scholarly journals Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: A cross-sectional study

2021 ◽  
Author(s):  
Pedro Pallangyo ◽  
Zabella S Mkojera ◽  
Makrina Komba ◽  
Lucy R. Mgopa ◽  
Smita Bhalia ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Renal Dysfunction ◽  
Cognitive Functions ◽  
Cross Sectional Study ◽  
Systemic Hypertension ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hypertensive Patients

Abstract Background: The evolution of cognitive impairment of vascular origin is increasingly becoming a prominent health threat particularly in this era where hypertension is the leading contributor of global disease burden and overall health loss. Hypertension is associated with the alteration of the cerebral microcirculation coupled by unfavorable vascular remodeling with consequential slowing of mental processing speed, reduced abstract reasoning, loss of linguistic abilities, and attention and memory deficits. Owing to the rapidly rising burden of hypertension in Tanzania, we sought to assess the prevalence and correlates of cognitive impairment among hypertensive patients attending a tertiary cardiovascular hospital in Tanzania.Methodology: A hospital-based cross-sectional study was conducted at Jakaya Kikwete Cardiac Institute, a tertiary care public teaching hospital in Dar es Salaam, Tanzania between March 2020 and February 2021. A consecutive sampling method was utilized to recruit consented hypertensive outpatients during their scheduled clinic visit. General Practitioner Assessment of Cognition (GPCOG) Score was utilized in the assessment of cognitive functions. All statistical analyses utilized STATA v11.0 software. Pearson Chi square and Student’s T-test were used to compare categorical and continuous variables respectively. Logistic regression analyses were used to assess for factors associated with cognitive impairment. Odd ratios with 95% confidence intervals and p-values are reported. All tests were 2-sided and p<0.05 was used to denote a statistical significance. Results: A total of 1201 hypertensive patients were enrolled in this study. The mean age was 58.1 years and females constituted nearly two-thirds of the study population. About three quarters had excess body weight, 16.6% had diabetes, 7.7% had history of stroke, 5.7% had heart failure, 16.7% had renal dysfunction, 53.7% had anemia, 27.7% had hypertriglyceridemia, 38.5% had elevated LDL, and 2.4% were HIV-infected. Nearly two-thirds of participants had uncontrolled blood pressure and 8.7% had orthostatic hypotension. Overall, 524 (43.6%) of participants had cognitive impairment. During bivariate analysis in a logistic regression model of 16 characteristics, 14 parameters showed association with cognitive functions. However, after controlling for confounders, multivariate analysis revealed ≤primary education (OR 3.5, 95%CI 2.4-5.2, p<0.001), unemployed state (OR 1.7, 95%CI 1.2-2.6, p<0.01), rural habitation (OR 1.8, 95%CI 1.1-2.9, p=0.01) and renal dysfunction (OR 1.7, 95%CI 1.0-2.7, p= 0.04) to have independent association with cognitive impairment. Conclusion: This present study underscore that cognitive decline is highly prevalent among individuals with systemic hypertension. Moreover, our observation suggests that low education, rural life, unemployment status and renal dysfunction interactions with elevated blood pressure has the potential to predict cognitive performance over time. As the effective disease-modifying treatments for cognitive impairment are lacking, these findings imply that several modifiable risk factors including hypertension represents a potentially vital mechanism for prevention or delay of cognitive impairment.

scholarly journals Burden and Correlates of Cognitive Impairment Among Hypertensive Patients in Tanzania: A Cross-Sectional Study

2021 ◽  
Author(s):  
Pedro Pallangyo ◽  
Zabella S Mkojera ◽  
Makrina Komba ◽  
Lucy R. Mgopa ◽  
Smita Bhalia ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Renal Dysfunction ◽  
Cognitive Functions ◽  
Cross Sectional Study ◽  
Systemic Hypertension ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hypertensive Patients

Abstract Background The evolution of cognitive impairment of vascular origin is increasingly becoming a prominent health threat particularly in this era where hypertension is the leading contributor of global disease burden and overall health loss. Hypertension is associated with the alteration of the cerebral microcirculation coupled by unfavorable vascular remodeling with consequential slowing of mental processing speed, reduced abstract reasoning, loss of linguistic abilities, and attention and memory deficits. Owing to the rapidly rising burden of hypertension in Tanzania, we sought to assess the prevalence and correlates of cognitive impairment among hypertensive patients attending a tertiary cardiovascular hospital in Tanzania. Methodology: A hospital-based cross-sectional study was conducted at Jakaya Kikwete Cardiac Institute, a tertiary care public teaching hospital in Dar es Salaam, Tanzania between March 2020 and February 2021. A consecutive sampling method was utilized to recruit consented hypertensive outpatients during their scheduled clinic visit. General Practitioner Assessment of Cognition (GPCOG) Score was utilized in the assessment of cognitive functions. All statistical analyses utilized STATA v11.0 software. Pearson Chi square and Student’s T-test were used to compare categorical and continuous variables respectively. Logistic regression analyses were used to assess for factors associated with cognitive impairment. Odd ratios with 95% confidence intervals and p-values are reported. All tests were 2-sided and p < 0.05 was used to denote a statistical significance. Results A total of 1201 hypertensive patients were enrolled in this study. The mean age was 58.1 years and females constituted nearly two-thirds of the study population. About three quarters had excess body weight, 16.6% had diabetes, 7.7% had history of stroke, 5.7% had heart failure, 16.7% had renal dysfunction, 53.7% had anemia, 27.7% had hypertriglyceridemia, 38.5% had elevated LDL, and 2.4% were HIV-infected. Nearly two-thirds of participants had uncontrolled blood pressure and 8.7% had orthostatic hypotension. Overall, 524 (43.6%) of participants had cognitive impairment. During bivariate analysis in a logistic regression model of 16 characteristics, 14 parameters showed association with cognitive functions. However, after controlling for confounders, multivariate analysis revealed ≤ primary education (OR 3.5, 95%CI 2.4–5.2, p < 0.001), unemployed state (OR 1.7, 95%CI 1.2–2.6, p < 0.01), rural habitation (OR 1.8, 95%CI 1.1–2.9, p = 0.01) and renal dysfunction (OR 1.7, 95%CI 1.0-2.7, p = 0.04) to have independent association with cognitive impairment. Conclusion This present study underscore that cognitive decline is highly prevalent among individuals with systemic hypertension. Moreover, our observation suggests that low education, rural life, unemployment status and renal dysfunction interactions with elevated blood pressure has the potential to predict cognitive performance over time. As the effective disease-modifying treatments for cognitive impairment are lacking, these findings imply that several modifiable risk factors including hypertension represents a potentially vital mechanism for prevention or delay of cognitive impairment.

scholarly journals Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pedro Pallangyo ◽  
Zabella S. Mkojera ◽  
Makrina Komba ◽  
Lucy R. Mgopa ◽  
Smita Bhalia ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cognitive Impairment ◽  
Renal Dysfunction ◽  
Cognitive Functions ◽  
Cross Sectional Study ◽  
Systemic Hypertension ◽  
Attention And Memory ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hypertensive Patients

Abstract Background The evolution of cognitive impairment of vascular origin is increasingly becoming a prominent health threat particularly in this era where hypertension is the leading contributor of global disease burden and overall health loss. Hypertension is associated with the alteration of the cerebral microcirculation coupled by unfavorable vascular remodeling with consequential slowing of mental processing speed, reduced abstract reasoning, loss of linguistic abilities, and attention and memory deficits. Owing to the rapidly rising burden of hypertension in Tanzania, we sought to assess the prevalence and correlates of cognitive impairment among hypertensive patients attending a tertiary cardiovascular hospital in Tanzania. Methodology A hospital-based cross-sectional study was conducted at Jakaya Kikwete Cardiac Institute, a tertiary care public teaching hospital in Dar es Salaam, Tanzania between March 2020 and February 2021. A consecutive sampling method was utilized to recruit consented hypertensive outpatients during their scheduled clinic visit. General Practitioner Assessment of Cognition (GPCOG) Score was utilized in the assessment of cognitive functions. All statistical analyses utilized STATA v11.0 software. Pearson Chi square and Student’s T-test were used to compare categorical and continuous variables respectively. Logistic regression analyses were used to assess for factors associated with cognitive impairment. Odd ratios with 95% confidence intervals and p-values are reported. All tests were 2-sided and p < 0.05 was used to denote a statistical significance. Results A total of 1201 hypertensive patients were enrolled in this study. The mean age was 58.1 years and females constituted nearly two-thirds of the study population. About three quarters had excess body weight, 16.6% had diabetes, 7.7% had history of stroke, 5.7% had heart failure, 16.7% had renal dysfunction, 53.7% had anemia, 27.7% had hypertriglyceridemia, 38.5% had elevated LDL, and 2.4% were HIV-infected. Nearly two-thirds of participants had uncontrolled blood pressure and 8.7% had orthostatic hypotension. Overall, 524 (43.6%) of participants had cognitive impairment. During bivariate analysis in a logistic regression model of 16 characteristics, 14 parameters showed association with cognitive functions. However, after controlling for confounders, multivariate analysis revealed ≤primary education (OR 3.5, 95%CI 2.4–5.2, p < 0.001), unemployed state (OR 1.7, 95%CI 1.2–2.6, p < 0.01), rural habitation (OR 1.8, 95%CI 1.1–2.9, p = 0.01) and renal dysfunction (OR 1.7, 95%CI 1.0–2.7, p = 0.04) to have independent association with cognitive impairment. Conclusion This present study underscore that cognitive decline is considerably prevalent among individuals with systemic hypertension. In view of this, it is pivotal to incorporate cognitive assessment in routine evaluation of hypertensive patients.

scholarly journals Association between H-type hypertension and Cognitive impairment in Kailuan community of China: A cross-sectional study.

2019 ◽  
Author(s):  
Xueyu Chen ◽  
Hui Xi ◽  
Long Ji ◽  
Weijia Xing ◽  
Haifeng Hou ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cognitive Impairment ◽  
Cross Sectional Study ◽  
Practice Management ◽  
Health Practice ◽  
Sectional Study ◽  
Cross Sectional ◽  
Intervention Measures ◽  
Study Participants ◽  
Over 40 Years

Abstract Background Hypertension (HTN) and hyperhomocysteinemia (HHcy) have been reported to be independent predictors of cognitive impairment. However, the conclusions were inconsistent and few studies had reported the combination prediction of HTN and HHcy for cognitive impairment. Our study aimed to evaluate the association between H-type HTN, HTN and HHcy and the risk of cognitive impairment.Methods We used a cross-sectional study- participants aged over 40 years, which were selected from Kailuan communities in China. Cognitive impairment was determined by MMSE scale (MMSE<24). Multivariable logistic regression was used to analyze the association of H-type HTN and cognitive impairment, and we also made stratification analysis by age of participants.Results A total of 3454 participants were included in our study, and ≥65 years old was 16.79%; the gender of male was 56.77%. The prevalence of cognitive impairment in the H-type HTN (HTN+/HHcy+) group (10.74%) was significantly higher than other three groups (2.92%, 6.42%, 5.86%, respectively). The logistic regression results showed that participants with H-type HTN was positively associated with cognitive impairment risk (OR = 2.57, 95% CI: 1.38-4.80). Similar results were observed in participants stratified by age (65 years) (<65 years old: OR =2.01, 95% CI: 0.87- 4.67 ; ≥65 years old: OR=3.63, 95% CI: 1.32-10.01).Conclusion Our finding indicated that H-type HTN was positively associated with the risk of cognitive impairment, especially in ≥ 65 years old. H-type HTN could be the major intervention measures to decrease the incidence of cognitive impairment as well as the stroke in Health Practice Management.

scholarly journals Relationship between obesity indices and hypertension among middle-aged and elderly populations in Taiwan: a community-based, cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031660 ◽  
Author(s):  
Yen-An Lin ◽  
Ying-Jen Chen ◽  
Yu-Chung Tsao ◽  
Wei-Chung Yeh ◽  
Wen-Cheng Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Cross Sectional Study ◽  
Multiple Logistic Regression ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Elderly Populations ◽  
Obesity Indices ◽  
Northern Taiwan

ObjectiveObesity and hypertension (HTN) have become increasingly prevalent in Taiwan. People with obesity are more likely to have HTN. In this study, we evaluated several anthropometric measurements for the prediction of HTN in middle-aged and elderly populations in Taiwan.DesignCross-sectional observational study.SettingCommunity-based investigation in Guishan Township of northern Taiwan.ParticipantsA total of 396 people were recruited from a northern Taiwan community for a cross-sectional study. Anthropometrics and blood pressure were measured at the annual health exam. The obesity indices included body mass index (BMI), body fat (BF) percentage and waist circumference (WC).Outcome measuresStatistical analyses, including Pearson’s correlation, multiple logistic regression and the area under ROC curves (AUCs) between HTN and anthropometric measurements, were used in this study.ResultsOf the 396 people recruited, 200 had HTN. The age-adjusted Pearson’s coefficients of BMI, BF percentage and WC were 0.23 (p<0.001), 0.14 (p=0.01) and 0.26 (p<0.001), respectively. Multiple logistic regression of the HTN-related obesity indices showed that the ORs of BMI, BF percentage and WC were 1.15 (95% CI 1.08 to 1.23, p<0.001), 1.07 (95% CI 1.03 to 1.11, p<0.001) and 1.06 (95% CI 1.03 to 1.08, p<0.001), respectively. The AUCs of BMI, BF percentage and WC were 0.626 (95% CI 0.572 to 0.681, p<0.001), 0.556 (95% CI 0.500 to 0.613, p=0.052) and 0.640 (95% CI 0.586 to 0.694, p<0.001), respectively.ConclusionsWC is a more reliable predictor of HTN than BMI or BF percentage. The effect of abdominal fat distribution on blood pressure is greater than that of total BF amount.

scholarly journals Sex-Specific Differences in Related Indicators of Blood Pressure in School-Age Children With Overweight and Obesity: A Cross-Sectional Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Hongmei He ◽  
Shujun Yang ◽  
Na Qiu ◽  
Ling Qiao ◽  
Yong Ding ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Mean Arterial Pressure ◽  
Cross Sectional Study ◽  
Overweight And Obesity ◽  
School Age Children ◽  
School Age ◽  
Sectional Study ◽  
Multivariate Logistic Regression ◽  
Cross Sectional

Objective: The objective of this study is to further explore the difference between elevated blood pressure (EBP), elevated pulse pressure (EPP), and elevated mean arterial pressure (EMAP) and obesity in Chinese school-age children by sex.Methods: We performed a cross-sectional study of 935 children between 7 and 12 years old. Overweight and obesity were defined by body mass index and body composition. The multivariate logistic regression and the adjusted population attributable risk were used to assess the effects of obesity on pre-EBP/EBP, EPP, and EMAP. The interactions were used to identify the modification of obese on the relationship between related indicators of blood pressure and height or age.Results: The average age of the children included in the study was 10. Boys with overweight and obesity had higher pre-EBP/EBP, EPP, and EMAP (p &lt; 0.05). The multivariate logistic regression analysis showed that overweight and obesity had a greater impact on BP and MAP than PP, especially in boys [odds ratio (OR) &gt; 1]. Pre-EBP/EBP in 79% of boys and 76% of girls could be attributable to the visceral fat level. The interaction between BP, PP, MAP, and height or age was modestly increased in children with overweight and obesity, especially in boys.Conclusions: Independent of age and height, obesity not only increases blood pressure, it also increases mean arterial pressure and pulse pressure, and this effect is more pronounced in boys.

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