scholarly journals Poor Trends in Glycemic, Weight and Blood Pressure Control during Screening in Population among Small town of Karachi.

2021 ◽  
Vol 6 (3) ◽  
Keyword(s):  
Blood Pressure ◽  
Glycemic Control ◽  
Early Detection ◽  
Rural Areas ◽  
Urban Areas ◽  
Diabetes Education ◽  
Vascular Complications ◽  
Poor Glycemic Control ◽  
Undiagnosed Diabetes ◽  
Diabetes Status

Introduction: Diabetes is common cause of mortality in adults globally due to the increase in the risk of vascular complications. Pakistanis are an ethics group having an inherent predilection to develop diabetes. But this rise in incidence and prevalence is associated with demographics a social pattern, life style, unawareness due to low-literacy rate thus leading to obesity in the country. The high number of people in the pre-diabetic state or with undiagnosed diabetes represents large pool of individuals in rural areas than urban areas. Aims and Objective: Knowing the prevalence of these comorbidities like Diabetes, obesity and Hypertension contributing with each other is important for determining the size of the population that may benefit from strategies that reduce blood pressure and weight while controlling blood glucose. Prevention and control need to be structured at all levels of prevention and through the Promotion of early detection of diabetes through screening and diabetes education. Material and Methods: All persons aged 20-70 years attending the medical camps organized in small towns near to Karachi during (2017 June-2021 June) were tested for diabetes for free with help of Sindh Graduate Association and Go Red for Women Program Pakistan Cardiac Society. Data on their age, gender, height, weight, diabetes status and blood pressure were also taken. Basal mass Index was calculated and stratified as per WHO classifications. 2120 persons were screened but complete data for 1289 persons was available for analysis. Result: Out of 1289 screened people who attended the medical camps, 377 were known diabetics with mean age was 47.5 years with 66% being above 40. 60.2% had poor glycemic control using an optimum of <7.8 mmol/L, 54.59% had poor glycemic control with blood sugars exceeding 10 mmol/L. patients with HBA1c<7%, 50% being hypertensive in spite of the treatment. 62% of women were either overweight or obese then 33.3% in men. BMI above 30 kg/m2 as measure of obesity was found in 32%. in all those who were known diabetics. 12% (92) of those not known to have diabetes had either impaired glucose tolerance or were newly diagnosed diabetics. Conclusion: In our Study the Large proportion of diabetics were found with poor glycemic control. The majority of known diabetes patients were also at risk due to owning overweight, obesity and poorly controlled blood pressure, Emphasis should be on the promotion of early detection of diabetes through screening and diabetes education in under develop areas of Pakistan.

scholarly journals Early Detection Of Hypertension As An Effort To Prevent Disease Complications

2021 ◽  
pp. 115-123
Author(s):  
Santy Irene Putri ◽  
Aris Widiyanto ◽  
Joko Tri Atmojo ◽  
Asruria Sani Fajriah
Keyword(s):  
Blood Pressure ◽  
Early Detection ◽  
Rural Areas ◽  
Urban Areas ◽  
Clinical Symptoms ◽  
Public Awareness ◽  
Signs And Symptoms ◽  
Health Care Facilities ◽  
Local Health ◽  
Central Java

Background: Measuring blood pressure is one way of early detection of the risk of hypertension, stroke and heart disease. Generally, in rural areas have lower access to health information and education than those in urban areas. Promotive and preventive efforts needed to increase public awareness to carry out early detection through measuring blood pressure regularly and adherence to taking medication regularly. This step is believed to be a form of controlling hypertension in the form of reducing the number of cases, complications, and deaths from hypertension. Methods: The method of activity to be carried out is a health check by measuring blood pressure and providing counseling which is carried out through lectures and discussions with the community about the signs and symptoms of hypertension, prevention of hypertension, and complications of hypertension. The activity was carried out on April 10, 2021 with the target of all members of the community in Wonosuko, Magelang, Central Java. Results: This activity was attended by a community of about 40 people. The implementation of this service went smoothly and the community was enthusiastic in examination and counseling activities. Most of the community felt the benefits of holding this activity because according to them, apart from getting knowledge about hypertension, the community also felt the benefits of checking blood pressure, and consulting various diseases related to complications due to hypertension. Conclusion: This community service activity has added insight and knowledge of communities about hypertension, especially about clinical symptoms, complications and also efforts to prevent hypertension. In addition, the public has also become more aware of the need to have their blood pressure checked at local health care facilities. In addition, communities' knowledge has also increased about several complications of hypertension which have been explained through consultation with the team of this activity.

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.

Abstract P080: Glucose Homeostasis, Diabetes, and Orthostatic Hypotension in a Community-based Population: The ARIC Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Stephen P Juraschek ◽  
Natalie Daya ◽  
A. Richey Sharrett ◽  
Elizabeth Selvin
Keyword(s):  
Blood Pressure ◽  
Orthostatic Hypotension ◽  
Standing Position ◽  
Continuous Variable ◽  
Undiagnosed Diabetes ◽  
Diabetes Group ◽  
Cross Sectional ◽  
Diabetes Status ◽  
Group 5 ◽  
Group 2

Background: Although orthostatic hypotension (OH) screening is recommended for adults with diabetes, the extent to which blood glucose (BG) levels are associated with OH has not been characterized. Hypothesis: Higher BG levels are associated with having OH, while low levels of BG are not associated with OH. Methods: We examined the cross-sectional association of OH with BG and diabetes status in middle-aged (range 44 to 66 yrs) ARIC participants (1987-1989). OH was defined as a drop in blood pressure (systolic ≥20 mm Hg or diastolic ≥10 mm Hg) within 2 min of standing, when transitioning from the supine to standing position. Using logistic regression, we examined the association of the following 5 categories of BG without diabetes or diabetes and OH: (1) low-normal BG (fasting BG <80 or non-fasting BG <100 mg/dL), (2) high-normal BG (fasting BG of 80-99 or non-fasting BG of 100-139 mg/dL), (3) pre-diabetes (fasting BG of 100-125 or non-fasting BG of 140-199 mg/dL), (4) undiagnosed diabetes (fasting BG ≥126 or non-fasting BG ≥200 mg/dL), or (5) diabetes (self-reported diagnosis or current medication use). We also modeled BG as a continuous variable by diabetes status, using restricted cubic splines to characterize the association between BG level and OH. Results: In 12,636 participants (mean age 54.6 ± 5.7 yrs, 55% women, 26% black), 4.3% had OH at baseline. The mean BG was 108 ± 38 mg/dL; 7% had diabetes (self-reported diagnosis or diabetes medications). After adjustment, adults with low BG (group 1) or diabetes (group 5) were both more likely to have OH compared to the normal BG group (group 2) with ORs of 2.15 (95% CI: 1.26, 3.65) and 2.20 (95% CI: 1.65, 2.92), respectively. Continuous characterization of the relationship between BG and OH was U-shaped for participants with or without diabetes ( Figure, panels A&B ). Conclusions: Low BG in adults without diabetes, diabetes, and high BG in adults with diabetes were associated with OH. This suggests a more prominent role for BG homeostasis in blood pressure stabilization with standing.

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.

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.

scholarly journals Waist:height ratio: a superior index in estimating cardiovascular risks in Turkish adults

2013 ◽  
Vol 17 (10) ◽  
pp. 2246-2252 ◽  
Author(s):  
Reci Meseri ◽  
Reyhan Ucku ◽  
Belgin Unal
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Undiagnosed Diabetes ◽  
Anthropometric Measurement ◽  
Cardiovascular Risks ◽  
Framingham Risk ◽  
Chd Risk ◽  
Diabetes Status

AbstractObjectiveTo determine the best anthropometric measurement among waist: height ratio (WHtR), BMI, waist:hip ratio (WHR) and waist circumference (WC) associated with high CHD risk in adults and to define the optimal cut-off point for WHtR.DesignPopulation-based cross-sectional study.SettingBalcova, Izmir, Turkey.SubjectsIndividuals (n 10 878) who participated in the baseline survey of the Heart of Balcova Project. For each participant, 10-year coronary event risk (Framingham risk score) was calculated using data on age, sex, smoking status, blood pressure, serum lipids and diabetes status. Participants who had risk higher than 10 % were defined as ‘medium or high risk’.ResultsAmong the participants, 67·7 % were female, 38·2 % were obese, 24·5 % had high blood pressure, 9·2 % had diabetes, 1·5 % had undiagnosed diabetes (≥126 mg/dl), 22·0 % had high total cholesterol and 45·9 % had low HDL-cholesterol. According to Framingham risk score, 32·7 % of them had a risk score higher than 10 %. Those who had medium or high risk had significantly higher mean BMI, WHtR, WHR and WC compared with those at low risk. According to receiver-operating characteristic curves, WHtR was the best and BMI was the worst indicator of CHD risk for both sexes. For both men and women, 0·55 was the optimal cut-off point for WHtR for CHD risk.ConclusionsBMI should not be used alone for evaluating obesity when estimating cardiometabolic risks. WHtR was found to be a successful measurement for determining cardiovascular risks. A cut-off point of ‘0·5’ can be used for categorizing WHtR in order to target people at high CHD risk for preventive actions.

scholarly journals Laboratory Parameters of Hemostasis, Adhesion Molecules, and Inflammation in Type 2 Diabetes Mellitus: Correlation with Glycemic Control

2020 ◽  
Vol 17 (1) ◽  
pp. 300 ◽  
Author(s):  
Eleonora Palella ◽  
Rossella Cimino ◽  
Salvatore A. Pullano ◽  
Antonino S. Fiorillo ◽  
Elio Gulletta ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Adhesion Molecules ◽  
Adhesion Molecule ◽  
Vascular Complications ◽  
Poor Glycemic Control ◽  
Pai 1

Background: Type 2 diabetes mellitus (T2DM) is characterized by a prothrombotic state, predisposing to vascular complications. Some related markers, linking thrombophilia to hemostasis and inflammation, however, have been poorly explored in relation to patients’ glycemia. We therefore investigated the association of laboratory hemostatic parameters, circulating adhesion molecules (ADMs), white blood cell (WBC) count, and neutrophil/lymphocyte ratio (NLR) with T2DM and glycemic control. Research design: In this study, 82 subjects, grouped into T2DM patients (n = 41) and healthy individuals (n = 41) were enrolled. To evaluate glycemic control, the T2DM cohort was expanded to 133 patients and sub-classified according to glycated hemoglobin (HbA1c) <7% and ≥ 7% (n = 58 and n = 75, respectively). We assessed glycemia, HbA1c, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, plasminogen activator inhibitor-1 (PAI-1), platelet and leukocyte parameters, vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), and selectins (E-, P-, L-). Results: PT % activity, PAI-1, VCAM-1, WBC, and neutrophil counts were significantly higher in T2DM patients than in healthy subjects. Poor glycemic control (HbA1c ≥ 7%) was correlated with increased PT activity (p = 0.015), and higher levels of E-selectin (p = 0.009), P-selectin (p = 0.012), and NLR (p = 0.019). Conclusions: Both T2DM and poor glycemic control affect some parameters of hemostasis, inflammation, and adhesion molecules. Further studies are needed to establish their clinical utility as adjuvant markers for cardio-vascular risk in T2DM patients.

scholarly journals Sociodemographic inequalities in cardiovascular risk factors among adolescents from indigenous areas of Chiapas, Mexico

2020 ◽  
Author(s):  
Elena Flores-Guillen ◽  
Itandehui Castro-Quezada ◽  
Hector Ochoa ◽  
Rosario Garcia-Miranda ◽  
Miguel Cruz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Rural Areas ◽  
Urban Areas ◽  
Descriptive Analysis ◽  
Geographic Area ◽  
Secondary Outcome ◽  
Cross Sectional

Objectives: The objective of this study was to determine the prevalence of cardiovascular risk factors among different sociodemographic and geographic areas of adolescents from indigenous areas of Chiapas, Mexico. Design: A cross-sectional study. Setting: Communities in the Totzil - Tseltal and Selva region of Chiapas, Mexico, were studied. Urban and rural areas of high marginalization according to the Human Development Index. Participants: 253 adolescents were studied, of which 48.2% were girls and 51.8% were boys. Primary and secondary outcome measures: a descriptive analysis of the quantitative variables was performed through central tendency and dispersion measures. Prevalence of cardiovascular risk factors and 95% confidence intervals (95% CI), stratified by sex, geographic area (rural/urban), schooling and ethnicity of mothers were estimated. Results: the predominant risk factor in the study population was low HDL-c (51%). Higher prevalences of abdominal obesity and high triglycerides in girls were found and abnormal diastolic blood pressure in boys was identified. In urban areas were found greater prevalences of overweight/obesity and of insulin resistance while abnormal blood pressure levels were more prevalent in rural areas. Differences were found in the educational levels and ethnicity of the adolescents' mothers. Prevalence of metabolic syndrome was 10% according to NCEP-ATPIII. Conclusions: In this study, sociodemographic and geographical disparities were found in cardiovascular risk factors. Prevalence of risk factors was high, affecting mostly girls and urban population. Thus, there is a great need to promote healthy lifestyles and health, social and economic interventions to prevent chronic diseases in adulthood.

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