Association between sleep quality and blood pressure control among hypertensive patients at a rural tertiary hospital in Southern Nigeria: a cross-sectional study.

OBJECTIVES: Restorative sleep is critical in preventing hypertension and other chronic diseases. Limited research has explored the relationship between sleep quality and hypertension in Africa. This study investigated the association between sleep quality and blood pressure control among hypertensive patients in Southern Nigeria. DESIGN: Cross-sectional study. SETTING: A rural tertiary hospital in Southern Nigeria, April to June 2023. PARTICIPANTS: 250 systematically selected hypertensive adults. Participants completed a validated semistructured interviewer-administered questionnaire to assess their sleep patterns, including sleep duration, self-reported trouble sleeping and a history of clinical diagnosis of sleep disorders. Sleep patterns were categorised as restorative (healthy) or non-restorative (unhealthy). The blood pressure of respondents was checked and categorised as controlled (<140/90 mm Hg) or uncontrolled (≥140/90 mm Hg). Data were analysed descriptively using SPSS V.24.0 OUTCOME MEASURES: Quality of sleep and blood pressure control. RESULTS: Respondents had a mean age of 51.5±10.0 years, with the majority being female (156, 62.4%), married (135, 54.0%) and belonging to the Esan tribe (125, 50.0%). The prevalence of restorative sleep was 36%, while the blood pressure control rate was 23.6%. An association was found between restorative sleep and blood pressure control (adjusted OR =4.38; 95% CI=2.37-8.10; p<0.0001). Respondents aged ≥60 years had 3.5 times higher odds of experiencing non-restorative sleep than those aged ≤40 years (aOR=3.46; 95% CI=1.37-8.74; p=0.009). CONCLUSION: The study found an association between poor quality sleep and poor blood pressure control. Incorporating sleep assessments and interventions into comprehensive hypertension management strategies could be explored as a possible approach to improve sleep quality and enhance blood pressure control. TRIAL REGISTRATION NUMBER: PACTR202301917477205.

Covid-19 and Pre-Morbid Lifestyle-Related Risk Factors-A Review.

Since its outbreak in December 2019 in China, COVID-19 has spread like wild fire to affect many communities of the world. The high infectivity and case fatality rates of the disease among the general population and the severely ill patients respectively drew the attention of the global community. Our review showed that socio-demographic and lifestyle-related risk factors and underlying comorbid diseases were directly and indirectly associated with increased susceptibility and severity of COVID-19. These factors included older age (⩾60 years), male gender, and ethnic minority groups (especially blacks), smoking, low serum level of vitamin D, unhealthy diet, physical inactivity (with poor exposure to sunlight), overweight/obesity, high blood pressure/hypertension, high blood cholesterol, cardiovascular diseases (like stroke and coronary heart disease), diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, chronic liver disease, and some cancers (like leukemia, lymphoma, or myeloma). The literature further revealed that the clinical progression of the majority of these associated risk factors can be modified through effective and comprehensive risk reduction through healthy living and lifestyle modification. COVID-19 preventive and treatment guidelines that give adequate attention to risk reduction and healthy lifestyle among people-either in the pre-, peri-, or post-COVID-19 stage, should be developed by public health policymakers and clinicians. This will play a significant role in the global effort to combat the pandemic, and reduce its negative impact on the life expectancy and socio-economic development of the world particularly in low- and middle-income countries (LMICs).

Being a resident of family medicine in Africa in 2019: a picture from the 6th WONCA Africa Conference in Kampala / Ser residente em medicina de família na África em 2019: um retrato da sexta conferência WONCA África em Kampala / Ser residente en medicina familiar en África en 2019: un retrato de la sexta conferencia WONCA África en Kampala

Training young doctors in family medicine is challenging in any setting and many variables can influence the success or failure of a residency program. This article is the end result of a collaborative work that started in June 2019 at the WONCA Africa Regional Conference in Kampala, during a workshop lead by the Besrour Centre for Global Family Medicine at the College of Family Physicians of Canada. We present here the perspective of a small group of young African family physicians on the experience of being a resident in family medicine in Africa in 2019, hoping that the picture we depict here helps to promote the necessary improvements in the training programs in Africa for the near future.

Formar novos médicos de família é um desafio em qualquer cenário e muitas variáveis podem influenciar o sucesso ou o fracasso de um programa de residência. Este artigo é o resultado final de um trabalho colaborativo iniciado em junho de 2019, na Conferência Regional WONCA África em Kampala, Uganda, durante um workshop liderado pelo Centro Besrour do Colégio Canadense de Medicina de Família. Apresentamos aqui a perspectiva de um pequeno grupo de jovens médicos de família africanos sobre a experiência de ser residente em medicina de família na África em 2019, esperando que a imagem que representamos aqui ajude a promover as melhorias necessárias nos programas de residência na África em um futuro próximo.

La formación de nuevos médicos de familia es un desafío en cualquier lugar y muchas variables pueden influir en el éxito o el fracaso de un programa de residencia. Este artículo es el resultado final del trabajo colaborativo iniciado en junio de 2019 en la Conferencia Regional de África WONCA en Kampala, Uganda, durante un taller dirigido por el Centro Besrour del Colegio Canadiense de Medicina Familiar. Presentamos aquí la perspectiva de un pequeño grupo de jóvenes médicos de familia africanos sobre la experiencia de ser residente en medicina familiar en África en 2019, con la esperanza de que la imagen que representamos aquí ayude a promover mejoras en los programas de residencia en África en un futuro próximo.