Prevalence Of Systolic Hypertension Research Articles

Factors associated with hypertension among adults in high burden kidney disease areas of Jigawa State, Nigeria: A cross-sectional survey.

Hypertension is the leading risk factor for preventable cardiovascular-related complications and mortalities worldwide. A cross-sectional survey was conducted to assess the prevalence and factors associated with hypertension among 361 adults from four local government areas (LGAs) of Jigawa state identified to have high burden of kidney diseases. The Modified WHO STEPS questionnaire and multi-stage sampling technique were employed and data were analysed using IBM SPSS version 22.0. The age of the respondents ranged from 18 to 102 years with a median of 45 (interquartile range = 30-80) years. More than a quarter (34.9%) of the respondents were unemployed. Few reported history of alcohol ingestion (0.8%) and cigarette smoking (1.1%). The prevalence of systolic hypertension was 116 (32.1%), while that of diastolic hypertension was 133 (36.8%). Jahun LGA had higher cases (36.7%) of systolic hypertension, whereas Dutse LGA had higher cases (47.8%) of diastolic hypertension. Systolic hypertension was significantly higher (P < 0.001) among those >35 years of age. The odds of developing systolic hypertension were significantly lower among those between the ages of 18 and 35 years, and those between the ages of 18 and 35 years were less likely to have systolic hypertension than those above the age of 35 years (adjusted odds ratio = 9.0; 95% confidence interval = 4.6-17.6). Similarly, those who reported family history of diabetes and hypertension (P < 0.001) had a significantly higher proportion of systolic hypertension. The prevalence of hypertension was alarming in the high burden kidney disease areas. The government should develop a sustainable model for the mass community screening of risk factors and community-based health insurance for the effective management of all identified cases.

The Prevalence of Cardiovascular Diseases and associated factors among patients in Low- and Middle-Income settings

Background &nbsp;Cardiovascular Diseases (CVDs) are the public health problems worldwide, causing over 18.9 million deaths per year. The major risk factors which are also preventable are tobacco use, diabetes, high blood pressure, overweight/ obesity and alcohol consumption. The aim of this study was to determine the Prevalence of CVDs and associated factors. Methodology We conducted a cross-sectional hospital-based study that consecutively enrolled 785 consenting adults who came to attend Jakaya Kikwete Cardiac Institute (JKCI) mobile clinic in South Western urban Tanzania, a typical LMIC, in 2018. A structured questionnaire was used to obtain demographic data and gather several co-morbid information. A 12 lead Electrocardiogram (ECG) and 2D, M mode Transthoracic Echocardiogram were done to determine the structural and none structural heart diseases from the participants. Results &nbsp;Of 785 participants, 528 (67.3 %) were females, 479 (61%) were middle aged (40-60 years) and 196 (25%) were 65 years old and above, their mean age (±SD) was 56 (±14) years. Most of participants were married 558 (71%), 625 (80%) sponsored by the National Health Insurance Fund (NHIF) and less than half were employed. Of all the participants, tobacco users were 29(3.6%), diabetics 60 (7.5%), alcoholic users 99 (12.5%) and more than half were overweight/obese. The prevalence of Systolic Hypertension was 65% and Diastolic Hypertension was 50% Few participants 85 (11%) had chest pain, 56 (7%) had tachycardia and difficulty in breathing 45 (6%). By ECHO diagnosis; the prevalence of dilated cardiomyopathy was 3.8%, hypertensive heart diseases 2.3% and valvular heart diseases was 2%. Majority 780 (99%) and 694 (88%) had normal Left Ventricular Systolic and Diastolic functions respectively. Furthermore, by ECG diagnosis, the prevalence of Left Ventricular Hypertrophy was 8% and ischemic heart disease was diagnosed in 4% of the participants. In a multivariate analysis, CVD were found to be statistically significant associated with the age 65+ years, 3.41 [95% CI 1.49 -7.78, p- value 0.004], diastolic blood pressure above or equal to 90 mmHg, 1.61 [95% CI 1.05 -2.48, p -value 0.03] and overweight/ obese 1.94 [95% CI 1.28 -2.92, p-value 0.002]. Conclusion The prevalence of cardiovascular diseases was found to be high and the main associated risk factors were advanced age, overweight/obese and diastolic hypertension. Some of the participants had already developed asymptomatic structural heart disease and features which were suggesting of coronary artery diseases.&nbsp; Recommendations Efforts for an early detection of CVD should be undertaken in order to offer an early and appropriate interventions

Cardiovascular Diseases Risk Prediction Using the Framingham Risk Score

Introduction: Cardiovascular diseases (CVD) are the world’s most common cause of death. The Framingham risk score (FRS) is the most commonly used method for CVD risk assessment. Low-risk individuals have 10% or less coronary heart diseases (CHD) risk at 10 years, 10-20% have intermediate risk and 20% or more have high risk. Aim of Work: To estimate the risk of developing cardiovascular diseases over next ten years among the administrativestaff at Zagazig University, Egypt. Material and Methods: A structured questionnaire was used to get data about socio demographic characteristics, anthropometric measurements was done, laboratory investigations to measurefasting and post brandial blood sugar and lipid profile. The Framingham risk score (FRS) was calculated by using information on age, gender, smoking ,diabetes mellitus (DM), systolic blood pressure , treatment for hypertension, and total blood cholesterol and high-density lipoprotein levels for everysubject. Results: About 55% of the studied sample were males and 44.8%were females, the overall prevalence of systolic hypertension was 45.7% ,36.2% had a positive family history of CVD , 25% were physically active( the majority of them were males),21.5% were diabetic, 63.7% had highblood cholesterol,55.1% had central obesity,68.1% were overweight orobese. FRS mean for males was higher as compared to females (14.3±7.1and11.9±5.8 respectively). Participants with high CVR risk were mainlyinactive, smokers, with positive family history, diabetics, hypertensive,with high blood cholesterol level, high density lipoprotein and with centralobesity .A statistically significant positive correlation was observed betweenFRS and age, cholesterol, systolic blood pressure, blood glucose ,weight ,waist circumference and body mass index(BMI) Conclusion: About 42%of our studied subjects were at low anticipated 10-year CVD risk, 30% were at moderate risk, and 28% of them were at high risk .The most significantrisk factors were male gender ,smoking, physical inactivity , hypertension,diabetes mellitus, obesity, abdominal obesity , high levels of total cholesteroland low HDL-cholesterol level in addition to positive family history . CVDis a preventable public health issue; most of its risk factors are modifiable.

Discordances between pediatric and adult thresholds in the diagnosis of hypertension in adolescents with CKD

BackgroundAdolescents with chronic kidney disease (CKD) are a unique population with a high prevalence of hypertension. Management of hypertension during the transition from adolescence to adulthood can be challenging given differences in normative blood pressure values in adolescents compared with adults.MethodsIn this retrospective analysis of the Chronic Kidney Disease in Children Cohort Study, we compared pediatric versus adult definitions of ambulatory- and clinic-diagnosed hypertension in their ability to discriminate risk for left ventricular hypertrophy (LVH) and kidney failure using logistic and Cox models, respectively.ResultsOverall, among 363 adolescents included for study, the prevalence of systolic hypertension was 27%, 44%, 12%, and 9% based on pediatric ambulatory, adult ambulatory, pediatric clinic, and adult clinic definitions, respectively. All definitions of hypertension were statistically significantly associated with LVH except for the adult ambulatory definition. Presence of ambulatory hypertension was associated with 2.6 times higher odds of LVH using pediatric definitions (95% CI 1.4–5.1) compared to 1.4 times higher odds using adult definitions (95% CI 0.8–3.0). The c-statistics for discrimination of LVH was statistically significantly higher for the pediatric definition of ambulatory hypertension (c=0.61) compared to the adult ambulatory definition (c=0.54), and the Akaike Information Criterion was lower for the pediatric definition. All definitions were associated with progression to kidney failure.ConclusionOverall, there was not a substantial difference in pediatric versus adult definitions of hypertension in predicting kidney outcomes, but there was slightly better risk discrimination of the risk of LVH with the pediatric definition of ambulatory hypertension.Graphical abstract

Sex differences in diastolic blood pressure changes with age using 24-hour ABPM in 30,513 patients

Abstract Background We have previously shown, using 24-hour ABPM monitoring, that diastolic blood pressure (DBP) in a large referral population, containing both males and females, increases until age 42 years, following which DBP falls progressively. This occurs in the hypertensive population some 13 years sooner than previous general population studies. There is conflicting emerging data on sex differences in the lifelong trajectory of both systolic and diastolic blood pressure. Purpose To examine sex-specific patterns of diastolic blood pressure throughout the lifespan of patients referred for 24-hour ABPMs. Methods Our database was searched for all 24-hour ABPMs. We used the average 24-hour SBP and DBP for this analysis. Scatter grams were produced for age versus systolic BP (SBP) and DBP for both males and females. Second order polynomial regression was performed on the DBP scatter grams for both genders and their inflection points calculated. The inflection point is the age at which the DBP on the polynomial curve where the slope changes from positive to negative. This, inflection point, corresponds to the age at which DBP begins to decrease. The DBP polynomial curves for males and females were then superimposed to show any gender differences. Results There were 30,513 24-hour analysable ABPMs over 24 years, representing 97% of all ABPMs. There were 15,913 females aged 60.8±14.6 years (range 15–97 years) and 14,600 males aged 58.8±14.2 years (range 15–100 years). As can be seen from the charts below, in females DBP begins to fall at a very early age of 22.3 years, whereas in males the diastolic BP begins to fall at 46.5 years. Conclusions There are significant sex differences in the changes in DBP with increasing age. For the first 35 years DBP is higher in women, thereafter DBP is lower in females and only intersects again much later in life at 95 years. The significance of this sex difference is unclear but may explain the increased prevalence of systolic hypertension in elderly females. Figure 1 Funding Acknowledgement Type of funding source: None

Blood Pressure Profiles And Determinants Of Hypertension Among Public Secondary School Students In Nnewi, Southeast Nigeria

Background: Hypertension and associated factors among adolescents have not been given the deserved attention in health care, more so as hypertensive children end up as hypertensive adults with serious co-morbidities. This is even more expedient among public school students, who in our environment are generally of lower socioeconomic status than those in private schools.&#x0D; Objective: To determine the BP profiles and association of obesity indicators, socioeconomic level and physical activity with hypertension among public secondary school students.&#x0D; Methodology: A cross-sectional school-based assessment of blood pressure (BP), body mass index (BMI), weight to height ratio (WHR), waist circumference (WC), physical activity and socioeconomic level among 593 students aged 10 – 17 years in public schools in Nnewi, Southeast Nigeria was carried out.&#x0D; Results: The mean systolic BP increased with age and was higher for girls than for boys. The prevalence of systolic hypertension and prehypertension were 8.4% and 6.6% respectively, while that of diastolic hypertension and prehypertension were 5.7% and 11.8% respectively. Both systolic and diastolic hypertension occurred in 2.4% of students. Girls had a higher prevalence of hypertension – both systolic and diastolic. There was no significant gender difference in the prevalence of systolic hypertension and prehypertension between early and late adolescents. Early adolescent males were more likely to have diastolic hypertension and prehypertension compared to late adolescent males, while no difference in prevalence was noted among the females. Systolic hypertension was more evident in the lower socioeconomic level, those with minimal physical activity, and those in the obese/overweight categories of BMI, WC, and WHR.&#x0D; Conclusion: There is a noteworthy prevalence of hypertension among adolescent public secondary school students in Nnewi. This was significantly higher among the female gender, lower socioeconomic level and students with minimal physical activity. Waist circumference in the obese/overweight category very likely predicts hypertension.

Prevalence of Hypertension in Cardiovascular Disease in Iran: Systematic Review and Meta-Analysis.

Background:Hypertension is a major cause of noncommunicable diseases such as cardiovascular disease. Therefore, this study aimed to estimate the prevalence of hypertension in cardiovascular patients in Iran by meta-analysis.Methods:The search was carried out using authentic Persian and English keywords in national and international databases including IranMedex, Scientific Information Database (SID), Magiran, IranDoc, Medlib, ScienceDirect, PubMed , Scopus, Cochrane, Embase, Web of Science, and Google Scholar search engine without any time limitation until 2017. Heterogeneity of studies was assessed using I2 statistic . Data were analyzed using STATA 11.1.Results:In 66 reviewed studies with a sample of 111,406 participants, the prevalence of hypertension was 44% in Iranian patients with cardiovascular disease 67%(95%CI: 38%–49%) in women and 42% in men. The prevalence of systolic hypertension in cardiac patients was 25%, diastolic 20%, diabetes 27%, and overexposure 43%. The prevalence of hypertension was 44% in patients with coronary artery disease, 50% in myocardial infarction, 33% in aortic aneurysm, and 44% in cardiac failure.Conclusions:Hypertension has a higher prevalence in women with cardiovascular disease than men, and it increases with age. Among patients with cardiovascular disease, myocardial infarction patients have the highest levels of hypertension. The prevalence of systolic hypertension in cardiac patients is higher than diastolic hypertension.

Early Detection of Renal Dysfunction in Adolescents Aged 10-13 Years Born with very Low Birth Weight

Objective: Very low birth weight (VLBW), defined as less than 1500 gr, is an established risk factor for kidney disease in adulthood. To assess that, we examined whether VLBW manifests signs of renal dysfunction at as early as age 10 years, as reflected by elevated blood pressure, proteinuria and reduced glomerular filtration rate (GFR). Methods: 103 children aged 10-13 years and born with VLBW underwent consecutive blood pressure measurements, spot urine analysis, and weight and height measurements. Prevalence rates of hypertension, pre-hypertension and proteinuria were calculated. Characteristics were compared between children with normal and abnormal renal function, to identify risk factors for renal dysfunction. Results: The prevalence of systolic hypertension was 15.8% (95% CI 8.69% - 22.91%) of systolic pre-hypertension 6.9% (95% CI1.96% - 11.84%), and of proteinuria 15.7% (95% CI 8.64% - 22.76%) of the study population. Hypertension was associated with a significantly diminished mean birth weight compared to the remainder of the cohort (939.3gr vs 1111gr, P=0.024). Proteinuria and microalbuminuria were associated with lower mean current body weights: 27.2kg vs 36.7kg P=0.015 and 31.3 kg vs 36.8kg; P=0.023; and with increased mean estimated GFR (126.1 vs 108.3 mL/min per 1.73 m2; P = 0.0059). Conclusions: In a cohort of children aged 10-13 years, who were born preterm with VLBW, disturbed kidney function presented in considerably higher proportions than in general populations of this age. The findings merit considering initiation of routine screening during early adolescence, for hypertension, proteinuria and GFR in this risk group.

Respiratory and other illnesses among the jute-mill workers in an industrial unit of Bangladesh

Background and aims: Bangladesh produces 33% of the world’s jute and about 40 million people in Bangladesh are directly or indirectly involved in the jute sector. The jute (organic) dust inhalation causes byssinosis and other respiratory illnesses. However, no study has yet addressed the health status of the jute handlers/workers in Bangladesh. This study aimed to determine the prevalence of respiratory illnesses among the Jute Mill Workers (JMWs). Additionally, this study tried to find out the overall health status of the JMWs which included presence of non-communicable diseases (NCD) and its related risk, which are usually ignored.&#x0D; Study design: A cross-sectional study conducted in a purposively selected jute mill - 40km off from Dhaka City. Of the 5500 workers, a list of 600 workers was provided by the mill authority for enrollment in the study. The investigations included – a) interviewing on socio-demography and clinical history; b) anthropometry (height, weight, waist- and hip-circumference); c) blood pressure measurement; d) estimation of fasting blood glucose and lipids; e) peak flow meter test; f) spirometry; g) high resolution computerized tomography (HRCT) and electrocardiography.&#x0D; Results: Of the enlisted 600 jute mill workers, 514 (men / women = 478 / 36) took part in the study. The response rate was 85%. For overall estimate of bio-physical characteristics (n = 514), the means (95% confidence interval) of age, body mass index (BMI), waist-hip ratio (WHR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 44.19 (43.34 – 45.04) years, 24.44 (24.16 – 24.73), 0.90 (0.90 – 0.91), 118.9 (117.4 – 120.4), 79.69 (78.81 – 8/0.54), respectively. Regarding social class and education, 84.4% were from non-affluent (poor) class and 50% were illiterate. About 88% of the JMWs had been working for ≥42 hours a week and 91.6% were exposed to moderate or heavy work (equivalent to ≥60 min walk). The prevalence of breathlessness, tightness of chest and chronic cough were 16.5%, 25.7% and 16.3%, respectively. The restrictive and obstructive pulmonary functions were detected in 7.0% and 0.8% of study population respectively. The prevalence of systolic hypertension was 16.5%, diastolic hypertension was 7.2% and diabetes (IFG+DM) was 13.3%. They had increased cardiovascular risks – hypertriglyceridemia (23.9%) and hypercholesterolemia (24.3%).&#x0D; Conclusions: JMWs have been suffering mostly from respiratory illnesses and a substantial number of them suffer from undiagnosed hypertension, diabetes and other non-communicable diseases. Dyslipidemia was also prevalent as a potential risk factor. The study could not assess ocular, auditory, musculoskeletal and mental health and it suggests that a well designed study should address these health related problems of JMWs.&#x0D; IMC J Med Sci 2019; 13(1): 007

Prevalence and risk factors for hypertension among school children in Ilorin, Northcentral Nigeria.

BACKGROUND:The global prevalence of childhood hypertension has increased from 1% to 2% to 4%–5%, with a value as high as 9.8% reported in Nigeria. However, the various risk factors associated with childhood hypertension in Nigeria are less explored. The aim of this study was to determine the prevalence of hypertension and related risk factors (sociodemographic, family history of hypertension, history of snoring, birth order, and anthropometric indices) in primary school children in Nigeria.MATERIALS AND METHODS:A total of 1745 school children aged 6-12 years were selected using systematic random sampling method. Blood pressure (BP) was measured using the fourth report guideline. Those with BP higher than 90th percentile had repeated BP measurements on two more occasions (2 and 4 weeks after initial measurement). Relevant history was obtained, and anthropometric measurements were taken by the standard methods. Data were analyzed using SPSS version 20.RESULTS:Prevalence of systolic and or diastolic hypertension at the third visit was 3.0%. Prevalence of systolic hypertension (3rd visit) was more in females (3.3%) than males (1.3%), P = 0.004. Prevalence of diastolic hypertension (3rd visit) was higher in females (1.4%) than males (0.3%), P = 0.019. Hypertension showed no significant relationship with socioeconomic class, family history of hypertension, birth order, and history of snoring. Of the anthropometric indices (weight, height, body mass index (BMI), hip circumference, waist circumference, waist-to-hip ratio, and waist-to-height ratio, and only obesity (BMI ≥ 95th centile) was related with hypertension (odd ratio 8.3, 95% confidence interval 1.7, 40.3).CONCLUSIONS:Prevalence of hypertension is low (3.0%), and only obesity (BMI ≥ 95th centile) is associated with hypertension.

Prevalence of Hypertension in Renal Diseases in Iran: Systematic Review and Meta-Analysis.

Background:Hypertension is a risk factor for renal disease. Therefore, this study was aimed at estimating the prevalence of hypertension in renal patients in Iran through meta-analysis.Methods:The search was carried out using authentic Persian and English keywords in national and international databases including IranMedex, SID, Magiran, IranDoc, Medlib, ScienceDirect, Pubmed, Scopus, Cochrane, Embase, Web of Science, Medline, and Google Scholar search engine without any time limitation until 2017. Heterogeneity of studies was assessed using the I2 index. Data were analyzed using STATA ver 11.Results:In 35 reviewed studies with a sample of 39,621 subjects, the prevalence of hypertension in renal patients was 35% (95% CI: 29%–41%) (25% in women and 18% in men). The prevalence of systolic hypertension in renal patients was 5%, diastolic hypertension 26%, and diabetes 23%. The prevalence of hypertension in hemodialysis patients was 34%, 27% in peritoneal dialysis, 43% in kidney transplantation, and 26% in chronic renal failure. In addition, meta-regression showed that the prevalence of hypertension in renal patients did not significantly decrease during the years 1988–2017.Conclusions:More than a third of kidney patients in Iran suffer from high blood pressure. The diastolic blood pressure of these patients is about five times higher than their systolic blood pressure. Moreover, the age group under 30 is a high-risk group. The prevalence of hypertension in women with kidney disease is higher than in men. In addition, patients who have kidney transplants are more likely to have high blood pressure than other kidney patients.

Abstract P172: A Correlative Study of Cuff Hypertension and Anthropometric Variables in Obese and Non Obese Subjects

Introduction: According to the National Health And Nutrition Examination Survey (NHANES), 65 million Americans have hypertension and one-quarter of adults have blood pressure in the “pre hypertension” range. In such scenario accurate BP measurement is very important. This study focused on prevalence of hypertension among Obese individuals. Methods: 400 patients ( 200 patients each with &lt; and &gt; BMI 25 ) were studied in rural tertiary hospital in India. Inclusion criteria - patients aged 20-50 yrs. Obese ( defined by BMI &gt; 25) . Exclusion criteria, Subjects on anti- hypertensive medication , Secondary causes of clinically identifiable hypertension Diabetic subjects who are known hypertensives or with complications of DM , Pregnant women, Known cases of Ischemic heart disease. Enrolled patient were evaluated for Height , weight. Two cuff sizes 12 cm/15 cm used to measure BP. Statistical analysis was done with SPSS package and MS Excel, Student’s t-test and linear correlation coefficient used. p values &lt; 0.05 were considered t significant. SBP - systolic Blood pressure and DBP - Diastolic Blood pressure. Results: SBP and DBP increased significantly with increase of BMI in both men and women ( p &lt; 0.005 ). There is statistically significant standard and large cuff differences in SBP with P value 0.003 and 0.01 and DBP with p values were 0.004 and 0.00 for male and female respectively. There was also a statistically significant ( p value &lt; 0.05) standard-large cuff difference in both SBP and DBP in W/H ratio categories ( &lt;1 and &gt;1 ) in males Discussion: Cuff characteristics, i.e. the cuff-bladder width and length, can bias measurement of blood pressure in obese. Our study explained the potential for overdiagnosis of BP with using a wrong size cuff for people with BMI &gt; 25 and W/H &gt; 1. The prevalence of Systolic Hypertension based on JNC guidelines in the obese population with a regular cuff was 28% and with large appropriate size cuff it was 12%, a difference of 16% and similarly a difference of 12.5 % with diastolic BP. The prevalence of obesity in the US is 37% and this concept of Cuff Hypertension highlighted in our study is very important is such a setting as it can lead to lot of mis-diagnosed hypertension with unnecessary treatment burden and side effects.

Dyslipidemia is associated with pediatric nonalcoholic fatty liver disease

With the increasing prevalence of childhood obesity, nonalcoholic fatty liver disease (NAFLD) has emerged as the most common cause of pediatric chronic liver disorder. Factors underlying the pathophysiology of NAFLD remain poorly defined. This study aimed to describe the metabolic characteristics of children with NAFLD differing in race/ethnicity and to test associations between dyslipidemia and NAFLD. A retrospective chart review was conducted at a tertiary referral university hospital among 309 children with a diagnosis of NAFLD. Participants (mean age 12.5±3.4years) were 64% male, 63% white, 23% Hispanic, and 14% black. Hispanic children were diagnosed with NAFLD at a significantly younger age (10.6±3.1years, P<.0001) and lower body mass index (31.5±6.8kg/m2, P<.0001) than their white and black counterparts. For the entire cohort, prevalence of systolic hypertension was 41%, diabetes 14%, elevated cholesterol 42%, elevated non-high-density lipoprotein cholesterol (non-HDL-C) 58%, elevated low-density lipoprotein cholesterol 36%, elevated triglycerides (TG) 88%, and low high-density lipoprotein cholesterol 77%. Whites had elevated non-HDL-C, low-density lipoprotein cholesterol, and TG compared to blacks or Hispanics. Serum TG and non-HDL-C were significantly correlated to alanine aminotransferase (r=0.18, P=.01; r=0.16, P=.02), respectively, and persisted after adjusting for age and body mass index. Cardiometabolic derangements, especially dyslipidemia, are highly prevalent in children with NAFLD and differ based on race/ethnicity. Serum TG and non-HDL-C may play an important role in the pathophysiology of pediatric NAFLD.

Prevalence and risk factors of hypertension among women in a rural community of Maharashtra

Background: There are very few epidemiological studies on the prevalence of hypertension and its risk factors among women in the rural population. This cross-sectional study was carried out to determine the same in a rural community. This study was carried out in a rural population of Maharashtra in a rural field practice area of a Medical college with which the author is affiliated. The present study is thus a novel effort to measure the burden related to hypertension and related sociodemographic factors in a rural setting among women aged >30 years. Materials and Methods: A random sample of 220 women of 30 years and above were selected from a rural area. The study participants were selected using simple random sampling technique using lottery method. Numbers were allotted to every individual. All the women were then listed. This became the sampling frame. An individual was taken as the sampling unit. The pre-tested pro forma was used to collect the data by trained doctors. Results: Maximum participants in the study were from age group 30–39 years (33.6%), followed by 40–49 years (23.2%). Mean and standard deviation (SD) of age among study participants was found to be 47.7 ± 13.4 years. A total of 155 (70.5%) of the study participants used tobacco in one or the other smokeless form. About 29.5% of the study participants never used tobacco in the lifetime. The most common form of smokeless tobacco consumption was Mishri (71.6%) followed by tobacco which was used by 27% of the participants. Supari was also consumed by few of the participants. About 51.4% of the participants consumed >5 g (World Health Organization recommended level) of salt per day. All the participants consumed extra salt in the form of pickle/papad/table salt over and above that consumed in meals. About 8.2% of the study participants were found to be underweight while 21.2% were overweight. 3.2% of the study participants were in Grade I obesity and only one (0.4%) was in morbid obesity category. 70% of the study participants who had waist-hip ratio ≤ 0.85, whereas 30% of them had ratio > 0.85. Nearly 52% of the study participants gave a positive family history of hypertension among first-degree relatives. Only 22 (68.7%) of those participants diagnosed with hypertension were taking antihypertensive drugs and nearly half of these participants 12 (54.5%) were taking regular medication. 34.1% of participants had systolic blood pressure (BP) >140 than mmHg (isolated systolic hypertension) while 37.2% had diastolic BP >90 mmHg (isolated diastolic hypertension). The mean systolic BP calculated was 130 mmHg with SD 20.7 with 95% confidence interval (CI) of mean to be 127.5–132.8 mmHg, whereas diastolic BP was 83 mmHg with SD 11.1 with 95% CI of mean to be 81.7–84.6 mmHg. The overall prevalence of hypertension among the study participants was calculated to be 23.6% with 95% CI to be 18.2–26.8 mmHg. Conclusion: Prevalence of systolic hypertension in rural community was 34.1% and of diastolic hypertension 37.2% with an overall prevalence of 23.6%. Significant associations were found between the presence of hypertension and various sociodemographic variables using Chi-square test. Furthermore, there was a significant association between hypertension and consumption of smokeless tobacco, low physical activity level.

Sedentary Lifestyle and Hypertension in a Periurban Area of Mbarara, South Western Uganda: A Population Based Cross Sectional Survey.

Introduction Globally, cardiovascular diseases (CVDs) and diabetes constitute over 50% of the noncommunicable disease (NCD) burden and projections indicate Sub-Saharan Africa will experience a larger burden. Urbanization on the continent is contributing to the change in lifestyle such as diet and physical activity, which may increase the risk for CVDs. There is lack of sufficient data from the African continent on hypertension and its association with sedentary lifestyle. Methods We conducted a cross sectional study in periurban Uganda among adults aged at least 35 years. We administered questions on diet, physical activity, and smoking. We took anthropometric measurements, blood pressure, and fasting blood glucose. Hypertension was defined as systolic BP > = 140 and/or diastolic BP > = 90 and/or history of hypertension medications. Logistic regression was used to determine the crude and adjusted odds ratios for the factors associated with hypertension. Results We enrolled 310 participants and 50% were female. The prevalence of systolic hypertension was 24.5%, diastolic hypertension was 31%, obesity was 46%, and diabetes was 9%. Of those with hypertension (n = 76), 53 participants (69.7%) were not aware they had high BP. Sedentary lifestyle was significantly associated with hypertension even after adjusting for age and obesity. Conclusion There is a high prevalence of obesity, hypertension, and diabetes and majority of participants with hypertension are not aware. Participants with a sedentary work style should be targeted for prevention and screening.

Prevalence of cuff hypertension among overweight and obese subjects

Background: “Obesity is a lifestyle affliction, it is a side effect of poor habit and it can be reversed.” Obesity is defined either by increased waist circumference, waist-hip ratio, and/or body mass index. Overestimation of blood pressure (BP) using an inappropriately small cuff is well documented. Using a BP cuff small for midarm circumference (AC) in obese patient’s results in higher BP readings. Therefore, it was felt that there is a requirement to study the effect of different cuff sizes for different arm circumferences in obese individuals. The purpose of this study is to determine if cuff hypertension (HTN) is present in obese subjects. Aims and Objective: To determine the presence of cuff HTN in obese subjects. Materials and Methods: A total of 200 obese and 200 non-obese subjects between 20 and 50 years of age reporting to OHRC were included in the study. Systolic and diastolic BP were measured using a mercury sphygmomanometer with two cuff sizes, i.e., standard cuff 12 cm width (for MAC 32 cm). Results: A total of 56 subjects were diagnosed as systolic HTN with standard cuff, i.e., 28% but with large cuff, it was only 24 subjects, i.e., 12% only, a difference of 16% between the prevalence of systolic HTN. Diastolic HTN diagnosed with standard cuff was 20% compared to large cuff 7.5%, a difference of 12.5%. The above differences are demonstrating “cuff HTN” in the obese subjects. Conclusion: In this study of 200 obese and 200 non-obese subjects, it was found that “cuff HTN” is present in obese subjects.

Comparisons of Office and 24-Hour Ambulatory Blood Pressure Monitoring in Children with Obstructive Sleep Apnea

To compare office blood pressure (BP) and 24-hour ambulatory BP (ABP) monitoring to facilitate the diagnosis and management of hypertension in children with obstructive sleep apnea (OSA). Children aged 4-16 years with OSA-related symptoms were recruited from a tertiary referral medical center. All children underwent overnight polysomnography, office BP, and 24-hour ABP studies. Multiple linear regression analyses were applied to elucidate the association between the apnea-hypopnea index and BP. Correlation and consistency between office BP and 24-hour ABP were measured by Pearson correlation, intraclass correlation, and Bland-Altman analyses. In the 163 children enrolled (mean age, 8.2 ± 3.3 years; 67% male). The prevalence of systolic hypertension at night was significantly higher in children with moderate-to-severe OSA than in those with primary snoring (44.9% vs 16.1%, P = .006). Pearson correlation and intraclass correlation analyses revealed associations between office BP and 24-hour BP, and Bland-Altman analysis indicated an agreement between office and 24-hour BP measurements. However, multiple linear regression analyses demonstrated that 24-hour BP (nighttime systolic BP and mean arterial pressure), unlike office BP, was independently associated with the apnea-hypopnea index, after adjustment for adiposity variables. Twenty-four-hour ABP is more strongly correlated with OSA in children, compared with office BP.

Prevalence of hypertension and pre-hypertension among adolescent school children in Thiruvananthapuram, Kerala, India

Background: The foundations of hypertension in a person are laid in childhood and adolescence. The phenomenon of tracking of blood pressure is one where those children and adolescents who are in a high blood pressure category tend to fall in the same category when they become adults. Early diagnosis of hypertension and prehypertension in children and adolescents will help in reducing the prevalence of hypertension and its complications in the future adult population of any country. The objective of this study was to find out the prevalence of hypertension and pre-hypertension among school children 13-17 years in Thiruvananthapuram City Corporation, Kerala. Methods: A two stage sampling technique was applied; in the first stage the schools were stratified as government, aided and unaided schools using probability proportionate to size. In the second stage, from the selected schools one division or class from each standard was identified at random as a cluster and all the eligible children in the selected cluster were studied. A single BP measurement was taken using a standardized digital sphygmomanometer (OMRON IA1). Hypertension and prehypertension was defined as per national high blood pressure education program (USA), working group on hypertension control in children and adolescents blood pressure tables. The data was entered in MS excel and further analysis was done using SPSS 16.0 version software and proportions of outcomes were analyzed. Results: The total number of children studied were 2438, Boys 1274 (52.3%, 95% CI 50.28-54.32) and girls 1164 (47.7%, 95% CI 45.68-49.72). The prevalence of hypertension was found to be 21.4% (95% CI 19.64% - 22.96%). The overall prevalence of systolic hypertension is slightly high among the girls (19.4%) than the boys (18.2%), (P value>0.05). The prevalence of pre-hypertension among the study subjects was 21.3 % (19.65-22.95%). The prevalence of systolic pre-hypertension was found to be 21.4% (95% CI 19.74%- 23.06%) and diastolic pre-hypertension 5.3% (95% CI 4.4%-6.2%). Conclusions: The overall prevalence of pre-hypertension and hypertension was 42.6%. These facts show us that preventive interventions are urgent.

Screening of Gestational Diabetes and Hypertension Among Antenatal Women in Rural West India.

BackgroundHypertension and gestational diabetes are among the leading causes of maternal and perinatal mortality, especially in rural areas of developing countries with meager health facilities. With early diagnosis and timely treatment, these adverse events can be decreased. The primary aim of this study was to implement a screening program for gestational diabetes and hypertension, and to assess risk factors associated with these conditions among antenatal women in the rural area of the Gujarat province in India.MethodsA cross–sectional study was conducted at one of the rural areas of Gujarat province in India. Following a random cluster sampling procedure, the village of Davas was selected. A multistage random sampling method was utilized, resulting in a sample of 346 antenatal women. Screening guidelines from the American Diabetes Association were followed for gestational diabetes screening.ResultsThe majority of antenatal mothers (55.50%) were between 21–25 years of age. 242 antenatal women were multigravida, and among them, 85.96% had institutional delivery at their last pregnancy. Of the total 346 women, 17.60% were prehypertensive. The prevalence of systolic hypertension was 1.40%, diastolic hypertension was 0.90%, and gestational diabetes was 1.73%.ConclusionSocioeconomically upper class, a family history of hypertension, and BMI ≥ 25 were strong risk factors for hypertension during pregnancy and gestational diabetes. Health education should be made readily available to antenatal mothers by paramedical workers regarding symptoms of hypertension and gestational diabetes mellitus for early self identification.

Prevalence of overweight, obesity and hypertension amongst school children and adolescents in North Karnataka: A cross sectional study

Introduction: Childhood obesity& hypertension are global health problems as they caused increase in morbidity & mortality. Objective: To find out the prevalence of obesity, overweight in school going children and adolescents of north Karnataka. Also to study obesity related morbidities like Prehypertension and Hypertension and associated risk factors for sustained hypertension. Materials and Methods: Total 2800 children in age group from 10-16 years from 3 schools of Urban and rural region of Bijapur district were screened. Weight, height, BMI and Blood pressure were recorded. These values were compared with WHO child growth standards. Children then classified as overweight (OW) and obesity (OB). Blood pressure values were compared with reference charts given by American heart association guidelinesand grouped as prehypertensive (PHTN) and Hypertension (HTN). Results: This study revealed that 3.6% rural school children were overweight (OW) in age group of 13 years, 1.4% children were obese (OB) in age group of 15 years. In urban school children, 3.3% OB in age group of 12 years and 11.1% OW in age group of 10 years. In Rural school children, prevalence of systolic HTN was 21% in OW children and 25% in OB children. Among urban schoolchildren prevalence of systolic PHTN was 5.1% among OW and in OB group it was 16.6%. Conclusions: This study revealed that prevalence of hypertension was significantly higher in overweight and obese compared to children with Normal BMI. Also the prevalence of overweight and obesity is more in urban school children than rural children population. We need further large scale studies to study obesity and associated morbidities like hypertension school children and adolescents.