A nationwide cross-sectional survey on prevalence, management and pharmacoepidemiology patterns on hypertension in Chinese patients with chronic kidney disease.
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ABSTRACT:
SUBMITTER: Zhang W
PROVIDER: S-EPMC5171924 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Background and purposeIdentifying changes in the prevalence, disability, and management patterns of migraine is important for reducing the burden of this disease. However, data on the changes in these variables are scarce.MethodsWe compared data obtained in the 2009 Korean Headache Survey and the 2018 Korean Sleep-Headache Survey.ResultsThe 1-year migraine prevalence did not differ significantly between 2018 and 2009 [5.2% (114/2,200) vs. 6.0% (91/1,507), p=0.492]. The number of days with missed activity due to headache during the previous 3 months was larger in the 2018 survey than in the 2009 survey [1.1±2.9 vs. 0.3±1.0 days (mean±standard deviation), p=0.013]. The number of days with reduced productivity during the previous 3 months did not differ significantly between the two surveys (0.8±2.8 vs. 1.4±1.4 days, p=0.679). The proportion of subjects with a substantial-to-severe headache impact (Headache Impact Test-6 score ≥56) was marginally larger in the 2018 survey than in the 2009 survey [42.1% (48/114) vs. 29.7% (27/91), p=0.066]. The rate of lifetime medical consultations did not differ between the 2018 and 2009 surveys [34.2% (39/114) vs. 30.8% (28/91), p=0.615].ConclusionsMigraine prevalence was stable over the 9-year period between the surveys, but disability due to missed activity was greater in 2018 than in 2009 in Korea.
| S-EPMC7840323 | biostudies-literature
Project description:BackgroundCurrent international guidelines on dyslipidemia are not concordant on various aspects of management. Also, there are no uniformly accepted Indian guidelines. We, therefore, performed a physician survey to understand lipid management practices in India.MethodsAn anonymous survey questionnaire was administered to gauge physicians' self-reported behavior regarding lipid management aspects. Results were expressed in terms of percentages based on the number of responses obtained.ResultsA total of 404 physicians participated in the survey. Eighty-eight percent respondents ordered a lipid profile before starting statin therapy, and 80% preferred to set lipid targets, though the tools used for calculating cardiovascular risk varied. Atorvastatin was preferred over rosuvastatin in primary prevention (72.9 vs. 32.4%), secondary prevention (54.6 vs. 46.7%), diabetic patients (56.3 vs. 40.3%) and post-ACS (78.3 vs. 34%). High-intensity statins were preferred by 73.7% of respondents in post-ACS cases. Fifty percent doctors chose not to use a statin in diabetic patients, irrespective of their LDL-C levels. The most preferred drug option for managing atherogenic dyslipidemia and moderate hypertriglyceridemia was statin-fibrate combination (55.1%) and fibrates (35.4%), respectively. Sixty-three percent doctors preferred to prescribe statins in patients with moderately high LDL-C and normal triglycerides, without CHD or CHD risk equivalents. Around 28% of doctors preferred not to use pharmacotherapy for managing isolated low HDL. Of the participants, 73% used fibrates in ?20% of their dyslipidemic patients, with fenofibrate being the most preferred (90.5%). Ezetimibe was mainly used in patients with uncontrolled LDL-C despite statin therapy (52.4% respondents). Most preferred approaches to manage statin intolerance included reducing statin dose (39%) and stopping and restarting statins at a lower dose (34.5%). Fifty-two percent of doctors chose not to alter pre-existing therapy in patients who had LDL-C levels at goal but elevated non-HDL-C levels.ConclusionThis is the first survey in India that provides useful insights into Indian physicians' self-reported perspectives on managing dyslipidemia in routine clinical practice. Despite concordance with the currently available guidelines in certain aspects, there is incongruence in managing specific dyslipidemia problems. Further continuing medical education and the development of evidence-based, India-specific lipid guidelines can help reduce some of these differences.
| S-EPMC5496264 | biostudies-literature
Project description:We conducted a cross-sectional survey including 23869 participants and aimed to measure the prevalences of and risk factors for chronic kidney disease (CKD) and diabetic kidney disease (DKD) in a Chinese rural population. CKD and DKD status was defined according to the combination of estimated glomerular filtration rate (eGFR) and presence of albuminuria Participant completed a questionnaire involving life-style and relevant medical history, and the blood and urinary specimen were taken. The age- and gender- adjusted prevalences of CKD and DKD were calculated and risk factors associated with the presence of CKD and DKD were analyzed by logistic regression. The overall prevalence of CKD was 16.4% (15.9-16.8%) and of DKD was 2.9% (2.7-3.1%). In participants with diabetes, the overall prevalence of CKD was 35.5% (95% CI = 33.7-37.3%). Factors independently associated with renal damage were age, gender, education, personal income, alcohol consumption, overweight, obesity, diabetes, hypertension and dyslipidemia. Our study shows current prevalences of CKD and DKD in Chinese rural residents. Further researches could identify potential factors explaining the observed differences and implement the interventions to relieve the high burden of CKD and DKD in rural population.
| S-EPMC6639314 | biostudies-literature
Project description:There is limited epidemiologic data on hypertension (HTN) in Lebanon. This study aimed to determine the prevalence and associated risk factors of HTN in the adult Lebanese population and evaluate the association between dietary and psychological factors on systolic blood pressure (SBP). Cross-sectional analyses were conducted using a multistage cluster sample across Lebanon. A total of 2014 participants were included. The prevalence and control rates of HTN were 31.2% and 28.7%, respectively. In women, educational level and physical activity were negatively associated with HTN (P < .05 for both) and adherence to the Lebanese Mediterranean diet was associated with a lower SBP. Other factors were associated with HTN in men. There was no relationship with SBP and psychological distress. Of the modifiable risk factors, body mass index persisted as the only contributory factor in both sexes (P < .01). Accordingly, prevention of HTN at the population level should focus mainly on overweight prevention.
| S-EPMC8031217 | biostudies-literature
Project description:The purposes of this study were to describe the hypertensive population and therapeutic management of hypertension in adults between 18 and 74 years of age in France in 2015. Esteban survey is a cross-sectional survey with a clinical examination conducted in a representative sample of French adults aged 18-74 years between 2014 and 2016. Esteban was entirely public-funded. Blood pressure (BP) was measured during clinical examination with a standardized protocol, and pharmacological treatment was collected through the exhaustive Système National des Données de Santé (SNDS) database. Hypertension was defined by systolic BP (SBP)> 140 mm Hg, diastolic BP (DBP)> 90 mm Hg or treatment with BP-lowering drugs. The therapeutic control of treated hypertensive patients was defined by SBP < 140 mm Hg and DBP < 90 mm Hg. Adherence to drug treatment was defined as more than 80% of days covered by BP-lowering drug per year. The prevalence of hypertension was 31.3%. 74.7% of aware hypertensive participants taking an antihypertensive drug, and 57.7% of them were treated with a single antihypertensive pharmacological class. Overall, among hypertensives, 24.3% had a satisfactory BP control. Only 49.7% of treated hypertensives participants were controlled, and 33.6% of them were adherent to their drug treatment. The prevalence of hypertension in France remains high, with only 74.7% of the aware hypertensive participants receiving pharmacological therapy and only 48.9% of aware hypertensives with a BP at goal. More effective measures are needed to improve clinical management of hypertension in France.
| S-EPMC8029843 | biostudies-literature
Project description:Although resistant hypertension (RH) is known to be associated with higher rates of cardiovascular events than is non-RH, there are no reported data on the prevalence of RH in Korean patients. We evaluated the prevalence and characteristics of RH among hypertensive patients treated at primary clinics in Korea.Between August 2010 and January 2011, 247 primary care physicians enrolled 3088 patients with essential hypertension. We acquired demographic and anthropometric data using a questionnaire, evaluated blood pressure, and conducted a variety of laboratory tests using serum and urine. RH was defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg with the use of three antihypertensive agents of different classes, including a diuretic, or controlled hypertension with the use of four or more medications.We analyzed 3088 patients with hypertension, 48.3 % of whom were men. The mean age of patients was 64.3 ± 11.3 years and the prevalence of RH was 7.9 %. Patients with RH were more likely to be men, and to have higher waist circumference, increased blood levels of HbA1c, triglycerides, and serum creatinine, lower blood levels of high-density lipoprotein (HDL), and higher rates of current smoker, history of heart failure or coronary artery disease, and electrocardiographic left ventricular hypertrophy (LVH), than were patients with non-RH (all comparisons, P < 0.05). In the multivariate analysis, RH was shown to be significantly associated with the following conditions: presence of electrocardiographic LVH (odds ratio [OR] 2.23, 95 % confidence interval [CI] 1.34-3.71), current smoker (OR 1.75, 95 % CI 1.27-2.40), renal impairment (OR 1.65, 95 % CI 1.23-2.22), abdominal obesity (OR 1.60, 95 % CI 1.20-2.13), and cardiovascular diseases (OR 1.50, 95 % CI 1.04-2.17).The prevalence of RH was relatively low at primary clinics in Korea compared with the prevalence reported in other countries. RH was associated with electrocardiographically confirmed LVH, renal impairment, current smoker, abdominal obesity, and cardiovascular diseases. These are the first reported data of RH in Korea. Our findings may be helpful in the early detection and thorough clinical management of patients with RH at primary clinics.
| S-EPMC4750802 | biostudies-other
Project description:BackgroundBurnout has gained increasing attention worldwide; however, there is a lack of relevant research in China. This study investigated the prevalence and factors associated with burnout in physicians of the intensive care unit (ICU) in mainland China.MethodsThis cross-sectional multicenter study included critical care physicians from all provinces in mainland China (except Tibet). A self-administered survey questionnaire was conducted. It included three parts: demographic information, lifestyle and work information, and the Maslach Burnout Inventory. The levels of burnout were calculated. The factors independently associated with burnout were analyzed by logistic regression.ResultsFinally, 1813 intensivists participated in the survey. The participation rate was 90.7%. The prevalence of burnout and severe burnout was 82.1% (1489/1813) and 38.8% (704/1813), respectively. According to the logistic regression analysis, "difficulty in making treatment decisions" was independently associated with burnout [OR = 1.365, CI (1.060, 1.757)]. "Higher number of children" [OR = 0.714, CI (0.519, 0.981)] and higher "income satisfaction" [OR = 0.771, CI (0.619, 0.959)] were independent protective factors against severe burnout.ConclusionsThe burnout rate in ICU physicians in China is high. Difficult treatment decisions, the number of children, and income satisfaction are independently associated with burnout rates among ICU physicians in China.Trial registrationBurnout syndrome of the Chinese personnel working in intensive care units: a survey in China, ChiCTR-EOC-17013044, registered October 19, 2017. http://www.chictr.org.cn/showproj.aspx?proj=22329 .
| S-EPMC7786985 | biostudies-literature
Project description:Background: Hypertension is one of the most common metabolic diseases in the elderly and its pathogenesis is associated with microbiota dysbiosis. Recent evidence suggests that oral microbiota dysbiosis is also an important factor in the development of hypertension. However, the relationship between hypertension and oral flora in the elderly has not been adequately investigated. Objective: The aim of this cross-sectional study was to investigate the structure of the oral microbiota and its correlation with hypertension in elderly hypertensive patients. To provide new ideas for the prevention and treatment of hypertension. Methods: 206 subjects aged 60 ~ 89 years were selected and divided into normal (CON) and hypertensive (HTN) groups, according to the 2018 Chinese Guidelines for the Management of Hypertension. The oral microbiome composition of saliva samples was determined by 16S rRNA gene sequencing. Results: Although there was no significant difference in α and β diversity between the two groups, systolic and diastolic blood pressure were the most important factors influencing the structure of the oral microbiota. At the phylum level, the relative abundance of the spirochete phylum and the mutualistic bacterial phylum was higher in the HT group than in the CON group (p < 0.05). Diastolic blood pressure was negatively correlated with Streptococcus. Furthermore, we analyzed HTN patients with 120 mmHg<systolic blood pressure<160 mmHg and systolic blood pressure>160 mmHg separately and found that the abundance of Saccharibacteria_(TM7) was significantly increased in the HTN_2 group. Conclusions: Our study identified specific oral microbiota in elderly hypertensive patients, confirming the relationship between oral microbiota and hypertension. This enhances our understanding of the important role of oral microbiota in the pathogenesis of hypertension and accumulates more evidence for microbial involvement in the development of hypertension.
2024-09-17 | GSE277296 | GEO
Project description:BackgroundPrevious studies that evaluated the prevalence, awareness and treatment of hypertension in Nigeria were either localized to some specific regions of the country or non-standardized thereby making evaluation of trend in hypertension care difficult.MethodsWe used the World Health Organization (WHO) STEPwise approach to chronic disease risk factor surveillance to evaluate in a nationally representative sample of 4192 adult Nigerians selected from a rural and an urban community in one state in each of the six geo-political zones of the country.ResultsThe overall age-standardized prevalence of hypertension was 38.1% and this varied across the geo-political zones as follows: North-Central, 20.9%; North-East, 27.5%; North-West, 26.8%; South-East, 52.8%; South-South, 44.6%; and South-West, 42.1%. Prevalence rate did not differ significantly (p > 0.05) according to place of residence; 39.2% versus 37.5 %; urban vs rural. Prevalence of hypertension increased from 6.8% among subjects less than 30 years to 63.0% among those aged 70 years and above. Awareness was better (62.2% vs. 56.6%; P = 0.0272); treatment rate significantly higher (40.9 % vs. 30.8%; P < 0.0001) and control similar (14 vs. 10.8%) among urban compared to rural residents. Women were more aware of (63.3% vs. 52.8%; P < 0.0001); had similar (P > 0.05) treatment (36.7 vs. 34.3%) and control (33.9% vs. 35.5%) rates of hypertension compared to men.ConclusionOur results suggest a large burden of hypertension in Nigeria and a closing up of the rural-urban gap previously reported. This calls for a change in public health policies anchored on a primary health care system to address the emerging disease burden occasioned by hypertension.
| S-EPMC7427662 | biostudies-literature
Project description:BACKGROUND: Several healthful dietary patterns appear to be effective at lowering blood pressure and preventing hypertension. However, the relationship between dietary patterns and hypertension among a representative Chinese population sample is unclear. METHODS: A nationally representative sample of 23 671 participants aged 18-59 years were recruited by the 2002 China National Nutrition and Health Survey. All participants had their blood pressure measured with standardized mercury sphygmomanometers. Hypertension was defined as systolic blood pressure ?140 mmHg and/or diastolic blood pressure ?90 mmHg. We conducted factor analysis using dietary information from a validated food frequency questionnaire to derive dietary patterns. Information of participants on physical activities, education level, annual household income, smoking status and family history of hypertension was collected by interviewer-administrated questionnaires. RESULTS: Three major dietary patterns, defined as 'Western', 'traditional northern', and 'traditional southern', were identified. Participants with the highest quartile for the score of the Western pattern had significantly higher blood pressure comparing with counterparts in the lowest quartile. In contrast, participants in the top quartile for the score of the traditional southern pattern presented significantly lower blood pressure comparing with counterparts in the lowest quartile. In multivariate analyses the traditional northern pattern score was associated with an odds ratio (OR) of 1.30 (95% confidence interval (CI) 1.11-1.53, P for trend = 0.0001) comparing with the lowest quartile. The OR for the top quartile of score for the traditional southern pattern was 0.73 (95% CI, 0.59-0.89, P for trend = 0.0040) compared with the lowest quartile of traditional southern pattern score. However, the significant association between the traditional northern pattern and prevalence of hypertension disappeared after further adjusting for body mass index (BMI) (P for trend = 0.3), whereas the association between the traditional southern pattern and prevalence of hypertension persisted after further adjusting for BMI (P for trend = 0.01). CONCLUSIONS: We observed a positive relationship between the traditional northern pattern and hypertension that was mediated through differences in BMI. In addition, the traditional southern pattern was significantly associated with lower odds of presenting with hypertension.
| S-EPMC3299712 | biostudies-literature