Relationships between depression and anxiety symptoms scores and blood pressure in young adults.

BACKGROUND: Depression and anxiety are risk factors for cardiovascular disease, but their relationship to blood pressure (BP) is less clear. Age-related comorbidity and lifestyle factors may confound these relationships. This study aimed to assess the relationships among BP, depression and anxiety symptom scores and self-reported history of depression in young adults. METHOD: Data on 1014 participants aged 20 years from the Western Australian Cohort (Raine) Study were analyzed for cross-sectional associations between clinic BP and Depression, Anxiety, Stress Scale questionnaire scores or a reported history of depression, accounting for relevant confounders. RESULTS: Multivariable adjusted analyses showed an inverse relationship between SBP with depression (coefficient = -0.10; P = 0.012) and anxiety (after excluding two outliers with SBP > 156 mmHg, coefficient = -0.13; P = 0.018) scores, independent of sex, BMI, female hormonal contraceptive use, alcohol consumption, birth weight and maternal hypertension in pregnancy. SBP was 1.6 mmHg lower for 2 SD (16 units) increase in depression score. There was an inverse association between self-reported history of depression (15.8% of participants) and SBP (coefficient = -1.91; P = 0.023), with an interaction with increasing BMI (interaction coefficient = -0.43; P = 0.002) enhancing this difference. CONCLUSION: Our findings show that SBP in young adults is inversely associated with depression and anxiety scores, independent of a range of lifestyle confounders. Despite a positive association between BMI and BP, adiposity enhanced the inverse association between self-reported history of depression and SBP. These findings contrast with the predisposition of depressed participants to cardiovascular disease in later life when decades of unhealthy lifestyle changes may dominate.

Contrasting effects of prenatal life stress on blood pressure and body mass index in young adults.

BACKGROUND: Various environmental stressors in pregnancy have been reported to affect high blood pressure (BP) in adult offspring. However, few studies have examined the effect of prenatal maternal psychological stress on offspring BP and BMI in early adulthood. METHOD: In 957 Raine cohort participants, regression analyses were used to examine the association between the count of maternal life stress events experienced during pregnancy and offspring BP and BMI at age 20. RESULTS: Prenatal life stress associated positively with offspring BMI but inversely with SBP. After adjustment for confounders each additional prenatal life stress event reduced offspring SBP by 0.66  mmHg (P = 0.013) in those with an average BMI and lowered the odds of systolic (pre)hypertension by 17% (odds ratio = 0.83; P = 0.008). The inverse relationship between prenatal life stress and adult SBP was stronger in offspring with higher BMI. On the contrary, each unit increase in prenatal life stress score predicted a BMI increase of 0.37  kg/m (P = 0.022). Longitudinal analysis showed similar effects of prenatal life stress for offspring BMI from age 8 and SBP from age 14. CONCLUSION: This study has shown that maternal stress in pregnancy significantly associated with BMI from early childhood, but contrary to our hypothesis predicted lower resting SBP and lower odds of systolic (pre)hypertension in young adult offspring. The effect of prenatal life stress on BP was accentuated by a higher BMI. Fetal programming events as a result of prenatal stress may underpin some of these relationships.

Profile of viral hepatitis patients in Dakhliya, Oman.

OBJECTIVE: With the availability of routine serological diagnosis of all the major forms of viral hepatitis, namely, A, B, C, D, E consequent to initiation of National Viral Hepatitis Surveillance, the twin objective of the study was to assess the trend of various types of viral hepatitis and analyze the profile of the patients in the region of Al Dakhliya. METHODS: A one year prospective cohort, of all the suspects of viral hepatitis enrolled from 01/08/2003 to 31/07/2004 involving all health facilities (a total of 18 health institutions) of Dakhliya region, Sultanate of Oman, was subjected to centralized laboratory confirmation. Notification of viral hepatitis confirmed cases was the tool for analysis. A subset of unconfirmed viral hepatitis cases that were admitted and discharged from the referral hospital were retrieved and analyzed utilizing their computerized hospital records. RESULTS: There was a shift of incidence of hepatitis B towards higher age groups (32.4 +/- 16.2 years) with only one case under 15 years of age (p<0.0001). While as under 15 year age group was less prone to hepatitis C (p<0.05), it had a high incidence for hepatitis A with mean age 11.4 +/- 13.9 years (p<0.01). Hepatitis E incidence had a higher mean age of 44.6 +/- 24.1 years with insignificant linear trend (p>0.05). CONCLUSION: Progress in decline of viral hepatitis B has occurred at a rapid pace during the last decade following successful intervention of immunization against hepatitis with an almost 100% coverage. Affliction of younger age groups to hepatitis A is indicative of continued transmission of the disease in the community demanding improvements in preventive practices to curb any impending outbreak.

Placenta previa in a referral hospital in Oman.

OBJECTIVE: To determine the incidence of placenta previa associated pregnancies, to find out the strength of association of identified risk factors with the major placenta previa associated pregnancies and to identify predictors for preterm outcome. METHODS: Records of women with placenta previa, who delivered at Nizwa Hospital, Al-Dakhliya region, Sultanate of Oman between October 1998 and September 2002, were analyzed retrospectively utilizing a case control approach. RESULTS: An incidence of 0.6% for placenta previa was noted in our study. Nearly two thirds (64.8%) of the pregnancies resulted in antepartum bleeding. Pregnancies with major placenta previa constituted 72% of all the subjects. Higher parity (>/=5), maternal age (>/=30) and history of previous abortion had high odds of association with major placenta previa of 2.1, 2.4 and 2.5. Antepartum hemorrhage was not significantly associated with pregnancies presenting with major placenta previa (odds ratio [OR] 1.3; p>0.05). The proportion of preterm deliveries was 55.5% in the study. There was a significant association between preterm outcome and presence of antepartum hemorrhage (OR 10.8; p<0.001). CONCLUSION: In spite of higher maternal age, parity and previous abortions having high odds of presenting in pregnancies with major placenta previa, no significant statistical association could be proven. Also, no significant difference among pregnancies presenting with major or minor placenta previa as regards the preterm outcome, could be established. Antepartum hemorrhage, irrespective of severity, was a strong predictor of preterm outcome.