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Predictors of Tuberculosis and Non-Communicable Disease Comorbidities Among Newly Enrolled Tuberculosis Patients, Southern Ethiopia. 埃塞俄比亚南部新登记的结核病患者中结核病和非传染性疾病合并症的预测因素
IF 2.2 Q2 Medicine Pub Date : 2023-11-22 eCollection Date: 2023-01-01 DOI: 10.2147/IBPC.S432251
Mengistu Handiso Nunemo, Kassa Daka Gidebo, Eskinder Wolka Woticha, Yohannes Kebede Lemu

Introduction: Non-communicable diseases are comorbid with tuberculosis, however only a few record review based studies have been conducted, which are more concentrated on elevated glucose levels. This study aimed to assess non-communicable disease comorbidity and its predictors among tuberculosis patients.

Methods: A prospective cross-sectional study design was used and the data were collected by a previously validated tool from a sample of 443 tuberculosis patients using cluster random sampling methods. Multinomial logistic regression was interpreted by relative risk to predict the association of comorbidity status with independent variables.

Results: The majority (87.81%) of TB patients were not comorbid with NCDs. The prevalence of hypertension and diabetes mellitus among tuberculosis patients were 6.55%, and 5.64%, respectively. The people who had a risk score >8 were 6.47 times more likely to have tuberculosis comorbid with one non-communicable disease compared to those with a risk score ≤8. The relative risk of tuberculosis patients with BMI >25 is 3.33 times compared to those with a BMI <23 of being comorbid with one non-communicable disease vs tuberculosis patients without non-communicable diseases. Those tuberculosis patients with an awareness of non-communicable disease comorbidities are 9.33 times more likely to have tuberculosis with multi-comorbidities compared to those who are unaware.

Conclusion: The majority of TB patients were not comorbid with NCDs. The person's weight, family size of more than five, monthly income >3000 birr, risk score >8 and BMI >25 significantly predict comorbidity with one non-communicable disease compared to those without a comorbidity. The presence of non-communicable disease comorbidity, treatment awareness, and being aged 50+ years significantly predict the presence of multi-comorbidities compared to those without comorbidity. For early detection and management of both diseases, establishing bidirectional screening platforms in tuberculosis care programs is urgently required.

简介:非传染性疾病与结核病合并症,但仅进行了一些基于记录审查的研究,这些研究更多地集中在血糖水平升高上。本研究旨在评估结核病患者的非传染性疾病合并症及其预测因素。方法:采用前瞻性横断面研究设计,采用整群随机抽样方法,通过先前验证的工具从443例结核病患者样本中收集数据。用相对危险度解释多项逻辑回归来预测合并症状态与自变量的关联。结果:绝大多数(87.81%)结核病患者未合并非传染性疾病。肺结核患者中高血压和糖尿病患病率分别为6.55%和5.64%。与风险评分≤8的人相比,风险评分>8的人患结核病合并一种非传染性疾病的可能性是后者的6.47倍。BMI >25的结核病患者的相对危险度是BMI >25的结核病患者的3.33倍。结论:大多数结核病患者未合并非传染性疾病。一个人的体重、超过5人的家庭规模、月收入>3000 birr、风险评分>8和BMI >25与没有共病的人相比,显著地预测了一种非传染性疾病的共病。非传染性疾病合并症的存在、治疗意识和年龄在50岁以上与无合并症的患者相比,可以显著预测多重合并症的存在。为了尽早发现和管理这两种疾病,迫切需要在结核病护理规划中建立双向筛查平台。
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引用次数: 0
Self-Reported Hypertension and Associated Factors Among Adults in Butambala District, Central Uganda: A Community-Based Prevalence Study. 乌干达中部布坦巴拉地区成人自我报告的高血压及其相关因素:一项基于社区的流行病学研究
IF 2.2 Q2 Medicine Pub Date : 2023-11-09 eCollection Date: 2023-01-01 DOI: 10.2147/IBPC.S434230
Alex Male Kato, Winnie Kibone, Jerom Okot, Joseph Baruch Baluku, Felix Bongomin

Background: The prevalence of hypertension (HTN) differs among regions and income groups, showing a substantial increase in low- and middle-income countries. The development of hypertension is modulated by modifiable lifestyle factors, and uncontrolled hypertension poses a risk for the onset of cardiovascular diseases.

Objective: To determine the community-level point-prevalence and factors associated with self-reported HTN among adults in Butambala district, central Uganda.

Methods: A community-based cross-sectional study was conducted among adults aged ≥18 years in Budde subcounty, central Uganda. Data on sociodemographic characteristics and behavior were collected using a semistructured questionnaire. Self-reported HTN was assessed using a single question: "Do you have high blood pressure?" Bivariate and multivariate logistic regression analyses were performed to identify predictors of self-reported HTN.

Results: A total of 565 participants (53.5% female) with a median age of 38 years (IQR: 26-52) were included in the study. The prevalence of self-reported hypertension was 18.9%. Factors independently associated with HTN were age 60 years or older (aOR: 2.9, 95% CI: 1.64-5.23, p<0.001), female sex (aOR: 3.3, 95% CI: 2.3-6.3, p<0.001), being widowed (aOR: 10.4, 95% CI: 1.25-87.14, p=0.03), secondary (aOR: 0.4, 95% CI: 0.20-0.85, p=0.016) and tertiary (aOR: 0.2, 95% CI: 0.09-0.64, p=0.005) education, unemployment (aOR: 3.0, 95% CI: 1.11-7.96, p=0.03), tobacco use (aOR: 2.9, 95% CI: 1.83-4.53, p<0.001), having had at least one blood pressure measurement during antenatal visit (aOR: 4.7, 95% CI: 1.97-11.33, p<0.001) or medical checkup (aOR: 10.7, 95% CI: 6.06-18.

Conclusion: We observed a high prevalence of self-reported HTN affecting approximately one in five participants. More efforts are required to enhance routine screening, health education, and accessibility to HTN services in rural areas, with a particular emphasis on implementing HTN prevention and control strategies to effectively reduce the prevalence of HTN.

背景:不同地区和收入群体的高血压患病率不同,低收入和中等收入国家的高血压患病率大幅上升。高血压的发展受到可改变的生活方式因素的调节,不受控制的高血压会增加心血管疾病的发病风险。目的:确定乌干达中部布坦巴拉地区成人HTN的社区水平点患病率和自我报告的相关因素。方法:对乌干达中部布德县年龄≥18岁的成年人进行了一项以社区为基础的横断面研究。使用半结构化问卷收集社会人口特征和行为数据。自我报告的HTN通过一个简单的问题进行评估:“你有高血压吗?”进行双变量和多变量逻辑回归分析,以确定自我报告的HTN的预测因子。结果:共纳入565名参与者(53.5%为女性),中位年龄为38岁(IQR: 26-52)。自我报告的高血压患病率为18.9%。与HTN独立相关的因素是年龄在60岁或以上(aOR: 2.9, 95% CI: 1.64-5.23)。结论:我们观察到自我报告HTN的患病率很高,影响了大约五分之一的参与者。需要作出更多努力,加强农村地区的常规筛查、健康教育和HTN服务的可及性,特别强调实施HTN预防和控制战略,以有效减少HTN的流行。
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引用次数: 0
The Magnitude of Hypertension and Its Contributing Factors Among Patients Receiving Antiretroviral Therapy in Public Hospitals in Harar City, Eastern Ethiopia: A Cross-Sectional Study 埃塞俄比亚东部哈拉尔市公立医院接受抗逆转录病毒治疗的患者高血压程度及其影响因素:一项横断面研究
Q2 Medicine Pub Date : 2023-11-01 DOI: 10.2147/ibpc.s433907
Mesay Dechasa, Shambel Nigussie, Abera Jambo, Mekdes Lueleseged Sime, Aklilu Tamire, Monas Kitessa, Natanim Degefu, Jerman Dereje, Henok Demeke, Nanati Legese
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引用次数: 0
Blood Pressure Examination Habit and Its Determinants Among Civil Servants in Arba Minch Town: A Cross-Sectional Study - Using Hurdle Poisson Regression Model. Arba Minch镇公务员的血压检查习惯及其影响因素:基于Hurdle-Poisson回归模型的横断面研究。
IF 2.2 Q2 Medicine Pub Date : 2023-03-11 eCollection Date: 2023-01-01 DOI: 10.2147/IBPC.S397760
Tesfahun Zewde Legisso, Bereket Getachew Mamo, Abebaw Miskir Bimrew, Teshale Fikadu

Background: Hypertension is a common non-communicable disease detected through blood pressure measurement that makes periodic health examinations crucial for the detection, prevention, and timely treatment.

Objective: To assess the frequency of blood pressure examination and its determinant among civil servants in Arba Minch Town, south Ethiopia.

Methods: From February to March 2020 an organization-based cross-sectional study design was employed among civil servants in Arba Minch town. Data were collected from 580 randomly selected civil servants using a well-structured questionnaire. Hurdle Poisson regression model was conducted to identify determinants of frequency of blood pressure examination using R version 4.0.2.

Results: A total of 407 (70.2%) civil servants had never examined their blood pressure within a year before the study time. The mean frequency of blood pressure examination was 0.71 with a standard deviation of 1.46. The hurdle Poisson regression analysis indicates age above 40 years (IRR = 6.11, p < 0.001), elevated blood pressure (IRR = 1.48, p < 0.001), no family history of hypertension (IRR = 0.59, p < 0.001) had significant effects on the expected number of non-zero counts blood pressure examination. And education status (OR; 2.39, p < 0.05), poor knowledge about hypertension, not getting advice from health professionals (OR = 8.93, p < 0.001), and age above 40 years had significant effects on not taking blood pressure examination.

Conclusion: The frequency of blood pressure examinations among civil servants was found to be low. This study reveals age, elevated blood pressure, family history of hypertension, getting advice, and knowledge on hypertension were found to be determinants of the frequency of blood pressure examination. Thus, concerned health authorities and medical workers should work on these factors to prevent and detect hypertension among apparently healthy civil servants.

背景:高血压是一种常见的非传染性疾病,通过测量血压来检测,定期健康检查对检测、预防和及时治疗至关重要。目的:评估埃塞俄比亚南部Arba Minch镇公务员的血压检查频率及其决定因素。方法:2020年2月至3月,在Arba Minh镇公务员中采用基于组织的横断面研究设计。数据是从580名随机选择的公务员中收集的,使用结构良好的问卷调查。使用R版本4.0.2进行Hurdle-Poisson回归模型来确定血压检查频率的决定因素。结果:共有407名(70.2%)公务员在研究时间前一年内从未检查过血压。血压检查的平均频率为0.71,标准偏差为1.46。栏位泊松回归分析表明,年龄在40岁以上(IRR=6.11,p<0.001)、血压升高(IRR=1.48,p<0.001。受教育程度(OR;2.39,p<0.05)、对高血压知识了解不足、没有得到卫生专业人员的建议(OR=8.93,p<0.001)以及年龄在40岁以上对不进行血压检查有显著影响。结论:公务员血压检查频率偏低。这项研究表明,年龄、血压升高、高血压家族史、咨询和高血压知识是决定血压检查频率的因素。因此,有关卫生当局和医务工作者应该研究这些因素,以预防和检测表面健康的公务员中的高血压。
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引用次数: 1
Undiagnosed Hypertension Among Market Salespersons in Kitgum Central Market, Northern Uganda. 乌干达北部Kitgum中央市场销售人员未确诊的高血压
IF 2.2 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2147/IBPC.S402988
Denish Kilama, Daniel Okumu Ayella, Isaac Asiimwe, Betty Nakibuuka, Florence Laker, Felix Bongomin

Introduction: Hypertension may be common among market salespersons who are mostly physically inactive throughout the day. However, the burden of hypertension in this population remains unknown. In this study, we determined the prevalence of undiagnosed hypertension and associated factors among market salesperson in Kitgum central market, Kitgum district, Northern Uganda.

Methods: A cross-sectional study, recruiting market salespersons aged 18 years or older without a prior diagnosis of hypertension or currently on anti-hypertensive therapy was conducted. A standardized questionnaire was administered, and body mass index (BMI) estimated. Hypertension was defined as two consistent measurements of systolic blood pressure ≥140mmHg and/or diastolic blood pressure ≥90mmHg measured 4 hours apart. Multivariable logistic regression analysis was performed to determine factors independently associated with undiagnosed hypertension. P<0.05 was considered statistically significant.

Results: We enrolled 240 participants. The mean age was 39.4 ± 12.8 years. Most (83.3%, n=199) participants were female and urban dwellers (88.3%, n=212). The prevalence of undiagnosed hypertension was 16.7% (n=40). Of the 40 participants with hypertension, 16 (40%) were younger than 40 years. Factors associated with undiagnosed hypertension were, age >50 years (adjusted odds ratio (aOR): 7.0, 95% confidence interval (CI): 1.9-25.6, p=0.003), male gender (aOR: 4.2, 95CI: 1.5-11.1, p=0.005), alcohol consumption (aOR: 2.6, 95CI: 1.1-6.0, p=0.021), and being overweight (aOR: 3.6, 95CI: 1.5-8.8, p=0.005).

Conclusion: About one in six of market salespersons had undiagnosed hypertension, with a disproportionately high burden among those younger than 40 years. A larger multi-centric study is recommended to confirm our findings.

导读:高血压可能在市场销售人员中很常见,他们全天大多不运动。然而,这一人群的高血压负担仍然未知。在这项研究中,我们确定了乌干达北部Kitgum地区Kitgum中心市场销售人员中未确诊高血压的患病率及其相关因素。方法:采用横断面研究,招募年龄在18岁及以上、既往无高血压诊断或目前正在接受抗高血压治疗的市场销售人员。进行了标准化问卷调查,并估计了身体质量指数(BMI)。高血压定义为连续4小时测量收缩压≥140mmHg和/或舒张压≥90mmHg。采用多变量logistic回归分析确定与未确诊高血压独立相关的因素。结果:我们招募了240名参与者。平均年龄39.4±12.8岁。大多数(83.3%,n=199)参与者是女性和城市居民(88.3%,n=212)。未确诊的高血压患病率为16.7% (n=40)。在40名高血压患者中,16名(40%)年龄小于40岁。与未确诊高血压相关的因素有:年龄>50岁(校正优势比(aOR): 7.0, 95%可信区间(CI): 1.9-25.6, p=0.003)、男性(aOR: 4.2, 95CI: 1.5-11.1, p=0.005)、饮酒(aOR: 2.6, 95CI: 1.1-6.0, p=0.021)和超重(aOR: 3.6, 95CI: 1.5-8.8, p=0.005)。结论:约六分之一的市场销售人员患有未确诊的高血压,其中年龄小于40岁的负担高得不成比例。建议进行更大规模的多中心研究来证实我们的发现。
{"title":"Undiagnosed Hypertension Among Market Salespersons in Kitgum Central Market, Northern Uganda.","authors":"Denish Kilama,&nbsp;Daniel Okumu Ayella,&nbsp;Isaac Asiimwe,&nbsp;Betty Nakibuuka,&nbsp;Florence Laker,&nbsp;Felix Bongomin","doi":"10.2147/IBPC.S402988","DOIUrl":"https://doi.org/10.2147/IBPC.S402988","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension may be common among market salespersons who are mostly physically inactive throughout the day. However, the burden of hypertension in this population remains unknown. In this study, we determined the prevalence of undiagnosed hypertension and associated factors among market salesperson in Kitgum central market, Kitgum district, Northern Uganda.</p><p><strong>Methods: </strong>A cross-sectional study, recruiting market salespersons aged 18 years or older without a prior diagnosis of hypertension or currently on anti-hypertensive therapy was conducted. A standardized questionnaire was administered, and body mass index (BMI) estimated. Hypertension was defined as two consistent measurements of systolic blood pressure ≥140mmHg and/or diastolic blood pressure ≥90mmHg measured 4 hours apart. Multivariable logistic regression analysis was performed to determine factors independently associated with undiagnosed hypertension. P<0.05 was considered statistically significant.</p><p><strong>Results: </strong>We enrolled 240 participants. The mean age was 39.4 ± 12.8 years. Most (83.3%, n=199) participants were female and urban dwellers (88.3%, n=212). The prevalence of undiagnosed hypertension was 16.7% (n=40). Of the 40 participants with hypertension, 16 (40%) were younger than 40 years. Factors associated with undiagnosed hypertension were, age >50 years (adjusted odds ratio (aOR): 7.0, 95% confidence interval (CI): 1.9-25.6, p=0.003), male gender (aOR: 4.2, 95CI: 1.5-11.1, p=0.005), alcohol consumption (aOR: 2.6, 95CI: 1.1-6.0, p=0.021), and being overweight (aOR: 3.6, 95CI: 1.5-8.8, p=0.005).</p><p><strong>Conclusion: </strong>About one in six of market salespersons had undiagnosed hypertension, with a disproportionately high burden among those younger than 40 years. A larger multi-centric study is recommended to confirm our findings.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/9e/ibpc-16-37.PMC10362878.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10221888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Prevalence of and Factors Associated with Hypertension Among Adults on Dolutegravir-Based Antiretroviral Therapy in Uganda: A Cross Sectional Study. 乌干达接受多路地韦为基础的抗逆转录病毒治疗的成人高血压患病率及相关因素:一项横断面研究
IF 2.2 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2147/IBPC.S403023
Ronald Kasoma Mutebi, Andrew Weil Semulimi, John Mukisa, Martha Namusobya, Joy Christine Namirembe, Esther Alice Nalugga, Charles Batte, David Mukunya, Bruce Kirenga, Robert Kalyesubula, Pauline Byakika-Kibwika

Introduction: Dolutegravir-based anti-retroviral therapy (ART) regimens were rolled out as first line HIV treatment in Uganda due to their tolerability, efficacy and high resistance barrier to human immunodeficiency virus (HIV). They have however been associated with weight gain, dyslipidemia and hyperglycemia which are cardiometabolic risk factors of hypertension. We assessed the prevalence and factors associated with hypertension among adults on dolutegravir regimens.

Methods: We conducted a cross-sectional study on 430 systematically sampled adults on dolutegravir-based ART for ≥ 6 months. Hypertension was defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or history of use of antihypertensive agents.

Results: The prevalence of hypertension was 27.2% (117 of 430 participants) [95% CI: 23.2-31.6]. Majority were female (70.7%), the median age 42 [34, 50] years, with body mass index (BMI) ≥ 25 kg/m3 (59.6%) and median duration on DTG-based regimens of 28 [15, 33] months. Being male [aPR: 1.496, 95% CI: 1.122-1.994, P = 0.006], age ≥ 45 years [aPR: 4.23, 95% CI: 2.206-8.108, P < 0.001] and 35-44 years [aPR: 2.455, 95% CI: 1.216-4.947, P < 0.012] as compared with age < 35 years, BMI ≥ 25 kg/m3 [aPR: 1.489, 95% CI: 1.072-2.067, P = 0.017] as compared with BMI < 25 kg/m3, duration on dolutegravir-based ART [aPR: 1.008, 95% CI: 1.001-1.015, P = 0.037], family history of hypertension [aPR: 1.457, 95% CI: 1.064-1.995, P = 0.019] and history of heart disease [aPR: 1.73, 95% CI: 1.205-2.484, P = 0.003] were associated with hypertension.

Conclusion: One in every four people with HIV (PWH) on dolutegravir-based ART has hypertension. We recommend the integration of hypertension management in the HIV treatment package and policies to improve existing supply chains for low cost and high-quality hypertension medications.

导语:基于dolutegravvir的抗逆转录病毒疗法(ART)方案由于其耐受性、有效性和对人类免疫缺陷病毒(HIV)的高抗性屏障,在乌干达作为一线艾滋病毒治疗方案推出。然而,它们与体重增加、血脂异常和高血糖有关,这些都是高血压的心脏代谢危险因素。我们评估了使用多替格拉韦治疗的成年人中高血压的患病率和相关因素。方法:我们对430名系统抽样的成年人进行了横断面研究,这些成年人接受了以盐酸孕酮为基础的抗逆转录病毒治疗≥6个月。高血压被定义为收缩压≥140 mmHg或舒张压≥90 mmHg或使用抗高血压药物的历史。结果:高血压患病率为27.2% (117 / 430)[95% CI: 23.2-31.6]。大多数为女性(70.7%),中位年龄42[34,50]岁,体重指数(BMI)≥25 kg/m3(59.6%),以dtg为基础的方案中位持续时间为28[15,33]个月。被男性[4月:1.496,95%置信区间CI: 1.122 - -1.994, P = 0.006),≥45岁(4月:4.23,95%置信区间CI: 2.206 - -8.108, P < 0.001]和35-44年[4月:2.455,95%置信区间CI: 1.216 - -4.947, P < 0.012),与年龄< 35年,BMI≥25公斤/立方米(4月:1.489,95%置信区间CI: 1.072 - -2.067, P = 0.017)与体重指数< 25公斤/立方米,持续时间dolutegravir-based艺术[4月:1.008,95%置信区间CI: 1.001 - -1.015, P = 0.037),高血压家族史(4月:1.457,95%置信区间CI: 1.064 - -1.995, P = 0.019)和心脏病史的[4月:[1.73, 95% CI: 1.205 ~ 2.484, P = 0.003]与高血压相关。结论:每4名接受以盐酸孕酮为基础的抗逆转录病毒治疗的HIV感染者中就有1人患有高血压。我们建议将高血压管理纳入艾滋病毒治疗方案和政策,以改善低成本和高质量高血压药物的现有供应链。
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引用次数: 2
High Prevalence of Uncontrolled Hypertension Among Afghan Hypertensive Patients: A Multicenter Cross-Sectional Study. 阿富汗高血压患者中未控制高血压的高患病率:一项多中心横断面研究。
IF 2.2 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2147/IBPC.S417205
Ahmad Haroon Baray, Muhammad Haroon Stanikzai, Mohammad Hashim Wafa, Khalid Akbari

Background: Despite striking advances in the management of hypertension, blood pressure (BP) control remains suboptimal worldwide. Sustainable Development Goals (SDGs) call for 80% control rates by 2030, highlighting the urgency for improvements in hypertension control.

Objective: We aimed to determine the prevalence of uncontrolled hypertension (≥140/90 mmHg) and assess its associated factors in Afghan hypertensive patients.

Methods: We conducted this multicenter cross-sectional study at three Afghan public hospitals in Afghanistan. We recruited hypertensive patients (n=950) on antihypertensive medications (AHMs) from August to December 2022. We analyzed only complete datasets (853). We employed the 14-item Hill-Bone compliance scale to assess compliance with AHMs. We performed multivariable logistic regression analyses to determine factors associated with uncontrolled hypertension.

Results: The mean age (±SD) of the patients was 47.5 (± 9.5) years and males constituted 50.5% (431) of the study sample. The prevalence of uncontrolled hypertension in this study was 77.3% (95% CI: 74.2-79.9%). Factors associated with uncontrolled hypertension and their adjusted OR (95% CI) were physical inactivity: 3.45 (1.87-6.35), current smoking: 3.04 (1.50-6.15), high salt intake: 3.57 (1.9-6.7), presence of comorbid medical disease: 2.22 (1.20-4.08), higher BMI: 3.32 (1.12-9.88), poor compliance to AHMs: 8.50 (4.62-15.6), and presence of depressive symptoms: 1.99 (1.2-3.27).

Conclusion: The prevalence of uncontrolled hypertension was high in the present study. Factors associated with uncontrolled hypertension may epitomize potential targets for public/individual health interventions in Afghanistan.

背景:尽管在高血压管理方面取得了显著进展,但在世界范围内,血压(BP)控制仍处于次优状态。可持续发展目标要求到2030年控制率达到80%,强调了改善高血压控制的紧迫性。目的:我们旨在确定阿富汗高血压患者未控制高血压(≥140/90 mmHg)的患病率,并评估其相关因素。方法:我们在阿富汗的三家公立医院进行了多中心横断面研究。我们于2022年8月至12月招募了服用抗高血压药物(AHMs)的高血压患者(n=950)。我们只分析了完整的数据集(853)。我们采用14项Hill-Bone依从性量表来评估ahm的依从性。我们进行了多变量logistic回归分析,以确定与不受控制的高血压相关的因素。结果:患者平均年龄(±SD)为47.5(±9.5)岁,男性占50.5%(431)。本研究中未控制的高血压患病率为77.3% (95% CI: 74.2-79.9%)。与不受控制的高血压相关的因素及其调整后的OR (95% CI)为:缺乏运动:3.45(1.87-6.35),当前吸烟:3.04(1.50-6.15),高盐摄入量:3.57(1.9-6.7),存在合并症:2.22(1.20-4.08),较高的BMI: 3.32(1.12-9.88),对AHMs的依从性差:8.50(4.62-15.6),以及存在抑郁症状:1.99(1.2-3.27)。结论:本研究中高血压未控制的患病率较高。与不受控制的高血压相关的因素可能是阿富汗公共/个人卫生干预措施的潜在目标。
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引用次数: 0
Long-Term Safety and Antihypertensive Effects of Renal Denervation: Current Insights. 肾去神经治疗的长期安全性和降压作用:最新见解。
IF 2.2 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2147/IBPC.S392410
Klevin Roger L Reyes, Florian Rader

Hypertension is the most potent modifiable risk factor for the development of cardiovascular morbidity and mortality worldwide. Nevertheless, blood pressure (BP) control on a broad scale appears to be insurmountable and has even worsened in the US. Barriers to sustained hypertension control are multifactorial and although lack of patient awareness and socioeconomic barriers to healthcare access may play a role, medication non-compliance and therapeutic inertia are major causes. Renal denervation (RDN) is a minimally invasive procedure that has been the subject of interest in clinical trials for more than a decade and although the first sham-controlled trial could not detect group difference between treated and untreated hypertensives, subsequent, better designed sham-controlled trials clearly demonstrated the BP lowering effect of RDN, as well as its safety. While to-date, RDN is not available for routine clinical practice, one major requirement for broad implementation is that the BP lowering effect is durable. Therefore, this review will summarize the available long-term data of the different RDN modalities with respect to both effectiveness and safety.

高血压是世界范围内心血管发病率和死亡率发展的最有效的可改变危险因素。然而,血压(BP)的控制在大范围内似乎是不可克服的,甚至在美国已经恶化。持续控制高血压的障碍是多因素的,尽管患者缺乏意识和获得医疗保健的社会经济障碍可能起作用,但不遵守药物治疗和治疗惰性是主要原因。肾去神经(RDN)是一种微创手术,十多年来一直是临床试验的主题,尽管第一个假对照试验不能检测治疗和未治疗高血压患者之间的组差异,但随后设计更好的假对照试验清楚地证明了RDN的降压效果及其安全性。虽然到目前为止,RDN还不能用于常规临床实践,但广泛实施的一个主要要求是降压效果是持久的。因此,本综述将总结不同RDN模式在有效性和安全性方面的可用长期数据。
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引用次数: 0
Drug Therapy Problems and Associated Factors Among Hypertensive Patients in North Wollo Public Hospitals, Northeast Ethiopia: Institutional-Based Cross-Sectional Study. 埃塞俄比亚东北部北沃罗公立医院高血压患者药物治疗问题及相关因素:基于机构的横断面研究
IF 2.2 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2147/IBPC.S416585
Tenaw Baye, Fentaw Girmaw, Getachew Ashagrie, Abebe Tarekegn Kassaw

Background: Drug therapy problems (DTPs) are common in people with hypertension and may threaten the effective management of the disease. The purpose of this study was to determine the prevalence and predictors for DTPs in hypertensive people in North Wollo public hospitals.

Methods: On patients with hypertension, a cross-sectional study based in a health institution was carried out using an interviewer-administered structured questionnaire and medical record review from 6 November 2022 to 18 January 2023. All hypertensive patients, ages 18 and older, who underwent regular follow-ups for at least 12 months were included in the study using a simple random sampling method. Multivariate logistic regression analysis was used to establish the association between independent variables and the occurrence of DTPs. Unnecessary drug therapy, the need for additional drug therapy, ineffective drugs, dosage too low, dosage too high, adverse drug reactions, and noncompliance were the outcome variables.

Results: The study included 376 hypertensive patients. Of the total participants, 258 (68.6%) were female. The mean number of drug therapy problems per patient was 1.55 ± 0.307, with 298 participants (79.3%) reporting having at least one such problem. This study found that the need for additional drug therapy was the most prevalent problem (149, 39.66%). Polypharmacy (AOR = 2.487, 95% CI = 1.375-4.499, p = 0.003), presence of comorbidity (AOR = 1.886, 95% CI = 1.035-3.439, p = 0.038), and uncontrolled BP (AOR = 2.961, 95% CI = 1.669-5.254, p = <0.001) predicts the development of drug therapy problems.

Conclusion: Patients with hypertension who are on follow-up experience drug therapy problems frequently. Promoting the involvement of clinical pharmacists in designing, implementing, and monitoring therapeutic plans is recommended to decrease the occurrence of drug therapy problems.

背景:药物治疗问题(dtp)在高血压患者中很常见,并可能威胁到疾病的有效控制。本研究的目的是确定北沃罗公立医院高血压患者dtp的患病率和预测因素。方法:从2022年11月6日至2023年1月18日,对某卫生机构的高血压患者进行横断面研究,采用访谈者管理的结构化问卷和病历回顾。所有年龄在18岁及以上的高血压患者,接受了至少12个月的定期随访,采用简单的随机抽样方法纳入研究。采用多因素logistic回归分析,建立自变量与dtp发生的关系。不必要的药物治疗、需要额外的药物治疗、无效药物、剂量过低、剂量过高、药物不良反应和不依从性是结果变量。结果:纳入376例高血压患者。在所有参与者中,258人(68.6%)是女性。每位患者出现药物治疗问题的平均次数为1.55±0.307次,其中298名参与者(79.3%)报告至少出现过一次此类问题。本研究发现,需要额外的药物治疗是最普遍的问题(149,39.66%)。多药(AOR = 2.487, 95% CI = 1.375 ~ 4.499, p = 0.003)、存在合并症(AOR = 1.886, 95% CI = 1.035 ~ 3.439, p = 0.038)、血压未控制(AOR = 2.961, 95% CI = 1.669 ~ 5.254, p =结论:高血压患者在随访中经常出现药物治疗问题。建议促进临床药师参与设计、实施和监测治疗计划,以减少药物治疗问题的发生。
{"title":"Drug Therapy Problems and Associated Factors Among Hypertensive Patients in North Wollo Public Hospitals, Northeast Ethiopia: Institutional-Based Cross-Sectional Study.","authors":"Tenaw Baye,&nbsp;Fentaw Girmaw,&nbsp;Getachew Ashagrie,&nbsp;Abebe Tarekegn Kassaw","doi":"10.2147/IBPC.S416585","DOIUrl":"https://doi.org/10.2147/IBPC.S416585","url":null,"abstract":"<p><strong>Background: </strong>Drug therapy problems (DTPs) are common in people with hypertension and may threaten the effective management of the disease. The purpose of this study was to determine the prevalence and predictors for DTPs in hypertensive people in North Wollo public hospitals.</p><p><strong>Methods: </strong>On patients with hypertension, a cross-sectional study based in a health institution was carried out using an interviewer-administered structured questionnaire and medical record review from 6 November 2022 to 18 January 2023. All hypertensive patients, ages 18 and older, who underwent regular follow-ups for at least 12 months were included in the study using a simple random sampling method. Multivariate logistic regression analysis was used to establish the association between independent variables and the occurrence of DTPs. Unnecessary drug therapy, the need for additional drug therapy, ineffective drugs, dosage too low, dosage too high, adverse drug reactions, and noncompliance were the outcome variables.</p><p><strong>Results: </strong>The study included 376 hypertensive patients. Of the total participants, 258 (68.6%) were female. The mean number of drug therapy problems per patient was 1.55 ± 0.307, with 298 participants (79.3%) reporting having at least one such problem. This study found that the need for additional drug therapy was the most prevalent problem (149, 39.66%). Polypharmacy (AOR = 2.487, 95% CI = 1.375-4.499, p = 0.003), presence of comorbidity (AOR = 1.886, 95% CI = 1.035-3.439, p = 0.038), and uncontrolled BP (AOR = 2.961, 95% CI = 1.669-5.254, p = <0.001) predicts the development of drug therapy problems.</p><p><strong>Conclusion: </strong>Patients with hypertension who are on follow-up experience drug therapy problems frequently. Promoting the involvement of clinical pharmacists in designing, implementing, and monitoring therapeutic plans is recommended to decrease the occurrence of drug therapy problems.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/ea/ibpc-16-47.PMC10364825.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10233492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medication Adherence and Blood Pressure Control Among Hypertensive Outpatients Attending a Tertiary Cardiovascular Hospital in Tanzania: A Cross-Sectional Study. 坦桑尼亚一家三级心血管病医院高血压门诊患者的用药依从性和血压控制:一项横断面研究。
IF 1.5 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2022-08-10 eCollection Date: 2022-01-01 DOI: 10.2147/IBPC.S374674
Pedro Pallangyo, Makrina Komba, Zabella S Mkojera, Peter R Kisenge, Smita Bhalia, Henry Mayala, Engerasiya Kifai, Mwinyipembe K Richard, Khuzeima Khanbhai, Salma Wibonela, Jalack Millinga, Robert Yeyeye, Nelson F Njau, Thadei K Odemary, Mohamed Janabi

Background: Notwithstanding the availability of effective treatments, asymptomatic nature and the interminable treatment length, adherence to medication remains a substantial challenge among patients with hypertension. Suboptimal adherence to BP-lowering agents is a growing global concern that is associated with the substantial worsening of disease, increased service utilization and health-care cost escalation. This study aimed to explore medication adherence and its associated factors among hypertension outpatients attending a tertiary-level cardiovascular hospital in Tanzania.

Methods: The pill count adherence ratio (PCAR) was used to compute adherence rate. In descriptive analyses, adherence was dichotomized and consumption of less than 80% of the prescribed medications was used to denote poor adherence. Logistic regression analyses was used to determine factors associated with adherence.

Results: A total of 849 outpatients taking antihypertensive drugs for ≥1 month prior to recruitment were randomly enrolled in this study. The mean age was 59.9 years and about two-thirds were females. Overall, a total of 653 (76.9%) participants had good adherence and 367 (43.2%) had their blood pressure controlled. Multivariate logistic regression analysis showed; lack of a health insurance (OR 0.5, 95% CI 0.3-0.7, p<0.01), last BP measurement >1 week (OR 0.6, 95% CI 0.4-0.8, p<0.01), last clinic attendance >1 month (OR 0.4, 95% CI 0.3-0.6, p<0.001), frequent unavailability of drugs (OR 0.6, 95% CI 0.3-0.9, p = 0.03), running out of medication before the next appointment (OR 0.6, 95% CI 0.4-0.9, p = 0.01) and stopping medications when asymptomatic (OR 0.6, 95% CI 0.4-0.8, p<0.001) to be independent associated factors for poor adherence.

Conclusion: A substantial proportion of hypertensive outpatients in this tertiary-level setting had good medication adherence. Nonetheless, observed suboptimal blood pressure control regardless of a fairly satisfactory adherence rate suggests that lifestyle modification plays a central role in hypertension management.

背景:尽管存在有效的治疗方法、无症状的特性和漫长的治疗时间,但坚持服药仍然是高血压患者面临的巨大挑战。降压药物的依从性不佳是一个日益受到全球关注的问题,它与疾病的严重恶化、服务使用的增加和医疗费用的攀升有关。本研究旨在探讨在坦桑尼亚一家三级心血管病医院就诊的高血压门诊患者的服药依从性及其相关因素:方法:采用药片计数依从率(PCAR)计算依从率。在描述性分析中,依从性采用二分法,用药量低于80%表示依从性差。逻辑回归分析用于确定与依从性相关的因素:本研究随机招募了 849 名在招募前服用降压药≥1 个月的门诊患者。平均年龄为 59.9 岁,约三分之二为女性。总体而言,共有 653 人(76.9%)的依从性良好,367 人(43.2%)的血压得到控制。多变量逻辑回归分析显示:缺乏医疗保险(OR 0.5,95% CI 0.3-0.7,p1 周(OR 0.6,95% CI 0.4-0.8,p1 个月(OR 0.4,95% CI 0.3-0.6,pC):在这所三级医院中,相当一部分高血压门诊患者的服药依从性良好。然而,尽管服药依从率相当令人满意,但观察到的血压控制情况仍不理想,这表明改变生活方式在高血压管理中发挥着核心作用。
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Integrated Blood Pressure Control
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