scholarly journals Hypertension Control and Guideline-Recommended Target Blood Pressure Goal Achievement at an Early Stage of Hypertension in the UAE

2021 ◽  
Vol 11 (1) ◽  
pp. 47
Author(s):  
Akshaya Srikanth Bhagavathula ◽  
Syed Mahboob Shah ◽  
Abubaker Suliman ◽  
Abderrahim Oulhaj ◽  
Elhadi Husein Aburawi
Keyword(s):  
Blood Pressure ◽  
United Arab Emirates ◽  
Treatment Initiation ◽  
Early Stage ◽  
Goal Achievement ◽  
Blood Pressure Goal ◽  
Hypertension Control ◽  
Lifestyle Modifications ◽  
Factors Associated ◽  
The Mean

(1) Background: The present study aimed to assess the changes in blood pressure (BP) within the first 6 months of treatment initiation in a newly treated hypertensive cohort and to identify the factors that are associated with achieving the target BP recommended by the American (ACC/AHA, 2017), European (ESC/ESH, 2018), United Kingdom (NICE, 2019), and International Society of Hypertension (ISH, 2020) guidelines. (2) Methods: We analyzed 5308 incident hypertensive outpatients across Abu Dhabi, United Arab Emirates (UAE), in 2017; each patient was followed up for 6 months. Hypertension was defined as a BP of 130/80 mmHg according to the ACC/AHA guidelines and 140/90 mmHg according to the ESC/ESH, NICE, and ISH guidelines. Multiple logistic regression was used to identify factors associated with achieving the guideline-recommended BP targets. (3) Results: At baseline, the mean BP was 133.9 ± 72.9 mmHg and 132.7 ± 72.5 mmHg at 6 months. The guideline-recommended BP targets were 39.5%, 43%, 65.6%, and 40.8%, according to the ACC/AHA, ESC/ESH, NICE, and ISH guidelines, respectively. A BMI of <25 kg/m2 was associated with better BP control according to the ACC/AHA (odds ratio (OR) = 1.26; 95% confidence interval (CI) = 1.07–1.49), ESC/ESH (OR = 1.27; 95% CI = 1.08–1.50), and ISH guidelines (OR = 1.22; 95% CI = 1.03–1.44). Hypertension treated in secondary care settings was more likely to achieve the BP targets recommended by the ACC/AHA (1.31 times), ESC/ESH (1.32 times), NICE (1.41 times), and ISH (1.34 times) guidelines. (4) Conclusions: BP goal achievement was suboptimal. BP control efforts should prioritize improving cardiometabolic goals and lifestyle modifications.

Hospitalization in patients with systemic lupus erythematosus at Tawam Hospital, United Arab Emirates (UAE): Rates, causes, and factors associated with length of stay

Lupus ◽  
2021 ◽  
pp. 096120332199008
Author(s):  
Reem Aldarmaki ◽  
Hiba I Al Khogali ◽  
Ali M Al Dhanhani
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Length Of Stay ◽  
Lupus Nephritis ◽  
United Arab Emirates ◽  
Lupus Erythematosus ◽  
Hospitalization Rate ◽  
Systemic Lupus ◽  
Factors Associated ◽  
Icu Admission ◽  
The Mean

Introduction Systemic lupus erythematosus (SLE) is a relapsing and remitting multiorgan disease associated with significant morbidity and mortality. The survival rate of patients with SLE has recently improved, which was associated with increased morbidity and hospitalization rates. Therefore, this study aimed to examine the rate and causes of hospitalization in patients with SLE and explore factors associated with increased length of stay (LOS). Methods Patients who visited rheumatology clinics (Tawam hospital, United Arab Emirates (UAE)) and fulfilled the American College of Rheumatology (ACR) SLE criteria were identified. Retrospective charts were reviewed to determine previous admissions. Demographic data, reason for hospitalization, duration of hospitalization, intensive care unit (ICU) admission, number of specialist consultations, medications used, and SLE characteristics at time of admission were collected. The hospitalization rate was calculated as the number of hospitalized patients divided by the total number of patients with the disease. We performed multivariable regression analysis for factors associated with increased LOS. Results A total of 91 patients with SLE (88 women and 3 men) met the inclusion criteria with a mean disease duration of 10.2 years (SD 5.5). A total of 222 admissions were identified, and 66 of 91 patients were admitted at least once. The mean crude hospitalization rate calculated was 29.8%. The primary reason for admission was pregnancy (29%), SLE activity (24%), and infection (20%). When combining primary and secondary reasons, the proportion of admissions due to SLE activity increased to 32%. The mean LOS was 5.9 (SD 6.0) days. About 7% of admitted patients required ICU admission. In multivariable analysis, patients with lupus nephritis, complications during hospitalization, and increased number of specialists consultations and who were admitted to ICU and started new medication were all associated with increased LOS. Conclusion A significant proportion of patients with SLE were hospitalized during their disease course. The hospitalization rate in this study appears to be higher than those reported elsewhere. Disease flare is the leading cause of admission in patients with SLE in this relatively young cohort. Lupus nephritis has been found to be significantly related to longer LOS. Measurements taken to reduce the incidence and severity of flares would likely decrease hospitalization rate and LOS in patients with SLE.

scholarly journals THE EPIDEMIOLOGICAL PATTERN OF FACTORS ASSOCIATED WITH ISCHEMIC STROKE IN PATIENTS UNDER 50 YEARS OF AGE: A CROSS-SECTIONAL STUDY

2021 ◽  
Vol 11 (3) ◽  
pp. 9-13
Author(s):  
Nourollah Ramroodi ◽  
Seyed Mehdi Hashemi ◽  
Mehrdad Ramroudi
Keyword(s):  
Blood Pressure ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
History Of ◽  
Epidemiological Pattern ◽  
The Mean

Objective: The aim of the present study was to investigate the epidemiological pattern of factors associated with ischemic stroke among patients under 50 years old. Methods: The present cross-sectional study was performed on 197 Stroke patients. Individuals with confirmed ischemic stroke based on of CT scan were included in the study. Demographic information included age, sex, history of smoking, place of residence, season of disease incidence, history of contraceptive use in women, history of hypertension, having high blood pressure at the onset of diabetes, hyperlipidemia, heart disease and patient weight. Finally, the collected data was analyzed using SPSS ver. 22. Results: The mean age of participants was 40.18 years. The mean weight, height, body mass index (BMI) were 79.83, 168.63, and 28.12, respectively. A total of 60.4% of the participants were male and 39.6% were female. Moreover, 66.9% were urban residents, 38.6% had complications in winter, 67% were smokers, and 50% used contraceptives. The history of hypertension, diabetes, hyperlipidemia, and heart disease was seen in 69%, 49.7, 66%, and 73.6% of cases, respectively. Also, 53.8% of patients had high blood pressure upon admission. Conclusion: The present study showed that a history of heart disease and a history of hypertension in the past and nicotine use are very common in people with stroke. Considering the above mentioned epidemiological factors, it is recommended to prioritize the mentioned factors when identifying new cases

scholarly journals Pattern of Blood Pressure Distribution among University Students in Ajman, United Arab Emirates

2011 ◽  
Vol 1 (3) ◽  
pp. 86-89
Author(s):  
S A Basha ◽  
E Mathew ◽  
Jayadevan Sreedharan ◽  
Jayakumari Muttappallymyalil ◽  
S A Sharbatti ◽  
...  
Keyword(s):  
Blood Pressure ◽  
University Students ◽  
Systolic Blood Pressure ◽  
Pressure Distribution ◽  
Diastolic Blood Pressure ◽  
United Arab Emirates ◽  
Allied Health ◽  
Health Science ◽  
P Value ◽  
The Mean

Background Elevated blood pressure has been identified as a silent killer contributing to mortality and morbidity worldwide, hence it is essential to identify the high risk individuals at an early age to prevent the progress of the disease and its co-morbid conditions. Objective The objective of the present cross-sectional study was to assess the pattern of blood pressure distribution among students of medical and allied health professions at Gulf Medical University (GMU) Ajman, United Arab Emirates (UAE). Methods The study was conducted from November 2009 to February 2010. GMU has academic programmes such as Bachelor of Medicine, Physical therapy, Pharm D and Dental Medicine with a multiethnic student population. A pretested structured instrument used for data collection and blood pressure was measured using mercury sphygmomanometer. Descriptive statistics such as means and standard deviation were used to summarize the quantitative variables. The association of age, gender and nationality with systolic and diastolic blood pressure was determined by Pearson's correlation coefficient and a p-value ≤ 0.05 was considered statistically significant. Results The systolic and diastolic blood pressures were evenly distributed across all students irrespective of their age. A significantly higher systolic blood pressure in males was observed when compared to females, but the difference was not significant in diastolic blood pressure. In the present study among medical and allied health science students, the distribution of blood pressure was not associated with age. The mean systolic blood pressure and diastolic blood pressure were seen to be higher among Arabs when compared to Non-Arabs though not statistically significant. Family history of metabolic diseases did not show any association with the mean blood pressure. Conclusion There was a strong association for developing hypertension among male when compared to female gender. Key Words: University students; Age; Gender; Nationality; Systolic blood pressure; Diastolic blood pressureDOI: http://dx.doi.org/10.3126/nje.v1i3.5572 Nepal Journal of Epidemiology 2011;1(3) 86-89

Venous Thromboembolism In Patients With Non-Hodgkin Lymphoma: Analysis Of The Veterans Health Administration (VHA) National Database

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1701-1701
Author(s):  
Peter A Riedell ◽  
Kristen M. Sanfilippo ◽  
Suhong Luo ◽  
Kenneth R Carson
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Venous Thromboembolism ◽  
Treatment Initiation ◽  
Factors Associated ◽  
Non Hodgkin Lymphoma ◽  
Morbidity Score ◽  
Co Morbidity ◽  
History Of ◽  
The Mean

Abstract Introduction The association between malignancy and venous thromboembolism (VTE) is well known. Non-Hodgkin lymphoma (NHL) increases VTE risk, though most studies do not differentiate between low- and high-grade NHL. In order to better understand the natural history of VTE in NHL, we examined the incidence and factors associated with VTE in patients with diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). Methods Patients diagnosed with DLBCL or FL between 1998 and 2008 and treated within the VHA system with CHOP or CHOP-like regimens (+/- rituximab) were identified in the VA Central Cancer Registry. Those with VTE prior to the lymphoma diagnosis or history of atrial fibrillation were excluded. Data on sex, race, stage, lactate dehydrogenase (LDH), disease histology, B-symptoms, body mass index, co-morbidities, medications, and date of VTE event were obtained. Incident cases of VTE were determined through the use of ICD-9 codes for VTE combined with either pharmacy records of anti-coagulation therapy, placement of a vena-cava filter, or death within 30 days of an ICD-9 code for VTE. Logistic regression analysis was used to identify baseline factors associated with VTE. VTE incidence was then analyzed to evaluate differences before, during, and after treatment. Results 2606 NHL patients (1838 DBLCL, 768 FL) were identified, of whom 179 developed VTE (119 DLBCL, 33 FL) within 2 years of treatment initiation. The mean age at NHL diagnosis was 64 years. A majority of patients were male (97%), Caucasian (87%), and had a diagnosis of DLBCL (70%). The mean Charlson co-morbidity score in the cohort was 2.2. Annualized VTE incidence rates were significantly different between DLBCL and FL patients during the time from diagnosis to treatment initiation (18.7% vs. 6.1%; p<0.001) and in the 6 months after treatment initiation (9.3% and 3.8%; p=0.001). The annualized incidence dropped to 1% or less in both DLBCL and FL patients during the period 6 months to 2 years following treatment initiation. On multivariate logistic regression analysis, factors associated with increased odds of developing VTE within 6 months of treatment initiation included: DLBCL histology (OR 2.04; 95% CI 1.27 – 3.31), BMI ≥ 30 (OR 2.58; 95% CI 1.61 – 4.17), and stage III/IV disease (OR 1.7; 95% CI 1.14 – 2.55). There was a protective association observed for each point increase in the Charlson co-morbidity score (OR= 0.85; 95% CI 0.78 – 0.96). Conclusion VTE risk was greatest in time between diagnosis and 6 months after treatment initiation in all NHL patients. This is potentially due to greater disease burden during the time between diagnosis and treatment initiation and the pro-thrombotic effects of chemotherapy in the six months after treatment initiation. After controlling for potential confounding factors, the odds of VTE were twice as high in DLBCL compared to FL patients. While prophylactic anticoagulation in cancer patients remains controversial, future efforts in NHL should be focused on patients with higher grade histology during the timeframe between diagnosis and shortly after treatment cessation. Disclosures: Carson: Spectrum Pharmaceuticals: Honoraria, Research Funding, Speakers Bureau.

155 Door to Blood Pressure Goal Achievement in Community Management of Hyperacute Intracerebral Hemorrhage

2012 ◽  
Vol 60 (4) ◽  
pp. S56 ◽  
Author(s):  
N. Sanossian ◽  
A. Flinders ◽  
E. Olivas ◽  
S. Starkman ◽  
D. Liebeskind ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intracerebral Hemorrhage ◽  
Goal Achievement ◽  
Community Management ◽  
Blood Pressure Goal

scholarly journals Prevalence, awareness, treatment, and control of hypertension in Bangladesh: Findings from National Demographic and Health Survey, 2017-18

2021 ◽  
Author(s):  
Md. Nuruzzaman Khan ◽  
John C. Oldroyd ◽  
Enayet K. Chowdhury ◽  
Mohammad Bellal Hossain ◽  
Juwel Rana ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Survey ◽  
Demographic And Health Survey ◽  
Hypertension Control ◽  
Control Blood Pressure ◽  
Factors Associated ◽  
Robust Variance ◽  
Control Programmes ◽  
Nationally Representative ◽  
And Control

AbstractObjectiveTo estimate the age-standardised prevalence, awareness, treatment and control of hypertension; and to identify their risk factors in Bangladeshi adults 18 years and above using the Bangladesh Demographic and Health Survey (BDHS) 2017-18 data.MethodsData from 12, 904 Bangladeshi adults aged 18 years and older available from the most recent nationally representative BDHS 2017-18 were used. Hypertension was defined as having systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg, and/or taking anti-hypertensive drugs to control blood pressure. Age-standardised prevalence of hypertension and control were estimated with direct standardisation, and a multilevel mixed-effects Poisson regression model with a robust variance was used to identify factors associated with hypertension and its awareness, treatment, and control.ResultsThe overall age-standardised prevalence of hypertension was 40.0% (95% CI, 38.9-42.2); (men: 37.1%, women: 42.0%). Among those with hypertension (n=3531), 44.3% were aware that they had the condition and 39.1% were taking anti-hypertensive medication. Among those treated for hypertension (n=1306), only 41% had controlled hypertension. Factors independently associated with hypertension were increasing age, higher body mass index, being women, having diabetes, and residing in selected administrative divisions. A declining trend of hypertension control was observed with increasing age and those not being educated.ConclusionHypertension is highly prevalent (4 out of 10) in Bangladeshi adults, while awareness, treatment, and control are low. Irrespective of risks associated with hypertension and its management, awareness and control programmes should be given high priority in reducing hypertension, and improving hypertension control in Bangladesh.

Association between lifestyle factors and completion of neoadjuvant chemotherapy for breast cancer.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 91-91
Author(s):  
Ilana M Usiskin ◽  
Fangyong Li ◽  
Melinda L Irwin ◽  
Brenda Cartmel ◽  
Tara Beth Sanft
Keyword(s):  
Breast Cancer ◽  
Blood Pressure ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Diagnosis ◽  
Early Stage ◽  
Menopausal Status ◽  
Lifestyle Factors ◽  
Moderate Intensity ◽  
Diabetes Medication ◽  
Factors Associated

91 Background: Completion of chemotherapy has been associated with improved breast cancer outcomes. We evaluated whether lifestyle factors, such as physical activity and diet, may contribute to neoadjuvant chemotherapy completion in breast cancer. Methods: We conducted a retrospective study of women treated with neoadjuvant chemotherapy for early stage (I-III) breast cancer. A medical record review recorded BMI, blood pressure, diabetes and hypertension medication, and chemotherapy completion. Completers received full doses of all prescribed chemotherapy, with or without cycle delays. We conducted a telephone survey about exercise and fruit/vegetable intake (>5 servings/day) during the year prior to cancer diagnosis. Exercisers completed at least 7.5 MET-hours/week (i.e., 150 minutes of moderate-intensity exercise). Multi-variable adjusted analyses were conducted to identify factors associated with chemotherapy completion. Results: Sixty-seven patients (45%) answered the survey. Chemotherapy completers were on average 11 years younger than non-completers (p<0.001), more likely premenopausal (p=0.02), and less likely on diabetes medication (p=0.05). Exercisers were more likely to complete chemotherapy than non-exercisers (p=0.002). After controlling for age, diastolic blood pressure, menopausal status, and diabetes medication, the adjusted odds ratio for exercise on chemotherapy completion was 4.1 (95% CI 1.1 – 15.3) (p=0.04). Conclusions: Women who reported exercising at recommended levels in the year prior to breast cancer diagnosis were more likely to complete neoadjuvant chemotherapy regimens, suggesting a potentially important role for lifestyle factors in chemotherapy completion. Factors associated with chemotherapy completion [Table: see text]

Early-stage breast cancer (BC) patients: Factors associated with aromatase inhibitor-induced musculoskeletal symptoms.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 525-525
Author(s):  
Simran Arora Elder ◽  
Yamin Sun ◽  
Seungyoun Jung ◽  
Candace Bavette Mainor ◽  
Shruti Murali ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Aromatase Inhibitor ◽  
Early Stage ◽  
Musculoskeletal Symptoms ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Tumor Characteristics ◽  
Factors Associated ◽  
The Mean

525 Background: Hormone receptor positive (HR+) breast cancer comprises the largest subgroup of breast cancer. Aromatase Inhibitors (AI) are a key treatment for HR+ BC patients (pts) and reduce mortality. Aromatase Inhibitor-Associated Musculoskeletal Symptoms (AIMSS), defined as myalgias, arthralgias, or joint stiffness, occur in up to 50% of pts leading to low adherence to and often discontinuation of therapy. Little is known of the mechanism of AIMSS or its predisposing risk factors. This study aims to identify risk factors associated with AIMSS development in BC patients on AI therapy. Methods: We conducted a medical record review of pts with non-metastatic HR+ BC on adjuvant AI therapy between January 2009 and June 2017 at the University of Maryland Comprehensive Cancer Center. This study included 194 ptswho were free of arthralgia prior to AI therapy. We analyzed pts’ demographics, lifestyle factors, reproductive history, tumor characteristics, medications, cancer treatment, co-morbidities, AI type, onset and severity of AIMSS. Severe AIMSS was defined as requiring change in AI therapy or discontinuation. Multivariable-adjusted logistic regression was used to identify risk factors for severe AIMSS. Results: The mean age of participants was 61. The mean BMI at diagnosis was 30 kg/m2. 41% of pts were White, 40% were Black, 7% other and 12% unknown. Most (79%) did not have a history of tamoxifen and 16% were on GnRH agonists. Most (71%) used letrozole as initial AI therapy; 18% anastrozole; and 11% exemestane. 56% experienced AIMSS while on AI therapy and 20% required change or hold of AI therapy. 4% permanently discontinued AI due to AIMSS severity. BMI at diagnosis was significantly positively associated with risk of AIMSS. Multivariate odds ratio (95% confidence intervals) comparing the highest to lowest tertile of body mass index (BMI) at diagnosis was 4.01 (1.07-10.90; Ptrend: 0.05). There were no significant associations with race, smoking, reproductive factors, type of AI therapy, tamoxifen use prior to AI therapy, medication use, experience of other cancer treatments, and tumor characteristics. Conclusions: 56% of BC pts on adjuvant AI therapy experienced AIMSS. 24% of these changed, held or discontinued AI regimen due to severe AIMSS. Higher BMI at diagnosis was associated with a higher risk of AIMSS. Our results confirm clinical significance of AIMSS among BC pts on AI therapy and suggest BMI as a modifiable factor for AIMSS. A larger study is warranted to replicate our findings and seek other possible risk factors for AIMSS.

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