood pressure was evident among health professionals in Africa and compared to the general population of other cities in Madagascar. Hypertensive people arrive at the hospital with complications despite the proximity and ease of diagnostic means; Our country needs simple but more incisive information to be shared with the health professional and then with the community to increase the number of patients better taken care.

High Blood Pressure and Stroke in the City of Lubumbashi: Determinants and Socio-Demographic Characteristics, Case of the Rail Ways Company Hospital

Introduction: We conducted a cross-sectional study to describe the epide-miological and sociodemographic situation of stroke and high blood pres-sure at the Lubumbashi rail ways company hospital. Methodology: Our cross-sectional analytical study is spread over a period of one year, from January 1st to December 31st, 2018. The study population is the one having suffered from high blood pressure and stroke at the Lubumbashi railways company hospital during our period. Our sampling is exhaustive and its size is 487 patients among 372 high blood pressure patients. The data were collected on Excel and analyzed on SPSS version 23. Results: The prevalence of high blood pressure is 76.4%. The average age of hypertensives is 62.6 ± 9.4 years. The extreme ages are respectively 17 and 91 years. Women are the majority with 52.9%. There is no statistically significant link between sexes, living in urban or rural areas, diabetes, or renal failure with the occurrence of high blood pressure at the Lubumbashi railways company hospital during our study period (P-value > 0.05). No statistically significant association was observed between vital records and arterial hypertension at the Lubumbashi railways company hospital during our study period (P-value > 0.05 and Chi-square 0.05). Living in an urban area (Chi-square: 5.02, P-value: 0.025) and kidney failure (Chi-square: 4.1, P-value: 0.04) predispose to accidents cerebrovascular disorders, whereas being diabetic does not predispose to stroke (Chi-square, 0.1, P-value: 0.7). Conclusion: High blood pressure remains a reality in our environment. Special attention must be paid to this pathology that spares no one. The consequences inherent to this pathology (stroke, death and even disability) remain formidable.

A Preliminary Study on Prevalence of certain Risk Factors for Non-communicable Diseases in a Rural Population of Karnataka, india

Background: In India the burden of non-communicable diseases (NCDs) has overtaken that of communicable diseases. Since two-thirds of India’s population continues to live in rural areas which have limited healthcare resources, studying the prevalence of non-communicable diseases and their risk factors in rural areas should take precedence in order to evolve a better health-care system. Objective: To study the prevalence of certain risk factors for NCDs in a rural population. Method: A detailed survey was conducted among adults above 25 years at Alike village in Karnataka. Information on behavioural risk factors like tobacco use, alcohol intake, physical activity and family history of hypertension, diabetes, ischaemic heart disease and stroke were recorded. Blood pressure was measured, BMI was calculated and categorised according to the Consensus Statement for Diagnosis of Obesity, Abdominal obesity and Metabolic Syndrome for Asian Indians. Descriptive analyses was done using SPSS version 21.0. Results: The mean ( ± SD) age of the population was 50.9 years ( ± 11.4). 678 adults were surveyed of which 35.5% had a family history of either hypertension, diabetes, IHD or stroke. Current tobacco use (smoke or smokeless) was prevalent among 34.2% and alcohol intake was 10.3%. The prevalence of inadequate physical activity was 65.8%. One hundred and thirty eight (20.4%) subjects were underweight, 103 (15.2%) were overweight and 133 (19.6%) were obese. The prevalence of high blood pressure was 41.8%. Conclusion: There is a high prevalence of risk factors for NCDs in this rural community. This necessitates the targeting of modifiable risk factors by improving awareness in the rural community.

Anthropometric indicators associated with high blood pressure in children living in urban and rural areas.

Objective:to evaluate anthropometric and demographic indicators associated with high blood pressure in children aged 6 to 10 years in urban and rural areas of Minas Gerais.Method:this is a cross-sectional study with 335 children. Anthropometric, demographic and blood pressure data were collected. The statistics analyzes were performed using the chi-square, t-student, Mann-Whitney and logistic regression tests, and the odds ratio was the association measure.Results:the prevalence of high blood pressure was significantly higher among rural children. In the urban area, the chance of high blood pressure was higher in children who had a high body mass index (2.97 [1.13-7.67]) and in the rural area, in those who had increased waist circumference (35.4 [3.0-406.2]) and the age range of 9-10 years (4.29 [1.46-12.6]).Conclusion:elevated body mass index and waist circumference were important anthropometric indicators for high blood pressure, as well as age in children living in rural area. The evaluation of body mass index and waist circumference, in addition to nutritional assessments, represents an important action for the screening of high blood pressure in children from different territorial contexts.

Prevalence, Awareness and Control of High Blood Pressure in a Semi-Urban Area of Cameroon: An Analysis of May Measurement Month 2019 Screening Results

Background: High blood pressure (HBP) is a global health crisis. More than one billion people in the world suffer from HBP and most of them live in low and middle income countries where the prevalence is increasing. Un-awareness, low treatment and control rates are the main barriers to the fight against this disease and the associated cardiovascular disease risk. Aims: To highlight the importance of measuring blood pressure and identify and reduce the blood pressure (BP) of those who require an intervention to lower their BP according to current guidelines. Methods: This was a cross-sectional study. A HBP screening was organized in two market places and at the district hospital of a semi-urban area in Cameroon during three days—from the 28th to the 30th May 2019. We included all people aged at least 18 years and who accepted to take part to the study. We used a predesigned form and electronic blood pressure machines for the screening. HBP was defined as having a BP ≥ 140/90 mmHg or taking antihypertensive medications. All statistical analysis were done using IBM SPSS version 20.0. Results: We included 200 people in the study. Women were more represented in our sample (57.5%) and the median age was 40 years [30 - 51]. More than a third of the participants had not taken their BP in the past year and 16% of them had never measured their BP. HBP was detected in 49 (24.5%) people among whom 25 (51.0%) were aware of their condition. Among those who were aware they had HBP, 17 (68.0%) were taking antihypertensive medications and as a single drug regimen in most cases (64.7%). BP was controlled in 9/17 (52.9%) people. Conclusion: Nearly one quarter of people living in semi-urban area in Cameroon has HBP. We have found in this area a high rate of unawareness and undertreatment of HBP.

Número de passos para discriminar pressão arterial elevada em jovens: quantos são o suficiente?


 
 
 A relação entre a prática de atividade física e pressão arterial (PA) tem sido reportada entre jovens. Contudo, pontos de corte do número de passos para discriminar PA elevada na população pediátrica ainda são incertos. O objetivo do presente estudo foi avaliar quantos passos por dia são suficientes para discriminar PA elevada em crianças e adolescentes. Estudo transversal com 1.044 escolares (456 meninos), de seis a 17 anos de idade, do município de Amargosa, Bahia, Brasil. A PA foi mensurada e a PA elevada foi classificada como sistólica ou diastólica ≥ percentil 95 de acordo com sexo, idade e estatura. O número de passos diários foi estimado por pedômetro. Curvas Receiver Operating Characteristic foram construídas e a área sob a curva, sensibilidade, especificidade e intervalos de con ança (IC) de 95% foram calculados, com análises separadas por sexo. A prevalência de PA elevada foi de 27,8%. O número de passos foi preditor de PA elevada tanto para o sexo masculino (acurácia = 0,55; IC95%: 0,51-0,60) quanto para o feminino (acuraria = 0,58; IC95%: 0,54-0,62). Os pontos de corte com maior equilíbrio entre sensibilidade e especificidade foram 14.228 passos para o sexo masculino e 10.796 passos para o feminino. O número de passos por dia, avaliado por pedômetro, foi preditor de PA elevada nas crianças e adolescentes investigados. Em termos práticos, sugere-se a utilização de 14.000 e 11.000 passos por dia para discriminar PA elevada em jovens do sexo masculino e feminino, respectivamente. Esses achados podem ser úteis para subsidiar ações de enfrentamento à PA elevada na infância e adolescência.
 
 

The analysis of the association of sleep with high blood pressure among children and adolescents aged 6-16 years in Beijing

Objective: To investigate the sleep status in children and adolescents and explore the relationship between the sleep and high blood pressure in them. Methods: Data was from the Schoolbased Cardiovascular and Bone Health Promotiow Program (SCVBH) in Beijing. And 13 471 children and adolescents aged 6-16 years were selected from grades 1 to 4 in 8 primary schools, grade 1 in 21 middle schools and senior grade 1 in one twelve-year education school in Dongcheng, Fangshan, Miyun and Tongzhou Districts of Beijing during 2017-2018 by using a cluster sampling method. Self-reported questionnaires were used to collect the demographic characteristics, lifestyle habits of children and adolescents. The blood pressure was measured by electronic sphygmomanometer. Multiple logistic regression model was used to analyze the association between sleep and hypertension risk. Results: The sleep duration was (8.4±1.1) hours. The prevalence of high blood pressure was 15.0%(2 021/13 471). The incidence of mouth breathing, slobber, snoring, and suffocate was 28.4%(3 823/13 471), 23.6%(3 184/13 471) and 18.7%(2 513/13 471), 2.8%(378/13 471) respectively. After adjusting for age, gender, snoring, mouth breaking, slobber, suffocate, the time for bed and sleep duration, we found that snoring and sleep duration (5.0-6.9 h) were both associated with high blood pressure (OR=1.49, 95%CI:1.32-1.69; OR=1.53, 95%CI: 1.28-1.81). Conclusion: Snoring and sleep duration were positively associated with high blood pressure in this study. Interventions focusing on sleep status should be developed to reduce the incidence of high blood pressure in children and adolescents.

Prevalence of High Blood Pressure among Civil Servants in the City Of Winnipeg

A mobile hypertension awareness campaign was created to: 1) determine the prevalence of hypertension in Winnipeg, Manitoba, Canada, 2) increase hypertension awareness, 3) identify reasons for lack of therapy adherence. The team participated in a wellness fair organized by the City of Winnipeg Occupational Health from September 2017 to March 2018 in the City of Winnipeg. 437 (310 males and 127 female civil servants participated from different departments including Fire Paramedic, Administration, Public Works and Transit. Blood pressure (BP) readings (systolic/diastolic) were classified as: Normotensive (90-120)/(60-80); Pre- Hypertensive (121-139)/(81-89); Stage 1 Hypertensive (140-159)/(90-99); and Stage 2 Hypertensive (>160/>100). Forty percent (175) of the participants presented with elevated BP. Additionally, 11% (46 of the participants, average age 53yrs) reported currently taking anti- hypertensive medications. However, of these 37% were pre hypertensive and 45% exhibited uncontrolled BP (>140/90 mmHg). The remaining 137 participants were not taking hypertensive medication. Two out of 5 subjects with BP reading of 180/100 (Stage 2) had not been diagnosed previously with hypertension. Four out of 43 subjects in the Stage 1 group were previously diagnosed with high BP but had stopped taking their medications for the last two years. The reasons for lack of therapy adherence included denial, and being unaware of the health consequences of improper management of hypertension. The prevalence of high BP and particularly hypertensive emergencies was higher than expected. A public mobile hypertension clinic may provide a strategy for increasing the awareness of impending medical need. These hypertension awareness clinics should be integrated into a strategic plan to prevent the impact of hypertension on our society. Supported by CIHR, Western Grain Research Foundation, ARDI, SaskFlax and St Boniface Foundation.

Socioeconomic Inequalities in the Risk Factors of Noncommunicable Diseases Among Women of Reproductive Age in Sub-saharan Africa: A Multi-Country Analysis of Survey Data.

Background: Understanding the socioeconomic discordance associated with the risk factors of non-communicable diseases (NCDs) can help direct effective interventions to end its persistent occurrence. We examined the prevalence of high blood pressure, overweight/obesity, alcohol consumption and tobacco use among women and compared across wealth quintiles in sub-Saharan Africa countries.Methods: This study included 454,080 women of reproductive age (15–49 years) from the current Demographic and Health Survey (DHS) conducted between 2008/09-2017 across 33 sub-Saharan Africa countries. The outcome variables were high blood pressure, overweight/obesity, alcohol consumption and tobacco use. The prevalence of the risk factors of NCDs and sample characteristics across different levels of wealth quintiles were examined. Furthermore, socioeconomic inequalities were measured using concentration index (CI) and Lorenz curve considering urban-rural differentials.Results: The prevalence of high blood pressure and overweight/obesity were 1.2–17.3% and 6.7–44.5% respectively with significant wealth quintile differences. More so, alcohol consumption prevalence was 4.1–47.3% and tobacco use was 0.3–9.9%. The overall prevalence of high blood pressure was 5.5%, overweight/obesity accounted for about 23.1%, alcohol consumption and tobacco users were 23.9 and 2.4%, respectively. The socioeconomic inequalities in high blood pressure (CI = 0.1352, p < 0.001); overweight/obesity (CI = 0.2285, p < 0.001), and alcohol consumption (CI = 0.0278, p < 0.001) were significantly more in the higher socioeconomic group, compared to the lower socioeconomic group. In contrast, the prevalence of tobacco use (CI = −0.2551, p < 0.001) was significantly more in the lower socioeconomic group, compared to the higher socioeconomic group. The test for differences in rural vs. urban concentration indices for high blood pressure, overweight/obesity, alcohol consumption, and tobacco use were statistically significant in all the health indicators (p < 0.05).Conclusion: An effective intervention should incorporate a high-risk approach to terminate risk distribution by directing resources to key population women. To improve the benefit to risk ratio and enhance the cost effectiveness of preventive health programmes, it is paramount to understand the worth of equity-based strategies. Integrating equity elements to interventions is a key measure toward ensuring that policies and programmes meet their milestones. Government should strengthen living standards, literacy and healthcare system to curtail the increasing prevalence of the risk factors of NCDs.

Multiple metal exposures and metabolic syndrome: A cross-sectional analysis of the National Health and Nutrition Examination Survey 2011–2014

BackgroundEpidemiologic studies suggest toxic metals are linked with diabetes and cardiovascular disease, while experimental studies indicate nutritionally essential metals are involved in the metabolism of macronutrients and defense against oxidative stress. ObjectivesWe sought to evaluate how essential and toxic metals are cross-sectionally related to metabolic syndrome, a clustering of cardiometabolic conditions. MethodsUsing data from the 2011–2014 National Health and Nutrition Examination Survey (n = 1088), we characterized metal concentrations as measured in spot urine (arsenic, cadmium, and inorganic/elemental mercury), whole blood (manganese, lead, methylmercury, and selenium), and serum (copper and zinc) samples. Principal component analysis was performed to derive patterns of exposures. Metabolic syndrome was defined according to the 2009 Joint Scientific Statement as the presence of ≥ 3 of the following conditions: high blood pressure, high triglycerides, low HDL cholesterol, high fasting glucose, and abdominal obesity. ResultsAfter adjustment for potential confounders, prevalence ratios for metabolic syndrome comparing the highest to the lowest quartiles were 1.41 (95% CI: 1.18–1.67) for the arsenic-inorganic/elemental mercury pattern, 0.95 (0.78–1.16) for the methylmercury-manganese pattern, 0.73 (0.57–0.94) for the cadmium-lead pattern, 0.91 (0.76–1.10) for the copper pattern, and 1.36 (1.13–1.63) for the selenium-zinc pattern. The positive associations observed for the arsenic-inorganic/elemental mercury pattern were due to an elevated prevalence of high blood pressure, low HDL cholesterol, and high triglycerides among those with greater exposures. Associations for the selenium-zinc pattern were driven by a positive relationship with high triglycerides. Greater lead-cadmium co-exposures were related to a lower prevalence of dyslipidemia and abdominal obesity. ConclusionsThese cross-sectional findings suggest both toxic and essential metal exposures may contribute to cardiometabolic health, but need to be confirmed with prospective data.

A REVIEW ON THE PREVALENCE OF HYPERTENSION IN SIDE-LINED POPULATIONS; SLUM DWELLERS, SHIFT JOB WORKERS AND OCCUPATIONAL NOISE AFFECTED WORKERS: ATTRIBUTABLE TO LIFESTYLE AND ENVIRONMENTAL FACTOR

Hypertension is a condition that is characterized by the persistent raised blood pressure. It is not seen as a disease rather as a major risk factor that is solely responsible for different types of cardiovascular diseases such as heart failure, ischemic heart disease, and left ventricular hypertrophy. Although this condition cannot be cured, hypertension can be managed and prevented by adopting a healthy lifestyle that encompasses factors such as diet, physical exercise, reduced alcohol consumption, moderate sodium and potassium intake, and psychological factors. Apart from these, environmental factor like noise has also proved to be associated with the high blood pressure. Different prevalence studies have been conducted to find out the relationship between high blood pressure and different lifestyle factors. This article aims to review and emphasize the prevalence of high blood pressure in slum dwellers and at-risk workers who are shift job workers and occupational noise affected workers. Different research articles pertaining to different authors and countries have been reviewed to portray the concern of this condition. There is the need for proper recognition to these folks of people who are exposed to the precarious and high-risk style of living in the slum dwellers, shift job workers, and occupational noise affected workers. The distress in the physiological functioning of the body leading to hypertension has been found in the slum dwellers and at-risk workers; shift job workers and occupational noise affected workers that are again attributable to aforementioned lifestyle and environmental factor. The proper management of hypertension is extremely required to safeguard these unacknowledged groups of people.

Objective sleep alterations and long-term use of short or intermediate half-life benzodiazepine receptor agonists are risk factors for high blood pressure in individuals with insomnia: a study in 1272 individuals referred for sleep examinations

IntroductionGiven conflicting data in the literature, the aim of this study was to examine the risk of high blood pressure (HBP) associated with sleep alterations, measured during polysomnography, and long-term use of benzodiazepine receptor agonists in a large sample of individuals with insomnia. MethodsDemographic and polysomnographic data from 1272 individuals with insomnia recruited from the research database of the sleep laboratory of Erasme Hospital were analyzed. HBP status was defined by the presence of one of the following: self-report at interview of either a physician's diagnosis or taking antihypertensive medication; or an average systolic blood pressure ≥140 mm Hg or an average diastolic blood pressure ≥90 mm Hg at the medical examination. Logistic regression analyses were conducted to examine the risk of HBP associated with objective sleep alterations and long-term use of benzodiazepine receptor agonists in individuals with insomnia. ResultsThe prevalence of HBP in individuals with insomnia is 30.03%. After adjustment for major confounding factors associated with HBP, multivariate logistic regression analysis revealed that short sleep duration (<5 h), severely reduced sleep efficiency (<65%), high sleep fragmentation (sleep fragmentation index ≥18/h), and long-term use of short or intermediate half-life benzodiazepine receptor agonists were significant risk factors for HBP in individuals with insomnia. ConclusionIn individuals with insomnia, objective sleep alterations and long-term use of short or intermediate half-life benzodiazepine receptor agonists are associated with higher risk of HBP. Therefore, better management of these reversible risk factors is required to avoid the negative consequences of the co-occurrence of insomnia and HBP.

Prevalence of high blood pressure among schoolchildren from Córdoba, Argentina, and its relation to socioeconomic status.

Prior studies conducted in Argentina found variable prevalence rates of high blood pressure (HBP) among children using different measurement methods. The objective of this study was to know the prevalence of HBP among schoolchildren from the city of Córdoba and its relation to sex, nutritional status, socioeconomic status (SES), and level of maternal education. Blood pressure measurements and information on SES, level of maternal education, and body mass index of schoolchildren from the city of Córdoba, Argentina, were obtained. HBP was defined as systolic or diastolic blood pressure levels that are greater than or equal to the 95th percentile for a given age, sex, and height percentile at three consecutive measurements on separate days. A total of 1531 boys and girls participated; their average age was 10.6 years. Fifty-five children had HBP. Systolic and diastolic blood pressure levels showed a significant association with obesity (p= 0.001), but not with age (p= 0.87), sex (systolic: p= 0.48; diastolic: p= 0.71) or SES (systolic: p= 0.07; diastolic: p= 0.09). The prevalence of HBP in a sample of schoolchildren from Argentina was 3.7%. It showed a significant association with obesity, but not with SES.

A11632 Efficacy of Iranian Primary Healthcare Network in control of hypertension

Objectives: Hypertension is an important cause of stroke, heart and kidney diseases which account for nearly about two-thirds of all mortalities worldwide. The aim of this study was to assess the prevalence, awareness treatment and control of hypertension in south of Iran, with an overview on Iranian primary healthcare network Methods: This descriptive study, included 5065 participants older than 18 years. A questionnaire was completed. Blood pressure was measured according to JNC-7 guidelines. Systolic blood pressure ≥140 mm Hg, diastolic BP ≥90 mm Hg or intake of any antihypertensive treatment was considered hypertension. Data were analyzed for logistic regression, likelihood ratio, odds ratio, chi square, t-test and descriptive statistics. Results: The prevalence of hypertension in Hormozgan province was 23.2% and only 28.3% were aware of their hypertension, 17.6% were treated and only 6.5% had controlled hypertension. Hypertension was more prevalent in urban areas (28.8% versus 18.1%) and more controlled among rural population (12.3% vs 2.8%). Pre-hypertension was highly prevalent (37.7%), in the studied population, more prevalent in men (36.4%), but the percentage of hypertensive men (35.1%) and women (35.5%) had no statistically significant difference (p > 0.05) Conclusion: Prevalence of high blood pressure in urban areas is higher than rural areas, but awareness, receiving medication, and hypertension control is more apparent in rural areas. Awareness of hypertension is high in rural residing women. which is strongly in favor of a resilient and strong PHC in rural areas.Enforcing health sector in health education, and providing health services is necessary to reduce the burden of HTN and associated morbidity and subsequent mortality

Self-rated health among migrants from the former Soviet Union in Germany: a cross-sectional study

ObjectivesTo assess the status and change in self-rated health among Aussiedler, ethnic German immigrants from the former Soviet Union, as a predictor for premature death 10 years after first assessment....

Cardiometabolic risk factors differ among adolescents with obesity in three European countries - a cross-sectional study.

AimWe aimed to compare modifiable cardiometabolic risk factors among treatment‐seeking adolescents with obesity in Italy, Germany and Norway.MethodsThis retrospective, registry‐based, cross‐sectional cohort study included 2,327 (59% girls) 12–18 year‐old adolescents with obesity from three tertiary care outpatient clinics in Europe, between 1999 and 2015. The prevalence of cardiometabolic risk factors was compared between clinics, and multivariate logistic regression models including gender, age, waist circumference and body mass index were used to assess the associations between population and cardiometabolic risk.ResultsIn total, 1,396 adolescents (60% girls) from Italy, 654 (58% girls) from Germany and 277 (51% girls) from Norway were included. The mean ± SD age was 15.2 ± 1.6 years, body mass index 38.8 ± 6.5 kg/m2 and body mass index standard deviation score 3.21 ± 0.43. The prevalence of elevated nonhigh‐density lipoprotein‐cholesterol in Norway, Germany and Italy was 60%, 54% and 45%, while the prevalence of high systolic or diastolic blood pressure (≥130 or ≥85 mmHg) were 15%, 46% and 66%, respectively.ConclusionCardiometabolic risk factors among treatment‐seeking adolescents with obesity from Italy, Germany and Norway differed across the populations in this study, which might imply that preventive clinical work should reflect such differences.

Informing NCD control efforts in India on the eve of Ayushman Bharat

Informing NCD control efforts in India on the eve of Ayushman Bharat

The changing patterns of cardiovascular diseases and their risk factors in the states of India: the Global Burden of Disease Study 1990-2016.

SummaryBackgroundThe burden of cardiovascular diseases is increasing in India, but a systematic understanding of its distribution and time trends across all the states is not readily available. In this report, we present a detailed analysis of how the patterns of cardiovascular diseases and major risk factors have changed across the states of India between 1990 and 2016.MethodsWe analysed the prevalence and disability-adjusted life-years (DALYs) due to cardiovascular diseases and the major component causes in the states of India from 1990 to 2016, using all accessible data sources as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016. We placed states into four groups based on epidemiological transition level (ETL), defined using the ratio of DALYs from communicable diseases to those from non-communicable diseases and injuries combined, with a low ratio denoting high ETL and vice versa. We assessed heterogeneity in the burden of major cardiovascular diseases across the states of India, and the contribution of risk factors to cardiovascular diseases. We calculated 95% uncertainty intervals (UIs) for the point estimates.FindingsOverall, cardiovascular diseases contributed 28·1% (95% UI 26·5–29·1) of the total deaths and 14·1% (12·9–15·3) of the total DALYs in India in 2016, compared with 15·2% (13·7–16·2) and 6·9% (6·3–7·4), respectively, in 1990. In 2016, there was a nine times difference between states in the DALY rate for ischaemic heart disease, a six times difference for stroke, and a four times difference for rheumatic heart disease. 23·8 million (95% UI 22·6–25·0) prevalent cases of ischaemic heart disease were estimated in India in 2016, and 6·5 million (6·3–6·8) prevalent cases of stroke, a 2·3 times increase in both disorders from 1990. The age-standardised prevalence of both ischaemic heart disease and stroke increased in all ETL state groups between 1990 and 2016, whereas that of rheumatic heart disease decreased; the increase for ischaemic heart disease was highest in the low ETL state group. 53·4% (95% UI 52·6–54·6) of crude deaths due to cardiovascular diseases in India in 2016 were among people younger than 70 years, with a higher proportion in the low ETL state group. The leading overlapping risk factors for cardiovascular diseases in 2016 included dietary risks (56·4% [95% CI 48·5–63·9] of cardiovascular disease DALYs), high systolic blood pressure (54·6% [49·0–59·8]), air pollution (31·1% [29·0–33·4]), high total cholesterol (29·4% [24·3–34·8]), tobacco use (18·9% [16·6–21·3]), high fasting plasma glucose (16·7% [11·4–23·5]), and high body-mass index (14·7% [8·3–22·0]). The prevalence of high systolic blood pressure, high total cholesterol, and high fasting plasma glucose increased generally across all ETL state groups from 1990 to 2016, but this increase was variable across the states; the prevalence of smoking decreased during this period in all ETL state groups.InterpretationThe burden from the leading cardiovascular diseases in India—ischaemic heart disease and stroke—varies widely between the states. Their increasing prevalence and that of several major risk factors in every part of India, especially the highest increase in the prevalence of ischaemic heart disease in the less developed low ETL states, indicates the need for urgent policy and health system response appropriate for the situation in each state.FundingBill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.

Druggable targets in the Rho pathway and their promise for therapeutic control of blood pressure.

The prevalence of high blood pressure (also known as hypertension) has steadily increased over the last few decades. Known as a silent killer, hypertension increases the risk for cardiovascular disease and can lead to stroke, heart attack, kidney failure and associated sequela. While numerous hypertensive therapies are currently available, it is estimated that only half of medicated patients exhibit blood pressure control. This signifies the need for a better understanding of the underlying cause of disease and for more effective therapies. While blood pressure homeostasis is very complex and involves the integrated control of multiple body systems, smooth muscle contractility and arterial resistance are important contributors. Strong evidence from pre-clinical animal models and genome-wide association studies indicate that smooth muscle contraction and BP homeostasis are governed by the small GTPase RhoA and its downstream target, Rho kinase. In this review, we summarize the signaling pathways and regulators that impart tight spatial-temporal control of RhoA activity in smooth muscle cells and discuss current therapeutic strategies to target these RhoA pathway components. We also discuss known allelic variations in the RhoA pathway and consider how these polymorphisms may affect genetic risk for hypertension and its clinical manifestations.