Osong Public Health and Research Perspectives

Original Articles

Associations of pre-existing cardiovascular morbidity with severity and the fatality rate in COVID-19 patients: a systematic review and meta-analysis: Foad Alzoughool, Suhad Abumweis, Lo’ai Alanagreh, Manar Atoum; Osong Public Health Res Perspect. 2022;13(1):37-50. Published online February 18, 2022; DOI: https://doi.org/10.24171/j.phrp.2021.0186

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Graphical Abstract Abstract PDF Supplementary Material

Objectives
The aim of this study was to evaluate the association of pre-existing cardiovascular comorbidities, including hypertension and coronary heart disease, with coronavirus disease 2019 (COVID-19) severity and mortality. Methods: PubMed, ScienceDirect, and Scopus were searched between January 1, 2020, and July 18, 2020, to identify eligible studies. Random-effect models were used to estimate the pooled event rates of pre-existing cardiovascular disease comorbidities and odds ratio (OR) with 95% confidence intervals (95% CIs) of disease severity and mortality associated with the exposures of interest. Results: A total of 34 studies involving 19,156 patients with COVID-19 infection met the inclusion criteria. The prevalence of pre-existing cardiovascular disease in the included studies was 14.0%. Pre-existing cardiovascular disease in COVID-19 patients was associated with severe outcomes (OR, 4.1; 95% CI, 2.9 to 5.7) and mortality (OR, 6.1; 95% CI, 2.9 to 12.7). Hypertension and coronary heart disease increased the risk of severe outcomes by 2.6 times (OR, 2.6; 95% CI, 1.9 to 3.6) and 2.5 times (OR, 2.5; 95% CI, 1.7 to 3.8), respectively. No significant publication bias was indicated. Conclusion: COVID-19 patients with pre-existing cardiovascular comorbidities have a higher risk of severe outcomes and mortality. Awareness of pre-existing cardiovascular comorbidity is important for the early management of COVID-19.

Citations

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Asthma and clinical outcomes of COVID-19 in a community setting
L. Jiao, D. Bujnowski, P. Liu, E. Bakota, L. Liu, Y. Ye, A. Dewangan, C.N. Duong, E. Kviten, S. Zaheer, A. Zangeneh, R. Roy, J. Floyd, J. Monroy, D. Wiltz-Beckham
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Understanding factors affecting implementation success and sustainability of a comprehensive prevention program for cardiovascular disease in primary health care: a qualitative process evaluation study combining RE-AIM and CFIR
Naomi Aerts, Kathleen Van Royen, Peter Van Bogaert, Lieve Peremans, Hilde Bastiaens
Primary Health Care Research & Development.2023;[Epub] CrossRef
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Lubov Mitrofanova, Igor Makarov, Andrey Gorshkov, Olga Vorobeva, Maria Simonenko, Anna Starshinova, Dmitry Kudlay, Tatiana Karonova
Life.2023; 13(7): 1551. CrossRef
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Prevalence and Associated Factors of Hypertension Subtypes Among the Adult Population in Nepal: Evidence from Demographic and Health Survey Data: Rajat Das Gupta, Animesh Talukdar, Shams Shabab Haider, Mohammad Rifat Haider; Osong Public Health Res Perspect. 2019;10(6):327-336. Published online December 31, 2019; DOI: https://doi.org/10.24171/j.phrp.2019.10.6.02; Correction in: Osong Public Health Res Perspect 2022;13(1):80

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Abstract PDF

Objectives

This study aims to determine the prevalence, and associated factors of undiagnosed hypertension [Systolic Diastolic Hypertension (SDH), Isolated Systolic Hypertension (ISH) and Isolated Diastolic Hypertension (IDH)] in the Nepalese adult population.

Methods

Nepal Demographic and Health Survey 2016 data from adults (≥ 18 years) was used in this study. The final weighted sample size was 13,393. Blood pressure (BP) was measured 3 times and the average of the second and third measurement was reported. SDH (systolic BP (SBP) ≥ 140 mmHg and diastolic BP (DBP) ≥ 90 mmHg), ISH (SBP ≥ 140 mmHg and DBP < 90 mmHg), and IDH (SBP < 140 mmHg and DBP ≥ 90 mmHg) were measured. Multilevel logistic regression analyses were conducted to find the association between the independent variables and the covariates.

Results

The prevalence of SDH, IDH and ISH were 8.1%, 7.5%, and 3.3% respectively. The odds of having SDH and ISH increased with old age. However, the odds of having IDH decreased with increasing age. Females has lower odds of having SDH and IDH compared with male participants. Individuals that had been married, resided in Province 4 (p < 0.05) or 5 (p < 0.01) were statistically significantly associated with having IDH. Being overweight or obese was statistically significantly associated with all 3 HTN subtypes (p < 0.001).

Conclusion

The necessary steps should be taken so that public health promotion programs in Nepal may prevent and control undiagnosed hypertension.

Citations

Citations to this article as recorded by

Correction to “Prevalence and Associated Factors of Hypertension Subtypes Among the Adult Population in Nepal: Evidence from Demographic and Health Survey Data” [Osong Public Health Res Perspect 2019;10(6):327–36]
Rajat Das Gupta, Animesh Talukder, Shams Shabab Haider, Mohammad Rifat Haider
Osong Public Health and Research Perspectives.2022; 13(1): 80. CrossRef
Is Isolated Diastolic Hypertension an Important Phenotype?
Cesar A. Romero, Aldo H. Tabares, Marcelo Orias
Current Cardiology Reports.2021;[Epub] CrossRef
Relationship between cigarette smoking and blood pressure in adults in Nepal: A population-based cross-sectional study
Renqiao Lan, Max K. Bulsara, Prakash Dev Pant, Hilary Jane Wallace, Palash Chandra Banik
PLOS Global Public Health.2021; 1(11): e0000045. CrossRef

Undiagnosed Isolated Systolic and Diastolic Hypertension Subtypes and Their Correlates in Bangladesh: A Nationwide Survey: Shyfuddin Ahmed, Sonia Pervin, Tuhin Biswas, Muhammad Ashique Haider Chowdhury, Mohammad Abul Hasnat, Muhammad Mizanur Rashid Shuvra; Osong Public Health Res Perspect. 2019;10(1):12-19. Published online February 28, 2019; DOI: https://doi.org/10.24171/j.phrp.2019.10.1.04

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Abstract PDF

Objectives

This study was performed to identify the distribution of undiagnosed isolated hypertension subtypes and their correlates amongst adults aged 35 years and older in Bangladesh using data from the Bangladesh Demography and Health Survey 2011.

Methods

Out of a total of 17,964 selected households, 7,880 were included in the final analysis for this study. Systolic and diastolic blood pressure (BP) were measured 3× at 10-minute intervals. Hypertension subtypes were defined for individuals not under antihypertensive treatment as systolic-diastolic hypertension (SDH): systolic BP (SBP) ≥ 140 mm Hg and diastolic BP (DBP) ≥ 90 mm Hg; isolated diastolic hypertension (IDH): SBP < 140 mm Hg and DBP ≥ 90 mm Hg, and isolated systolic hypertension (ISH): SBP ≥140 mm Hg and DBP < 90 mm Hg.

Results

The predominant hypertension subtypes were SDH and IDH [5.2%; 95% confidence interval (CI): 4.7–5.1] followed by ISH (3.8%; 95% CI: 3.4–4.2). Multiple logistic regression showed that age and gender were significant predictors of ISH. SDH was associated with females [odds ratio (OR): 1.8; 95% CI: 1.3–2.6], the older age group (OR-7.4; 95% CI: 4.3–12.7), and overweight or obese individuals (OR: 1.6; 95% CI: 1.1–2.4). Non-manual work (OR: 1.5; 95% CI: 1.0–2.0]) and being overweight or obese (OR: 1.9; 95% CI: 1.4–2.8) were factors associated with IDH.

Conclusion

ISH, IDH and SDH represent salient subtypes of hypertension in Bangladesh. To identify preventive intervention for averting adverse cardiovascular events, further research is needed.

Citations

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Obesity Accompanied by an Odd Lipid Profile is a Major Risk Factor for Hypertension Among Women
Sahar Abdulaziz Al Sedairy
International Journal of Pharmacology.2024; 20(1): 34. CrossRef
Prevalence and risk factors of hypertension among bank employees in Dhaka city of Bangladesh
Kamruzzaman Razibi, Rokshana Rabeya, Rashadul Islam, M. A. Rifat, Abdus Salam Mondol
Cogent Public Health.2023;[Epub] CrossRef
Adiposity and insulin resistance mediate the inverse association between legume intake and blood pressure: a cross-sectional analysis in secondary cardiovascular prevention
Alinne Paula de Almeida, Leidjaira Lopes Juvanhol, Ângela Cristine Bersch-Ferreira, Camila Ragne Torreglosa, Aline Marcadenti, Bernardete Weber, Josefina Bressan, Helen Hermana Miranda Hermsdorff
British Journal of Nutrition.2022; 128(12): 2353. CrossRef
Prevalence of isolated diastolic hypertension and the risk of cardiovascular mortality among adults aged 40 years and older in northeast China: a prospective cohort study
Ling Yue, Hongyun Chen, Qun Sun, Lei Shi, Jixu Sun, Guangxiao Li, Liying Xing, Shuang Liu
BMJ Open.2022; 12(9): e061762. CrossRef
Hypertension and undiagnosed hypertension among Bangladeshi adults: Identifying prevalence and associated factors using a nationwide survey
Ahmed Hossain, Shakib Ahmed Suhel, Saifur Rahman Chowdhury, Shofiqul Islam, Nayma Akther, Nipa Rani Dhor, Mohammad Zakir Hossain, Mohammad Anwar Hossain, Syed Azizur Rahman
Frontiers in Public Health.2022;[Epub] CrossRef
Prevalence of Hypertension and Associated Risk Factors Among Women in a Rural Community in Bangladesh: A Cross-Sectional Study
Anika Boitchia, Shabnam Naher, Sabbir Pervez, Moyazzem Hossainc
Millennium Journal of Humanities and Social Scienc.2021; : 1. CrossRef
Distribution of hypertension subtypes in a hill tribe of Mizoram, Northeast India
Prasanta K. Borah, J. Mahanta, H.C. Kalita, Chandra Kanta Bhattacharjee
Indian Heart Journal.2020;[Epub] CrossRef
The different associations between platelet distribution width and hypertension subtypes in males and females
Tingwei Li, Jiahui Jin, Zhaowei Meng, Wenjuan Zhang, Yongle Li, Xuefang Yu, Xin Du, Ming Liu, Qing Zhang, Ying Gao, Kun Song, Xing Wang, Yaguang Fan, Yan Wang
Bioscience Reports.2020;[Epub] CrossRef
Prevalence and Associated Factors of Hypertension Subtypes Among the Adult Population in Nepal: Evidence from Demographic and Health Survey Data
Rajat Das Gupta, Animesh Talukdar, Shams Shabab Haider, Mohammad Rifat Haider
Osong Public Health and Research Perspectives.2019; 10(6): 327. CrossRef

Obesity, Hypertension, and Type-2 Diabetes Mellitus: The Interrelationships and the Determinants among Adults in Gaza City, Palestine: Mohammed S. Ellulu; Osong Public Health Res Perspect. 2018;9(6):289-298. Published online December 31, 2018; DOI: https://doi.org/10.24171/j.phrp.2018.9.6.02

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Abstract PDF

Objectives

To describe the distribution of social factors, lifestyle habits and anthropometric measurements according to hypertension and Type-2 diabetes.

Methods

A cross-sectional study was conducted in Gaza City, Palestine that included 379 patients (20–60 years) who had hypertension and/or diabetes. Three groups of patients were involved; 106 hypertensive (HT), 109 diabetic (T2DM) and 164 hypertensive diabetics (HT + T2DM).

Results

The HT + T2DM group were older and had a higher body mass index compared to HT and T2DM groups. There were 62.3% patients who were female, 49.2% were highly educated HT patients, and 49.3% patients had a low level of education and were HT + T2DM. There were 55.8% patients who lived in large families. Patients who were passive smokers or never smoked before were mostly HT + T2DM, while active smokers and past smokers had T2DM. There were 48.2% patients who were highly physically active who had HT, 40.9% whom were moderately active had T2DM, and 53.8% of patients who had a low level of activity were HT + T2DM. Multivariate linear regression showed that having a diseased mother, living in a large family, being a past or passive smoker, or never having smoked, having a low or moderate level of activity, and having HT or HT + T2DM, were significantly associated with an increased body mass index.

Conclusion

Parental health/disease conditions and environmental factors (social network and lifestyle habits) played the greatest role in the development of obesity and disease.

Citations

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Analysis of the nutritional status in the Palestinian territory: a review study
Enas A. Assaf, Haleama Al Sabbah, Ayoub Al-Jawadleh
Frontiers in Nutrition.2023;[Epub] CrossRef
The hypertension cascade of care in the midst of conflict: the case of the Gaza Strip
Bassam A. Abu Hamad, Zeina Jamaluddine, Gloria Safadi, Marie-Elizabeth Ragi, Raeda El Sayed Ahmad, Eszter P. Vamos, Sanjay Basu, John S. Yudkin, Mohammed Jawad, Christopher Millett, Hala Ghattas
Journal of Human Hypertension.2022; 37(10): 957. CrossRef
Association between endothelial nitric oxide synthase and the renin-angiotensin-aldosterone system polymorphisms, blood pressure and training status in normotensive/pre-hypertension and hypertensive older adults: a pilot study
Roberta Fernanda da Silva, Riccardo Lacchini, Lucas Cezar Pinheiro, Letícia Perticarrara Ferezin, José Eduardo Tanus-Santos, Marcelo Rizzatti Luizon, Thiago José Dionísio, Carlos Ferreira Santos, Thaís Amanda Reia, André Mourão Jacomini, Ana Maria Guilmo
Clinical and Experimental Hypertension.2021; 43(7): 661. CrossRef
Breakfast characteristics, perception, and reasons of skipping among 8th and 9th-grade students at governmental schools, Jenin governance, West Bank
Manal Badrasawi, Ola Anabtawi, Yaqout Al-Zain
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Advanced Molecular Imaging (MRI/MRS/1H NMR) for Metabolic Information in Young Adults with Health Risk Obesity
Khin Thandar Htun, Jie Pan, Duanghathai Pasanta, Montree Tungjai, Chatchanok Udomtanakunchai, Thanaporn Petcharoen, Nattacha Chamta, Supak Kosicharoen, Kiattisak Chukua, Christopher Lai, Suchart Kothan
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Prevalence and Predictors of Co-occurring Hypertension and Depression Among Community-Dwelling Older Adults
Cicily A. Gray, Omar T. Sims, Hyejung Oh
Journal of Racial and Ethnic Health Disparities.2020; 7(2): 365. CrossRef
Prevalence of Type 2 Diabetes and Its Association with Added Sugar Intake in Citizens and Refugees Aged 40 or Older in the Gaza Strip, Palestine
Majed Jebril, Xin Liu, Zumin Shi, Mohsen Mazidi, Akram Altaher, Youfa Wang
International Journal of Environmental Research an.2020; 17(22): 8594. CrossRef

Comparison of Hypertension Prediction Analysis Using Waist Measurement and Body Mass Index by Age Group: So Hyun Park, Seong-Gil Kim; Osong Public Health Res Perspect. 2018;9(2):45-49. Published online April 30, 2018; DOI: https://doi.org/10.24171/j.phrp.2018.9.2.02

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Abstract PDF

Objectives

The purpose of this study was to evaluate hypertension with simple anthropometry data related to obesity in Korean adults and identify whether age specific waist circumference (WC) may be a useful screening tool for determining hypertension.

Methods

Subjects (n = 571) were classified into 3 groups by age; young (18–39 years), middle aged (40–64 years), and old aged (≥ 65 years). Correlations between demographic and anthropometric parameters and hypertension were performed using Spearman correlation analysis. Logistic regression analysis and ROC (receiver operating characteristics) curves were also analyzed for correlations with hypertension.

Results

Spearman correlation analyses, age, gender, WC, and body mass index were positively correlated with hypertension. When logistic regression analysis was performed, increased age and increased WC was associated with a higher incidence of hypertension, although gender and body mass index were not significantly related to hypertension. In ROC analysis of WC for hypertension demonstrated that patients in the old age group showed higher WC cutoff value than patients in the young and middle aged groups.

Conclusion

The findings of this study demonstrate that WC may be a useful predictor of hypertension incidence among demographic and anthropometric factors in Korean adults. In addition, WC in the young population was more sensitive to the incidence of hypertension than in the elderly population.

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A hybrid machine learning approach for hypertension risk prediction
Min Fang, Yingru Chen, Rui Xue, Huihui Wang, Nilesh Chakraborty, Ting Su, Yuyan Dai
Neural Computing and Applications.2023; 35(20): 14487. CrossRef
Relationship between Cardiometabolic Factors and the Response of Blood Pressure to a One-Year Primary Care Lifestyle Intervention in Metabolic Syndrome Patients
Elisa Marin-Couture, Marie-Josée Filion, Ryma Boukari, Khursheed Jeejeebhoy, Rupinder Dhaliwal, Paula Brauer, Dawna Royall, David M. Mutch, Doug Klein, Angelo Tremblay, Caroline Rhéaume
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The Role of Lifestyle Factors in Controlling Blood Pressure among Hypertensive Patients in Two Health Facilities in Urban Ghana: A Cross-Sectional Study
Emefa Modey Amoah, Darlene Esinam Okai, Adom Manu, Amos Laar, Joseph Akamah, Kwasi Torpey
International Journal of Hypertension.2020; 2020: 1. CrossRef
Obesity and hypertension: the role of criteria
D P Tsygankova, K E Krivoshapova, S A Maksimov, E V Indukaeva, E B Shapovalova, G V Artamonova, O L Barbarash
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Watch Your Waistline
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Brief Report

Evaluation of Hypertension Prevention and Control Programs in Lima, Peru: Bonhee Chung, Dohyeong Kim, Eun Woo Nam; Osong Public Health Res Perspect. 2018;9(1):36-41. Published online December 31, 2017; DOI: https://doi.org/10.24171/j.phrp.2018.9.1.07

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Abstract PDF

Objectives

The Korea International Cooperation Agency (KOICA) established 4 health centers to provide hypertension screening and a health support program in a deprived urban area of Lima, Peru. This case report provides a mid-term evaluation of the KOICA’s hypertension prevention and control programs.

Methods

A follow up study was performed on 663 residents who were diagnosed with prehypertension or hypertension (Stage 1 and 2) in the 4 KOICA health centers. Patients participated in programs designed to prevent and control hypertension through education sessions over the course of 6 months. Using simple descriptive statistics and computer simulations, we evaluated the effect of hypertension prevention and control programs on the participants.

Results

The KOICA health programs appeared to significantly contribute to lowering the blood pressure (BP) of the participants. The total number of participants with normal BP increased from none to 109. Overall, the female and younger patients responded better to the KOICA programs than the male and older participants. In addition, the average systolic BP, diastolic BP, and body mass index of all participants was significantly reduced.

Conclusion

The KOICA programs were effective at lowering blood pressure, particularly amongst the prehypertension group than the Stage 1 and 2 hypertension groups. This suggests that providing an extensive screening service for adults with prehypertension will help control hypertension in the early stages.

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Evaluation of workplace hypertension preventative and detection service in a Ghanaian University
Ivan Eduku Mozu, Afia Frimpomaa Asare Marfo, Mercy Opare Addo, Kwame Ohene Buabeng, Frances Thelma Owusu-Daaku
International Journal of Pharmacy Practice.2023; 31(2): 237. CrossRef
Evaluación psicométrica de una medida breve de ira en adultos mayores con hipertensión
Tomás Caycho-Rodríguez, Miguel Barboza-Palomino, José Ventura-León, Isabel Cabrera-Orosco
Revista Española de Geriatría y Gerontología.2021; 56(1): 61. CrossRef

Original Articles

Effect of Obesity on Blood Pressure and Arterial Stiffness in Middle-Aged Korean Women: Won-Mok Son, Do-Yeon Kim, You-Sin Kim, Min-Seong Ha; Osong Public Health Res Perspect. 2017;8(6):369-372. Published online December 31, 2017; DOI: https://doi.org/10.24171/j.phrp.2017.8.6.02

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Abstract PDF

Objectives

Our study aims to provide basic scientific data on the importance of obesity management in middle-aged Korean women by analyzing its effects on blood pressure and arterial stiffness. In addition, we examined the correlations of these two parameters.

Methods

The study participants were 40 middle-aged female volunteers, who were classified into obesity group (n = 20) and normal weight group (n = 20). Statistical analysis was performed using independent t-test and the Pearson correlation coefficient was used to correlate blood pressure and arterial stiffness.

Results

This study evaluated the systolic blood pressure, diastolic blood pressure, and pulse wave velocity (PWV). These results were higher in the obesity group than the normal weight group. Furthermore, blood pressure and arterial stiffness (PWV, augmentation pressure) were static correlated.

Conclusion

Obesity is closely related to blood pressure and arterial stiffness. Therefore, indices for blood pressure and arterial stiffness may play a vital role in predicting and preventing obesity and its sequelae.

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Food readjustment plus exercise training improves cardiovascular autonomic control and baroreflex sensitivity in high‐fat diet‐fed ovariectomized mice
Bruno Nascimento‐Carvalho, Adriano Dos‐Santos, Nicolas Da Costa‐Santos, Sabrina L. Carvalho, Oscar A. de Moraes, Camila P. Santos, Katia De Angelis, Erico C. Caperuto, Maria‐Claudia Irigoyen, Katia B. Scapini, Iris C. Sanches
Physiological Reports.2023;[Epub] CrossRef
Associations between body composition and cardiovascular disease risk in pre- and postmenopausal women
Nirmala Rathnayake, Gayani Alwis, Janaka Lenora, Sarath Lekamwasam
Journal of Health, Population and Nutrition.2023;[Epub] CrossRef
Comparison of Vascular Function, Cardiometabolic Parameters, Hemorheological Function, and Cardiorespiratory Fitness Between Middle-Aged Korean Women With and Without Obesity—A Pilot Study
Hun-Young Park, Won-Sang Jung, Sung-Woo Kim, Kyounghwa Jung, Kiwon Lim
Frontiers in Physiology.2022;[Epub] CrossRef
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Gökhan Yılmaz, Oğuzhan Bol
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G Kaleeswari, CVasantha Kalyani, JS Jayarani, KusumK Rohilla
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Association of obesity with arterial stiffness: The Multi-Ethnic Study of Atherosclerosis (MESA)
Jeongok G. Logan, Hyojung Kang, Soyoun Kim, Daniel Duprez, Younghoon Kwon, David R. Jacobs, Nketi Forbang, Jennifer Mason Lobo, Min-Woong Sohn
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P. Sansone, L.G. Giaccari, U. Colella, F. Coppolino, M.C. Pace, M.B. Passavanti, V. Pota, C. Aurilio
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Beata Moczulska, Maciej Zechowicz, Sylwia Leśniewska, Karolina Osowiecka, Leszek Gromadziński
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Prevalence of Dyslipidemia and Hypertension in Indian Type 2 Diabetic Patients with Metabolic Syndrome and its Clinical Significance: Dhananjay Yadav, Meerambika Mishra, Arvind Tiwari, Prakash Singh Bisen, Hari Mohan Goswamy, G.B.K.S. Prasad; Osong Public Health Res Perspect. 2014;5(3):169-175. Published online June 30, 2014; DOI: https://doi.org/10.1016/j.phrp.2014.04.009

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Abstract PDF

Objectives
The present study was designed to estimate the prevalence of dyslipidemia and hypertension based on the National Cholesterol Educational Programme Adult Treatment Panel III definition of metabolic syndrome (MetS). The study also focuses on prevalence for MetS with respect to the duration of disease in Gwalior–Chambal region of Madhya Pradesh, India.
Methods
Type 2 diabetic patients (n = 700) were selected from a cross-sectional study that is regularly being conducted in the School of Studies in Biochemistry, Jiwaji University Gwalior, India. The period of our study was from January 2007 to October 2009. Dyslipidemia and hypertension were determined in type 2 diabetic patients with MetS as per National Cholesterol Educational Programme Adult Treatment Panel III criteria.
Results
The mean age of the study population was 54 ± 9.3 years with 504 (72%) males and 196 (28%) females. The prevalence of MetS increased with increased duration of diabetes in females; however, almost constant prevalence was seen in the males. Notable increase in the dyslipidemia (64.1%) and hypertension (49%) in type 2 diabetic patients were seen. The steep increase in dyslipidemia and hypertension could be the reason for the growing prevalence of diabetes worldwide. The study also noted a close association between age and occurrence of MetS.
Conclusion
Individual variable of MetS appears to be highly rampant in diabetic population. Despite treatment, almost half of patients still met the criteria for MetS. Effective treatment of MetS components is required to reduce cardiovascular risk in diabetes mellitus hence accurate and early diagnosis to induce effective treatment of MetS in Indian population will be pivotal in the prevention of cardiovascular disease and type 2 diabetes.

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Plasma Calcium and Risk of Hypertension: Propensity Score Analysis Using Data From the Korean Genome and Epidemiology Study: Jong Wook Kim, Kwang-Pil Ko, Hee Jo Koo, Younjhin Ahn, Seon-Joo Park, Hyo-Mi Kim, Yeonjung Kim, Sung Soo Kim; Osong Public Health Res Perspect. 2011;2(2):83-88. Published online June 30, 2011; DOI: https://doi.org/10.1016/j.phrp.2011.07.004

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Abstract PDF Supplementary Material

Objective To investigate associations between plasma calcium and future incidence of hypertension in a healthy population.
Methods
We used prospective data from Ansung and Ansan cohorts (n = 10,038) of the Korean Genome and Epidemiology Study. Data from baseline (2001–02) to the fourth study (2007–08) were used. After excluding hypertensive cases at baseline, missing data, and outliers, 5560 participants were analyzed. Propensity scores for having higher plasma calcium (≥2.37 mmol/L) were created for each participant. After propensity score matching (1:1 nearest neighbor matching within caliper), 2153 pairs were left for analysis. Factors that were significantly different between the lower and higher plasma calcium groups before matching either became nonsignificant or the difference decreased in size.
Results
Using multivariable Cox proportional hazard models with robust standard errors accounting for clustering of matched pairs, higher plasma calcium was associated with higher incidence of hypertension (adjusted HR, 1.24; robust 95%CI, 1.07–1.43). Among those with higher plasma calcium, low dietary calcium intake increased the development of hypertension, but the effect was not significant. Sensitivity analysis showed that our results were robust to hidden bias.
Conclusions
Plasma calcium was positively associated with incidence of hypertension. These results expand on cross-sectional associations between hypercalcemia and the metabolic syndrome, and extend the link to future risk of hypertension.

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