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1.
BMC Public Health ; 21(1): 1068, 2021 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090396

RESUMO

BACKGROUND: Since early 2020, the Covid-19 pandemic has engulfed the world. Amidst the growing number of infections and deaths, there has been an emphasis of patients with non-communicable diseases as they are particularly susceptible to the virus. The objective of this literature review is to systematize the available evidence on the link between non-communicable diseases and Covid-19. METHODS: We have conducted a systematic review of the literature on Covid-19 and non-communicable diseases from December, 2019 until 15th of November, 2020. The search was done in PubMed and in doing so we used a variety of searching terms in order to isolate the final set of papers. At the end of the selection process, 45 papers were selected for inclusion in the literature review. RESULTS: The results from the review indicate that patients with certain chronic illnesses such as diabetes, hypertension (and other cardiovascular diseases), chronic respiratory illnesses, chronic kidney and liver conditions are more likely to be affected by Covid-19. More importantly, once they do get infected by the virus, patients with chronic illnesses have a much higher likelihood of having worse clinical outcomes (developing a more severe form of the disease or dying) than an average patient. There are two hypothesized channels that explain this strong link between the chronic illnesses enumerated above and Covid 19: (i) increased ACE2 (angiotensin-converting enzyme 2) receptor expressions, which facilitates the entry of the virus into the host body; and (ii) hyperinflammatory response, referred to as "cytokine storm". Finally, the literature review does not find any evidence that diabetes or hypertension related medications exacerbate the overall Covid-19 condition in chronic illness patients. CONCLUSIONS: Thus, the evidence points out to 'business as usual' disease management model, although with greater supervision. However, given the ongoing Covid-19 vulnerabilities among people with NCDs, prioritizing them for the vaccination process should also figure high on the agenda on health authorities.


Assuntos
COVID-19 , Hipertensão , Doenças não Transmissíveis , Humanos , Hipertensão/epidemiologia , Doenças não Transmissíveis/epidemiologia , Pandemias , SARS-CoV-2
2.
Wiad Lek ; 74(5): 1196-1199, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34090289

RESUMO

OBJECTIVE: The aim: Is the analysis of chronic kidney disease risk in patients with arterial hypertension and coexistent hyperuricemia. PATIENTS AND METHODS: Materials and methods:We observed 40 patients with arterial hypertension and coexistent hyperuricemia (I group), 35 - with arterial hypertension (II group) and 30 practically healthy people (control). The duration of hypertension was 4,3 ± 2,31 years and 4,0 ± 2,11 years (p = 0,9247) for I and II group respectively, of hyperuricemia - 4,1 ± 0,35 years for I group. Categories of albuminuria (А1, А2, А3) and glomerular filtration rate (G1, G2, G3A, G3B, G4, G5) were determined in all observed patients. Clinical, anthropometric, biochemical, immunoassay, statistical (SPSS 21, Graph Pad) methods were used. RESULTS: Results:The categories of albuminuria and glomerular filtration rate in patients from the I group demonstrated that A1G1 was confirmed in 3 persons, A1G2 - 5, A2G1 - 7, A2G2 - 20, A1G3A - 1, A1G3B - 1, A2G3A - 2, A2G3B - 1. Among patients from the II group category A1G1 was defined in 7, A1G2 - 2, A2G1 - 16, A2G2 - 10 persons. The percent of low chronic kidney disease risk was on 5,7 % higher in hypertensive persons comparable with comorbid persons. High and very high risk was confirmed in 10 % persons from I group and nobody from the ІІ group. CONCLUSION: Conclusions:Chronic kidney disease risk is increased in patients with arterial hypertension and coexistent hyperuricemia. This indicates an association between elevated uric acid levels and chronic kidney disease progression.


Assuntos
Hipertensão , Hiperuricemia , Insuficiência Renal Crônica , Taxa de Filtração Glomerular , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Hiperuricemia/complicações , Hiperuricemia/epidemiologia , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/epidemiologia , Medição de Risco
3.
Medicine (Baltimore) ; 100(22): e26121, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087861

RESUMO

ABSTRACT: This community-based study aimed to elucidate whether there is a gender difference in the effect of metabolic syndrome (MetS) and its individual components on an elevated risk for incident colorectal adenoma.A prospective cohort study was conducted by enrolling 59,767 subjects aged 40 years or older between 2001 and 2009 in Keelung, Taiwan, to test this hypothesis, excluding those with a prior history of colorectal cancer and those with colorectal cancer diagnosed at the first screening. Cox proportional hazards regression models were used to assess the effect of MetS in terms of a dichotomous classification, each individual component and the number of components for males and females.Colorectal adenoma was present in 2.7% (n = 652) of male participants and 1.1% (n = 403) of female participants. The prevalence rate of MetS was 26.7% and 23.3% for males and females, respectively. The effect of MetS on colorectal adenoma was statistically significant and similar for the 2 genders, with an adjusted hazard ratio (aHR) of 1.33 (95% CI: 1.13-1.58) in males and 1.33 (95% CI: 1.06-1.66) in females after adjustment for confounders. However, MetS led to higher risk of advanced colorectal adenoma in men than in women. Regarding the effect of each component of MetS on colorectal adenoma, abnormal waist circumference and hypertriglyceridemia led to an elevated risk of colorectal adenoma in both genders. A rising risk of colorectal adenoma among females was noted in those with a moderately higher level of glycemia (100-125 mg/dL, aHR = 1.44, 95% CI: 1.12-1.85). Hypertriglyceridemia and high blood pressure were associated with an increased risk of advance colorectal adenoma in males.Both male and female subjects with MetS had a higher risk of colorectal adenoma. The contributions from individual components of MetS varied by gender. These findings suggest that the possible risk reduction of colorectal adenoma through metabolic syndrome-based lifestyle modifications may differ between genders.


Assuntos
Adenoma/epidemiologia , Neoplasias Colorretais/epidemiologia , Síndrome Metabólica/epidemiologia , Adulto , Idoso , Pesos e Medidas Corporais , Feminino , Humanos , Hipertensão/epidemiologia , Hipertrigliceridemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Distribuição por Sexo , Taiwan/epidemiologia
4.
Cien Saude Colet ; 26(5): 1613-1624, 2021 May.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34076104

RESUMO

This research aimed to analyze the dwellers' knowledge of the territories, Pecém Port and Industrial Compound (CIPP), the quality of life of the communities living in the vicinity of the enterprises, and the prevalence of hypertension and overweight. This is a home-based, epidemiological survey of four areas of the Family Health Strategy (ESF) in São Gonçalo do Amarante and one area of the ESF in Caucaia, Ceará, Brazil. The study was carried out between 10/2017 and 03/2018. Anthropometric and blood pressure measurements were performed, and sociodemographic data and knowledge about community, the CIPP, and quality of life were collected. A total of 69.8% of the 503 adults interviewed were female, and the mean age was 44 years. Parada was the area reporting the highest percentage of problems related to air particles (51.1%), the worst concept regarding the CIPP (40.1% bad), the highest percentage of worse quality of life (29, 1%), and greater desire to move to another place (31.5%). Pecém had the highest percentage of community problems related to violence, consumption of illicit drugs, and prostitution. We concluded that there are signs of impact on local populations' health and quality of life without more significant direct work/income benefits.


Assuntos
Hipertensão , Qualidade de Vida , Adulto , Brasil/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Renda , Indústrias , Masculino
5.
Artigo em Chinês | MEDLINE | ID: mdl-34074080

RESUMO

Objective: To explore the relationship between the binaural high-frequency mean hearing threshold and the hypertension of female workers exposed to noise, and to understand the application significance of the binaural high-frequency mean hearing threshold as an internal effect indicator of the risk of hypertension in female workers exposed to noise. Methods: From January to December 2018, a total of 20882 female workers exposed to noise in Guangzhou were selected by cluster sampling. Pure tone audiometry, blood pressure, age and length of service were collected. Trend test was used to evaluate the effects of exposure to noise and binaural high-frequency mean hearing threshold on blood pressure. Binary logistic regression model was used to evaluate the risk of hypertension associated with exposure to noise and binaural high-frequency mean hearing threshold. Results: The detection rate of normal hearing threshold, mild hearing loss and severe hearing loss was 80.73% (16858/20882) , 16.21% (3384/20882) and 3.06% (640/20882) respectively. The prevalence of hypertension was 6.04% (1018/16858) in normal hearing group, 10.28% (348/3384) in patients with high frequency mild hearing loss, and 11.25% (72/640) in patients with high frequency severe hearing loss. There was a linear relationship between the increase of working age and high-frequency mean hearing threshold and the increase of systolic and diastolic blood pressure (P< 0.05) . Compared with those exposed to noise for less than 1 year, the risk of hypertension in female workers with 7-9 years and more than 9 years was decreased (OR= 0.79, 0.75, P<0.05) . Compared with normal hearing group, the risk of hypertension in high frequency mild hearing loss group was increased (OR=1.31, P<0.05) . Conclusion: The increase in the binaural high-frequency mean hearing threshold of female workers exposed to noise can increase the blood pressure level and the risk of hypertension, and attention should be paid to female workers with high-frequency mild hearing loss.


Assuntos
Perda Auditiva Provocada por Ruído , Hipertensão , Ruído Ocupacional , Doenças Profissionais , Exposição Ocupacional , Audiometria de Tons Puros , Limiar Auditivo , Feminino , Audição , Perda Auditiva Provocada por Ruído/epidemiologia , Humanos , Hipertensão/epidemiologia , Ruído Ocupacional/efeitos adversos , Doenças Profissionais/epidemiologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-34067850

RESUMO

Certain underlying diseases such as diabetic mellitus and hypertension are a risk factor for the severity and mortality of coronavirus disease (COVID-19) patients. Furthermore, both angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) are controversial at role in the process of COVID-19 cases. The aim of the study was to investigate whether underlying diseases and taking ACEi/ARBs, affect the duration of hospitalization and mortality in patients with confirmed COVID-19. Medical usage claims data for the past three years until 15 May 2020, from the "CORONA-19 International Cooperation Research" project was used. We analyzed the medical insurance claims data for all 7590 coronavirus (COVID-19) patients confirmed by RT-PCR tests nationwide up to 15 May 2020. Among the comorbidities, a history of hypertension (hazard ratio [HR], 1.51; 95% confidence interval [CI], 1.056-2.158) and diabetes (HR, 1.867; 95% CI, 1.408-2.475) were associated significantly with mortality. Furthermore, heart failure (HR, 1.391; 95% CI, 1.027-1.884), chronic obstructive pulmonary disease (HR, 1.615; 95% CI, 1.185-2.202), chronic kidney disease (HR, 1.451; 95% CI, 1.018-2.069), mental disorder (HR, 1.61; 95% CI, 1.106-2.343), end stage renal disease (HR, 5.353; 95% CI, 2.185-13.12) were also associated significantly with mortality. The underlying disease has increased the risk of mortality in patients with COVID-19. Diabetes, hypertension, cancer, chronic kidney disease, heart failure, and mental disorders increased mortality. Controversial whether taking ACEi/ARBs would benefit COVID-19 patients, in our study, patients taking ACEi/ARBs had a higher risk of mortality.


Assuntos
COVID-19 , Hipertensão , Preparações Farmacêuticas , Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , COVID-19/tratamento farmacológico , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Estudos Retrospectivos , SARS-CoV-2
7.
Zh Nevrol Psikhiatr Im S S Korsakova ; 121(4. Vyp. 2): 110-115, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34078869

RESUMO

In connection with the spread of the novel coronavirus infection (COVID-19) pandemic and the increase in the development of severe acute respiratory syndrome, works are published around the world that determined the risk factors for complications and poor outcomes in this disease. Among the main comorbidities in COVID-19, scientists distinguish hypertension, diabetes, obesity, etc. Recently, more and more physicians and researchers are concerned about the high frequency of severe and critical complications of COVID-19 in patients with obstructive sleep apnea (OSA). In this review, we present some data on COVID-19 and OSA in the age aspect, show the general pathophysiological pathways leading to increased systemic inflammation and adverse consequences in the comorbid course of these diseases. Special attention is paid to such studies in the pediatric population, but only a few works of foreign scientists were found that did not reveal the essence of the problem under discussion, which requires further research in this area.


Assuntos
COVID-19 , Hipertensão , Apneia Obstrutiva do Sono , Criança , Comorbidade , Humanos , Hipertensão/epidemiologia , Fatores de Risco , SARS-CoV-2 , Apneia Obstrutiva do Sono/epidemiologia
8.
West Afr J Med ; 38(5): 434-438, 2021 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-34051714

RESUMO

BACKGROUND AND OBJECTIVES: Non-communicable diseases have emerged as major public health concerns in developing nations, where communicable diseases used to be the major contributor to the public health burden. Diabetes and hypertension contribute significantly to this menace, and they are largely undiagnosed in the affected population. We determined the prevalence of previously diagnosed and undiagnosed hypertension and diabetes mellitus in adult Nigerians. METHODS: Participants who presented in response to advertisement for the study and gave informed consent were recruited using convenience sampling. Data was collected using a proforma to obtain salient medical and social history. Anthropometric and blood pressure measurements were done. Capillary blood was taken for initial glucose measurements. Oral glucose tolerance test (OGTT) was subsequently done in non-diabetics with elevated blood glucose to confirm the diagnosis of diabetes. RESULTS: One hundred and thirty-six participants with age range 24 - 90 years were recruited for the study. Participants were mainly females (61.8%). Prevalence of diabetes among study participants was 19.9% (previously diagnosed -16.9% vs undiagnosed - 3.0%) with higher occurrence among males. Hypertension was found in 50.7% of participants; 28.7% were on treatment for hypertension, while 22.0% were newly diagnosed. Diabetes was associated with older age and elevated systolic blood pressure while hypertension was associated with older age, obesity and elevated blood glucose. CONCLUSION: This study showed a high occurrence of diabetes and hypertension among adult Nigerians; hence efforts to address these should be intensified. Targeted screening of people at risk for non-communicable diseases is an added benefit.


Assuntos
Diabetes Mellitus , Hipertensão , Adulto , Idoso , Idoso de 80 Anos ou mais , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Feminino , Teste de Tolerância a Glucose , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Obesidade , Adulto Jovem
9.
Clin Interv Aging ; 16: 801-810, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34017170

RESUMO

Background and Purpose: Elevated high-density lipoprotein cholesterol (HDL-C) levels have displayed protection against cardiovascular disease. However, the association between specific lipoprotein classes and first ischemic stroke (IS) has not been well defined, particularly in higher-risk hypertensive populations. Our study evaluated the associations of HDL-C with first IS in a Chinese hypertensive population. Methods: The study population was obtained from a community-based cohort study of hypertension in Lianyungang and Rongcheng, China. A nested case-control design was used that included 2463 identified first IS cases and 2463 controls matched by age ± 1 year, sex, and region. Results: After adjusting for potential confounders, HDL-C was inversely associated with first IS (adjusted odds ratio [aOR]: 0.91; 95% confidence interval [CI]: 0.85-0.98). HDL-C levels of at least 65.4 mg/dL displayed a significant protective effect for first IS (aOR: 0.82; 95% CI: 0.69-0.98). Conversely, adverse effects of first IS were observed for low-density lipoprotein cholesterol (LDL-C) levels ≥138.1 mg/dL (aOR: 1.20; 95% CI: 1.02-1.42) and triglyceride (TG) levels ≥140.8 mg/dL (aOR: 1.27; 95% CI: 1.09-1.49). The risk associations of LDL-C and TG with first IS were attenuated in the presence of high HDL-C (≥53.0 mg/dL); an increased risk of first IS was only found in the presence of low HDL-C (<53.0 mg/dL) when LDL-C (aOR: 1.66; 95% CI: 1.19-2.31) and TG (aOR: 1.47; 95% CI: 1.17-1.84) were combined with HDL-C for analysis. Conclusion: In this community-based Chinese hypertensive population, higher HDL-C was a significant protective factor of first IS. These data add to the evidence describing the relationship between lipids and IS and suggest that HDL-C maybe is a marker of IS risk in Chinses hypertensive population.


Assuntos
HDL-Colesterol/sangue , Hipertensão/epidemiologia , AVC Isquêmico/epidemiologia , Idoso , Biomarcadores , Estudos de Casos e Controles , China/epidemiologia , Feminino , Humanos , Hipertensão/fisiopatologia , AVC Isquêmico/fisiopatologia , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco
10.
J Stroke Cerebrovasc Dis ; 30(7): 105831, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33940364

RESUMO

OBJECTIVES: Cardiocerebral infarction (CCI) is the rare occurrence of acute ischemic stroke (AIS) and acute myocardial infarction (AMI), either at the same time (simultaneous or synchronous) or one after the other (metachronous). The aim of this study is to describe the clinical profile, management and treatment outcomes of patients with CCI. MATERIALS AND METHODS: This is a 3-year cross-sectional study of patients with CCI describing their clinical presentation, management, and outcomes. The primary outcome measures were all-cause mortality and functional outcome measured with the modified Rankin Scale score (mRS) at discharge and at 30 days post-CCI. We also described the frequency of major and minor hemorrhagic events. RESULTS: Out of 1683 AIS patients and 1983 AMI patients admitted during our time period, 29 patients fulfilled the inclusion criteria (mean age 60 ±12, 79% males, median admission NIHSS 16 [range 1-26]). Of these, 20 (69%) had metachronous CCI while 9 (31%) had synchronous CCI. Most of the patients were given antithrombotics and only 14% were given reperfusion therapies. The all-cause mortality is 45% and 69% of which were cardiovascular deaths. Seventeen and 21% of CCI patients had a good functional outcome on discharge and at 30 days from CCI onset respectively. A total of 8 (28%) patients had hemorrhagic events. CONCLUSIONS: We present the largest single institutional series showing the prevalence rate of cardiocerebral infarction to be 0.79% (0.55% for metachronous, 0.25% for synchronous), with patients presenting as moderate-severe acute ischemic strokes and high-risk acute myocardial infarction. These patients have a high mortality rate with a significant proportion having cardiovascular deaths.


Assuntos
AVC Isquêmico/epidemiologia , Infarto do Miocárdio/epidemiologia , Adulto , Idoso , Estudos Transversais , Diabetes Mellitus/epidemiologia , Avaliação da Deficiência , Feminino , Fibrinolíticos/uso terapêutico , Estado Funcional , Humanos , Hipertensão/epidemiologia , AVC Isquêmico/diagnóstico , AVC Isquêmico/mortalidade , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/terapia , Prevalência , Recuperação de Função Fisiológica , Reperfusão , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Resultado do Tratamento
11.
BMC Res Notes ; 14(1): 186, 2021 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-34001234

RESUMO

OBJECTIVE: African ancestry seems to be a risk factor for hypertension; however, few genetic studies have addressed this issue. This study aimed to investigate the prevalence of polymorphisms NOS3; rs1799983, IGFBP3; rs11977526 and TCF7L2; rs7903146 in Brazilian women of African descent and their association with hypertension. RESULTS: The prevalences of the less frequent genotypes were 26.5% TT genotype of NOS3; rs1799983, 16.7% AA genotype of IGFBP3; rs11977526, and 18.3% TT genotype of TCF7L2; rs7903146. For these conditions, the prevalence of hypertension and PR (adjusted) relatively to the ancestral genotype were, respectively: 52.0% vs 24.5% (PR = 1.54; p < 0.001), 62.0% vs 24.1% (PR = 1.59; p < 0.001), and 38.9% vs 27.9% (PR = 0.86; p = 0.166). Associations with hypertension were statistically significant, except for the TCF7L2; rs7903146 polymorphism, after adjusted analysis. Brazilian Afro-descendant women with the TT genotype for the NOS3 gene and the AA genotype for the IGFBP3 gene are more susceptible to hypertension. The understanding of underlying mechanisms involving the pathogenesis of hypertension can motivate research for the development of new therapeutic targets related to nitric oxide metabolism and the management of oxidative stress.


Assuntos
Hipertensão , Polimorfismo de Nucleotídeo Único , Brasil/epidemiologia , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Hipertensão/epidemiologia , Hipertensão/genética , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina , Óxido Nítrico Sintase Tipo III/genética , Prevalência , Proteína 2 Semelhante ao Fator 7 de Transcrição/genética
12.
Emergencias ; 33(3): 174-180, 2021 06.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33978330

RESUMO

OBJECTIVES: We aimed to analyze the clinical course of patients discharged from our emergency departament (ED) with pneumonia symptoms compatible with a diagnosis of COVID-19. MATERIAL AND METHODS: We followed 102 patients discharged home with a diagnosis of pneumonia compatible with COVID19 between March 12 and 21, 2020, in our hospital in the southern part of the autonomous community of Madrid. Descriptive statistics (medians and interquartile ranges or frequencies, as appropriate) were compiled for the main variables. Treatments and prognoses were compared with 􀁆2, Kruskal-Wallis, or Mann-Whitney tests. The data then underwent logistic regression analysis. RESULTS: Most patients (accounting for 74.5% of the discharges) were treated with hydroxychloroquine alone. The readmission rate was 15.7%; the ED revisiting rate was 25.7%. Admission was associated with an elevated lactate dehydrogenase (LDH) level (P=.011), elevated creatine kinase (CK) (P=.004), and lymphopenia (P=.034). Hypertension and chronic obstructive pulmonary disease were also related to admission. Ischemic heart disease was associated with longer duration of symptoms. CONCLUSION: Lymphopenia, and elevated LDH and CK levels predicted the need for hospital admission better than other traditional biological markers in patients with mild to moderate symptoms. Telephone follow-up proved useful for dealing with the overloading of health care services.


Assuntos
COVID-19/sangue , Creatina Quinase/sangue , L-Lactato Desidrogenase/sangue , Contagem de Linfócitos , Adulto , Idoso , Antivirais/uso terapêutico , Biomarcadores , COVID-19/tratamento farmacológico , COVID-19/epidemiologia , Comorbidade , Feminino , Seguimentos , Hospitais Universitários/estatística & dados numéricos , Humanos , Hidroxicloroquina/uso terapêutico , Hipertensão/epidemiologia , Linfopenia/sangue , Linfopenia/etiologia , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/epidemiologia , Alta do Paciente , Readmissão do Paciente/estatística & dados numéricos , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , SARS-CoV-2 , Espanha/epidemiologia , Telefone
13.
BMC Public Health ; 21(1): 903, 2021 05 12.
Artigo em Inglês | MEDLINE | ID: mdl-33980187

RESUMO

BACKGROUND: Assessing inequities in health services utilization contributes to build effective strategies for health equity promotion. This study aimed to evaluate the socioeconomic inequalities and inequities in health services utilization among hypertensive patients and explore the changes between 2015 and 2019 in Pearl River Delta of China. METHODS: The cross-sectional surveys were conducted using the questionnaire. Eight hundred thirty and one thousand one hundred sixty-six hypertensive patients in 2015 and 2019 were interviewed, respectively. The concentration index (CI) and the horizontal inequity index (HI) were used to access the socioeconomic inequalities and horizontal inequities in outpatient and inpatient health services use. The contribution of influential factors to the overall inequalities was estimated via the concentration index decomposition. Oaxaca-type decomposition technique was utilized to measure the changes in socioeconomic inequalities between the observation periods. RESULTS: In 2015 and 2019, the CIs for outpatient and inpatient utilization decreased from 0.1498 to 0.1198, 0.1982 to 0.1648, respectively, and the HIs for outpatient and inpatient utilization decreased from 0.1478 to 0.1078, 0.1956 to 0.1390, respectively. Economic status contributed the maximum ratio of the socioeconomic inequalities in the use of outpatient service (81.05% in 2015, 112.89% in 2019) and inpatient service (82.46% in 2015, 114.68% in 2019) in these 2 years. Oaxaca decomposition revealed that educational level (78.30% in outpatient, 53.79% in inpatient) and time to the nearest health facilities (66.78% in outpatient, 31.06% in inpatient) made the main positive contributions to decline the inequalities. While the main factor pushing the equalities toward deterioration was economic status (- 46.11% in outpatient, -76.56% in inpatient). CONCLUSION: There were certain declines in the socioeconomic inequalities and inequities in health services utilization by hypertensive patients in Pearl River Delta of China over time. The widening economic gap was the largest contribution to the observed inequalities. Interventions to protect the vulnerable group deserve further concern from policy makers.


Assuntos
Utilização de Instalações e Serviços , Hipertensão , China/epidemiologia , Estudos Transversais , Disparidades em Assistência à Saúde , Humanos , Hipertensão/epidemiologia , Hipertensão/terapia , Rios , Fatores Socioeconômicos
14.
BMJ Open ; 11(3): e043951, 2021 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-34006029

RESUMO

OBJECTIVES: This study was designed to assess levels of awareness, knowledge, attitude and practices relating to hypertension and diabetes among adults aged 35 years resident in selected communities in Imo and Kaduna states, Nigeria. DESIGN: A descriptive cross-sectional study. SETTING: Selected communities across 14 local government areas in Imo and Kaduna states were included. PARTICIPANTS: In total, 824 adults, aged 35 years or older and resident in selected communities where the Access-N project was being implemented in Imo and Kaduna states participated in the study. PRIMARY AND SECONDARY OUTCOME MEASURES: The study assessed the level of hypertension and diabetes knowledge among the participants. Regular blood pressure (BP) and glucose screening practices were also examined as outcome measures. RESULTS: The mean age of the respondents was 48.32 years. In total, 778 (94.4%) and 746 (90.5%) of the respondents were aware of hypertension and diabetes, respectively. The mean hypertension and diabetes knowledge scores (±SD) were 4.99 (±1.99) and 8.02 (±2.61), respectively. A total of 326 (41.9%) respondents aware of hypertension had a good knowledge of hypertension while 477 (63.9%) of those aware of diabetes had a good knowledge of diabetes. Levels of hypertension and diabetes knowledge were found to be associated with physical activity and the level of education of the respondents. About two-thirds (62.6%) and less than half (41.5%) of the respondents, respectively check their BP and blood glucose (BG) levels regularly (at least once yearly). Statistically significant associations were observed between age and regular BP and BG level checks. CONCLUSIONS: Despite the high awareness rate of hypertension and diabetes observed in this study and a relatively good knowledge about the two conditions, unhealthy lifestyle practices and non-regular routine screening abounds among the respondents. Thus, there is a need to improve access to quality information about hypertension and diabetes aimed at motivating adoption of healthy behaviours.


Assuntos
Diabetes Mellitus , Hipertensão , Adulto , Estudos Transversais , Diabetes Mellitus/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Hipertensão/epidemiologia , Hipertensão/prevenção & controle , Pessoa de Meia-Idade , Nigéria , Inquéritos e Questionários
15.
BMC Womens Health ; 21(1): 224, 2021 05 28.
Artigo em Inglês | MEDLINE | ID: mdl-34049551

RESUMO

BACKGROUND: The association between oral contraceptives (OCP) and hypertension has been reported in the literature with controversial results. According to the growing use of OCPs among women in Iran, this study aims to investigate the association between the duration of the OCP consumption and risk of hypertension among Iranian women. METHODS: In the current study, the data collected during the enrolment phase of the Tabari cohort were analyzed. Of 6106 women recruited in the cohort, 133 pregnant women were excluded. Epidemiological variables were collected using pre-designed questionnaires as well as the health insurance evidences. In addition, blood pressure and anthropometric factors were measured based on the standard guidelines. Chi square and partial correlation tests as well as logistic regression models were applied for data analysis. RESULTS: Frequency of oral contraceptive use among 35-70 year-old women in Tabari cohort study (TCS) was 42.2% (2520/5973). Hypertension was observed among 25% (1793/5973) of them. The adjusted odds ratio for OCP use was 1.23 (95% confidence interval: 1.08, 1.40, p = 0.002). The corresponding odds ratios for 61-120 months and more than 120 months OCP use were 1.39 (1.12,1.73) and 1.47 (1.16,1.87) respectively. CONCLUSIONS: Oral contraceptives especially in long term use can be associated with hypertension.


Assuntos
Anticoncepcionais Orais , Hipertensão , Adulto , Idoso , Pressão Sanguínea , Estudos de Coortes , Anticoncepcionais Orais/efeitos adversos , Feminino , Humanos , Hipertensão/epidemiologia , Irã (Geográfico)/epidemiologia , Pessoa de Meia-Idade , Gravidez
16.
BMJ Open ; 11(5): e041481, 2021 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-33952534

RESUMO

OBJECTIVE: To assess the prevalence of hypertension, impaired fasting capillary glucose (IFCG) and coexistence of both as well as determinants of these conditions among rural adolescents. DESIGN: A retrospective cross-sectional population-based study. SETTING: Three rural communities in southeast Nigeria. PARTICIPANTS: A total of 401 adolescents (10 - 19 years) selected through a five-stage sampling technique completed the study. Sick adolescents, pregnant and nursing adolescent mothers were excluded. PRIMARY OUTCOME MEASURES: Prevalence and determinants of hypertension, IFCG and comorbidity of both were assessed through weight, height, blood pressure, fasting capillary glucose measurements and statistical analysis. RESULTS: Prehypertension (10.7%), hypertension alone (12.7%), IFCG alone (11.0%), diabetes (0.2%) and hypertension with IFCG (6.2%) were prevalent among the adolescents. The adolescents aged 15 - 19 years were less likely to be affected by hypertension alone (adjusted OR (AOR)=0.36, 95% CI 0.18 to 0.74, p<0.01). The likelihood of having hypertension alone was three times higher among those who smoked any substance (AOR=3.43, 95% CI 1.34 to 8.78, p<0.05) and 2.85 times higher among those who consumed alcohol (AOR=2.85, 95% CI 1.33 to 6.10, p<0.01). Meal skipping (AOR=2.69, 95% CI 1.16 to 6.25, p<0.05), consumption of fried/baked snacks (AOR=15.46, 95% CI 1.62 to 147.37, p<0.05) and vegetables (AOR=2.27, 95% CI 1.11 to 4.66, p<0.05) were also significant risk factors of hypertension alone. Skipping meals (AOR=2.15, 95% CI 0. 93 to 4.99, p>0.05) and longer than 7 hours of night sleep (AOR=1.88, 95% CI 0.94 TO 3.73, p>0.05) increased the risk of IFCG alone by twofold. Female adolescents (AOR=0.29, 95% CI 0.10 to 0.78, p<0.05) and those who consumed fried/baked snacks (AOR=0.09, 95% CI 0.02 to 0.37, p<0.01) were less likely to have hypertension with IFPG than males and those who consumed non-fried/baked snacks, respectively. CONCLUSION: This study reported relatively low prevalence of hypertension alone, IFCG alone, hypertension with IFCG and epidemiological characteristics that can become focus of interventions to curtail the emergence of cardiovascular events at an early age. Awareness creation through health and nutrition education is emphasised.


Assuntos
Hipertensão , População Rural , Adolescente , Comorbidade , Estudos Transversais , Jejum , Feminino , Glucose , Humanos , Hipertensão/epidemiologia , Masculino , Nigéria/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco
17.
BMJ Open ; 11(5): e041566, 2021 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-33952535

RESUMO

OBJECTIVE: To investigate the long-term risk of developing hypertension and cardiovascular disease (CVD) among those women who suffered a postpartum haemorrhage (PPH) compared with those women who did not. DESIGN: Population-based longitudinal open cohort study. SETTING: English primary care (The Health Improvement Network (THIN)) and secondary care (Hospital Episode Statistics (HES)) databases. POPULATION: Women exposed to PPH during the study period matched for age and date of delivery, and unexposed. METHODS: We conducted an open cohort study using linked primary care THIN and HES Databases, from 1 January 1997 to 31 January 2018. A total of 42 327 women were included: 14 109 of them exposed to PPH during the study period and 28 218 matched for age and date of delivery, and unexposed to PPH. HRs for cardiovascular outcomes among women who had and did not have PPH were estimated after controlling for covariates using multivariate Cox regression models. OUTCOME MEASURES: Risk of hypertensive disease, ischaemic heart disease, heart failure, stroke or transient ischaemic attack. RESULTS: During a median follow-up of over 4 years, there was no significant difference in the risk of hypertensive disease after adjustment for covariates (adjusted HR (aHR): 1.03 (95% CI: 0.87 to 1.22); p=0.71). We also did not observe a statistically significant difference in the risk of composite CVD (ischaemic heart disease, heart failure, stroke or transient ischaemic attack) between the exposed and the unexposed cohort (aHR: 0.86 (95% CI: 0.52 to 1.43; p=0.57). CONCLUSION: Over a median follow-up of 4 years, we did not observe an association between PPH and hypertension or CVD.


Assuntos
Doenças Cardiovasculares , Hipertensão , Hemorragia Pós-Parto , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos de Coortes , Feminino , Humanos , Hipertensão/epidemiologia , Estudos Longitudinais , Hemorragia Pós-Parto/epidemiologia , Hemorragia Pós-Parto/etiologia , Gravidez , Fatores de Risco , Atenção Secundária à Saúde
18.
Int J Cardiol ; 334: 135-141, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33932429

RESUMO

AIM: To quantify the relation between apparent treatment resistant hypertension (aTRH) and the risk of recurrent major adverse cardiovascular events (MACE including stroke, myocardial infarction and vascular death) and mortality in patients with stable vascular disease. METHODS: 7455 hypertensive patients with symptomatic vascular disease were included from the ongoing UCC-SMART cohort between 1996 and 2019. aTRH was defined as an office blood pressure ≥140/90 mmHg despite treatment with ≥3 antihypertensive drugs including a diuretic. Cox proportional hazard models were used to quantify the relation between aTRH and the risk of recurrent MACE and all-cause mortality. In addition, survival for patients with aTRH was assessed, taking competing risk of non-vascular mortality into account. RESULTS: A total of 1557 MACE and 1882 deaths occurred during a median follow-up of 9.0 years (interquartile range 4.8-13.1 years). Compared to patients with non-aTRH, the 614 patients (8%) with aTRH were at increased risk of cardiovascular mortality (HR 1.27; 95% CI 1.03-1.56) and death from any cause (HR 1.25; 95% CI 1.07-1.45) but not recurrent MACE (HR 1.13; 95% CI 0.95-1.34). At the age of 50 years, patients with aTRH after a first cardiovascular event on average had a 6.4 year shorter median life expectancy free of recurrent MACE than patients with non-aTRH. CONCLUSION: In hypertensive patients with clinically manifest vascular disease, aTRH is related to a higher risk of vascular death and death from any cause. Moreover, patients with aTRH after a first cardiovascular event have a 6.4 year shorter median life expectancy free of recurrent cardiovascular disease.


Assuntos
Doenças Cardiovasculares , Hipertensão , Infarto do Miocárdio , Anti-Hipertensivos/farmacologia , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/epidemiologia , Humanos , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Pessoa de Meia-Idade , Infarto do Miocárdio/tratamento farmacológico , Fatores de Risco
19.
Curr Hypertens Rep ; 23(5): 27, 2021 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-33961166

RESUMO

PURPOSE OF REVIEW: Arterial hypertension is an important risk factor for cardiovascular disease. In the world, about 45% of people suffer from arterial hypertension, while good blood pressure control is achieved by only approximately 50% of all hypertensive patients treated. The reason for the high prevalence of arterial hypertension and its poor control is low knowledge of hypertensinogenic factors. One such factor is periodontitis, which is a disease of social importance. RECENT FINDINGS: It has been shown that the occurrence of periodontitis leads to an increase in blood pressure, increasing the risk of arterial hypertension. Periodontitis can also lead to ineffectiveness of antihypertensive treatment. Some interventional studies have shown that treatment of periodontitis reduced blood pressure in patients with arterial hypertension. The pathogenesis of arterial hypertension in periodontitis is complex and concerns mainly the impairment of the vasodilatation properties of the endothelium. Hygiene and periodontitis treatment should be a method of preventing arterial hypertension and a method of increasing the effectiveness of antihypertensive treatment.


Assuntos
Doenças Cardiovasculares , Hipertensão , Periodontite , Anti-Hipertensivos/farmacologia , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Doenças Cardiovasculares/tratamento farmacológico , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Periodontite/complicações , Periodontite/tratamento farmacológico , Periodontite/epidemiologia
20.
BMC Infect Dis ; 21(1): 474, 2021 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-34034649

RESUMO

BACKGROUND: Defining socio-demographic factors, clinical presentations and underlying diseases associated with COVID-19 severity could be helpful in its management. This study aimed to further clarify the determinants and clinical risk factors of the disease severity in patients infected with COVID-19. METHODS: A multi-centre descriptive study on all patients who have been diagnosed with COVID-19 in the province of Tehran from March 2020 up to Dec 2020 was conducted. Data on socio-demographic characteristics, clinical presentations, comorbidities, and the health outcomes of 205,654 patients were examined. Characteristics of the study population were described. To assess the association of study variables with the disease severity, the Chi-Squared test and Multiple Logistic Regression model were applied. RESULTS: The mean age of the study population was 52.8 years and 93,612 (45.5%) were women. About half of the patients have presented with low levels of blood oxygen saturation. The ICU admission rate was 17.8% and the overall mortality rate was 10.0%. Older age, male sex, comorbidities including hypertension, cancer, chronic respiratory diseases other than asthma, chronic liver diseases, chronic kidney diseases, chronic neurological disorders, and HIV/AIDS infection were risk markers of poor health outcome. Clinical presentations related with worse prognosis included fever, difficulty breathing, impaired consciousness, and cutaneous manifestations. CONCLUSION: These results might alert physicians to pay attention to determinants and risk factors associated with poor prognosis in patients with COVID-19. In addition, our findings aid decision makers to emphasise on vulnerable groups in the public health strategies that aim at preventing the spread of the disease and its mortalities.


Assuntos
COVID-19/epidemiologia , SARS-CoV-2 , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/mortalidade , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Doença Crônica/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Hipertensão/epidemiologia , Lactente , Irã (Geográfico)/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Prognóstico , Fatores de Risco , Índice de Gravidade de Doença , Adulto Jovem
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