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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
  • 1,211 View
  • 72 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary 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.
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
  • 3,628 View
  • 86 Download
  • 3 Citations
AbstractAbstract 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.

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
  • 3,100 View
  • 41 Download
  • 5 Citations
AbstractAbstract 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.

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
  • 2,922 View
  • 110 Download
  • 5 Citations
AbstractAbstract 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.

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
  • 2,637 View
  • 89 Download
  • 4 Citations
AbstractAbstract 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.

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
  • 2,827 View
  • 32 Download
  • 1 Citations
AbstractAbstract 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.

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
  • 2,005 View
  • 35 Download
  • 7 Citations
AbstractAbstract 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.

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
  • 1,446 View
  • 22 Download
  • 11 Citations
AbstractAbstract 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.
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
  • 1,401 View
  • 12 Download
  • 3 Citations
AbstractAbstract PDFSupplementary 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.

PHRP : Osong Public Health and Research Perspectives