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Kiyotaka Uchiyama ◽  
Keigo Shibagaki ◽  
Akane Yanai ◽  
Ei Kusahana ◽  
Takashin Nakayama ◽  

2021 ◽  
Firaol Regea

Abstract Background: Hypertension affects more than one quarter of adults worldwide and one in three peoples in developing countries. Although Hypertension is known to be a silent medical condition, there is limited information on the prevalence of unscreened hypertension and associated factors among rural dwellers in Ethiopia in general and Dano district in particular. Objective: To assess the prevalence of Unscreened hypertension and associated factors among adults living in the rural area of Dano district, West Shewa, Oromia, Ethiopia 2020.Methods and materials - A community-based cross-sectional study was employed. A multi-stage sampling technique was used to select 605 Adults from the rural community of Dano District from May 23 -July 5, 2020. Data were collected by trained BSc nurses and Public health officers. Standardized WHO STEPS survey tool was used to collect socio-demographic and behavioral characteristics of the participants. Standardized digital blood pressure device was used to measure Blood pressure. The mean score of three blood measurements was used to classify hypertension after intra-class correlation was tested. GmateTM blood glucose measuring device was used to measure blood sugar. Multivariable logistic regression analysis was done to identify factors independently associated with unscreened hypertension. Adjusted Odds Ratio with 95% CI was estimated to measure the strength of association. The level of statistical significance was declared at p-value < 0.05. The results presented by tables and figures. Result: The prevalence of Unscreened Hypertension was 14.6%, (95% CI: 11.95%, 17.4%). Being in age of 19-33 years[(AOR: 2.5,95%CI:( 1,6)], having family history of hypertension [AOR=3.1,95%CI:(1.23,7.77)],having other chronic disease [AOR=0.28,95%CI:(0.11, 0.72)], Participants’ health-seeking behaviour to hypertension[AOR=3.3,95%CI:(1.6,6.5)] and participants knowledge about hypertension[AOR=2.3,95%CI:(1.2,4.5)]were independently associated with unscreened Hypertension.Conclusion - The evidence from this study shows unscreened hypertension is prevalent among adults in the study area. Therefore, opportunistic screening of adults regardless of their age and health status is important.

2021 ◽  
An-le Li ◽  
Ying Qi ◽  
Shuai Zhu ◽  
Zhi-hao Hu ◽  
Xue-jin Xu ◽  

Abstract Objective To explore the risk probability and influencing factors of stroke in followed-up hypertension (HP) patients through the analysis of long-term followed-up cohort data. Methods The method of followed-up observation cohort was used to collect the information of 168417 hypertension patients from 2002 to 2020 in Jiading district in Shanghai. Kaplan-Meier method was used to analyze the risk probability of stroke complications in long-term followed-up HP patients, and the influencing factors were analyzed by Cox proportional risk model. Results Among 168417 hypertension patients, 11143 cases had stroke, and the cumulative incidence rate was 6.62%, the male was 6.87% and the female was 6.37%. With the extension of the observation of patients, the cumulative risk probability of stroke in HP patients would continue to increasing, and the interval was not equidistant. The total cumulative risk probability of stroke in HP patients was 78.9%, and male was 91.0%, female was 70.7%. During the whole observation, the risk probability of stroke was not fixed, but fluctuates. There were 4 peak onset periods, which were 8 years (peak period 4.2%), 15 years (peak period 14.0%), 22 years (peak period 6.0%) and 26 years (peak period 13.9%). The highest risk probability of male patients was in 26 years (peak period 23.1%), and the second peak was in 15 years (peak period 15.6%). The highest risk probability of female patients was in 15 years (peak period 12.9%), and the second peak was in 26 years (peak period 8.7%). The risk probability of different sex, BP grad and BMI was different, male was higher than female, grade 3 HP higher than grade 1 and grad 2 HP, thin higher than normal weight. The major influencing factors of stroke complications were age (RR = 2.917, p < 0.001), body mass index (RR = 1.450, p < 0.001), family history of stroke (RR = 1.386, p < 0.001), blood pressure grad (RR = 1.148, p < 0.001), registry age (RR = 1.071, P < 0.001 and family history of hypertension (RR = 1.051, P < 0.001). Conclusion The risk probability of stroke among hypertension patients would continue to disproportionately increase during observation, and the total cumulative risk probability could finally reach 78.9%. Male was higher than female. Age, BMI, family history (stroke and HP), blood pressure grad and duration of HP were related to the occurrence of stroke complications.

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255373
Jie Guo ◽  
Jun Lv ◽  
Yu Guo ◽  
Zheng Bian ◽  
Bang Zheng ◽  

Background Blood pressure (BP) categories are useful to simplify preventions in public health, and diagnostic and treatment approaches in clinical practice. Updated evidence about the associations of BP categories with cardiovascular diseases (CVDs) and its subtypes is warranted. Methods and findings About 0.5 million adults aged 30 to 79 years were recruited from 10 areas in China during 2004–2008. The present study included 430 977 participants without antihypertension treatment, cancer, or CVD at baseline. BP was measured at least twice in a single visit at baseline and CVD deaths during follow-up were collected via registries and the national health insurance databases. Multivariable Cox regression was used to estimate the associations between BP categories and CVD mortality. Overall, 16.3% had prehypertension-low, 25.1% had prehypertension-high, 14.1% had isolated systolic hypertension (ISH), 1.9% had isolated diastolic hypertension (IDH), and 9.1% had systolic-diastolic hypertension (SDH). During a median 10-year follow-up, 9660 CVD deaths were documented. Compared with normal, the hazard ratios (95% CI) of prehypertension-low, prehypertension-high, ISH, IDH, SDH for CVD were 1.10 (1.01–1.19), 1.32 (1.23–1.42), 2.04 (1.91–2.19), 2.20 (1.85–2.61), and 3.81 (3.54–4.09), respectively. All hypertension subtypes were related to the increased risk of CVD subtypes, with a stronger association for hemorrhagic stroke than for ischemic heart disease. The associations were stronger in younger than older adults. Conclusions Prehypertension-high should be considered in CVD primary prevention given its high prevalence and increased CVD risk. All hypertension subtypes were independently associated with CVD and its subtypes mortality, though the strength of associations varied substantially.

2021 ◽  
Vol 21 (1) ◽  
Elvis Safary ◽  
Micrina Mwandeti ◽  
Beatrice Matanje ◽  
Claudia Beiersmann ◽  
Caroline Mtaita ◽  

Abstract Background In recent years, there has been greater recognition of the important role of community health volunteers in many countries and their important role informs many health programs. This include health education, provision of services such as screening, monitoring and referral to health facilities. Their roles are better understood in the areas of communicable diseases like HIV infection, Tuberculosis and Malaria however little is known about their role in non-communicable diseases. This study seeks to explore perception of CHVs’ functions, tasks, and their fulfilment in identifying people with elevated blood pressure for diagnosis and monitoring of hypertension in Lilongwe, Malawi. Methods This was a qualitative naturalistic research design utilizing observation and semi-structured interviews with community health volunteers working in Lilongwe, Malawi. Interviews were carried out with the researcher. Participants were recruited from the ZaMaC project. An interview guide was developed with a category-guided deductive approach. The interviews were recorded through note taking. Data analysis was performed using content analysis approach. Results Community health volunteers have multiple roles in prevention and monitoring of hypertension. They act as health educators and provide lifestyle counselling. They screened for hypertension and monitored blood pressure and assisted community members to navigate the health system such as linkage to health facilities. These roles were shaped in response to community needs. Conclusion This study indicates the complexities of the roles of community health volunteer in identifying people with elevated BP for diagnosis and monitoring of hypertension. Understanding community health volunteers’ roles provides insight into their required competencies in provision of their daily activities as well as required training to fill in their knowledge gaps.

2021 ◽  
pp. 1357633X2110317
Valerie HY Teo ◽  
Sok Huang Teo ◽  
Sarah M Burkill ◽  
Yi Wang ◽  
Evelyn AL Chew ◽  

Introduction Technology to enhance hypertension management is increasingly used in primary care; however, it has not been evaluated in an Asian primary care setting. We aimed to understand the clinical impact and cost-effectiveness of a technology-enabled home blood pressure monitor when deployed in primary care, and patients’ perspectives about the technology. Methods A quasi-experimental cohort study was conducted in a polyclinic in Singapore. In total, 120 patients with hypertension were assigned to the telemonitoring intervention group. Patients received a home blood pressure device connected to the clinical care team's dashboard through a mobile gateway. Tele-consultations and nurse-led tele-support were carried out using established clinical protocols. In total, 120 patients assigned to the control group continued to receive usual care in the polyclinic. Clinical outcomes, cost-effectiveness, and patient satisfaction were measured 6 months after recruitment. Results In total, 217 patients completed 6 months of follow-up. Telemonitoring intervention patients had significantly increased odds of having controlled blood pressure by a factor of 2.69 ( p = 0.01), with the greatest improvement in those whose blood pressure was uncontrolled at baseline ( p < 0.05). The incremental cost-effectiveness ratios for all patients was S$23,935.14/quality-adjusted life year (<1 gross domestic product per capita), which was very cost-effective based on World Health Organization cost-effectiveness thresholds. There was greater satisfaction in telemonitoring intervention group relating to the convenience of recording and sharing blood pressure measurements with the health care team, consultation advice received, understanding by the health care team of their condition, and were more motivated to monitor their blood pressure. Discussion Telemonitoring with tele-consultation improved blood pressure control and was more cost-effective than usual care. Patients receiving telemonitoring intervention were also more motivated and satisfied with their care.

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