Prevalence, awareness, treatment, and control of hypertension in Northern China: a cross-sectional study

Background Hypertension has always been a worldwide health concern. The purpose of this study was to investigate the prevalence, awareness, treatment, and control rates of hypertension among adult residents of northern China, where people usually have a high-fat, high-salt diet and heavy alcohol consumption. Methods Through the Early Screening and Comprehensive Intervention Project for High Risk Groups of Cardiovascular Diseases in the Inner Mongolia of northern China, we collected data of 70,380 residents, from September 2015 to June 2017. We assessed the prevalence, awareness, treatment, and control of hypertension in the total population and sub-populations. Multivariable logistic regression analyses were used to identify the factors associated with the prevalence and control of hypertension. Results Among participants, only 13.4% had optimal blood pressure levels. About 55.7% (95% confidence interval (CI) = 55.3–56.1%) of the participants had hypertension. In addition, the awareness, treatment, control and control under-treatment rate of hypertension were 52.8% (95%CI = 52.3–53.3%), 43.3% (95%CI = 42.8–43.8%), 8.6% (95%CI = 8.3–8.9%) and 19.8% (95%CI = 19.2–20.4%), respectively. Multivariable logistic regression showed that older, male, Han, living in rural areas, current drinker, not married, lower educational level, lower annual income, diabetes, obesity, and dyslipidemia were more likely to be suffered from hypertension (P < 0.05). Controlled hypertension was less common in those younger, Mongol, not married, farmer, current drinker, lower educational level, obesity, diabetes, without prior CHD, and without prior CVD (P < 0.05). Conclusion Among populations aged 35–75 years in Northern China, more than half have hypertension, fewer than one-tenth have successfully controlled hypertension, and fewer than one-fifth of hypertension patients receiving treatment have controlled hypertension.

955Risk of drowning: the Japan Collaborative Cohort (JACC) Study

Background In Japan, the unintentional drowning mortality rate among the elderly is exceptionally high. However, the risk factors for drowning in Japan are not fully understood. This study aims to explore the risk factors of drowning in Japan. Methods This study used data from the Japan Collaborative Cohort Study, a prospective cohort aged 40–79 years initiated 1988-1990. A total of 86,298 individuals (35,984 men and 50,314 women) completed a self-administered questionnaire and were mainly followed up by the end of 2009. We calculated hazard ratios (HRs) and 95% confidence intervals (95%CIs) for drowning according to age, body mass index, drinking habits, medical history, marital status, and years of education. Results A total of 194 drownings occurred during a median follow-up period of 18.9 years. The multivariable HRs (95%CIs) of drowning were 0.21 (0.10–0.45) for aged &lt;50 years, 0.37 (0.21-0.65) for 50–59 years compared with 60–69 years, 3.08 (1.39–6.85) for bereaved compared with married, 3.39 (1.19-9.66) for with medical history of stroke compared without, and 3.18 (1.39–7.30) for current drinker with ≥69.0g ethanol/day compared with never drinker in men, 0.20 (0.09-0.43) for aged &lt;50 years and 3.39 (1.19-9.66) for 50-59 years in women. Conclusions Younger people were found to have a lower risk of drowning. For men, bereavement, history of stroke, and current heavy drinking were found to have higher risk of drowning. Key messages In Japan, bereavement, a history of stroke, and heavy drinking among men found to have higher risk of drowning

Private Health Insurance in Malaysia: Who Is Left Behind?

Despite various efforts introduced, private health insurance coverage is still low in Malaysia. The objective of this article is to find the factors associated with not having a private health insurance in Malaysia. We analyze data involving 19 959 respondents from the 2015 National Health Morbidity Survey. In this article, we describe the prevalence of not having health insurance and conducted binary logistic regression to identify determinants of uninsured status. A total of 56.6% of the study population was uninsured. After adjusting for other variables, the likelihood of being uninsured was higher among those aged 50 years and above, females, Malay/other Bumiputra ethnicities, rural, government/semigovernment, self-employed, unpaid workers and retirees, unemployed, lower education level, without home ownership and single/widowed/divorced, daily smoker, underweight body mass index, and current drinker. The likelihood of being uninsured also increased with increasing household size while the inversed trend was seen for household income. A substantial proportion of population in Malaysia did not have private health insurance, and these subgroups have limited preferential choices for provider, facility, and care.

Prevalence, Awareness, Treatment and Control of Hypertension in Northern China: a Cross-Sectional Study

Background: Hypertension has always been a worldwide health concern. The purpose of this study was to investigate the prevalence, awareness, treatment, and control rates of hypertension among adult residents of northern China, where people usually have a high-fat, high-salt diet and heavy alcohol consumption.Methods: Through the Early Screening and Comprehensive Intervention Project for High Risk Groups of Cardiovascular Diseases in the Inner Mongolia Autonomous Region of northern China, we collected data of 70,380 residents, from September 2015 to June 2017. We assessed the prevalence, awareness, treatment, and control of hypertension in the total population and subpopulations.Results: Among participants, only 13.4% had optimal blood pressure levels. About 55.7% (95% confidence interval (CI): 55.3%–56.1%) of the participants had hypertension. The national standardized and the regional standardized prevalence rate was 49.4% and 55.4%, respectively. Multivariate logistic regression showed that old age, male, Han, living in rural, farmer, current drinker, not married, diabetes, obesity and dyslipidemia were associated with hypertension. In addition, the awareness, treatment, control and control under treatment rate of hypertension were 52.8% (95% CI: 52.3%–53.3%), 43.3% (95% CI: 42.8%–43.8%), 8.6% (95% CI: 8.3%–8.9%) and 19.8% (95% CI: 19.2%–20.4%), respectively. And the 70,380 population subgroups varied with respect to hypertension prevalence (range 32.6%-73.4%), awareness (35.1%-76.2%), treatment (24.9%-64.6%), control (3.9%-20.4%), and control under treatment (11.2%-31.6%). Controlled hypertension were less common in those younger age, Mongol, not married, farmer and current drinker. Conclusion: Most patients of hypertension are going undetected and uncontrolled in northern China. Even if patients with hypertension are under treatment, hypertension can remain inadequately controlled.

Prevalence, Awareness, Treatment and Control of Hypertension in Northern China: a Cross-Sectional Study

Background: Hypertension has always been a worldwide health concern. The purpose of this study was to investigate the prevalence, awareness, treatment, and control rates of hypertension among adult residents of northern China, where people usually have a high-fat, high-salt diet and heavy alcohol consumption.Methods: Through the Early Screening and Comprehensive Intervention Project for High Risk Groups of Cardiovascular Diseases in the Inner Mongolia Autonomous Region of northern China, we collected data of 70,380 residents, from September 2015 to June 2017. We assessed the prevalence, awareness, treatment, and control of hypertension in the total population and subpopulations.Results: Among participants, only 13.4% had optimal blood pressure levels. About 55.7% (95% confidence interval (CI): 55.3%–56.1%) of the participants had hypertension. The national standardized and the regional standardized prevalence rate was 49.4% and 55.4%, respectively. Multivariate logistic regression showed that old age, male, Han, living in rural, farmer, current drinker, not married, diabetes, obesity and dyslipidemia were associated with hypertension. In addition, the awareness, treatment, control and control under treatment rate of hypertension were 52.8% (95% CI: 52.3%–53.3%), 43.3% (95% CI: 42.8%–43.8%), 8.6% (95% CI: 8.3%–8.9%) and 19.8% (95% CI: 19.2%–20.4%), respectively. And the 70,380 population subgroups varied with respect to hypertension prevalence (range 32.6%-73.4%), awareness (35.1%-76.2%), treatment (24.9%-64.6%), control (3.9%-20.4%), and control under treatment (11.2%-31.6%). Controlled hypertension were less common in those younger age, Mongol, not married, farmer and current drinker. Conclusion: Most patients of hypertension are going undetected and uncontrolled in northern China. Even if patients with hypertension are under treatment, hypertension can remain inadequately controlled.

Associations of education and income with alcohol use among Japanese pregnant women

Background Alcohol use during pregnancy can lead to adverse health consequences for the fetus. Identification of pregnant women who are most likely to drink is essential for targeting interventions. However, evidence on associations of education and income with alcohol use during pregnancy is inconsistent. Methods We analyzed data from 11484 pregnant women who agreed to participate in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan from 2013 to 2017. Women were dichotomized as current drinker and non-drinker (past drinker, never drinker, constitutionally never drinker) during early pregnancy and during middle pregnancy, respectively. Multivariate logistic regression analyses were conducted to examine whether educational attainment or equivalent household income was associated with alcohol use, after adjusting for women's age, work status, smoking, income/education, and their partners' education. Results Prevalence of alcohol use during early and middle pregnancy was 21.1% and 6.5%, respectively. Higher education and higher income were significantly associated with an increased risk of alcohol use during early pregnancy; the odds ratio (OR) of ≥university education compared with ≤high school education was 1.54 (95% confidence interval [CI], 1.35-1.76), and the OR of ≥ 4 million compared with &lt;2 million Japanese yen was 1.39 (95% CI, 1.20-1.61). Education and income were not associated with alcohol use during middle pregnancy; the corresponding ORs were 1.08 (95% CI, 0.87-1.35) and 1.03 (95% CI, 0.82-1.29), respectively. Conclusions Associations of education and income with alcohol use were observed during early pregnancy, not during middle pregnancy. No amount of alcohol and no time to drink can be considered safe during pregnancy. More public health awareness is needed to prevent alcohol use during early pregnancy. Key messages Different strategies for preventing alcohol use are required during early pregnancy and during middle pregnancy. Interventions for alcohol use during early pregnancy should focus on women with higher education and/or higher income.

Awareness of alcohol marketing, ownership of alcohol branded merchandise, and the association with alcohol consumption, higher-risk drinking, and drinking susceptibility in adolescents and young adults: a cross-sectional survey in the UK

ObjectivesTo explore awareness of alcohol marketing and ownership of alcohol branded merchandise in adolescents and young adults in the UK, what factors are associated with awareness and ownership, and what association awareness and ownership have with alcohol consumption, higher-risk drinking and susceptibility.DesignOnline cross-sectional survey conducted during April–May 2017.SettingThe UK.ParticipantsAdolescents and young adults aged 11–19 years in the UK (n=3399).Main outcome measuresAlcohol Use Disorders Identification Test–Consumption (AUDIT-C) (0–12) and indication of higher-risk consumption (>5 AUDIT-C) in current drinkers. Susceptibility to drink (yes/no) in never drinkers.ResultsEighty-two per cent of respondents were aware of at least one form of alcohol marketing in the past month and 17% owned branded merchandise. χ2tests found that awareness of marketing and ownership of branded merchandise varied within drinking variables. For example, higher awareness of alcohol marketing was associated with being a current drinker (χ2=114.04, p<0.001), higher-risk drinking (χ2=85.84, p<0.001), and perceived parental (χ2=63.06, p<0.001) and peer approval of consumption (χ2=73.08, p<0.001). Among current drinkers, multivariate regressions (controlling for demographics and covariates) found that marketing awareness and owning branded merchandise was positively associated with AUDIT-C score and higher-risk consumption. For example, current drinkers reporting medium marketing awareness were twice as likely to be higher-risk drinkers as those reporting low awareness (adjusted OR (AOR)=2.18, 95% CI 1.39 to 3.42, p<0.001). Among never drinkers, respondents who owned branded merchandise were twice as likely to be susceptible to drinking as those who did not (AOR=1.98, 95% CI 1.20 to 3.24, p<0.01).ConclusionsYoung people, above and below the legal purchasing age, are aware of a range of alcohol marketing and almost one in five own alcohol branded merchandise. In current drinkers, alcohol marketing awareness was associated with increased consumption and greater likelihood of higher-risk consumption. In never drinkers, ownership of branded merchandise was associated with susceptibility.

Prevalence of Alcohol Consumption and Knowledge About Alcohol at Bhimtar, Sindhupalchowk

Introduction: Alcohol causes several health problems, economic and social consequences across the world. Nepal is a multicultural and multi-ethnic country with an ambivalent regarding alcohol use according to social, religious and cultural values. Alcohol use is very common and easily available everywhere in Nepal. Objective of study is to find the prevalence of alcohol consumption and knowledge of alcohol among people at Bhimtar. Methods: A cross sectional study was conducted on a total of 369 households, age above 20 years of Bhimtar, Sindhupalchowk district on November 2016. 41 households were selected using cluster sampling from all nine wards of Bhimtar village development committee. Results: The prevalence of alcohol consumption was 232 (62.9%) in which 144 (77.4%) of males and 88 (48.1%) of females. There was 3.3 times more chance of consuming alcohol in male than female. Majority 137 (37%) consumed Raksi followed by Jaand/Chhyang 115 (31.3% ) and mix 97 (26.4%). On knowledge of alcohol consumption, 280 (75.9 %) and 288 (78.0%) of current drinker opined that it would effects own health and on the family respectively. After drinking alcohol 118 (31.9%) felt it relieved tiredness followed by felt better 103 (28%) and reduced stress 70 (18.9%). It affects heart and damage liver said by 72 (19.4%) and 59 (16%) respectively. There were family conflict after drinking alcohol replied by 132 (35.8%). They have good knowledge about the affect of alcohol on pregnant women. Only 50 (13.5%) of respondent expressed that it can be given to pregnant women. Conclusions: The prevalence of alcohol consumption was very high. There is markedly differed in alcohol consumption by sex. It is affecting their health and family. Consumption of alcohol is financial burden and makes conflict in the family, which will also make psychological affect on their children. There is significant difference in knowledge of harm on alcohol consumption by education status. It is essential to plan and develop a specific health education program among these at-risk populations for prevention of alcohol consumption. Keywords: current drinker; economic burden; ever drinker; family conflict; initiation.