scholarly journals Gaps in secondary prevention among stroke survivors in rural Gadchiroli, India: a community-based cross-sectional study

2020 ◽  
Vol 5 ◽  
pp. 263
Author(s):  
Yogeshwar Kalkonde ◽  
Sunil Jadhao ◽  
Mahesh Deshmukh ◽  
Shoummo Sen Gupta ◽  
Abhay Bang
Keyword(s):  
Blood Pressure ◽  
Secondary Prevention ◽  
Rural Areas ◽  
Economic Status ◽  
Population Level ◽  
Antiplatelet Agents ◽  
Stroke Survivors ◽  
Antihypertensive Medications ◽  
Community Based ◽  
Cross Sectional

Background: With epidemiological transition, stroke has emerged as a public health priority in rural India. However, population-level information on secondary prevention of stroke from rural areas of India and other low- and middle-income countries remains exceedingly rare. Methods: In a cross-sectional community-based survey, trained surveyors screened a well-defined population of 74,095 individuals living in 64 villages in Gadchiroli district of India for symptoms of stroke. A trained physician evaluated screen positive patients, diagnosed stroke, measured blood pressure and collected information on prior diagnosis of risk factors and current use of medications using a structured questionnaire. Results: A total of 265 stroke survivors were identified. Prior diagnosis of hypertension was made in 57.4%, diabetes in 9.8%, hyperlipidaemia in 0.4%, ischaemic heart disease in 1.5%. and atrial fibrillation in 1.1%. Blood pressure was uncontrolled (>140/90) in 46% of stroke survivors. Among men 71.2% used tobacco and 30% used alcohol, while among women 38.2% used tobacco and none used alcohol. Only 40.8% of stroke survivors were receiving antihypertensive medications, while 10.6% were on antiplatelet agents and 4.9% were on statins. In a multivariate analysis, age <50 years (OR 0.2, 95% CI 0.1-0.5), male sex (OR 0.2, 95% CI 0.2-0.8) and lower economic status (no assets vs four assets; OR 0.3, 95% CI 0.1-0.9) were associated with lower odds of receiving medications for secondary prevention of stroke. Conclusions: There were significant gaps in secondary prevention of stroke in rural Gadchiroli. Healthcare programmes for secondary prevention of stroke in rural areas will have to ensure that blood pressure is adequately controlled, alcohol and tobacco cessation is promoted and special attention is paid to those who are younger, men and economically weaker.

Disparities in Secondary Prevention between Stroke and Coronary Heart Disease in China: Cross-Sectional Community-Based Study, 2014–2016

2021 ◽  
pp. 1-10
Author(s):  
Shijun Xia ◽  
Chi Wang ◽  
Xin Du ◽  
Lizhu Guo ◽  
Jing Du ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Secondary Prevention ◽  
Lipid Lowering ◽  
Community Based ◽  
Cross Sectional ◽  
History Of ◽  
Cvd Prevention

<b><i>Background:</i></b> Health care quality and insurance coverage have improved with economic development in China, but the burden of cardiovascular diseases (CVDs) continues to increase with ongoing gaps in prevention. We aimed to compare the uptake of secondary CVD prevention between stroke and coronary heart disease (CHD) patients in China. <b><i>Methods:</i></b> In a cross-sectional community-based survey of 47,841 adults (age ≥45 years) in 7 regions of China between 2014 and 2016, we identified those with a history of stroke or CHD to quantify disparities in conventional secondary CVD prevention strategies in multivariable logistic regression models. <b><i>Results:</i></b> There were 4,105 and 1,022 participants with a history of stroke and CHD, respectively. Compared to participants with CHD, those with a history of stroke were significantly less likely to be taking blood-pressure-lowering (39.7% vs. 53%), lipid-lowering (13.7% vs. 36.8%), and antiplatelet (20.8% vs. 50.6%) agents, at least one (48.9% vs. 70.8%) or all 3 recommended medicines (6.1% vs. 24.0%), and were less likely to achieve a lipid-cholesterol target (30.3% vs. 44.0%). Participants with a history of stroke achieved less optimal secondary prevention goals for medication use, either from any (adjusted odds ratio [aOR] 0.54, 95% confidence interval [CI] 0.44–0.66) or all 3 medications (aOR 0.27, 95% CI 0.20–0.36), as well as better blood pressure (aOR 0.81, 95% CI 0.66–0.98) and low-density lipoprotein cholesterol (aOR 0.34, 95% CI 0.27–0.43) levels of control. There were no significant differences in weight, smoking, or physical activity between the groups. <b><i>Conclusion:</i></b> Stroke patients had lower use of secondary CVD-preventive medication and achieved lower levels of risk factor control than those of CHD patients in China. Nationwide disease-specific strategies, and better education of participants and health care providers, may narrow these gaps.

scholarly journals A comparative study on the adherence to anti-hypertensive medications in urban and rural areas of Hubballi

2019 ◽  
Vol 6 (4) ◽  
pp. 1701 ◽  
Author(s):  
Pratibha Rao Katapadi ◽  
Dattatreya D. Bant
Keyword(s):  
Blood Pressure ◽  
Rural Areas ◽  
Rural Population ◽  
Antihypertensive Drugs ◽  
Cross Sectional Study ◽  
Uncontrolled Hypertension ◽  
Public Health Issue ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Hypertensive Patients

Background: Hypertension is a significant public health issue worldwide and can have deleterious effects on the health when it is not under control. Adherence to antihypertensive medications is thus necessary for better control of blood pressure and to reduce the risk of complications. There are various factors which support or hinder the patient’s adherence to anti- hypertensive treatment. Thus this study was done to reflect the factors influencing the adherence to antihypertensive drugs among urban and rural population.Methods: A community based cross sectional study was conducted in urban and rural field practice areas of Karnataka Institute of Medical Sciences, Hubballi. A semi-structured questionnaire was used for data collection among the known hypertensive patients. The data was entered in Microsoft Excel and analysed using SPSS software.Results: Most of the hypertensive patients were aged 45 and above (89.5%). A total of 73.5% of the participants were adherent to antihypertensive medications and adherence was more among urban (76%) as compared to rural population (71%). Knowledge regarding complications of uncontrolled hypertension was the major factor for adherence in both the areas. The mean systolic and diastolic blood pressure was controlled in patients who were adherent.Conclusions: There is a higher level of adherence to antihypertensive medications in urban population as compared to rural population of Hubballi. The findings suggest patient factors, clinical factors and socio-demographic factors play an important role in determining the adherence to the medication.

scholarly journals Prevalence and Associated Factors of Hypertension among Adults in Rural Uttarakhand: A Community Based Cross Sectional Study

2018 ◽  
Vol 6 (2) ◽  
pp. 481-490
Author(s):  
Vinita Thapliyal ◽  
Karuna Singh ◽  
Anil Joshi
Keyword(s):  
Blood Pressure ◽  
Waist Circumference ◽  
High Blood Pressure ◽  
Rural Areas ◽  
Nutrition Transition ◽  
Population Based ◽  
P Value ◽  
Sample Population ◽  
Community Based ◽  
Cross Sectional

India is in a state of transition epidemiological, economic, and demographic and nutrition transition. And all these transitions are leading to non communicable diseases like obesity, hypertension and insulin resistance. The study was aimed to estimate the Prevalence of hypertension and its associated risk factors among adults of rural Uttrakhand. It is a cross sectional community based study. Survey was conducted in rural areas of Uttrakhand, to make a sample size of 300 adults (18-45yr), using WHO STEPS questionnaire. Waist Circumference, Blood pressure, Body Mass Index of the participants was calculated. P value < 0.05 was considered significant. In the sample population based on systolic BP, 61.3% were non-hypertensive, 29.7% were pre-hypertensive and 9% were hypertensive. Based on diastolic BP, 43.3% were non-hypertensive, 32.7% were pre-hypertensive and 24% were hypertensive. Subjects with hypertension and pre-hypertension have higher BMI and waist circumference. A high prevalence rate of pre-hypertension and hypertension was depicted in rural areas of Uttrakhand region.4.8% of the female participants had systolic high blood pressure compared to the 11.9% of the male participants. On the other hand, 21.8% of the female participants had diastolic high blood pressure compared to the over 25% of the male participants.

scholarly journals Prevalence, patterns and socio-demographic correlates of tobacco use in Davangere taluka, Karnataka: a community-based, cross-sectional study

2020 ◽  
Vol 7 (12) ◽  
pp. 4799
Author(s):  
Basanagouda K. Patil ◽  
Vijay S. Patil ◽  
A. Nagrajachari ◽  
D. Kiran ◽  
Sunita B. Patil
Keyword(s):  
Tobacco Use ◽  
Rural Areas ◽  
Urban Areas ◽  
Economic Status ◽  
Cross Sectional Study ◽  
Family Type ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Demographic Correlates

Background: Tobacco use is the single, largest preventable cause of death and disability worldwide. Area-specific community-based epidemiological studies on tobacco use are required to quantify the problem, identify the determinants and their distribution. The objectives were to find out the prevalence, patterns and socio-demographic correlates of tobacco use in Davangere taluka, Karnataka, India.Methods: This was a community-based, cross-sectional study of 2008 subjects (>10 years of age) in urban and rural areas of Davangere taluka, Karnataka. Interviews were conducted by using a structured, pre-tested questionnaire by house-house visits.  Results are presented using percentages, chi-square test, odds ratio and multiple logistic regression analysis.Results: The prevalence of tobacco use was 30.7%. Among urban males it was 39.5%, rural males 39.6%, rural females 26% and urban females 18.5%. Tobacco use was significantly associated with sex, locality, religion, caste, marital status, family type, occupation, and tobacco use in family or friends. There was direct relationship of tobacco use with age and inverse relationship with education and socio-economic status. Mixed tobacco use was higher in rural areas compared to urban areas. About 73.9% of 10-29 years persons had started before the age of 18 years. Among older participants there was higher frequency of consumption and duration of use.Conclusions: Tobacco use is common and it is influenced by various local socio-demographic factors. Addressing these factors and providing tobacco cessation services should be included as key strategies in tobacco control.

scholarly journals Heart rate variability and blood pressure among Japanese men and women: a community-based cross-sectional study

2014 ◽  
Vol 37 (8) ◽  
pp. 779-784 ◽  
Author(s):  
Hiromi Mori ◽  
Isao Saito ◽  
Eri Eguchi ◽  
Koutatsu Maruyama ◽  
Tadahiro Kato ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Japanese Men ◽  
Men And Women

scholarly journals Treatment adherence and blood pressure outcome among hypertensive out-patients in two tertiary hospitals in Sokoto, Northwestern Nigeria

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Rasaq Adisa ◽  
Olumide Ayodeji Ilesanmi ◽  
Titilayo Oyelola Fakeye
Keyword(s):  
Blood Pressure ◽  
Cigarette Smoking ◽  
Treatment Adherence ◽  
Pressure Control ◽  
Patient Specific ◽  
Lifestyle Modifications ◽  
Antihypertensive Medications ◽  
Chi Square ◽  
Cross Sectional ◽  
Adherence To Medication

Abstract Background Treatment adherence play important roles in blood pressure control leading to reduction in morbidity and mortality. This study therefore assessed adherence to pharmacological and non-pharmacological therapies among ambulatory hypertensive patients. Reasons for treatment non-adherence, and association between adherence and blood pressure were also investigated. Methods Cross-sectional questionnaire-guided interview and retrospective review of medical records of 605-patients from two-tertiary healthcare institutions in Sokoto, Northwestern Nigeria. Nine-item modified Morisky adherence scale was used to assess medication adherence. Overall adherence score to lifestyle modifications was obtained from the total scores from 4-domains of non-pharmacological measures including cigarette smoking and alcohol cessation, salt-restriction and exercise. Patient-specific adherence education was provided at contact to resolve the knowledge gap(s). Clinical-parameters were retrieved at contact and subsequent 2-months appointment. Descriptive statistics, Chi-square and Student’s t-test were used for analysis at p < 0.05. Results Fifty-four (8.9%) patients were adherent to medications. Forgetfulness (404; 35.2%) was the most common reason for medication non-adherence. Use of buddy/companion reminder (605, 30.2%) top the list of adherence education. Overall adherence to lifestyle modifications was 36(6.0%). Mean systolic blood pressure (SBP) at contact was 149.6 ± 22.5 versus 134.2 ± 15.8 mmHg at 2-months with a 10% reduction. There were significant associations in baseline SBP for patients with or without adherence to medication, cigarette smoking cessation, and exercise (p < 0.05). Conclusions Overall adherence to antihypertensive medications and lifestyle modifications is suboptimal, underscoring the need for continuous patient-specific adherence education to ensure better therapeutic outcomes.

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 Manuscript title: Prevalence and determinants of undernutrition among under-five children residing in urban slums and rural area, Maharashtra, India: a community-based cross-sectional study

2020 ◽  
Author(s):  
Sujata Kapil Murarkar ◽  
Jayashree Sachin Gothankar ◽  
Prakash Doke ◽  
Prasad Pore ◽  
Sanjay Lalwani ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Breast Feeding ◽  
Rural Areas ◽  
Maternal Education ◽  
Economic Status ◽  
Urban Slums ◽  
Cross Sectional ◽  
Exclusive Breast Feeding ◽  
Under Five ◽  
Under Five Children

Abstract BackgroundUndernutrition among under five children in India is a major public health problem.Despite India’s growth in the economy, the child mortality rate due to undernutrition is still high in both urban and rural areas.Studies that focus on urban slums are scarce. Hence the present study was carried out to assess the prevalence and determinants of undernutrition in children under five in Maharashtra, India.Methods A community-based cross-sectional study was conducted in 16 randomly selected clusters in two districts of Maharashtra state, India. Data were collected through house to house survey by interviewing mothers of under five children. Total 2929 mothers and their 3,671 under five children were covered. Multivariate logistic regression analysis was carried out to identify the determinants of child nutritional status seperately in urban and rural areas. ResultsThe mean age of the children was 2.38 years (±SD 1.36) and mean age of mothers was 24.25 years (± SD 6.37).Overall prevalence of stunting among children under five was 45.9 %, wasting was 17.1% and 35.4% children were underweight.Prevalence of wasting, stunting and underweight were more seen in an urban slum than a rural area.In the rural areas exclusive breast feeding(p<0.001) and acute diarrhea (p=0.001) were associated with wasting, children with birth order 2 or less than 2 were associated with stunting and exclusive breast feeding (p<0.05) and low maternal education were associated with underweight. Whereas in the urban slums exclusive breast feeding(p<0.05) was associated with wasting, sex of the child (p<0.05) and type of family(p<0.05)were associated with stunting,and low income of the family(p<0.05) was associated with underweight.ConclusionsFactors like sex of the child, birth order,exclusive breast feeding ,economic status of the family, type of family,acute diarrhea and maternal education have influence on nutritional status of the child. Improvement of maternal education will improve the nutritional status of the child. Strategies are needed to improve the economic status of the community.Trial registration-Trial registration number:CTRI/2017/12/010881;Registration date:14/12/2017. Retrospectively registered.

scholarly journals Socio-economic Analysis and the Study of Prevalence, Awareness, Treatment, Control and Risk Factors of Hypertension in Hospital Staff

2013 ◽  
Vol 7 (1) ◽  
pp. 15-19
Author(s):  
Samjhana Shakya ◽  
J Bhattarai ◽  
K Rawal ◽  
AR Kunwar ◽  
YR Shakya ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Economic Status ◽  
Hospital Staff ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Cluster Sampling ◽  
Sectional Study ◽  
Cross Sectional ◽  
Public Health Challenge

Hypertension is an important public health challenge in the developing and the developed world alike. This worksite based descriptive cross-sectional study was undertaken in Sahid Gangalal National Heart Centre in 2010 with 50 subjects were recruited by multistage purposive cluster sampling. The primary aim of this descriptive cross-sectional study was to assess the socioeco­nomic status and to measure the prevalence, awareness, treatment, and correlates of hypertension. The prevalence of pre-hypertension is 38% and hypertension is 34%. Among the hypertensive 53% are aware of their condition and 66.66% of them are under treatment and 16.66% have con­trol over the condition. The prevalence of overweight and obesity were 22% and 4% respectively. The prevalence of central obesity was 29.72% among male and 69% among female. Knowledge, Attitude and Practice on hypertension was satisfactory. Fourteen percent understood hypertension as a raised blood pressure during blood flow in the arteries. Majority of them (72%) have posi­tive attitude towards use of medicine in hypertension. Majority of them (86%) had checked their blood pressure in last 2 years. Difference in prevalence of hypertension was found among the tobacco users and non- users (65% vs 40%), who do regular exercise and those who do not (28% vs. 38%) and sleep disturbance was higher among hypertensive than non-hypertensive (48% vs. 10%). Patients with Dislipidemia (32%) had higher prevalence of hypertension than those without Dislipidemia (44% vs 30 %) Similar finding were found between overweight participants (26%) and normal weight participants (46% vs 34%). The prevalence of hypertension is higher with the higher socio-economic status. Nepalese Heart Journal | Volume 7 | No.1 | November 2010 (special issue) | Page 15-19 DOI: http://dx.doi.org/10.3126/njh.v7i1.8496

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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