scholarly journals Epidemiological features of hypertension among ischemic survivors in Northeast China: insights from a population-based study, 2017–2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Jing ◽  
Yuanmeng Tian ◽  
Guocheng Ren ◽  
Limin Zhang ◽  
Lei Shi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Rural Areas ◽  
Urban Areas ◽  
Northeast China ◽  
World Health ◽  
Stroke Recurrence ◽  
Hypertensive Patients ◽  
Epidemiological Features ◽  
Stroke Population

Abstract Background Hypertension remains the major modifiable risk factor of stroke recurrence. The study aimed to determine the up-to-date epidemiological features of hypertension among the survivors of ischemic stroke. Methods Our cross-sectional study included 18,796 adults aged ≥40 years and residing in northeast China. Ischemic stroke was diagnosed according to the World Health Organization’s criteria, which requires the clinical record, computed tomography (CT) and/or magnetic resonance imaging (MRI) during the hospital stay. Hypertension was defined according to the Chinese hypertension guidelines (mean SBP ≥140 mmHg and/or mean DBP ≥90 mmHg, and/or self-reported use of anti-hypertensive medication in the past 2 weeks). Results Of the 986 survivors of ischemic stroke, 819 (83.1%) were identified with hypertension (535 were pre-stroke hypertension and 284 were post-stroke hypertension). Among hypertensive patients, the awareness and treatment rates were 76.8 and 66.7% respectively. Only 11.0% achieved an appropriate blood pressure (< 140 mmHg and < 90 mmHg) among those who took hypertensive medications. 16.8% of treated hypertensive patients received combination therapy, and calcium channel blockers were the most frequently used anti-hypertensive medication as monotherapy. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the stroke population was 155.3 ± 22.9 mmHg and 89.2 ± 12.3 mmHg. Both SBP and DBP were higher in rural patients than in urban patients (158.5 ± 23.8 mmHg vs. 146.4 ± 17.5 mmHg and 90.3 ± 12.9 mmHg vs. 85.9 ± 10.1 mmHg, respectively; p < 0.001). The rates of stage 2 and above hypertension in the ischemic stroke population were 32.5 and 18.7%, and was significantly higher in rural areas than in urban areas. Conclusions The prevalence of poorly-controlled hypertension and the high rates of blood pressures at stages 2 and above in patients with prior ischemic stroke demonstrated an alarming situation in northeast China.

Epidemiological Features of Hypertension Among Ischemic Survivors in Northeast China: Insights From A Population-Based Study, 2017-2019

2021 ◽  
Author(s):  
Li Jing ◽  
Yuanmeng Tian ◽  
Guocheng Ren ◽  
Limin Zhang ◽  
Lei Shi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Rural Areas ◽  
Urban Areas ◽  
Northeast China ◽  
World Health ◽  
Stroke Recurrence ◽  
Hypertensive Patients ◽  
Epidemiological Features ◽  
Stroke Population

Abstract Background Hypertension remains the major modifiable risk factor of stroke recurrence. The study aimed to determine the up-to-date epidemiological features of hypertension among the survivors of ischemic stroke.Methods Our cross-sectional study included 18,796 adults aged ≥ 40 years and residing in northeast China. Ischemic stroke was diagnosed according to the World Health Organization’s criteria. Hypertension was defined according to the Chinese hypertension guidelines.Results Of the 986 survivors of ischemic stroke, 819 (83.1%) were diagnosed with hypertension. Among hypertensive patients, the awareness, treatment and control rates were 76.8%, 66.7% and 7.3% respectively. Only 11.0% achieved an appropriate blood pressure among those who took hypertensive medications. 16.1% of treated hypertensive patients received combination therapy, and calcium channel blockers were the most frequently used anti-hypertensive medication as monotherapy. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the stroke population was 155.3 ± 22.9 mm Hg and 89.2 ± 12.3 mm Hg. Both SBP and DBP were higher in rural patients than in urban patients (158.5 ± 23.8 mm Hg vs. 146.4 ± 17.5 mm Hg and 90.3 ± 12.9 mm Hg vs. 85.9 ± 10.1 mm Hg, respectively; p < 0.001). The rates of stage 2 and above hypertension in the ischemic stroke population were 32.5% and 18.7%, and was significantly higher in rural areas than in urban areas.Conclusions The prevalence of poorly-controlled hypertension and the high rates of blood pressures at stages 2 and above in patients with prior ischemic stroke demonstrated an alarming situation in northeast China.

scholarly journals Salt intake and blood pressure in Iranian children and adolescents: a population-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Hassan Emamian ◽  
Hossein Ebrahimi ◽  
Hassan Hashemi ◽  
Akbar Fotouhi
Keyword(s):  
Blood Pressure ◽  
Rural Areas ◽  
Urban Areas ◽  
Salt Intake ◽  
Daily Intake ◽  
Population Based ◽  
World Health ◽  
Second Phase ◽  
Salt Consumption ◽  
The Mean

Abstract Background Previous studies have reported a high prevalence of hypertension in Iranian students, especially in rural areas. The aim of this study was to investigate the daily intake of salt in students and its association with high blood pressure. Methods A random sub-sample was selected from the participants of the second phase of Shahroud schoolchildren eye cohort study and then a random urine sample was tested for sodium, potassium and creatinine. Urine electrolyte esexcretion and daily salt intake were calculated by Tanaka et al.’s formula. Results Among 1455 participants (including 230 participants from rural area and 472 girls), the mean age was 12.9 ± 1.7 year and the mean daily salt intake was 9.7 ± 2.6 g (95% CI 9.5–9.8). The mean salt consumption in rural areas [10.8 (95% CI 10.4–11.2)] was higher than urban areas [9.4 (95% CI 9.3–9.6)], in people with hypertension [10.8 (95% CI 10.3–11.3)] was more than people with normal blood pressure [9.4 (95% CI 9.3–9.6)], and in boys [9.8 (95% CI 9.7–10.0)] was more than girls [9.3 (95% CI 9.1–9.6)]. Higher age, BMI z-score, male sex and rural life, were associated with increased daily salt intake. Increased salt intake was associated with increased systolic and diastolic blood pressure. Conclusion Daily salt intake in Iranian adolescents was about 2 times the recommended amount of the World Health Organization, was higher in rural areas and was associated with blood pressure. Reducing salt intake should be considered as an important intervention, especially in rural areas.

scholarly journals Determinants of change in blood pressure in Ghana: Longitudinal data from WHO-SAGE Waves 1–3

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244807
Author(s):  
Elias K. Menyanu ◽  
Barbara Corso ◽  
Nadia Minicuci ◽  
Ilaria Rocco ◽  
Joanna C. Russell ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Insurance ◽  
Rural Areas ◽  
Urban Areas ◽  
World Health ◽  
Adult Health ◽  
Cross Sectional ◽  
Middle Income ◽  
Significant Difference ◽  
Survey Instruments

The prevalence of hypertension is increasing in low- and middle-income countries, however statistics are generally derived from cross sectional surveys that utilize different methodologies and population samples. We investigated blood pressure (BP) changes over 11–12 years in a large cohort of adults aged 50 years and older (n = 820) included in the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE Ghana) Wave 1 (2007/8) with follow up in Wave 3 (2019). Participants’ BP were measured in triplicate and a survey completed at both time points. Survey instruments collected information on sociodemographic characteristics, lifestyle, health behaviors and chronic conditions. While no significant difference was found in systolic BP between Waves 1 and 3, diastolic BP decreased by 9.7mmHg (mean = 88.6, 15.4 to 78.9, 13.6 respectively) and pulse pressure increased by 9.5mmHg (44.8, 13.7 to 54.3, 14.1). Awareness of hypertension increased by 37%, from (20% to 57%), but no differences were found for the proportion of hypertensives receiving treatment nor those that had controlled BP. Mixed effects modelling showed a decrease in diastolic BP was associated with increasing age, living in rural areas and having health insurance. Factors associated with an increased awareness of hypertension were residing in urban areas, having health insurance and increasing body mass index. While diagnosis of hypertension has improved over time in Ghana, there is an ongoing need to improve its treatment in older adults.

scholarly journals The importance of good blood pressure control in the prevention of stroke recurrence in hypertensive patients

1981 ◽  
Vol 57 (673) ◽  
pp. 690-693 ◽  
Author(s):  
J. H. Johnston ◽  
F. G. Dunn ◽  
D. G. Beevers ◽  
H. Larkin ◽  
D. M. Titterington
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Stroke Recurrence ◽  
Hypertensive Patients ◽  
Good Blood Pressure Control

Abstract P132: Clinical Outcomes In Ischemic Stroke Patients With Uncontrolled Hypertension

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Zahra Abuzaid ◽  
Sara Almuslem ◽  
Farah Aleisa
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Clinical Outcomes ◽  
Recurrent Stroke ◽  
Uncontrolled Hypertension ◽  
Stroke Recurrence ◽  
Stroke Patients ◽  
Stroke Event ◽  
Uncontrolled Blood Pressure

Background: Hypertension is considered major risk factor for incidence of ischemic stroke, controlling blood pressure reduces this risk, the relationship of uncontrolled blood pressure and stroke outcomes is complex, post stroke uncontrolled blood pressure remains one of the major contributing factors for stroke recurrence and mortality, in our study we studied the long term effects of uncontrolled hypertension in modern health care setting. Methodology: Patients in the study were admitted to the neurology department at KFSH-D between March 2015- August 2019, we included 102 acute ischemic stroke patients whom had hypertension, all patients had follow up appointments at stroke clinic a minimum of 2 visits over 4 years. We retrospectively compared blood pressure data from stroke patients with recurrent ischemic stroke events vs. patients with initial stroke event, and recurrent stroke, also we studied blood pressure readings for different stroke severity groups, patients who had severe stroke with mRS>4, compared to milder stroke group of mRS<4. Results: We found 48 patients identified with recurrent stroke event, those with uncontrolled hypertension had significantly higher stroke recurrence events (P=0.002), despite acute stroke treatment, patients who had history of uncontrolled hypertension were found to have more severe stroke deficits than those who had controlled blood pressure (P=0.029). We found significant difference in the long term stroke clinical outcomes between patients who had uncontrolled blood pressure and patients who had controlled blood pressure recordings within the same hospital setting (P=0.064). Conclusion: Based on our findings, uncontrolled hypertension was associated with higher risk of stroke recurrence, it also increased susceptibility to worse stroke clinical outcomes up to 1 year after initial stroke event, which deserved further close attention and better blood pressure control.

scholarly journals The Differences in the Prevalence of Cardiovascular Disease, Its Risk Factors, and Achievement of Therapeutic Goals among Urban and Rural Primary Care Patients in Poland: Results from the LIPIDOGRAM 2015 Study

2021 ◽  
Vol 10 (23) ◽  
pp. 5656
Author(s):  
Krzysztof Studziński ◽  
Tomasz Tomasik ◽  
Adam Windak ◽  
Maciej Banach ◽  
Ewa Wójtowicz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Primary Care Physicians ◽  
Primary Care Patient ◽  
Care Patient ◽  
Cross Sectional ◽  
Therapeutic Goals ◽  
Rural Primary Care

A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the years 2015 and 2016. A total of 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. The prevalence of hypertension, diabetes mellitus, dyslipidaemia, and CVD were similar in urban and rural areas (49.5 vs. 49.4%; 13.7 vs. 13.1%; 84.2 vs. 85.2%; 14.4 vs. 14.2%, respectively). The prevalence of obesity (32.3 vs. 37.5%, p < 0.01) and excessive waist circumference (77.5 vs. 80.7%, p < 0.01), as well as abdominal obesity (p = 43.2 vs. 46.4%, p < 0.01), were higher in rural areas in both genders. Mean levels of LDL-C (128 vs. 130 mg/dL, p = 0.04) and non-HDL-C (147 vs. 148 mg/dL, p = 0.03) were slightly higher in rural populations. Altogether, 14.3% of patients with CVD from urban areas and 11.3% from rural areas reached LDL <70 mg/dL (p = 0.04). There were no important differences in the prevalence of hypertension, diabetes, dyslipidaemia, and CVD, or in mean levels of blood pressure, cholesterol fractions, glucose, and HbA1c between Polish urban and rural primary care patient populations. A high proportion of patients in cities and an even-higher proportion in rural areas did not reach the recommended targets for blood pressure, LDL-C, and HbA1c, indicating the need for novel CVD-prevention programs.

scholarly journals Risk factor assessment and screening for diabetes in field practice area of a private medical college in Thiruvallur district of Tamil Nadu

2017 ◽  
Vol 4 (8) ◽  
pp. 2670 ◽  
Author(s):  
Sathish Dev ◽  
Timsi Jain ◽  
Sivaprakasam P. ◽  
Dinesh Raja
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Tamil Nadu ◽  
Univariate Analysis ◽  
The Elderly ◽  
World Health ◽  
Chi Square ◽  
Medical College ◽  
Diabetes Status ◽  
Field Practice

Background: Diabetes, which was known to be an epidemic in the urban areas, has been found to be increasing rapidly in the rural areas too as a result of the socioeconomic transitions. Diabetes is no longer only a disease of the elderly but is one of the major causes of morbidity and mortality affecting youth and middle aged people.Methods: Screening camp for diabetes was conducted by the Department of Community Medicine in three different areas in the field practice area of Saveetha Medical College and Hospital viz. Thirumazhisai, Kuthambakkam and Velavedu in Thiruvallur district of Tamil Nadu on 7th April 2016 as a part of World Health Day 2016 celebration. Data was collected using a predesigned interview schedule. Descriptive statistics was calculated using rates, ratios & proportions. Univariate analysis was done using Chi square test to find the association between various factors and diabetes status. A parsimonious regression model was developed to find the predictor variables for diabetes.Results: A total of 188 people aged above 18 years attended the screening camps. Majority of the camp attendees were females (62.2%). Proportion of people having diabetes (already diagnosed plus newly screened) was found to be 18.1% out of which 3.2% were screened positive for diabetes. On regression analysis, Intake of alcohol and perceived stress were found to be significantly associated with diabetes (p<0.05).Conclusions: This study highlights a significant burden of undiagnosed cases of diabetes in the community. This indicates the need for systematic screening and awareness programs to identify the undiagnosed cases in the community and offer early life style modifications, treatment and regular follow up to such individuals.

Status and disparities of diabetes among urban and rural residents aged 40 years and older: insight from a population-based study in northeast China, 2017–2019

2021 ◽  
pp. jech-2020-213755
Author(s):  
Liying Xing ◽  
Yuanmeng Tian ◽  
Li Jing ◽  
Min Lin ◽  
Zhi Du ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Urban Areas ◽  
Northeast China ◽  
Population Based ◽  
Cross Sectional Study ◽  
Haemoglobin A1c ◽  
Rural Residents ◽  
Cross Sectional ◽  
High Prevalence

ObjectivesTo evaluate the up-to-date epidemiology of diabetes in northeast China.MethodsThe cross-sectional study was conducted between September 2017 and March 2019 using a multistage, stratified and cluster random sampling method. 18 796 participants (28.9% urban and 71.1% rural) aged ≥40 years were enrolled. Diabetes and pre-diabetes were diagnosed according to the history, fasting plasma glucose (FPG) and glycosylated haemoglobin A1c (HbA1c) levels.ResultsThe prevalence of diabetes was 17.1%, higher in urban than in rural residents (20.2% vs 15.8%, p<0.001). Meanwhile, the prevalence of pre-diabetes was 44.3%, higher in rural than in urban areas (49.4% vs 31.8%, p<0.001). The overall FPG and HbA1c were 6.10±1.94 mmol/L and 5.59%±1.08%. The FPG level was higher in rural area than in urban areas (6.15±1.83 mmol/L vs 5.97±2.18 mmol/L, p<0.001). Among participants with diabetes, 47.5% were aware of their diabetes condition; 39.5% were taking antidiabetic medications and 36.8% of people had their diabetes controlled. The awareness and treatment rates in rural areas were lower than those in urban areas (47.3% vs 57.5%, 34.4% vs 49.5%, p<0.001). Patients with diabetic, especially those in rural areas, tended to have multiple risk factors including hypertension (71.7%), overweight or obesity (69.6%) and dyslipidaemia (52.8%).ConclusionA considerable burden of diabetes was observed in northeast China, with high percentage of untreated diabetes, high prevalence of pre-diabetes, high overall FPG level and multiple uncontrolled risk factors in patients with diabetics. Therefore, region-specific strategies on prevention and management of diabetes should be emphasised.

Abstract 13706: Differences in the Distribution of Systolic Blood Pressure by Rural and Urban Residence

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Brittain Heindl ◽  
George Howard ◽  
Elizabeth A Jackson
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Racial Differences ◽  
Rural Areas ◽  
Urban Areas ◽  
Census Bureau ◽  
Urban Group ◽  
Rural And Urban ◽  
Urban Rural ◽  
The Difference

Introduction: The incidence of stroke is higher in rural areas. Hypertension is the leading risk factor for stroke, but the difference in systolic blood pressure (SBP) for those living in rural and urban areas is unknown. Hypothesis: We hypothesized that rural residence is associated with higher SBP levels, and this difference is modified by race, sex, and United States (US) division. Methods: We analyzed 26,113 participants enrolled in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study, recruited between 2003 and 2007. Participants were grouped based on the Rural-Urban Commuting Area (RUCA) scheme into urban, large-rural, and small-isolated rural groups. Resting SBP was measured during the initial home visit. Differences in percentiles of SBP distribution were compared using multivariate models with adjustment for age, race, sex, and US Census Bureau division. Results: Of the participants, 20,976 (80.3%) were classified as urban, 3,020 (11.6%) as large-rural, and 2,137 (8.2%) as small-isolated rural, reflecting the distribution of the population. The large-rural group had a 0.09 mmHg higher mean SBP compared to the urban group (95% CI, 0.33 to 1.52 mmHg, p = 0.0023), but the difference in SBP at the 95th percentile between these groups was 3.23 mmHg (95% CI, 1.43 to 4.73 mmHg, p = 0.0006). A similar difference was present between the small-isolated rural and urban groups at the highest percentiles. No urban-rural interaction was observed by race, sex, or US division. However, large SBP differences were present between US divisions, especially at the highest percentiles. To illustrate, SBP at the 95th percentile was 9.51 mmHg higher in the East North Central division than in the Pacific (95% CI, 6.41 to 12.61 mmHg, p < 0.0001). Conclusions: Residence in a rural area is associated with higher SBP, with larger differences at the highest percentiles of distribution. SBP differences are present between US divisions, independent of urban-rural status.

scholarly journals The effectiveness of hypertension management in China: a community-based intervention study

2019 ◽  
Vol 20 ◽  
Author(s):  
Xiaoguo Zheng ◽  
Feng Xiao ◽  
Ruili Li ◽  
Delu Yin ◽  
Qianqian Xin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Healthcare System ◽  
Primary Healthcare ◽  
Rural Areas ◽  
Urban Areas ◽  
Blood Pressure Reduction ◽  
Hypertension Management ◽  
Hypertension Control ◽  
Community Based ◽  
One Year

Abstract Aim: This study aimed to evaluate the effectiveness of hypertension management and analyse the factors associated with blood pressure reduction within China’s primary healthcare system. Background: Hypertension is one of the leading risk factors for global disease burden and is strongly associated with cardiovascular diseases. In China, hypertension is a serious public health problem, but few studies have evaluated the effectiveness of hypertension management in China’s primary healthcare system. Methods: The study sites were 24 primary healthcare institutions, selected using multistage stratified random sampling method. In each institution, hypertension patients aged at least 35 years who agreed to participate and had no disabilities or mental health problems were enrolled for hypertension management. Participants received comprehensive interventions in the primary healthcare system via a team. After a one-year intervention, data from 6575 hypertension patients were analysed to check the effectiveness of hypertension management and examined factors associated with hypertension control. Findings: There was an overall mean reduction of 4.5 mmHg in systolic blood pressure (SBP) and 1.9 mmHg in diastolic blood pressure (DBP). The blood pressure reduction after one year was greater in rural patients than in urban patients, 6.6 mmHg versus 3.4 mmHg for SBP and 2.6 mmHg versus 1.6 mmHg for DBP, respectively. The hypertension control rate also increased more in rural areas (22.1%) than in urban areas (10.6%) after the one-year intervention. Age, body mass index, region and being in an urban area had a significant negative association with the reduction of SBP (P < 0.05). Education level and baseline SBP showed a significant positive association (P < 0.05). Conclusions: Community-based hypertension management by general practitioners was feasible and effective. The effectiveness of hypertension management in rural areas was greater than in urban areas. Intervention strategies should pay more attention to patients in rural areas and western China.

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