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The association of sex differences in ambulatory blood pressure with cardiovascular events and mortality in dialysis patients 透析患者流动血压的性别差异与心血管事件和死亡率的关系
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-02 DOI: 10.1038/s41371-024-00952-z
Fotini Iatridi, Marieta P. Theodorakopoulou, Areti Georgiou, Artemios G. Karagiannidis, Nasra Haddad, Nikolaos Devrikis, Christopher C. Mayer, Vasileios Kamperidis, Vasileios Anastasiou, Antonios Karpetas, Pantelis Sarafidis
Male patients with pre-dialysis chronic kidney disease (CKD) have worse ambulatory blood pressure (BP) control than females; this is associated with higher mortality. Male hemodialysis patients have higher ambulatory BP levels than females. This analysis aimed to investigate the association of sex differences in ambulatory BP with cardiovascular events and mortality in hemodialysis individuals. 129 male and 91 female hemodialysis patients with valid 48-h BP monitoring were followed for 53.4 ± 31.1 months. The primary endpoint was cardiovascular mortality; the secondary endpoint was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, resuscitation after cardiac arrest, heart failure-hospitalization, coronary or peripheral revascularization. Cumulative freedom from the primary endpoint was lower for women (logrank-p = 0.032), while cumulative-freedom from the secondary endpoint did not differ significantly between-groups (logrank-p = 0.644). The crude risk for cardiovascular mortality was significantly higher in women (HR = 1.613, 95% CI [1.037, 2.509]). The crude risk for the combined endpoint was not different between the two groups (HR = 0.918, 95% CI [0.638, 1.320]). After adjusting for major risk factors (age, diabetes, dialysis vintage, coronary disease and hemoglobin) no significant differences in the risk for both the primary and the secondary endpoint were observed between women and men (primary: HR = 1.295 (95% CI [0.808, 2.078]), secondary: HR = 0.763 (95% CI [0.521, 1.118])). After additional adjustment for 44-h systolic BP the above relationships did not alter (primary: HR = 1.329 (95% CI [0.826, 2.137]), secondary: HR = 0.808 (95% CI [0.551, 1.184])). In conclusion, female hemodialysis patients have higher crude but similar adjusted cardiovascular mortality rates compared to male counterparts. In contrast to pre-dialysis CKD, the neutral relationship between gender and adverse cardiovascular outcomes in hemodialysis is not further affected by ambulatory BP.
透析前慢性肾病(CKD)男性患者的动态血压(BP)控制比女性患者差;这与死亡率较高有关。男性血液透析患者的动态血压水平高于女性。这项分析旨在研究血液透析患者流动血压的性别差异与心血管事件和死亡率的关系。对 129 名男性和 91 名女性血液透析患者进行了为期 53.4 ± 31.1 个月的有效 48 小时血压监测。主要终点是心血管死亡率;次要终点是心血管死亡、非致死性心肌梗死、非致死性中风、心脏骤停后复苏、心力衰竭住院、冠状动脉或外周血管再通术的复合终点。女性的主要终点累积自由度较低(logrank-p = 0.032),而次要终点累积自由度在组间无显著差异(logrank-p = 0.644)。女性的心血管死亡粗风险明显更高(HR = 1.613,95% CI [1.037,2.509])。综合终点的粗风险在两组之间没有差异(HR = 0.918,95% CI [0.638,1.320])。在对主要风险因素(年龄、糖尿病、透析年限、冠心病和血红蛋白)进行调整后,未观察到女性和男性在一级和二级终点风险方面存在显著差异(一级:HR = 1.295 (95% CI [0.808, 2.078]),二级:HR = 0.763 (95% CI [0.521, 1.118]))。在对 44 h 收缩压进行额外调整后,上述关系没有改变(一级:HR = 1.329 (95% CI [0.826, 2.137]),二级:HR = 0.808 (95% CI [0.551, 1.184]))。总之,女性血液透析患者的粗略心血管死亡率高于男性患者,但调整后的心血管死亡率与男性患者相似。与透析前慢性肾脏病相比,血液透析患者的性别与不良心血管预后之间的中性关系不会受到流动血压的进一步影响。
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引用次数: 0
The moderating effect of self-efficacy in the risk awareness and treatment compliance of hypertensive patients 自我效能感对高血压患者风险意识和治疗依从性的调节作用。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-28 DOI: 10.1038/s41371-024-00949-8
Ayşe Soylu, Ömer Tanrıverdi
The WHO reported that 46% of adults with HT in the global statistics were unaware of the disease.The aim of this study was to examine the moderating role of self-efficacy in risk awareness and treatment compliance of hypertensive patients. Data for this descriptive and correlational study were collected between 22.08.2023 and 22.02.2024. A personal information form was used for data collection together with a risk awareness scale, self-efficacy scale, and antihypertensive treatment compliance scale. The data were collected from 169 patients in face-to-face intterviews. Multiple linear regression and PROCESS macro-Model vn.3.5 were used in the analyses. The STROBE control list was followed in the study. A moderate level of risk awareness (40.03 ± 7.98) and self-awareness (56.11 ± 10.18) of the study participants was determined, and there was seen to be treatment compliance (6.53 ± 2.34). Risk awareness was seen to be positively correlated with both treatment compliance and self-efficacy (p < 0.05). The moderating effect of the treatment points between risk awareness and self-efficacy was analyzed and the model formed was found to be statistically significant (F = 1.942, p = 0.006). Independent variables in the model explained 28% of the change in the dependent variable. Self-efficacy points were not found to have a moderating effect on the effect of cardiovascular risk awareness on antihypertensive treatment compliance (p = 0.144). Treatment compliance can increase with an increase in the self-efficacy and risk awareness of an individual. Increased self-efficacy may affect the moderating role.
本研究旨在探讨自我效能感对高血压患者风险意识和治疗依从性的调节作用。这项描述性和相关性研究的数据收集时间为 2023 年 8 月 22 日至 2024 年 2 月 22 日。收集数据时使用了个人信息表、风险意识量表、自我效能感量表和降压治疗依从性量表。通过面对面访谈收集了 169 名患者的数据。分析中使用了多元线性回归和 PROCESS 宏模型 vn.3.5。研究采用了 STROBE 对照表。研究结果表明,研究参与者的风险意识(40.03 ± 7.98)和自我意识(56.11 ± 10.18)处于中等水平,治疗依从性(6.53 ± 2.34)良好。风险意识与治疗依从性和自我效能呈正相关(p
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引用次数: 0
Feel the rhythm of the beat: rhythmic components in ambulatory blood pressure monitoring for predicting cardiovascular risk in CKD patients 感受跳动的节奏:用于预测慢性肾脏病患者心血管风险的动态血压监测中的节奏成分。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-27 DOI: 10.1038/s41371-024-00950-1
Artemios G. Karagiannidis, Fotini Iatridi, Pantelis A. Sarafidis
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引用次数: 0
Dialysate sodium and short-term blood pressure variability in patients with intradialytic hypertension: a randomized crossover study 透析液钠与肾内高血压患者的短期血压变化:随机交叉研究。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-24 DOI: 10.1038/s41371-024-00947-w
Fotini Iatridi, Robert Ekart, Efstathios Xagas, Eleni Karkamani, Antonios Karpetas, Marieta P. Theodorakopoulou, Nikolaos Devrikis, Ioanna Revela, Aikaterini Papagianni, Pantelis Sarafidis
Increased blood pressure (BP) variability (BPV) is associated with high cardiovascular risk in hemodialysis. Patients with intradialytic hypertension (IDH) also exhibit an increased cardiovascular risk compared to hemodialysis patients without this condition. The impact of non-pharmacological BP-lowering interventions on BPV in this population remains unknown. This analysis evaluated the effect of low (137mEq/L) compared to standard (140mEq/L) dialysate sodium concentration on short-term BPV in patients with IDH. In a randomized cross-over manner, 29 IDH patients underwent 4 hemodialysis sessions with low (137mEq/L) followed by 4 sessions with standard (140mEq/L) dialysate sodium or vice versa. 48 h ambulatory BP measurement was performed from the start of the 4th session on each dialysate sodium. BPV indices during the 48 h, 24 h, day-time and night-time periods were calculated. Mean 48 h BP was 5.3/2.6 mmHg lower with low compared to standard dialysate sodium concentration, (p = 0.005/p = 0.007 respectively). All 48 h systolic BPV indices examined showed non-significant differences between low and standard dialysate sodium (SBP-SD: 16.99 ± 5.39 vs. 16.98 ± 4.33 mmHg, p = 0.982; SBP-wSD: 15.93 ± 5.02 vs. 16.12 ± 4.16 mmHg, p = 0.769; SBP-ARV: 11.99 ± 3.67 vs. 11.45 ± 3.35 mmHg, p = 0.392; SBP-CV: 12.36 ± 3.65 vs. 11.92 ± 3.18%, p = 0.302, with low vs. standard dialysate sodium, respectively). Diastolic BPV indices were numerically, but not statistically, lower with low dialysate sodium. Overall, significant differences were observed in some comparisons with a trend for lower BPV during day-time 2 and higher BVP during night-time 2 with low dialysate sodium. In conclusion, low dialysate sodium concentration does not affect BPV levels in patients with IDH. Future research should explore alternative interventions to reduce BP and BPV in this high-risk population.
血压(BP)变异性(BPV)增加与血液透析中的心血管高风险有关。与无此症状的血液透析患者相比,析出内高血压(IDH)患者的心血管风险也会增加。非药物降压干预对该人群 BPV 的影响尚不清楚。本分析评估了低浓度(137mEq/L)与标准浓度(140mEq/L)透析液钠对 IDH 患者短期 BPV 的影响。29 名 IDH 患者以随机交叉方式接受了 4 次低浓度(137mEq/L)血液透析,然后接受了 4 次标准(140mEq/L)透析液钠浓度血液透析,反之亦然。从第 4 次透析开始,每种透析液钠均进行 48 小时动态血压测量。计算了 48 小时、24 小时、白天和夜间的血压变异指数。与标准透析液钠浓度相比,低浓度透析液钠的 48 小时平均血压降低了 5.3/2.6 mmHg(分别为 p = 0.005/p = 0.007)。低浓度透析液钠与标准透析液钠相比,所有 48 小时收缩压 BPV 指数均无显著差异(SBP-SD:16.99 ± 5.39 vs. 16.98 ± 4.33 mmHg,p = 0.982;SBP-wSD:15.93 ± 5.02 vs. 16.12 ± 4.16 mmHg,p = 0.769;SBP-ARV:11.99 ± 3.67 vs. 11.45 ± 3.35 mmHg,p = 0.392;SBP-CV:12.36 ± 3.65 vs. 11.92 ± 3.18%,p = 0.302,分别为低透析液钠与标准透析液钠)。低透析液钠的舒张压 BPV 指数在数值上较低,但在统计学上并不低。总体而言,在一些比较中观察到了明显的差异,低透析液钠的趋势是白天 2 的 BPV 较低,夜间 2 的 BVP 较高。总之,低透析液钠浓度不会影响 IDH 患者的 BPV 水平。未来的研究应探索其他干预措施,以降低这一高风险人群的血压和血压变压。
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引用次数: 0
Validation of combiomed hipermax-BF model A7101 automatic oscillometric upper-arm sphygmomanometer in general population: AAMI/ESH/ISO universal standard (ISO 81060-2:2018/Amd 1:2020) 康美药业 hipermax-BF A7101 型自动示波上臂式血压计在普通人群中的验证:AAMI/ESH/ISO通用标准(ISO 81060-2:2018/Amd 1:2020)。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-24 DOI: 10.1038/s41371-024-00948-9
Damaris Hernández Véliz, Yamilé Valdés González, Nurys Bárbara Armas Rojas, Reinaldo De la Noval García, Jennifer Ringrose, Raj Padwal
This study evaluates the accuracy of the Hipermax-BF model A7101 (Combiomed, Havana, Cuba) automatic oscillometric upper-arm sphygmomanometer for office and home use in general population as part of the HEARTS in the Americas initiative. The research was developed according to the Universal Standard AAMI/ESH/ISO ISO 81060-2:2018/Amd 1:2020. The subjects were recruited according to the requirements of age, gender, blood pressure values and upper-arm circumference. The same upper-arm sequential blood pressure measurement method was used. For measurements with the device under test, the 2-piece cuff from 22–44 cm limb circumference range was used. 92 subjects were recruited and 85 were analyzed. Mean age was 44.8 ± 14.7 years, mean upper-arm circumference was 32.3 ± 6.2, and 56.5% were female. For Validation Criterion 1, the mean value ± standard deviation of the differences in readings between the device under test and the reference device was 1.2 ± 4.9/0.8 ± 4.9 mmHg (systolic/diastolic). For both pressures, in criterion 1 the standard requires a mean value of the differences ≤ ± 5 mmHg and a standard deviation ≤ ± 8 mmHg. For Validation Criterion 2, the standard deviation of the mean blood pressure differences per subject was 4.2/4.2 mmHg (systolic/diastolic). According to Table 1 of criterion 2, for the mean values of 1.2/0.8 mmHg (systolic/diastolic), the maximum allowable standard deviation had to be < 6.84 for systolic and < 6.89 for diastolic pressure. The Combiomed Hipermax-BF A7101 automatic sphygmomanometer meets the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018/Amd 1:2020) in the general population.
作为美洲 HEARTS 计划的一部分,本研究评估了 Hipermax-BF A7101 型(Combiomed,古巴哈瓦那)自动示波上臂血压计在普通人群中用于办公室和家庭的准确性。这项研究是根据通用标准 AAMI/ESH/ISO ISO 81060-2:2018/Amd 1:2020 制定的。受试者是根据年龄、性别、血压值和上臂围度等要求招募的。采用相同的上臂顺序血压测量方法。在使用测试设备进行测量时,使用的是 22-44 厘米肢围范围内的两件式袖带。共招募了 92 名受试者,对 85 名受试者进行了分析。平均年龄为 44.8 ± 14.7 岁,平均上臂周长为 32.3 ± 6.2,56.5% 为女性。对于验证标准 1,被测设备与参照设备之间读数差异的平均值(± 标准差)为 1.2 ± 4.9/0.8 ± 4.9 mmHg(收缩压/舒张压)。对于这两种压力,标准 1 要求差异的平均值≤ ± 5 mmHg,标准偏差≤ ± 8 mmHg。对于验证标准 2,每个受试者的平均血压差异标准偏差为 4.2/4.2 mmHg(收缩压/舒张压)。根据标准 2 的表 1,对于 1.2/0.8 mmHg(收缩压/舒张压)的平均值,收缩压的最大允许标准偏差必须小于 6.84,舒张压的最大允许标准偏差必须小于 6.89。Combiomed Hipermax-BF A7101 自动血压计符合 AAMI/ESH/ISO 通用标准(ISO 81060-2:2018/Amd 1:2020)对普通人群的要求。
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引用次数: 0
Text messaging to improve retention in hypertension care in Bangladesh 通过短信提高孟加拉国高血压患者的就医率。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-24 DOI: 10.1038/s41371-024-00942-1
Shamim Jubayer, Jubaida Akhtar, Ahmad Khairul Abrar, Md. Noor Nabi Sayem, Shahinul Islam, Khondoker Ehsanul Amin, Muhtamim Fuwad Nahid, Mahfuzur Rahman Bhuiyan, Mohammad Abdullah Al Mamun, Abdul Alim, Mohammad Robed Amin, Daniel Burka, Prabhanshu Gupta, Di Zhao, Kunihiro Matsushita, Andrew E. Moran, Sohel Reza Choudhury, Reena Gupta
Visit non-attendance is a common barrier to hypertension control in low and middle-income countries (LMICs). We aimed to evaluate the effectiveness of mobile text messaging in improving visit attendance among patients with hypertension in primary healthcare facilities in Bangladesh. A randomized A/B testing study was conducted with two patient groups: (1) patients regularly attending visits (regular patients) and (2) patients overdue for their follow-up clinic visit (overdue patients). Regular patients were randomized into three groups: a cascade of three text reminders, a single text reminder, or no text reminder. Overdue patients were randomized into two groups: a single text reminder or no text reminder. 20,072 regular patients and 12,708 overdue patients were enrolled. Among regular patients, visit attendance was significantly higher in the cascade reminder group and the single reminder group compared to the no reminder group (78.2% and 76.6% vs. 74.8%, p < 0.001 and 0.027, respectively). Among overdue patients, the single reminder group had a 5.8% higher visit attendance compared to the no reminder group (26.5% vs. 20.7%, p < 0.001). The results remained consistent in multivariable analysis; adjusted prevalence ratio (PR) was 1.04 (95% CI 1.02–1.06) for the cascade reminder group and 1.02 (95% CI 1.00–1.05) for the single reminder group among regular patients. The adjusted PR for the single reminder group vs. the no reminder group among overdue patients was 1.23 (95% CI 1.15–1.33). Text message reminders are an effective strategy for improving retention of patients in hypertension treatment in LMICs, especially for patients overdue to care.
不就诊是中低收入国家控制高血压的常见障碍。我们旨在评估手机短信在提高孟加拉国初级医疗机构高血压患者就诊率方面的效果。我们对两组患者进行了随机 A/B 测试研究:(1) 定期就诊的患者(定期患者)和 (2) 逾期复诊的患者(逾期患者)。定期就诊患者被随机分为三组:一连发送三条短信提醒、一条短信提醒或无短信提醒。逾期患者被随机分为两组:单条短信提醒或无短信提醒。共有 20,072 名定期就诊患者和 12,708 名逾期就诊患者登记在册。在定期就诊的患者中,串联提醒组和单一提醒组的就诊率明显高于无提醒组(78.2% 和 76.6% vs. 74.8%,p<0.05)。
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引用次数: 0
Adolescent obesity and short sleep duration as independent risk factors for hypertension: a population-based cohort study 青少年肥胖和睡眠时间短是高血压的独立风险因素:一项基于人群的队列研究。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-22 DOI: 10.1038/s41371-024-00946-x
Youngju Choi, Jang Soo Yook, Eun-Jeong Cho, Ilyoung Jeong, Junghoon Kim, Asako Zempo-Miyaki, Eunwook Chang, Dong-Ho Park, Hyo-Bum Kwak
Prevalence of hypertension in adolescents has increased worldwide and is considered a risk factor for hypertension and cardiovascular disease in adulthood. Although obesity and sleep deficiency increase this risk, the combined effects of these factors on hypertension remain unclear. This study aimed to examine the combined effects of obesity and sleep duration on hypertension in adolescents. This study was conducted using data from the 2016 to 2018 Korean National Health and Nutrition Examination Survey, which included a study population of 1272 adolescents. The participants were categorized into four groups based on sleep duration and body mass index (BMI) percentiles: normal sleep and normal body mass group (reference; normal), only short sleep group (short sleep), only overweight/obesity group (overweight/obesity), and short sleep and overweight/obesity group (short sleep and overweight/obesity). Short sleep duration was defined as <8 h of average sleep duration, and overweight/obesity was defined as a BMI ≥ 85th percentile. Hypertension in adolescents was defined as a systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg. The prevalence of hypertension was 9.2% among Korean adolescents. Short sleep duration with overweight/obesity were associated with a significantly increased risk of hypertension (odds ratio = 6.57; 95% confidence interval: 3.27–13.20) in adolescents, and controlling for the potential confounding variables only partially attenuated this relationship (odds ratio = 5.28; 95% confidence interval: 2.28–12.26). This study demonstrated that the coexistence of short sleep duration and obesity was associated with an increased risk of hypertension in Korean adolescents.
青少年高血压的发病率在全球范围内不断上升,被认为是成年后患高血压和心血管疾病的风险因素。虽然肥胖和睡眠不足会增加这一风险,但这些因素对高血压的综合影响仍不清楚。本研究旨在探讨肥胖和睡眠时间对青少年高血压的综合影响。这项研究使用了 2016 年至 2018 年韩国全国健康与营养调查的数据,研究对象包括 1272 名青少年。根据睡眠时间和体重指数(BMI)百分位数将参与者分为四组:正常睡眠和正常体重组(参考;正常)、仅短睡眠组(短睡眠)、仅超重/肥胖组(超重/肥胖)和短睡眠和超重/肥胖组(短睡眠和超重/肥胖)。短睡眠时间定义为
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引用次数: 0
Chronic hypertension diagnosed before or during pregnancy and its effects on pregnancy outcomes 孕前或孕期诊断出的慢性高血压及其对妊娠结果的影响。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-22 DOI: 10.1038/s41371-024-00944-z
Qingwen Nie, Weizhang Liang, Yuan Xue, Lijie Pan, Mindi Jiang, Fang He
Chronic hypertension (CH) during pregnancy, identified before or within the first 20 weeks, presents varying risks depending on the timing of diagnosis. This real-world study was conducted from January 2018 to June 2023 and included singleton pregnancies with CH to compare pre-pregnancy CH (Group 1) and newly diagnosed CH (Group 2). There were 565 women in the final analysis, with 307 in Group 1 with pre-pregnancy CH and 258 in Group 2 with new-onset CH. Those in Group 1 more frequently had pre-gestational diabetes and a history of hypertensive disorders in pregnancy, whereas Group 2 had a higher incidence of excessive gestational weight gain. Notably, 56.2% of Group 2 patients did not receive antihypertensive treatment before 20 weeks, while the proportion was 36.2% in Group 1, resulting in a significant difference in baseline blood pressure. The study revealed higher incidences of preterm preeclampsia (44.2% vs. 34.9%) and placental abruption (5.4% vs. 2.0%) in Group 2 compared to Group 1. After adjustment, logistic regression indicated that Group 2 had a 1.8-fold higher risk of preterm preeclampsia than Group 1. These findings suggest that pregnant women newly diagnosed with CH in the first 20 weeks face increased adverse outcomes compared to those diagnosed before pregnancy. Intense monitoring and earlier intervention may help manage women with new-onset CH.
妊娠期慢性高血压(CH)在最初 20 周前或 20 周内发现,根据诊断时间的不同,其风险也不同。这项真实世界研究于2018年1月至2023年6月进行,纳入了患有CH的单胎妊娠,对孕前CH(第1组)和新诊断的CH(第2组)进行比较。共有 565 名妇女参与了最终分析,其中 307 人在第一组中患有孕前妊娠合并症,258 人在第二组中患有新发妊娠合并症。第一组中更多的人患有妊娠前糖尿病和妊娠高血压病史,而第二组中妊娠体重增加过多的发生率更高。值得注意的是,56.2%的第 2 组患者在 20 周前没有接受降压治疗,而第 1 组的这一比例为 36.2%,这导致了基线血压的显著差异。研究显示,与第一组相比,第二组先兆子痫(44.2% 对 34.9%)和胎盘早剥(5.4% 对 2.0%)的发病率更高。 这些研究结果表明,与孕前确诊的孕妇相比,在孕前 20 周新确诊 CH 的孕妇面临的不良后果更多。加强监测和尽早干预可能有助于控制新发CH的孕妇。
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引用次数: 0
Social determinants of health and hypertension screening among women in The Gambia: an evaluation of 2019-2020 demographic and health survey data. 冈比亚妇女健康和高血压筛查的社会决定因素:2019-2020 年人口与健康调查数据评估。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-17 DOI: 10.1038/s41371-024-00945-y
Heather F McClintock, Victoria Peacock, Rose Nkiri Asong

Hypertension is a leading modifiable risk factor for morbidity and mortality among women in Sub-Saharan Africa. Social determinants of health (SDH) are associated with sex-based differences in access to preventative screenings globally. Little research has assessed the influence of SDH on screening for hypertension among women in The Gambia. The aim of this study was to identify SDH associated with the utilization of hypertension screening among women in The Gambia. Data was examined from the 2019-2020 Gambia Demographic and Health Survey. Weighted multivariate logistic was used to identify whether SDH were associated with hypertension screening. Among 4116 women, over one-fifth (21.1%) had not been screened for hypertension in their lifetime. In fully adjusted models, older age, rural residence, higher than secondary educational attainment, employment, identification with specific ethnic groups, richer wealth status, parity (1 or more), and antenatal care visits increased the likelihood of lifetime hypertension screening. Women who indicated that others made their healthcare decisions for them (partners or someone else) were significantly less likely to have been screened for hypertension in their lifetime than women who made their healthcare decisions alone (adjusted odds ratio = 0.552, 95% confidence interval = (0.384-0.794)). SDH influence access to screening for hypertension among women in The Gambia. Initiatives may need to address the role of SDH to improve access and uptake of hypertension screening.

高血压是撒哈拉以南非洲妇女发病和死亡的主要可改变风险因素。在全球范围内,健康的社会决定因素(SDH)与获得预防性筛查的性别差异有关。有关 SDH 对冈比亚妇女高血压筛查影响的评估研究很少。本研究旨在确定与冈比亚妇女利用高血压筛查相关的 SDH。研究数据来自 2019-2020 年冈比亚人口与健康调查。采用加权多变量逻辑来确定 SDH 是否与高血压筛查相关。在 4116 名妇女中,超过五分之一(21.1%)的人一生中未接受过高血压筛查。在完全调整模型中,年龄较大、居住在农村、中等以上教育程度、就业、认同特定种族群体、财富状况较富裕、均妻数(1 或以上)以及产前检查次数增加了终生接受高血压筛查的可能性。表示由他人(伴侣或其他人)代为做出医疗保健决定的妇女,一生中接受高血压筛查的可能性明显低于独自做出医疗保健决定的妇女(调整后的几率比=0.552,95%置信区间=(0.384-0.794))。SDH 影响了冈比亚妇女接受高血压筛查的机会。可能需要采取一些措施来解决 SDH 的作用,以提高高血压筛查的可及性和接受率。
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引用次数: 0
Effectiveness of biofeedback on blood pressure in patients with hypertension: systematic review and meta-analysis 生物反馈对高血压患者血压的疗效:系统回顾和荟萃分析。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-14 DOI: 10.1038/s41371-024-00937-y
Sian Jenkins, Ainslea Cross, Hanad Osman, Farah Salim, Dan Lane, Dennis Bernieh, Kamlesh Khunti, Pankaj Gupta
Hypertension is the leading modifiable risk factor for cardiovascular disease, but less than 50% have their blood pressure controlled. A possible avenue to support hypertension management is a holistic approach, using non-pharmacological interventions. Since hypertension is mediated in part by dysregulation of the autonomic nervous system (ANS), biofeedback may help improve hypertension management by targeted self-regulation and self-awareness of parameters that regulate the ANS. This systematic review aimed to assess the effectiveness of biofeedback on blood pressure in hypertensive patients. The review was pre-registered on PROSPERO and followed the PICO strategy. A total of 1782 articles were retrieved, 20 met the inclusion criteria. Sample sizes ranged from 15 to 301 participants; with a median age of 49.3 (43.3–55.0) years and 45% were female. There was a significant effect of biofeedback on systolic (−4.52, Z = 2.31, P = 0.02, CI [−8.35, −0.69]) and diastolic blood pressure (−5.19, Z = 3.54, P = 0.0004, CI [−8.07, −2.32]). Six different biofeedback modalities were used, with biofeedback delivered by psychologists, trained therapists and research assistants. There was no publication bias, heterogeneity was rated as substantial and data quality was rated to be poor. This review demonstrated that biofeedback had a significant effect on blood pressure. However, this should be viewed in the context of included studies being limited by heterogeneity and dated literature, meaning the research does not reflect the current biofeedback technology such as wearable devices. Future research should incorporate these technologies with robust methodology to fully understand the effect of biofeedback on hypertension.
高血压是心血管疾病的主要可改变风险因素,但只有不到 50%的人血压得到控制。支持高血压管理的一个可能途径是采用非药物干预的整体方法。由于高血压部分是由自律神经系统(ANS)调节失调引起的,因此生物反馈可通过有针对性的自我调节和对自律神经系统调节参数的自我意识,帮助改善高血压管理。本系统综述旨在评估生物反馈对高血压患者血压的影响。该综述在 PROSPERO 上进行了预注册,并遵循 PICO 策略。共检索到 1782 篇文章,其中 20 篇符合纳入标准。样本量从 15 到 301 人不等,中位年龄为 49.3(43.3-55.0)岁,45% 为女性。生物反馈对收缩压(-4.52,Z = 2.31,P = 0.02,CI [-8.35,-0.69])和舒张压(-5.19,Z = 3.54,P = 0.0004,CI [-8.07,-2.32])有明显影响。使用了六种不同的生物反馈模式,由心理学家、训练有素的治疗师和研究助理提供生物反馈。没有发表偏倚,异质性被评为严重,数据质量被评为较差。该综述表明,生物反馈疗法对血压有显著效果。然而,这应结合所纳入的研究受到异质性和文献年代久远的限制,这意味着研究没有反映出当前的生物反馈技术,如可穿戴设备。未来的研究应结合这些技术和可靠的方法,以充分了解生物反馈对高血压的影响。
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Journal of Human Hypertension
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