Prevalence of Hypertension and Its Associated Factors among Adults in Selected Areas of Bangladesh: A Community Based Cross-sectional Study

Background: Hypertension is a silent killer and an overwhelming global public health challenge. This study aimed to determine the prevalence and associated factors of hypertension among adults in Bangladesh. Methods: A community-based cross-sectional study design was conducted among 400 adults who lived in Dhaka, Mymensing, Sylhet and Khulna District. Data were collected using a structured questionnaire that is adapted from the WHO Stepwise approach. Data was analyzed by SPSS version 25. Descriptive statistics and bivariate logistic regression analysis were conducted and statistical significance was declared at a p-value ≤0.05. Results: This study identified a high prevalence of hypertension in the study area and it was 39.75%. Among the male the prevalence was 23.5% and the prevalence was 16.5% among female. In this study hypertension was significantly associated with the age group 51-65 years (OR=1.02; CI 0.557-1.862) , ever smoking (OR= 2.59; CI 1.718-3.917) consume  less fruits (OR=3.125; CI 0.839-11.632) and vegetable (OR=2.25; CI 1.364-3.725), physically inactive (OR=1.48;CI 0.973-2.252) overweight (OR=7.98; CI 4.612-13.793) and had diabetes mellitus (0R=2.38; CI 1.213-4.659). Conclusion: The prevalence of hypertension was considerably higher in this study area. Hence, the health care system needs to establish strategies to improve the diagnostic and screening services. Community-level intervention and regular assessment, screening, and diagnosis of behavioral, socio-demographic, and physiological risk factors, screening, should be institutionalized to address the occult burden of hypertension.

Influence of Preseason Versus In-Season Play on Achilles Tendon Injuries in the National Football League

Background: A ruptured Achilles tendon (AT) can sideline a player for 6 to 12 months and reduce their power rankings by more than 50%. Previous research has compared AT rupture rates in different game conditions. Purpose: To determine environmental and physiological risk factors for AT tears, given the minimal amount of research on AT ruptures in the National Football League (NFL). Study Design: Case series; Level of evidence, 4. Methods: NFL players with a diagnosed AT tear between 2009 and 2016 were selected as the study population for this retrospective analysis. Data on NFL injury were collected from an established database composed of publicly available information. Player profiles were employed to determine position, team, and game statistics at the time of injury. The proportion of NFL rookies was approximated by summing the number of draft picks and the number of signed, undrafted free agents and measured against the number of roster spots before the season. Results: Between 2009 and 2016, there were 101 documented AT tears. Of these, 64% (65/101) occurred before the official season, including preseason games. Of the 36 tears that occurred in-season, 34 were during games. Overall, 29% (19/65) of the preseason tears occurred in rookies and 100% (36/36) of the in-season tears affected nonrookies. Of the rookies with AT ruptures, 42.11% returned to play in the NFL, while 62.20% of the nonrookies came back to partake in future seasons. Despite an average age of 26.7 years, the tear distribution was bimodal with players aged 24 and 36 years exhibiting the highest rates of tear. Conclusion: In our review of AT tears in NFL athletes, a large percentage of the tears occurred in rookie players, especially during the preseason. We also found that tears during the season occurred in only nonrookies, suggesting that the preseason is when rookies experience the greatest risk for injury.

The Effects Of Exercise Training On Physical, Physiological And Psychological Risk Factors Of Patients With Cardiovascular Disease

Background — Exercise training is an important component of wellness for individuals diagnosed with cardiovascular disease (CVD). Exercise may have an effect on cardiovascular risk factors such as hypertension, lipid levels, and other associated physical, psychological, and physiological risk factors. Exercise intensity may further impact those risk factors. Aim — This narrative review of the literature aims to identify the effect of regular physical exercise on modifying risk factors for CVD and increased morbidity and mortality related to CVD. Methods — Published English-language papers from 2011 to 2020, available in Scopus, PubMed, Cochrane, Google Scholar, and Thompson were included in this review. Keywords for this search were exercise training, cardiovascular disease, hypertension, physical function, physiological, and psychological risk factors. Conclusions — Exercise training may be a cost-effective intervention that improves the physical, physiological, and psychological risk factors and the motor function of patients with cardiovascular disease.

Occupational Stress and Burnout in the Fire Service: Examining the Complex Role and Impact of Sleep Health

The occupational stress inherent in firefighting poses both physiological and psychological risks to firefighters that have been found to possess a reciprocal nature. That is, the nature of these relationships in terms of indicator and impact are elusive, especially as it relates to sleep health (e.g., quality, quantity, hygiene, etc.) as a specific physiological risk and burnout as a specific psychological risk. A series of mediation models were assessed to examine the reciprocal relationships between occupational stress, burnout, and sleep health in a sample of 161 career firefighters. The mediation models confirmed reciprocity among the variables in so much that relationships were best described by the underlying mechanism at work. Comprehensive assessments of both subjective and objective markers of sleep health should be incorporated into firefighter research to supplement behavioral health assessments and interventions, especially related to burnout and occupational stress.

Diabetes, hypertension and dyslipidemia medication prescribing in Qatari primary care settings: a retrospective analysis of electronic medical records

Background Globally, non-communicable diseases (NCDs) are recognised as a leading cause of morbidity and mortality. Medications and medicines optimisation play an important role in the management of modifiable physiological risk factors and NCDs. The importance of lifestyle interventions in prevention of modifiable risk factors is also well established. The aim of this paper was to describe the quantity of type 2 diabetes mellitus (T2DM), hypertension and dyslipidaemia prescribing in Qatari primary care settings. Its findings will provide necessary information to inform pharmaceutical policy and practice. Methods The study was undertaken in Qatar’s publicly funded primary health care centres. Data sources for this study comprised electronic medical records. The Anatomical Therapeutic Chemical (ATC) drug classification system was used to classify the medications prescribed. The number and proportion of medications by age, sex, nationality and diagnosis (T2DM, hypertension and dyslipidaemia) were reported. Results A total 81,569 individuals were included (18–29 years 2.4%; 30–39 years 11.7%; 40–49 years 25.4%; 50–59 years 31.9% and ≥ 60 years 28.6%). 55.6% participants were male. On average 10.2 medications were prescribed per person and 2.3 medications were included in each prescription. T2DM medications were most prescribed (N = 361,87780,799; 43.2%) followed by hypertension (N = 303,086; 36.2%) and dyslipidaemia (N = 172,163; 20.5%). Of the total medications prescribed, 72% (N = 605,488) were prescribed in individuals aged 50 years and above. Men were prescribed 62% (N = 515,043) medications while women were prescribed 38% (N = 322,083) medications. Southern Asians (N = 330,338; 39%) were prescribed most medication followed by Qataris (N = 181,328; 22%) and Northern African (N = 145,577; 17%). Conclusions In Qatar’s primary care settings, average medications prescribed per patients were found to be higher compared to other populations. While medications were actively prescribed for the 3 conditions, the study found variations by medication type, age, gender and nationality. Rational guidelines for the utilisation of medications need to be established with the support of real-world evidence.

Anaemic women are more at risk of injectable contraceptive discontinuation due to side-effects in Ethiopia

Introduction This paper investigates the importance of women’s physiological condition for predicting the risk of discontinuation due to side-effects of the injectable contraceptive in Ethiopia, where side-effects account for around 20% of all discontinuations. Methods Contraceptive calendar data from the 2016 Ethiopian Demographic and Health Survey were analysed. Women aged 15-49 who had initiated the injectable contraceptive in the two years prior to interview were included in the analysis (N=1,513). After checking for reverse causality, the associations between physiological risk factors and discontinuation of the injectable contraceptive due to either side-effects (DSE) or other reasons (DOR) were estimated using multivariate Cox proportional regression analyses. Results In 2016, 10% of women had initiated the injectable in the last two years, and 1 in 4 had discontinued use by the time of the interview. Of these, 1 in 5 discontinued due to side-effects. Women with anaemia were at twice the risk of DSE compared with non-anaemic women, while anaemia status was not associated with DOR. Sociocultural factors including religion, wealth and relationship status were significant predictors for DOR, but not for DSE. Conclusion Accounting for diversity in physiological condition is key for understanding contraceptive discontinuation due to side-effects.

Anaemic women are more at risk of injectable contraceptive discontinuation due to side-effects in Ethiopia

IntroductionThis paper investigates the importance of women’s physiological condition for predicting the risk of discontinuation due to side-effects of the injectable contraceptive in Ethiopia, where side-effects account for around 20% of all discontinuations.MethodsContraceptive calendar data from the 2016 Ethiopian Demographic and Health Survey were analysed. Women aged 15-49 who had initiated the injectable contraceptive in the two years prior to interview were included in the analysis (N=1,513). After checking for reverse causality, the associations between physiological risk factors and discontinuation of the injectable contraceptive due to either side-effects (DSE) or other reasons (DOR) were estimated using multivariate Cox proportional regression analyses.ResultsIn 2016, 10% of women had initiated the injectable in the last two years, and 1 in 4 had discontinued use by the time of the interview. Of these, 1 in 5 discontinued due to side-effects. Women with anaemia were at twice the risk of DSE compared with non-anaemic women, while anaemia status was not associated with DOR. The association between anaemia and experience of side-effects is likely driven by iron-deficiency anaemia, as having taken iron supplements during last pregnancy is found to decrease the risk of DSE. Sociocultural factors including religion, wealth and relationship status were significant predictors for DOR, but not for DSE.ConclusionAccounting for diversity in physiological condition is key for understanding contraceptive discontinuation due to side-effects. To reduce side-effects and thereby unmet need for contraception, family planning programs may benefit from providing an integrated service package addressing anaemia as well as supplying hormonal contraception.

Health factors as potential mediators of the longitudinal effect of loneliness on general cognitive ability

OBJECTIVE: Higher levels of loneliness in older adulthood predict cognitive decline, but research on mediating mechanisms is sparse. We examine multisystemic physiological risk, functional ability, self-rated health, depressive symptoms, and social participation as mediating processes for the association between loneliness and general cognitive ability over a 10-year follow-up in an older adult sample. METHODS: Three waves of data from 3,005 individuals (mean intake age: 69.30 (SD: 7.85) years; female = 51.61%) recruited during Wave 1 of the National Social Life, Health, and Aging Project were used to test whether hypothesized mediators collected at the 5-year follow-up explained effects of baseline loneliness on 10-year general cognitive ability. RESULTS: The relationship between baseline loneliness and 10-year general cognitive ability was not mediated by multisystemic physiological risk. Functional ability ( = -0.24, SE = 0.05, p < .001), self-rated health (= -0.08, SE = 0.02, p < .001), depressive symptoms (= -0.20, SE = 0.05, p < .001), and social participation ( = -0.03, SE = 0.01, p = .016) significantly mediated effects. Indirect effects remained significant after adjusting for demographic covariates and 5-year general cognitive ability, except social participation. DISCUSSION: Loneliness may influence cognitive ability indirectly, signaling waning physical and psychiatric health more proximally correlated with cognitive ability. These mechanisms may serve as targets of intervention for cognitive maintenance in lonely older adults.

Physiological risk of falls, physical and aerobic capacity in community-dwelling elderly

Introduction: Falls are multifactorial and are related to the aging process, reduced functional capacity, comorbidities, sensory deficits, muscle weakness, postural instability and decreased protective response. Objective: To verify the correlation between physiological risk of falls and physical and aerobic capacity of the community-dwelling elderly. Method: Participated elderly individuals from the community, aged ≥65 years, without distinction of sex, race, and/or social class. We excluded cognitive impairments, locomotion incapacity, neurological diseases or sequelae, and/or severe pain that prevented the performance of the tests. We evaluated risk of falls (Physiological Profile Assessment - PPA), physical capacity (Short Physical Performance Battery - SPPB) and aerobic capacity (Shuttle Walk Test - ISWT). Results: Participated 59 elderly (71.8±5.0 ys). The mean performance in PPA was 0.4±0.4; SPPB was 10.4±1.7 and ISWT was 281±111.7 meters. PPA presented a moderate and statistically significant correlation (P<0.001) for SPPB (r= -0.53) and ISWT (r= -0.46). Conclusion: There is a moderate correlation between the physiological risk of falls (PPA) and functional (SPPB) and aerobic capacity (ISWT). Preventive measures to reduce the risk of falls should include strategies to increase functional and aerobic capacity. It is suggested the systematic use of SPPB in clinical practice.