scholarly journals The Effects of Socioeconomic Determinants on Hypertension in a Cardiometabolic At-Risk European Country

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Sarah Cuschieri ◽  
Josanne Vassallo ◽  
Neville Calleja ◽  
Nikolai Pace ◽  
Julian Mamo

Background. A relationship has been established between socioeconomic status and hypertension. The aim of this study was to determine the prevalence of hypertension and to explore the links between hypertension and socioeconomic factors in the adult population of Malta. Methods. A national representative cross-sectional health examination study was performed between 2014 and 2016. Sociodemographic and medical history data was gathered by validated questionnaires while blood pressure was measured. Prevalence rates of known hypertension, newly hypertension, and global hypertension were calculated. Associations between sociodemographic characteristics and hypertension were identified through logistic regression models. Results. Hypertension contributed to 30.12% (CI 95%: 28.71–31.57) of the study population, with a male preponderance. The majority was known hypertensive (73.59% CI 95%: 71.01–76.02), with only three-quarters on medication. Multivariant analyses showed that increasing age and body mass index, male gender, and living in Gozo, Western district, and Northern Harbour district were associated with having hypertension. Conclusion. Hypertension is a problem in Malta especially in the male population and with increasing age and body mass index. Education did not exhibit any associated risk for having hypertension, which is inconsistent with the literature, while habitat localities played a role in hypertension development.

2018 ◽  
Vol 50 (07) ◽  
pp. 556-561 ◽  
Author(s):  
Xiaojing Ma ◽  
Chengyin Zhang ◽  
Hong Su ◽  
Xiaojie Gong ◽  
Xianglei Kong

AbstractWhile obesity is a recognized risk factor for chronic kidney disease, it remains unclear whether change in body mass index (ΔBMI ) is independently associated with decline in renal function (evaluated by the change in estimated glomerular filtration rate, ΔeGFR) over time. Accordingly, to help clarify this we conducted a retrospective study to measure the association of ΔBMI with decline in renal function in Chinese adult population. A total of 4007 adults (aged 45.3±13.7 years, 68.6% male) without chronic kidney disease at baseline were enrolled between 2008 and 2013. Logistic regression models were applied to explore the relationships between baseline BMI and ΔBMI, and rapid decline in renal function (defined as the lowest quartile of ΔeGFR ). During 5 years of follow-up, the ΔBMI and ΔeGFR were 0.47±1.6 (kg/m2) and –3.0±8.8 (ml/min/1.73 m2), respectively. After adjusted for potential confounders, ΔBMI (per 1 kg/m2 increase) was independently associated with the rapid decline in renal function [with a fully adjusted OR of 1.12 (95% CI, 1.05 to 1.20). By contrast, the baseline BMI was not associated with rapid decline in renal function [OR=1.05 (95% CI, 0.98 to 1.13)]. The results were robust among 2948 hypertension-free and diabetes-free participants, the adjusted ORs of ΔBMI and baseline BMI were 1.14 (95% CI, 1.05 to 1.23) and 1.0 (95% CI, 0.96 to 1.04) for rapid decline in renal function, respectively. The study revealed that increasing ΔBMI predicts rapid decline in renal function.


2022 ◽  
Vol 40 (1) ◽  
pp. 14-21
Author(s):  
Mohammad Syfur Rahman ◽  
Mohammad Farhadul Haque ◽  
Tayeba Sultana ◽  
Tahera Sultana ◽  
Syed Asif Ul Alam

Background: Patients under maintenance hemodialysis are at increased risk of malnutrition, causing from multitude of factors. Present study aims to assess the prevalence of malnutrition among maintenance hemodialysis patients using both modified subjective global assessment score and body mass index, compare them and assess the sensitivity and specificity of body mass index for detecting malnutrition, along with determining a new cutoff value for BMI that better represent the maintenance hemodialysis patient’s nutritional status. Methods: This was a cross-sectional study conducted in the hemodialysis unit of Bangabandhu Sheikh Mujib Medical University, Sir Salimullah Medical College Mitford Hospital, BIRDEM General Hospital and National Institute of Kidney Diseases & Urology; among 80 adult CKD patients who were on regular (≥2 sessions per week) maintenance hemodialysis for more than 3 months without any acute infection, during the period of July 2016 to June 2017. Nutritional assessment was done for each patient using modified SGA score along with BMI. Sensitivity analysis of WHO recommended cutoff value for BMI was done among the study population using modified SGA score as gold standard test for detection of malnutrition among the respondents. ROC curve was used to estimate the best fitting cutoff value of BMI that showed highest sensitivity, specificity and accuracy for detracting malnutrition among maintenance hemodialysis patients. Results: The study participants were predominantly male (66.3%) and from age group 45 to 59 years (36.3%). Modified SGA score detected 90.0% of the study population as malnourished. WHO recommended 18.5 kg/m2 cutoff value was also used to detect malnutrition among study population and 13.8% were found to be malnourished, with a sensitivity and specificity of 12.5% and 75.0% respectively. Accuracy was found to be 18.8%. Using ROC curve, 23.1 kg/m2 was found to be the best fitting cutoff value of BMI for the study population to detect malnutrition. With a sensitivity of 47.2%, specificity of 37.5% and accuracy of 46.3%. Conclusion: BMI showed low sensitivity for detecting malnutrition among patients under maintenance hemodialysis, compared to modified SGA score and should be avoided as a screening tool, but 23.1 kg/m2 cutoff value for BMI showed potential to be used as an easy to use and quick tool for detecting malnutrition among such patients. Further study with larger sample size could shed more light on this. JOPSOM 2021; 40(1): 14-21


2019 ◽  
Vol 11 (1) ◽  
pp. 1-8
Author(s):  
S Naher ◽  
SS Sejooti ◽  
MM Hoque ◽  
MS Zaman ◽  
H Imam ◽  
...  

Obesity has become a global epidemic and has been found to be associated with numerous comorbidities. Body mass index (BMI) based classification of obesity is simple but co-morbidities do not affect all obese and overweight people. The present study was aimed to find out the frequency of metabolic phenotypes in different BMI groups using metabolic syndrome (MetS) criteria and cardiometabolic disabilities (CA) criteria and also to find out an appropriate method for defining metabolic health among adult population attending out patient department of Bangabandhu Sheikh Mujib Medical University (BSMMU). This cross-sectional analytical study was carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) from March 2016 to February 2017. By non probability sampling, a total of 1023 study subjects were selected from apparently healthy adult individuals attending outpatient department of BSMMU. The study subjects were grouped into three body mass index classes and also further categorized into six groups according to metabolically unhealthy or healthy phenotypes by presence or absence of metabolic syndrome (MetS) criteria as well as cardiometabolic disabilities (CA) criteria respectively. Then agreement among different metabolic phenotypes based on these two criteria were observed. Frequency of different metabolic phenotypes i,e metabolically healthy normal weight (MHNW), metabolically obese normal weight (MONW), metabolically healthy over weight (MHOW), metabolically obese over weight (MOOW), metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO) were 12.3%, 6.9%, 21.4%, 27.7%, 7.7%, 23.9% by MetS criteria and 7.7%, 11.5%, 11.6%, 37.4%, 6.1%, 25.6% by CA criteria respectively. MOOW followed by MUO were found to be predominant among all phenotypes. Fare agreement was found between two criteria in case of normal weight and overweight groups and good agreement was found in case of obese groups. From this study, it may be concluded that, attention should be given to the metabolically obese phenotypes in different BMI classes to reduce co-morbidities. Bangladesh J Med Biochem 2018; 11(1): 1-8


2021 ◽  
Vol 15 (5) ◽  
pp. 1507-1510
Author(s):  
K. H. Samejo ◽  
S. K. Kumar ◽  
G. Lail ◽  
A. B. Langove ◽  
S. Ahsam ◽  
...  

Objective: Gastroesophageal reflux disease (GERD) prevalence ranges from 24% to 35% in Pakistani population. Studies have demonstrated GERD frequency is directly proportional to increasing weight. Thus, the frequency of obesity among gastro esophageal reflux disease patients was determined. Methodology: This cross-sectional study was conducted on outpatients with GERD visiting Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi; from December 2017 to June 2018. Clinical and demographic parameters of study population were recorded. Body mass index (BMI) more than 27 was labeled as obese. Patients with history of ischemic heart disease, pregnancy, ascites and/or Patients on NSAIDS, bisphosphonates or steroids were excluded. Results: One hundred and fifty patients with mean age of 43.3±11.5 years were included in study. Eighty-seven patients (63.3%) had age more than 40 years. Majority of study population were males 95 (63.3%). Mean height and weight of study population were 163.09±9.56 cm and 72.92±15.13 kg, respectively. Mean BMI were 27.55±6.02 in which 71 (47.3%) were obese i.e., BMI >27. Majority were Urdu speaking i.e., 57 (38%) followed by Sindhi 31 (20%) Diabetes mellitus was documented in 22 (14.7%) and hypertension in 16 (10.7%) patients. Statistically significant association of GERD was seen in obese females (p-value: 0.018) Conclusion: Increase frequency of obesity is significantly associated with GERD. More proportion of obese females has GERD. Keywords: Gastro esophageal reflux disease; Body mass index; Weight; height


2021 ◽  
Vol 50 (4) ◽  
pp. 306-314
Author(s):  
Kumarasan Roystonn ◽  
Edimansyah Abdin ◽  
Rajeswari Sambasivam ◽  
Yunjue Zhang ◽  
Sherilyn Chang ◽  
...  

Introduction: The study assessed whether self-reported height, weight and derived body mass index (BMI) can provide an accurate measure of anthropometric data in a multiethnic adult population in Singapore. Methods: Standardised anthropometric measurements were compared against the self-reported values from 5,132 adult residents in a cross-sectional, epidemiological survey. Discrepancies in self-reports from measurements were examined by comparing overall mean differences. Intraclass correlations, Cohen’s kappa and Bland-Altman plots with limits of agreement, and sub-analysis by sex and ethnicity were also explored. Results: Data were obtained from 5,132 respondents. The mean age of respondents was 43.9 years. Overall, the height was overestimated (0.2cm), while there was an underestimation of weight (0.8kg) and derived BMI (0.4kg/m2). Women had a larger discrepancy in height (0.35cm, 95% confidence interval [CI] 0.22 to 0.49), weight (-0.95kg, 95% CI -1.11 to -0.79) and BMI (-0.49kg/m2, 95% CI -0.57 to -0.41) compared with men. Height reporting bias was highest among Indians (0.28cm, 95% CI 0.12 to 0.44) compared with Chinese and Malays, while weight (-1.32kg, 95% CI -1.53 to -1.11) and derived BMI (-0.57kg/m2, 95% CI -0.67 to -0.47) showed higher degrees of underreporting among Malays compared with Chinese and Indians. Substantially high self-reported versus measured values were obtained for intraclass correlations (0.96–0.99, P<0.001) and kappa (0.74). For BMI categories, good to excellent kappa agreement was observed (0.68–0.81, P<0.0001). Conclusion: Self-reported anthropometric estimates can be used, particularly in large epidemiological studies. However, sufficient care is needed when evaluating data from Indians, Malays and women as there is likely an underestimation of obesity prevalence. Keywords: Body mass index, epidemiology, public health, self-report, validity


Author(s):  
Prem S. Panda ◽  
Kamlesh K. Jain ◽  
Gopal P. Soni ◽  
Shubhra A. Gupta ◽  
Srishti Dixit ◽  
...  

Background: Obesity is now an important emerging public health problem in India. It is one of the major risk factor for hypertension. Overweight persons have two to six fold increase in the risk of developing hypertension. This study was carried out with objective to find out prevalence of Hypertension and assess its association with four obesity-related indices- body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR).Methods: A cross-sectional community-based study was done among 640 study subjects of age group 25-59 years during July 2015 to June 2016. Multi stage random sampling method was used. Data collection was done using WHO STEPS instrument V 3.1. Privacy and confidentiality of data was maintained. Data was entered in the Microsoft excel, collected data was checked for its completeness and correctness before data analysis with the help of PSPP software.Results: Prevalence of hypertension among study subjects was found to be 22.19% (142 out of 640).With respect to body mass index, waist circumference, waist hip ratio and waist height ratio, 4.38%, 64.35%, 85.33%, 76.2% were found to be obese respectively. Hypertension was strongly associated with BMI (p<0.001), waist circumference (p<0.001), waist hip ratio (p<0.05), waist height ratio (p<0.05). Out of the four anthropometric variables waist hip ratio (WHR) was most strongly associated with hypertension (β=420.236, p=0.007).Conclusions: The study shows a rising burden of hypertension among study population. As WHR is the best indicator for measuring obesity, so measurement of WHR should be made compulsory in healthy life style clinics along with other parameters.


2021 ◽  
pp. bjophthalmol-2020-318208
Author(s):  
Charumathi Sabanayagam ◽  
Rehena Sultana ◽  
Riswana Banu ◽  
Tyler Rim ◽  
Yih Chung Tham ◽  
...  

Background/aimsObesity is a well-known risk factor for diabetes, but its association with diabetic retinopathy (DR) is inconclusive, in particular in Asians. We aimed to assess whether body mass index (BMI) is associated with the presence and severity of DR in Asian populations with diabetes.MethodsPooled analysis of individual-level cross-sectional data from 10 010 adults with diabetes who participated in 12 population-based studies conducted in China, India, Japan, Russia (Asian), Singapore and South Korea that were part of the Asian Eye Epidemiology Consortium (AEEC). BMI was calculated as weight in kilograms divided by height in square metres and categorised into normal (<25 kg/m2, reference), overweight (25–29.9 kg/m2) and obese (≥30 kg/m2). Any-DR (n=1669) and vision-threatening DR (VTDR, n=489) were assessed from digital retinal photographs and graded according to standard protocols. Each study was analysed separately using multivariable logistic regression models adjusted for age, sex, haemoglobin A1c%, systolic blood pressure and diabetes duration, and the estimated odds ratios (ORs) and 95% confidence interval (CIs) from all studies were then combined using random-effects models.ResultsIn multivariable models, obesity showed a significant inverse association with any-DR (pooled OR (95% CI) =0.74 (0.59 to 0.91)) and VTDR (0.75 (0.60 to 0.93)). Similarly, in continuous analysis, BMI showed a significant inverse association with both any-DR (0.93 (0.87 to 0.99)) and VTDR (0.79 (0.68 to 0.92) per SD increase). Overweight did not show a significant association with any-DR.ConclusionsAmong Asian adults with diabetes, both BMI and obesity showed an inverse association with DR. These findings warrant confirmation in further longitudinal studies.


2013 ◽  
Vol 44 (10) ◽  
pp. 2231-2240 ◽  
Author(s):  
Z. Ul-Haq ◽  
D. F. Mackay ◽  
E. Fenwick ◽  
J. P. Pell

BackgroundThe evidence is conflicting as to whether body mass index (BMI) is associated with mental health and, if so, to what extent it varies by sex and age. We studied mental health across the full spectrum of BMI among the general population, and conducted subgroup analyses by sex and age.MethodWe undertook a cross-sectional study of a representative sample of the Scottish adult population. The Scottish Health Survey provided data on mental health, measured by the General Health Questionnaire-12 (GHQ), BMI, demographic and life-style information. Good mental health was defined as a GHQ score <4, and poor mental health as a GHQ score ⩾4. Logistic regression models were applied.ResultsOf the 37 272 participants, 5739 (15.4%) had poor mental health. Overall, overweight participants had better mental health than the normal-weight group [adjusted odds ratio (OR) 0.93, 95% confidence interval (CI) 0.87–0.99, p = 0.049], and individuals who were underweight, class II or class III obese had poorer mental health (class III obese group: adjusted OR 1.26, 95% CI 1.05–1.51, p = 0.013). There were significant interactions of BMI with sex (p = 0.013) and with age (p < 0.001). Being overweight was associated with significantly better mental health in middle-aged men only. In contrast, being underweight at all ages or obese at a young age was associated with significantly poorer mental health in women only.ConclusionsThe adverse associations between adiposity and mental health are specific to women. Underweight women and young women who are obese have poorer mental health. In contrast, middle-aged overweight men have better mental health.


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