ABSTRACT
BACKGROUND, Hypertension is one of the major causes of cardiovascular morbidity and mortality. However, awareness, treatment, and control of hypertension remain major challenges worldwide. In this article, we present the baseline prevalence of hypertension from an ongoing intervention program for its control in a community-based sample in Kerala, Southern India. METHODS, We measured blood pressure, body weight, and height of 4955 individuals above the age of 30 yers (men;2159:mean-age: 50 years) and collected information on alcohol use, tobacco use, and other demographic variables using a pre-tested structured questionnaire. RESULTS, The overall prevalence of hypertension (JNC-VII) was 36.7% ( 95% CI:35.5-38.0; men: 36.0% and women 37.2% ) in multipile logistic regression analysis, a body mass index of >/=25 kg/m(2) was associated with a 1.65-fold (95% CI:1.37-1.98) prevalence of hypertension compared to a body mass index <25kg/m(2). Individuals with diabetes mellitus had 2.10 higher odds of hypertension prevalence (95% CI: 1.62-2.73) compared to people wihtout diabetes mellitus. Participants with increased waist circumference (90 cm in men, 85 cm in women) were 1.84 times more likely to be hypertensive compared to those with normal waist circumference (95% CI: 1.55-2.19). Among hypertensives, 24% were aware of the condition, 20% were on treatment, and 6.4% achieved effective blood pressure control. CONCLUSION, A higher body mass index, increased waist circumference, and self-reported diabetes mellitus were the important correlates of hypertension in our community-based sample. Our data emphasize the importance of educational interventions and appropriate lifestyle modifications that target increased body mass index and waist circumference to reduce the community burden of hypertension.
ABSTRACT
BACKGROUND: Left atrial compliance is an important determinant of symptoms in mitral stenosis. About one-third of patients with mitral stenosis have reduced left ventricular compliance. We measured the net atrioventricular compliance in rheumatic mitral stenosis patients noninvasively and analyzed if there were any clinical, electrocardiographic, roentgenographic or echocardiographic correlates of net atrioventricular compliance. METHODS AND RESULTS: Seventy-six patients with mitral stenosis were analyzed and as many normal subjects were taken as control group. Patients were divided into two groups--those 20 years and below were grouped as juvenile mitral stenosis and those above 20 years as adult mitral stenosis patients. The net atrioventricular compliance in patients with mitral stenosis was significantly impaired compared to normal population. Mean compliance in juvenile group was 4.66+/-2.18 ml/mmHg (range 2.17-9.6) and in adult group it was 4.79+/-1.99 ml/mmHg (range 2.04-8.9) (p = ns). There was no difference in net atrioventricular compliance between the juvenile and adult patients with mitral stenosis. Mitral valve area showed an independent positive correlation with net atrioventricular compliance. CONCLUSIONS: The net atrioventricular compliance was significantly reduced in patients with rheumatic mitral stenosis; however, there was essentially no difference in the net atrioventricular compliance between the juvenile and adult patients with mitral stenosis. The net atrioventricular compliance may not be responsible for the more severe symptoms observed in juvenile mitral stenosis.