scholarly journals 1127Uncontrolled hypertension among patients with comorbidities in sub-Saharan Africa; pooled analysis using individual participant data

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Shukri Mohamed
Keyword(s):  
Body Size ◽  
Central Obesity ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Uncontrolled Hypertension ◽  
Individual Participant Data ◽  
Cross Sectional ◽  
Improve Blood Pressure Control ◽  
Individual Participant ◽  
Sub Saharan

Abstract Background Despite the numerous studies on hypertension, the current literature reveals little about the relationship between patient comorbidities and uncontrolled hypertension in sub-Saharan Africa (SSA). We aimed to assess the associations between body size, dyslipidemia, diabetes and uncontrolled hypertension. Methods We harmonised and pooled individual-level data from 25 cross-sectional studies. We did a meta-analysis of individual participant data to assess the association between uncontrolled hypertension with body size, diabetes and dyslipidemia using a logistic regression while adjusting for potential confounders. Results The pooled dataset included 107,339 participants, of whom 64,811 were women and 42,528 were men. The pooled prevalence of uncontrolled hypertension (UHTN) among those on treatment was (3,449) 59.89%. The UHTN estimate ranged from 47.0% in Malawi to 80.0% in Guinea. Significant association were noted between UHTN and diabetes for all countries. The overall pooled estimate for UHTN among patients with diabetes was OR = 1.49 (95% CI 1.30 to 1.67). All countries had significant associations between UHTN and central obesity except for Gambia, Kenya and Tanzania. Study participants from Uganda with central obesity had the highest likelihood of UHTN OR = 1.14 (95% CI 0.38 to 1.89). All countries had significant associations between UHTN and general obesity except for Kenya, Tanzania and Uganda. Conclusions The prevalence of uncontrolled hypertension among patients with comorbidities is high in SSA. Key messages Effective strategies to improve blood pressure control among patients with chronic comorbidities are needed.

scholarly journals Arm Based on LEg blood pressures (ABLE-BP): can systolic leg blood pressure measurements predict systolic brachial blood pressure? Protocol for an individual participant data meta-analysis from the INTERPRESS-IPD Collaboration

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e040481
Author(s):  
Sinead T J McDonagh ◽  
James P Sheppard ◽  
Fiona C Warren ◽  
Kate Boddy ◽  
Leon Farmer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Public Involvement ◽  
Meta Analysis ◽  
Patient And Public Involvement ◽  
Prognostic Models ◽  
Individual Participant Data ◽  
Dissemination Strategy ◽  
Cross Sectional ◽  
Individual Participant ◽  
Meta Analyses

IntroductionBlood pressure (BP) is normally measured on the upper arm, and guidelines for the diagnosis and treatment of high BP are based on such measurements. Leg BP measurement can be an alternative when brachial BP measurement is impractical, due to injury or disability. Limited data exist to guide interpretation of leg BP values for hypertension management; study-level systematic review findings suggest that systolic BP (SBP) is 17 mm Hg higher in the leg than the arm. However, uncertainty remains about the applicability of this figure in clinical practice due to substantial heterogeneity.AimsTo examine the relationship between arm and leg SBP, develop and validate a multivariable model predicting arm SBP from leg SBP and investigate the prognostic association between leg SBP and cardiovascular disease and mortality.Methods and analysisIndividual participant data (IPD) meta-analyses using arm and leg SBP measurements for 33 710 individuals from 14 studies within the Inter-arm blood pressure difference IPD (INTERPRESS-IPD) Collaboration. We will explore cross-sectional relationships between arm and leg SBP using hierarchical linear regression with participants nested by study, in multivariable models. Prognostic models will be derived for all-cause and cardiovascular mortality and cardiovascular events.Ethics and disseminationData originate from studies with prior ethical approval and consent, and data sharing agreements are in place—no further approvals are required to undertake the secondary analyses proposed in this protocol. Findings will be published in peer-reviewed journal articles and presented at conferences. A comprehensive dissemination strategy is in place, integrated with patient and public involvement.PROSPERO registration numberCRD42015031227.

HIV-1 discordant couples in Karnataka, South India: is the sex ratio of index cases changing?

2012 ◽  
Vol 23 (7) ◽  
pp. 502-506 ◽  
Author(s):  
S Shastri ◽  
A Shet ◽  
B Rewari ◽  
A De Costa
Keyword(s):  
Index Case ◽  
Meta Analysis ◽  
Hiv Infections ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Similar Data ◽  
Cross Sectional ◽  
Infected Partner ◽  
Discordant Couples ◽  
Sub Saharan

India has an estimated 2.5 million HIV infections, most of which are heterosexually transmitted. Women comprise 40% of infected adults. In India, 90% of women between the ages of 15 and 45 years are married. Previous literature has suggested that sexual intercourse with an HIV-infected husband represents a married woman's greatest risk for being infected. However, a recent meta-analysis of discordant couples from sub-Saharan Africa reported that women were the index case in half of all couples. Similar data are not available from India. This cross-sectional study describes the epidemiology of 925 discordant couples from five districts in Karnataka province, one of the high HIV prevalence provinces in India. Men were the index case in 74% of couples. However, in young couples (where the index case was aged <30 years), women were more likely to be the infected partner (64% of couples). Condom use was reported by 46% of these discordant couples. These results suggest an emerging predominance of female index case infections among younger discordant couples in India, and point to the need for focusing HIV preventive messages on youth and couples before marriage.

scholarly journals Investigation of the Possible Moderators of Alcohol-Related Intimate Partner Violence in Sub-Saharan Africa

2021 ◽  
Vol 4 (2) ◽  
pp. 67-83
Author(s):  
Ekpenyong M.S. ◽  
Tawari E. P.2
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Meta Analysis ◽  
Intimate Partner ◽  
Sub Saharan Africa ◽  
Public Health Issue ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Cross Sectional ◽  
Sub Saharan

Alcohol-related intimate partner violence (IPV) is a serious public health issue which has attracted a lot of research and debates. While some studies have reported the relationship between alcohol and IPV to be linear, others have reported threshold effects. While some studies have found the link to be strong, others have reported it to be weak or to show no association. The aim of this study was to determine the possible moderators on the alcohol-IPV link in sub-Saharan Africa. For the quantitative study, secondary analysis and meta-analysis were used to analyze cross-sectional data from the demographic and health surveys of ten countries in sub-Saharan Africa (Burkina Faso, Ghana, Kenya, Liberia, Malawi, Nigeria, Sao Tome and Principe, Tanzania, Zambia, and Zimbabwe). Logistic regression analysis of possible moderators of the alcohol-IPV link was determined in ten sub-Saharan African countries. The nature of moderation was different among countries. The results of this study can be applied in planning country-specific and multi-faceted intervention programmes.

Abstract 020: Testosterone, Sex Hormone-binding Globulin and the Metabolic Syndrome: An Individual Participant Data Meta-analysis of 20 Observational Studies Involving 12,811 Men

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Judith S Brand ◽  
Maroeska M Rovers ◽  
Yvonne T van der Schouw ◽  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Observational Studies ◽  
Meta Analysis ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Individual Participant Data ◽  
Hormone Binding ◽  
Cross Sectional ◽  
Individual Participant

Background: The role of testosterone in metabolic syndrome (MetS) etiology is receiving increasing attention, given the overlap of testosterone deficiency and MetS in ageing men. We conducted an individual participant data (IPD) meta-analysis to examine this association in a uniform way and to produce more precise estimates of risk overall and in certain subgroups. Methods: Individual participant data of 20 observational studies including 12,811 men (mean age: 58.6 ± 15.6 years) were pooled and cross-sectional as well as prospective associations between total testosterone (TT), sex hormone-binding globulin (SHBG), free testosterone (FT) and MetS were assessed. We calculated odds ratios (ORs) and hazard ratios (HRs) by study-specific quartiles of sex hormones using mixed effects models (with random effects at the study level) and tested for effect modification by age and body mass index (BMI). Results: Cross-sectional analyses revealed that men with low concentrations of TT, SHBG or FT were more likely to have MetS. ORs for the lowest versus highest quartile were 4.56 (95% CI 4.02-5.16) for TT, 5.26 (95% CI 4.49-6.17) for SHBG and 2.18 (95% CI 1.88-2.53) for FT. Associations were attenuated but remained significant after adjustment for BMI and insulin resistance (homeostasis model assessment of insulin resistance (HOMA-IR)). Prospective analyses yielded similar results, but of smaller magnitude (HRs for the lowest versus highest quartile were 2.00 (95% CI 1.57-2.56) for TT, 2.71 (95% CI 1.99-3.70) for SHBG and 1.41 (95% CI 1.04-1.92) for FT). Stratified analyses revealed significant interactions by age and BMI, such that associations were strongest in young and nonobese men. Sex hormone concentrations decreased gradually with increasing number of MetS components and, for single components, were most strongly associated with abdominal obesity and hypertriglyceridemia. Conclusion: This meta-analysis of pooled individual data shows a robust, dose-response relationship of testosterone and SHBG concentrations with prevalent and incident MetS in men. The strong associations with abdominal obesity and hypertriglyceridemia provide insight into the underlying biological mechanisms.

scholarly journals Prevalence of uncontrolled hypertension in people with comorbidities in sub-Saharan Africa: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e045880
Author(s):  
Shukri F Mohamed ◽  
Olalekan A Uthman ◽  
Martin K Mutua ◽  
G Asiki ◽  
Mustapha S Abba ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Uncontrolled Hypertension ◽  
Diabetic Patients ◽  
Registration Number ◽  
Sub Saharan ◽  
Meta Analyses

BackgroundThe burden of uncontrolled hypertension in sub-Saharan Africa (SSA) is high and hypertension is known to coexist with other chronic diseases such as kidney disease, diabetes among others. This is the first systematic review and meta-analysis to determine the burden of uncontrolled hypertension among patients with comorbidities in SSA.MethodsA comprehensive search was conducted on MEDLINE, Excerpta Medica Database (Embase) and Web of Science to identify all relevant articles published between 1 January 2000 and 17 June 2021. We included studies that reported on the prevalence of uncontrolled hypertension among people in SSA who report taking antihypertensive treatment and have another chronic condition. A random-effects meta-analysis was performed to obtain the pooled estimate of the prevalence of uncontrolled hypertension among patients with comorbid conditions while on treatment across studies in SSA.ResultsIn all, 20 articles were included for meta-analyses. Eleven articles were among diabetic patients, five articles were among patients with HIV, two were among patients with stroke while chronic kidney disease and atrial fibrillation had one article each. The pooled prevalence of uncontrolled hypertension among patients with comorbidities was 78.6% (95% CI 71.1% to 85.3%); I² 95.9%, varying from 73.1% in patients with stroke to 100.0% in patients with atrial fibrillation. Subgroup analysis showed differences in uncontrolled hypertension prevalence by various study-level characteristicsConclusionThis study suggests a high burden of uncontrolled hypertension in people with comorbidities in SSA. Strategies to improve the control of hypertension among people with comorbidities are needed.PROSPERO registration numberCRD42019108218.

scholarly journals Uncontrolled hypertension among patients with comorbidities in sub-Saharan Africa: protocol for a systematic review and meta-analysis

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Shukri F. Mohamed ◽  
Olalekan A. Uthman ◽  
Rishi Caleyachetty ◽  
Ivy Chumo ◽  
Martin K. Mutua ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Uncontrolled Hypertension ◽  
Sub Saharan
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