The prevalence and risk factors associated with hypertension subtypes among ethnic Dai adults in rural China

Abstract Objective Hypertension is an important risk factor for cardiovascular disease. The purpose of this survey was to determine the prevalence of hypertension subtypes and the risk factors associated with hypertension subtypes among ethnic Dai adults in rural China. Methods A population-based survey was carried out with 2150 rural inhabitants aged 50 years or older. The definition of hypertension was a systolic blood pressure (SBP) ≥140 mmHg and/or a diastolic blood pressure (DBP) ≥90 mmHg, or a current treatment plan with an antihypertensive medication. Hypertension included the following subtypes: systolic–diastolic hypertension (SDH), isolated systolic hypertension (ISH) and isolated diastolic hypertension (IDH). All participants were interviewed, had physical examinations performed, and had blood pressure measurements taken. Multivariate logistic regression analysis was applied to analyse the risk factors for hypertension. Results The prevalence of HBP was 43.2% (95% CI: 41.1-45.3). The subtype-specific prevalence of hypertension was 16.5% (95% CI: 14.9-18.0) for SDH, 24.2% (95% CI: 22.4-26.0) for ISH and 2.5% (95% CI: 1.9-3.2) for IDH. Among hypertensive participants, 37.9% were SDH, 56.8% were ISH and 5.8% were IDH. Older age is a risk factor for HBP and ISH. Obesity, smoking, drinking and history of hypertension are risk factors for HBP, SDH, ISH and IDH (OR>1). Of the hypertensive participants, the awareness of hypertension in our study was 25.0% for HBP, 34.7% for SDH, 20.0% for ISH and 9.3% for IDH. The rates of treatment and control were 23.8% and 6.9% for HBP, 26.8% and 7.9% for SDH, 23.1% and 6.3% for ISH and 11.1% and 5.6% for IDH, respectively. Conclusions Among Dai people in rural China, the prevalence of hypertension is high, and the awareness, treatment and control of hypertension is low. ISH is the most frequent kind of high blood pressure in rural elderly people. With the ageing population in China, ISH remains an important public health problem and a challenging issue for practising physicians in rural China. Public health strategies should regularly provide more information about hypertension to both the local physicians and the general population. To reduce cardiovascular events, a combination of drugs and lifestyle changes are strongly recommended.

Download Full-text

Dyslipidemia in northeastern China

Open Medicine ◽

10.2478/s11536-010-0075-9 ◽

2011 ◽

Vol 6 (2) ◽

pp. 220-226 ◽

Cited By ~ 1

Author(s):

Xiao Shi ◽

Qinglong Jin ◽

Yulin Hu ◽

Xiumei Chi ◽

Yanhang Gao ◽

...

Keyword(s):

Public Health ◽

Risk Factors ◽

Logistic Regression ◽

Risk Factor ◽

Coronary Artery ◽

Binary Logistic Regression ◽

Northeastern China ◽

Major Risk Factor ◽

Coronary Artery Diseases ◽

Factors Associated

AbstractDyslipidemia, is a major risk factor for premature coronary artery disease. Our aim was to estimate the prevalence of dyslipidemia (blood lipid abnormalities) and other risk factors associated with coronary artery diseases among an adult population in northeastern China. Throughout the months of September and October of 2007,a population-based cross-sectional study was conducted and a total of 3,815 individuals were included. Total cholesterol (TC), high-density cholesterol (HDL-C), low-density cholesterol (LDL-C), and triglycerides (TG) were measured. A binary logistic regression analysis was conducted to determine risk factors associated with dyslipidemia. The prevalence of hypercholesterolemia, high LDL-C, low HDL-C, and hypertriglyceridemia were 17.3%, 27.8%, 11.66% and 29.85%, respectively. The prevalence of hypertension, central obesity, alcoholic liver disease (ALD), non-ALD, diabetes and metabolic syndrome was higher in serum lipid abnormality groups than in the non-dyslipidemia group (p < 0.001). In a binary logistic regression, hyperlipidemia was positively correlated with age, male, hypertension, high body mass index, etc. There were negative correlations with being female and the level of education a subject had attained. Dyslipidemia is a major risk factor for premature coronary artery diseases and an important public health issue in the northeastern part of China. Dyslipidemia is more frequent than expected based on previous studies. To control dyslipidemia, routine evaluations in clinics and community centers are needed, as well as effective public health education.

Download Full-text

Factors associated with awareness, treatment and control of hypertension among 3579 hypertensive adults in China: data from the China Health and Nutrition Survey

BMC Public Health ◽

10.1186/s12889-021-10417-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Junxiang Wei ◽

Yang Mi ◽

Yan Li ◽

Bo Xin ◽

Youfa Wang

Keyword(s):

Public Health ◽

Blood Pressure ◽

Hypertension Treatment ◽

Chinese Adults ◽

Nutrition Survey ◽

Antihypertensive Medications ◽

Factors Associated ◽

Health And Nutrition ◽

Hypertension Awareness ◽

And Control

Abstract Background The prevalence of hypertension is high and rising in China, but most people with hypertension do not have their blood pressure under control. This study investigated hypertension awareness, treatment, and control and their associated factors among Chinese adults. Methods Data collected from the 2011 China Health and Nutrition Survey (CHNS) from 12,991 Chinese adults were used. Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, self-reported prior diagnosed hypertension, or taking antihypertensive medications. Hypertension awareness, treatment, and control were defined as a self-reported diagnosis of hypertension, current use of antihypertensive medication, and blood pressure < 140/90 mmHg, respectively. Multivariate logistic regression was performed to examine factors associated with hypertension awareness, treatment, and control. Results Overall, 3579 (27.6%) of the CHNS adult participants had hypertension, of whom 55.7% were aware of their diagnosis, 46.5% were treated with antihypertensive medications, but only 20.3% had their blood pressure under control. Higher hypertension treatment was associated with older age (OR = 2.57; 95%CI, 1.65–4.02), urban residency (1.50; 1.14–1.97), living in the Eastern region (1.52; 1.14–2.01), and being overweight/obese (1.99; 1.39–2.84). Hypertension awareness was associated with similar factors as hypertension treatment but was also associated with being female (1.37, 1.12–1.66). Poor hypertension control was associated with being overweight/obese (0.56; 0.42–0.76) and minority ethnicity (0.52; 0.31–0.86). Conclusion Hypertension is a major public health challenge in China. The prevalence of hypertension awareness, treatment, and control are still low despite existing public health policies and programs to reduce the burden of hypertension. More intensive hypertension screening and treatment programs are warranted in China.

Download Full-text

COVID-19 :Determinants of Hospitalization, ICU and Death among 20,293 reported cases in Portugal

10.1101/2020.05.29.20115824 ◽

2020 ◽

Author(s):

Vasco Ricoca Peixoto ◽

André Vieira ◽

Pedro Aguiar ◽

Paulo Sousa ◽

Carlos Carvalho ◽

...

Keyword(s):

Public Health ◽

Risk Factors ◽

Risk Factor ◽

Preventive Behavior ◽

Factors Associated ◽

Health Measures ◽

Relative Risks ◽

Routine Surveillance ◽

Directorate General ◽

Independent Risk Factors

SummaryIntroductionDeterminants of hospitalization, intensive care unit (ICU) admission and death are still unclear for Covid-19 and only a few studies have adjusted for confounding for different clinical outcomes including all reported cases in a country. We used routine surveillance data from Portugal to identify risk factors for COVID-19 outcomes, in order to support risk stratification, clinical and public health interventions, and scenarios to plan health care resources.MethodsWe conducted a retrospective cohort study including 20,293 laboratory confirmed cases of COVID-19 in Portugal extracted in April 28 2020, electronically through the National Epidemic Surveillance System of the Directorate-General of Health(DGS). We calculated absolute risks, relative risks (RR) and adjusted relative risks (aRR) to identify demographic and clinical factors associated with hospitalization, admission to ICU and death using Poisson regressions.ResultsIncreasing age after 60 years was the greatest determinant for all outcomes. Assuming 0–50 years as reference, being aged 80–89 years was the strongest determinant of hospital admission (aRR-5.7), 70–79 years for ICU(aRR-10.4) and > 90 years for death(aRR-226.8) with an aRR of 112.7 in those 70–79. Among comorbidities, Immunodeficiency, cardiac disease, kidney disease, and neurologic disease were independent risk factors for hospitalization (aRR 1.83,1.79,1.56, 1.82), for ICU these were cardiac, Immunodeficiency, kidney and lung disease (aRR 4.33, 2.76, 2.43, 2.04), and for death they were kidney, cardiac and chronic neurological disease (aRR: 2.9, 2.6, 2.0) Male gender was a risk factor for all outcomes. There were small statistically significant differences for the 3 outcomes between regions.Discussion and ConclusionsOlder age stands out as the strongest risk factor for all outcomes specially for death as absolute is risk was small for those younger than 50. These findings have implications in terms of risk stratified public health measures that should prioritize protecting older people although preventive behavior is needed in all ages. Epidemiologic scenarios and clinical guidelines may consider these estimated risks, even though under-ascertainment of mild and asymptomatic cases should be considered.

Download Full-text

Factors associated with awareness, treatment and control of hypertension among 3,579 hypertensive adults in China: data from the China Health and Nutrition Survey

10.21203/rs.3.rs-18826/v4 ◽

2020 ◽

Author(s):

junxiang Wei ◽

Yang Mi ◽

Yan Li ◽

Bo Xin ◽

Youfa Wang

Keyword(s):

Public Health ◽

Blood Pressure ◽

Hypertension Treatment ◽

Chinese Adults ◽

Nutrition Survey ◽

Antihypertensive Medications ◽

Factors Associated ◽

Health And Nutrition ◽

Hypertension Awareness ◽

And Control

Abstract Background: The prevalence of hypertension is high and rising in China, but most people with hypertension do not have their blood pressure under control. This study investigated hypertension awareness, treatment, and control and their associated factors among Chinese adults. Methods: Data collected from the 2011 China Health and Nutrition Survey (CHNS) from 12,991 Chinese adults were used. Hypertension was defined as systolic blood pressure ≥ 140 mm Hg, diastolic blood pressure ≥ 90 mm Hg, self-reported prior diagnosed hypertension, or taking antihypertensive medications. Hypertension awareness, treatment, and control were defined as a self-reported diagnosis of hypertension, current use of antihypertensive medication, and blood pressure < 140/90 mm Hg, respectively. Multivariate logistic regression was performed to examine factors associated with hypertension awareness, treatment, and control. Results: Overall, 3,579 (27.6%) of the CHNS adult participants had hypertension, of whom 55.7% were aware of their diagnosis, 46.5% were treated with antihypertensive medications, but only 20.3% had their blood pressure under control. Higher hypertension treatment was associated with older age (OR=2.57; 95%CI, 1.65-4.02), urban residency (1.50; 1.14-1.97), living in the Eastern region (1.52; 1.14-2.01), and being overweight/obese (1.99; 1.39-2.84). Hypertension awareness was associated with similar factors as hypertension treatment but was also associated with being female (1.37, 1.12-1.66). Poor hypertension control was associated with being overweight/obese (0.56; 0.42-0.76) and minority ethnicity (0.52; 0.31-0.86). Conclusion: Hypertension is a major public health challenge in China. The prevalence of hypertension awareness, treatment, and control are still low despite existing public health policies and programs to reduce the burden of hypertension. More intensive hypertension screening and treatment programs are warranted in China.

Download Full-text

Factors associated with awareness, treatment and control of hypertension among 3,579 hypertensive adults in China: data from the China Health and Nutrition Survey

10.21203/rs.3.rs-18826/v5 ◽

2020 ◽

Author(s):

Junxiang Wei ◽

Yang Mi ◽

Yan Li ◽

Bo Xin ◽

Youfa Wang

Keyword(s):

Public Health ◽

Blood Pressure ◽

Hypertension Treatment ◽

Chinese Adults ◽

Nutrition Survey ◽

Antihypertensive Medications ◽

Factors Associated ◽

Health And Nutrition ◽

Hypertension Awareness ◽

And Control

Download Full-text

798. Metronidazole Exposure Prior to Clostridiodes difficile Infection (CDI) is a Risk Factor for Severe C. difficile Disease in Cancer Patients

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.988 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S442-S443

Author(s):

Denise Marie A Francisco ◽

Liangliang Zhang ◽

Ying Jiang ◽

Adilene Olvera ◽

Eduardo Yepez Guevara ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cancer Patients ◽

Research Study ◽

Research Support ◽

Factors Associated ◽

Patients With Cancer ◽

Study Investigator ◽

Severity Levels ◽

Permutation Analysis

Abstract Background Antibiotic use is a risk factor for CDI. Few studies have correlated use of prior antibiotics with CDI severity in cancer patients. This study identified clinical and microbiology risk factors associated with severe CDI in patients with cancer. We hypothesized that previous antibiotic exposure and microbiome composition at time of CDI presentation, are risk factors for severe disease in cancer patients. Methods This non-interventional, prospective, single-center cohort study examined patients with cancer who had their first episode or first recurrence of CDI between Oct 27, 2016 and Jul 1, 2019. C. difficile was identified using nucleic acid amplification testing. Multivariate analysis was used to determine significant clinical risk factors for severe CDI as defined in the 2018 IDSA/SHEA guidelines. Alpha, and beta diversities were calculated to measure the average species diversity and the overall microbial composition. Differential abundance analysis and progressive permutation analysis were used to single out the significant microbial features that differed across CDI severity levels. Results Patient (n=200) demographics show mean age of 60 yrs., 53% female, majority White (76%) and non-Hispanic (85%). Prior 90 day metronidazole use (Odds Ratio OR 4.68 [1.47-14.91] p0.009) was a significant risk factor for severe CDI. Other factors included Horn’s Index > 2 (OR 7.75 [1.05-57.35] p0.045), Leukocytosis (OR 1.29 [1.16-1.43] p< 0.001), Neutropenia (OR 6.01 [1.34-26.89] p0.019) and Serum Creatinine >0.95 mg/dL (OR 25.30 [8.08-79.17] p< 0.001). Overall, there were no significant differences in alpha and beta diversity between severity levels. However, when identifying individual microbial features, the high presence of Bacteroides uniformis, Ruminococceae, Citrobacter koseri and Salmonella were associated with protection from severe CDI (p< 0.05). Table 1 - Results of multivariate logistic regression analysis of factors associated with severe CDI Figure 1. Microbiome features identified by progressive permutation analysis as seen in a volcano plot. Conclusion A number of risk factors for severe CDI were identified among this population, including prior 90 day metronidazole use. Also, increased relative abundance of Bacteroides uniformis, Ruminococceae, Citrobacter koseri and Salmonella were linked to protection from severe CDI. Reducing metronidazole use in patients with cancer may help prevent subsequent severe CDI. Disclosures Adilene Olvera, MPH MLS (ASCP), MERK (Grant/Research Support, Scientific Research Study Investigator) Kevin W. Garey, PharmD, MS, FASHP, Merck & Co. (Grant/Research Support, Scientific Research Study Investigator) Ryan J. Dillon, MSc, Merck & Co., Inc., (Employee) Engels N. Obi, PhD, Merck & Co. (Employee)

Download Full-text

Components of a risk assessment tool for prevention and control of bovine respiratory disease in preweaned dairy calves

Animal Health Research Reviews ◽

10.1017/s1466252320000201 ◽

2020 ◽

pp. 1-7

Author(s):

Sharif S. Aly ◽

Betsy M. Karle ◽

Deniece R. Williams ◽

Gabriele U. Maier ◽

Sasha Dubrovsky

Keyword(s):

Risk Factors ◽

Risk Assessment ◽

Risk Factor ◽

Respiratory Disease ◽

Scoring System ◽

Prevention And Control ◽

Assessment Tool ◽

Bovine Respiratory Disease ◽

And Control ◽

Management Changes

Abstract Bovine respiratory disease (BRD) is the leading natural cause of death in US beef and dairy cattle, causing the annual loss of more than 1 million animals and financial losses in excess of $700 million. The multiple etiologies of BRD and its complex web of risk factors necessitate a herd-specific intervention plan for its prevention and control on dairies. Hence, a risk assessment is an important tool that producers and veterinarians can utilize for a comprehensive assessment of the management and host factors that predispose calves to BRD. The current study identifies the steps taken to develop the first BRD risk assessment tool and its components, namely the BRD risk factor questionnaire, the BRD scoring system, and a herd-specific BRD control and prevention plan. The risk factor questionnaire was designed to inquire on aspects of calf-rearing including management practices that affect calf health generally, and BRD specifically. The risk scores associated with each risk factor investigated in the questionnaire were estimated based on data from two observational studies. Producers can also estimate the prevalence of BRD in their calf herds using a smart phone or tablet application that facilitates selection of a true random sample of calves for scoring using the California BRD scoring system. Based on the risk factors identified, producers and herd veterinarians can then decide the management changes needed to mitigate the calf herd's risk for BRD. A follow-up risk assessment after a duration of time sufficient for exposure of a new cohort of calves to the management changes introduced in response to the risk assessment is recommended to monitor the prevalence of BRD.

Download Full-text

Informing the public health response to COVID-19: a systematic review of risk factors for disease, severity, and mortality

BMC Infectious Diseases ◽

10.1186/s12879-021-05992-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

M. Flook ◽

C. Jackson ◽

E. Vasileiou ◽

C. R. Simpson ◽

M. D. Muckian ◽

...

Keyword(s):

Public Health ◽

Risk Factors ◽

Systematic Review ◽

At Risk ◽

Risk Factor ◽

Disease Severity ◽

Severe Disease ◽

Public Health Response ◽

Wide Range ◽

Multivariable Analyses

Abstract Background Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) has challenged public health agencies globally. In order to effectively target government responses, it is critical to identify the individuals most at risk of coronavirus disease-19 (COVID-19), developing severe clinical signs, and mortality. We undertook a systematic review of the literature to present the current status of scientific knowledge in these areas and describe the need for unified global approaches, moving forwards, as well as lessons learnt for future pandemics. Methods Medline, Embase and Global Health were searched to the end of April 2020, as well as the Web of Science. Search terms were specific to the SARS-CoV-2 virus and COVID-19. Comparative studies of risk factors from any setting, population group and in any language were included. Titles, abstracts and full texts were screened by two reviewers and extracted in duplicate into a standardised form. Data were extracted on risk factors for COVID-19 disease, severe disease, or death and were narratively and descriptively synthesised. Results One thousand two hundred and thirty-eight papers were identified post-deduplication. Thirty-three met our inclusion criteria, of which 26 were from China. Six assessed the risk of contracting the disease, 20 the risk of having severe disease and ten the risk of dying. Age, gender and co-morbidities were commonly assessed as risk factors. The weight of evidence showed increasing age to be associated with severe disease and mortality, and general comorbidities with mortality. Only seven studies presented multivariable analyses and power was generally limited. A wide range of definitions were used for disease severity. Conclusions The volume of literature generated in the short time since the appearance of SARS-CoV-2 has been considerable. Many studies have sought to document the risk factors for COVID-19 disease, disease severity and mortality; age was the only risk factor based on robust studies and with a consistent body of evidence. Mechanistic studies are required to understand why age is such an important risk factor. At the start of pandemics, large, standardised, studies that use multivariable analyses are urgently needed so that the populations most at risk can be rapidly protected. Registration This review was registered on PROSPERO as CRD42020177714.

Download Full-text

The impact of obesity on cardiovascular disease risk factor

Asian Journal of Medical Sciences ◽

10.3126/ajms.v10i1.21294 ◽

2018 ◽

Vol 10 (1) ◽

pp. 1-12 ◽

Cited By ~ 1

Author(s):

Arun Kumar

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Blood Pressure ◽

Cardiovascular Disease ◽

Risk Factor ◽

Cardiovascular Risk ◽

Sodium Intake ◽

Action Plan ◽

Saturated Fat ◽

The World

Obesity has emerged as the most potential cardiovascular risk factor and has raised concern among public and their health related issues not only in developed but also in developing countries. The Worldwide obesity occurrence has almost has gone three times since 1975. Research suggests there are about 775 million obese people in the World including adult, children, and adolescents. Nearly 50% of the children who are obese and overweight in Asia in are below 5 years. There is a steep incline of childhood obesity when compared to 1971 which is not only in developed countries but also in developing countries. A considerable amount of weight gain occurs during the transition phase from adolescence to young adulthood. It is also suggested that those adultswho were obese in childhood also remained obese in their adulthood with a higher metabolic risk than those who became obese in their adulthood. In India, the urban Indian female in the age group of 30-45 years have emerged as an 〝at risk population” for cardiovascular diseases. To understand how obesity can influence cardiovascular function, it becomes immense important to understand the changes which can take place in adipose tissue due to obesity. There are two proposed concepts explaining the inflammatory status of macrophage. The predominant cause of insulin resistance is obesity. Epidemiological and research studies have indicated that the pathogenesis of obesity-related metabolic dysfunction involves the development of a systemic, low-grade inflammatory state. It is becoming clear that targeting the pro-inflammatory pathwaymay provide a novel therapeutic approach to prevent insulin resistance, particularly in obesity inducedinsulin resistance. Some cost effective interventions that are feasible by all and can be implemented even in low-resource settings includes - population-wide and individual, which are recommended to be used in combination to reduce the greatest cardiovascular disease burden. The sixth target in the Global NCD action plan is to reduce the prevalence of hypertension by 25%. Reducing the incidence of hypertension by implementing population-wide policies to educe behavioral risk factors. Reducing cigarette smoking, body weight, blood pressure, blood cholesterol, and blood glucose all have a beneficial impact on major biological cardiovascular risk factors. A variety of lifestyle modifications have been shown, in clinical trials, to lower bloodpressure, includes weight loss, physical activity, moderation of alcohol intake, increased fresh fruit and vegetables and reduced saturated fat in the diet, reduction of dietary sodium intake, andincreased potassium intake. Also, trials of reduction of saturated fat and its partial replacement by unsaturated fats have improved dyslipidaemia and lowered risk of cardiovascular events. This initiative driven by the Ministry of Health and Family Welfare, State Governments, Indian Council of Medical Research and the World Health Organization are remarkable. The Government of India has adopted a national action plan for the prevention and control of non-communicable diseases (NCDs) with specific targets to be achieved by 2025, including a 25% reduction inoverall mortality from cardiovascular diseases, a 25% relative reduction in the prevalence of raised blood pressure and a 30% reduction in salt/sodium intake. In a nutshell increased BMI values can predict the nature of obesity and its aftermaths in terms inflammation and other disease associated with obesity. It’s high time; we must realize it and keep an eye on health status in order to live long and healthy life.

Download Full-text