Effect of antihypertensive medications on sleep status in hypertensive patients.

Purpose: Antihypertensive medication is an effective way to control blood pressure. However, some studies reported that it may affect patients' sleep quality during the treatment. Due to the inconsistency of present results, a comprehensive systematic review and network meta-analysis are needed. Methods: Electronic databases (MEDLINE, EMBASE, WEB OF SCIENCE, PUBMED) were searched up to April 10th, 2021 including no restriction of publication status. Randomized controlled trials (RCTs) or quasi-experimental studies or cohort studies were eligible. The network meta-analysis was used within a Bayesian framework. Results: Finally, 16 publications (including 12 RCTs and 4 quasi-experimental studies) with 404 subjects were included in this study. Compared to placebo, the results of the network meta-analysis showed that diuretics were effective in improving sleep apnea with a mean difference (MD) of - 15.47 (95% confidence interval [CI]: - 23.56, - 6.59) which was consistent with the direct comparison result (MD: - 17.91; 95% CI - 21.60, - 14.23). In addition, diuretics were effective in increasing nocturnal oxygen saturation with an MD of 3.64 (95% CI 0.07, 7.46). However, the effects of ß-blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and the others on sleep apnea were not statistically significant. Additionally, the effects of antihypertensive medication on the total sleep time (min), rapid eye movement (%), and sleep efficiency (%) were not statistically significant. Conclusion: Our study found that diuretics could effectively reduce the severity of sleep apnea in hypertensive patients. However, the effects of antihypertensive drugs on sleep characteristics were not found. Supplementary Information: The online version contains supplementary material available at 10.1007/s41105-022-00391-8.

Study of KAP with regard to taking folic acid supplements and factors affecting the recommendation and prescription of those supplements among obstetricians and specialists in women's health in six provinces of Northern China, 2009.

Taking folic acid (FA) supplements reduces the risks of neural tube defects (NTDs) in early pregnancy. Obstetricians and specialists in women's health play important roles in promoting FA intake. However, surveys on their knowledge of, attitudes toward, and behavior regarding giving FA to pregnant women are limited. A cross-sectional study was conducted with 5,860 obstetricians and specialists in women's health using a self-administered questionnaire to collect information on participants' demographic characteristics and their knowledge of and attitudes toward and practices related to taking FA supplements. Chi-square analysis was used for rate comparison while logistic regression analysis was performed to predict influencing factors. For items on knowledge about FA and taking FA supplements the overall correct response rate was 60.3% (24,235/40,173). Questions about related practices and attitudes were correctly answered for the most part (more than 90%), but participants were less likely to follow the practice of prescribing FA tablets to women planning a pregnancy while working (77.2%). Statistical analysis indicated that the "Level of facility where the participant works" and "Rate of correct responses on a test of knowledge" were the main factors affecting participants' recommendation to take FA while "Job title", "Amount of professional work experience", and "Rate of correct responses on a test of knowledge" were the main factors affecting participants' prescription of FA. In conclusion, participants had a good deal of knowledge about NTDs and FA but the lack of some knowledge possibly led to the relatively low rate of correct behaviors. Therefore, educating obstetricians and specialists in women's health in this regard is crucial.

Folic acid awareness and intake among women in areas with high prevalence of neural tube defects in China: a cross-sectional study.

OBJECTIVE: To measure folic acid awareness and intake rates among women of childbearing age in certain areas of China with a high prevalence of neural tube defects (NTD). DESIGN: A cross-sectional survey was carried out utilising a nineteen-item questionnaire enquiring into individual women's knowledge of, attitude towards and practice of folic acid supplementation. SETTING: A total of 293 low-income counties in six provinces of China. SUBJECTS: Women aged 19-44 years from six provinces with a high prevalence of NTD recruited from June to August 2008. RESULTS: Among 33 025 participants, 57 % had heard of folic acid but only 15 % knew all of the core information. The intake rate was 12 %; only 8 % took the recommended dose and only 4 % of non-pregnant women took folic acid. Some women did not take folic acid because they did not know that they should take it (49 %) or they had misconceptions about it (24 %). According to logistic regression analysis, rural residence was a risk factor for folic acid awareness. Ethnicity, educational level, average annual income per person and pregnancy were the influencing factors of folic acid awareness and folic acid intake. CONCLUSIONS: Although more than half of the respondents had heard of folic acid, the intake rate was still very low in areas with a high prevalence of NTD. Thus, more efforts are needed to increase folic acid awareness and intake among women of reproductive age in these areas.