Correlation between fasting blood sugar and resting blood pressure in teachers residing in Shiraz, Iran 2009

Coronary Artery Disease [CAD] is the major cause of morbidity and mortality. The knowledge about correlation between the different risk factors of CAD provides valuable information for prediction and prevention of the disease in a specific population.The aim of this study was to evaluate the correlation between fasting blood sugar [FBS] and resting blood pressure in teachers residing in Shiraz, Iran. A total of 3115 teachers from different educational centers of Shiraz, Iran were interviewed in this cross sectional study. The data obtained comprised demographic information including age, sex, and history of hypertension [HTN], diabetes mellitus [DM], and current use of medications. Other parameters measured were height, weight, fasting blood sugar [FBS] and resting blood pressure [BP] as well as calculating the body mass index [BMI]. Out of all the cases studied, undiagnosed and/or untreated cases of diabetes and hypertension were 1.5% and 15.2% respectively. FBS was higher in the elderly and in cases with higher BMI, but without any significant difference in relation to sex. The prevalence of HTN was higher in males, in older cases and in those with higher BMI. A significant relationship was observed between FBS and resting BP in hypertensive and prehypertensive groups [P < 0.001] as compared to normotensive subjects. There was a significant correlation between FBS and resting BP in hypertensive and prehypertensive teachers residing in Shiraz,Iran. But this correlation was not present in the vast majority of the population with normal resting blood pressure. The prevalence of neglected DM and HTN in this population was high enough to warrant regular screening

Correlation between HDL-C and smoking in teachers residing in Shiraz, Iran

It has been established that serum HDL-C is a main predictor for cardiovascular diseases. The aim of this study was to assess the relationship of HDL-C to smoking in teachers residing in Shiraz in order to improve the health status of the group under study and community as a whole. The present study comprised a total of 3115 teachers working in Shiraz recruited in a prospective cohort study. Of these, two groups of 235 smokers and 235 non-smokers were randomly selected for evaluation of cardiovascular risk factors, and to determine any association between serum HDL-C, LDL, triglyceride [TG], systolic and diastolic blood pressure with smoking, gender and BMI. One way ANOVA, Pearson correlation and independent sample t tests by SPSS version 16 were used for statistical analysis and all means were followed by SD. Mean age of subjects was 45.5+/-6.7 years. Of smokers 4.7% were females. Among smokers males had a significantly higher mean of HDL [P=0.002] compared to females [42 vs. 32.4 mg/dl]. HDL level was significantly lower [P<0.001] in heavy smokers compared to non-smokers and light smokers [36.5 vs 41.7 and 43.5]. However, light smokers had a higher mean of HDL than non-smokers, although the difference was not statistically significant [43.5 vs. 41.7 mg/dl, P=0.131]. Serum HDL was not affected by other factors. Smoking was associated with a low serum HDL in the subjects under study who were intellectual class of the population. It is thus warranted to take preventive measures to combat cardiovascular diseases in this sector of community

Systolic and diastolic blood pressure among three groups of occupation

It is believed that occupation influences cardiovascular risk factors. To assess blood pressure [BP] and other cardiovascular risk factors in three occupation groups-teachers, military personnel and female housekeepers residing in Shiraz, southern Iran. We studied 2783 teachers, 366 military personnel, and 1896 female housekeepers who attended various medical education centers in Shiraz. BP, anthropometric parameters as well as fasted lipid profile and blood glucose level were measured determined for each participant. The mean values of all analyzed cardiovascular risk factors were higher among female housekeepers compared to female teachers. The mean systolic and diastolic BP was significantly [<0.001, and P=0.047, respectively] higher in female housekeepers than female teachers. Neither systolic nor diastolic BP had association with the type of occupation in men [military personnel vs. male teachers]. Housekeeping compared to teaching, may increase both systolic and diastolic BP in women

Correlation between cigarette smoking and blood pressure and pulse pressure among teachers residing in Shiraz, southern Iran

Hypertension [HTN] affects nearly 26% of the adult population worldwide. Assessment of factors which influence blood pressure is a major topic for public health. One of these preventable risk factors is smoking. This cross-sectional study was conducted on 3115 [1842 [59.1%] females] teachers from Shiraz. The participants aged between 21 and 73 years. A questionnaire was used to collect data on several cardiovascular disease risk factors including smoking and blood pressure. The prevalence of smoking in our study group was 5.85%; 1.52% of the studied participants were ex-smokers. The prevalence of pre-HTN and HTN [JNC VII] was 42.6% and 18.2%, respectively. HTN was more prevalent among men and elderly people. Pre-HTN was more prevalent in smokers but HTN was more frequent in non-smokers. The mean rang of systolic and diastolic HTN, and pulse pressure was greater in heavy smokers than those who smoked <20 packs year, although the difference was not statically significant. The relation between the smoking status and blood pressure is not yet obvious. However, it seems that cessation or at least reduction in the amount of smoking would significantly decrease blood pressure

relationship between body mass index and pre-diabetes in teachers residing in Shiraz-Iran 2009

Diabetes and cardiovascular diseases often go hand in hand and conversely, many patients with established coronary heart disease suffer from diabetes or its pre-states. Thus, it is high time that diabetologists and cardiologists join their forces to improve the quality management in diagnosis and care for the millions of patients who have both cardiovascular and metabolic diseases in common. The cardio-diabetological approach not only is of utmost importance for the sake of those patients, but also instrumental for further progress in the fields of cardiology and diabetology and prevention. This descriptive cross- sectional study was conducted February to December 2009. A total of 3115 teachers residing in Shiraz aged 21- 73 years, were enrolled. Questionnaires were applied to collect information including demographic data, physical activity, history of CAD, hypertension, dyslipidemia,and smoking. In addition, waist circumference, height, weight, body mass index [BMI], and hip circumference [HC] were measured and serum biochemistry profiles were determined on venous blood samples. The prevalence of diabetes, hypercholesterolemia,hypertriglyceridemia, hypertension, overweight, obesity, central obesity, and smoking were identified based on the above mentioned data. Total prevalence of impaired fasting glucose and diabetes were 47.2% and 6.2% and the prevalence of impaired fasting glucose and diabetes were 44.3% and 5.3% among men and 49.2% and 6.6% among women respectively. Thus the association of sex with prevalent impaired fasting glucose and diabetes was signi?cant and greater among women. Diabetes and prediabetes are more prevalent in men and women who are considered as obese in regard to waist circumference and waist/hip ratio scales. This study showed a relationship between higher range of BMI and prevalence of diabetes and prediabetes. Obesity is a preventable risk factor for diabetes mellitus and preventive measures taken to control obesity are effective means of reducing the risk of diabetes mellitus and also cardiovascular disease

Prevention of deep vein thrombosis associated with temporary transvenous cardiac pacemakers by enoxaparin

The purpose of this prospective study is to quantify the risk of lower limb deep venous thrombosis [DVT] in patients requiring temporary transvenous femoral pacing and to evaluate the use of different enoxaparin dosages [Prophylactic or therapeutic] for thrombus prevention. Transvenous temporary cardiac pacemaker, with catheters frequently used along the femoral vein is useful to relieve difficult bradyarrythmias and some tachyarrythmias. Up to one-third of patients receiving transfemoral pacing develop asymptomatic DVT. At present, there are no recommendations for thrombus prophylaxis in these patients. Besides, the efficacy in this specific condition has not been studied. Sixty consecutive patients who underwent transvenous femoral pacing and had no contraindication to low molecular weight herparin [LMWH] therapy were divided into 3 groups each group consisted of 20 patietns. Group I received prophylactic enoxaparin [1mg/kg/day; subcutaneously], group II received therapeutic enoxaparin [1mg/kg/day every 12 hours; subcutaneously], and group III consisting of patients who were not treated with enoxaparin was considered as control groups. Patients were evaluated daily for clinical features of DVT. Color Doppler sonography imaging was performed on both lower limbs of all patients within 24 hours after removal of the temporary pacemakers. Of the sixty patients, two who belonged to group III, had definitive evidence of right lower limb DVT by color Doppler sonography. These two cases of DVT were asymptomatic and had thrombosis of femoral vein. No evidence of thrombus was detected in contra lateral lower limb. No DVT was detected among patients who received prophylactic or therapeutic doses of enoxaparin. No heparin related complications were detected in this study. There were no significant difference in the clinical characteristics among 2 groups [I,II] and control group. Correlations of age and gender with occurrence of DVT were not significant [P= 0.512, 0.737]. This study showed that DVT is a common complication of femoral pacing, and that its incidence can be reduced with the use of prophylaxis and therapeutic intravenous enoxaparin

Interleukin- 18 gene polymorphism in patients with and without atherosclerotic coronary artery disease

Several studies have revealed that inflammation plays an important role in development of Coronary Artery Disease [CAD] and its other manifestations. IL-18 is a pleiotropic cytokine that enhances Th1 [T helper 1] or Th2 [T helper 2] immune response depending on its cytokine milieu and genetic background. It strongly induces formation of plaques in patients with CAD. Variation in the Il-18 gene found to influence both levels of IL-18 and clinical outcomes in individuals with history of heart disease. To investigate the association of two IL-18 promoter gene polymorphisms at -607C/A and - 137 G/D positions with CAD, and some CAD risk factors such as diabetes, arterial hypertension, hypercholesterolemia, cigarette smoking and obesity. Genomic DNA was extracted by the salting out method from the peripheral arterial blood of 280 patients with CAD documented by coronary angiography [143 with a documented history of myocardial infarction termed positive MI and 137 without myocardial infarction designated negative MI] and 140 age- sex matched persons with a normal coronary angiography [control group]. The genotype of both CAD and control groups were assessed by ASP-PCR method. Arlequin program was used for gametic phase estimation and haplotype analysis. There was no significant difference between patient and control groups either allelic, genotypic, and haplotypic for both variants[p>0.05]. Furthermore, no significant correlation was found between IL-18 genotypes and CAD risk factors in the patient group [P>0.05]. There results suggest that the investigated IL-18 gene promoter polymorphisms at -607 C/A and -137G/C positions are not associated with genetic susceptibility to CAD in southern Iran

Safety of enoxaparin versus unfractioned heparin in patients undergoing percutaneous coronary intervention using drug eluting stents: a pilot study

Unfractioned heparin [UFH] is the standard antithrombotic agent in elective percutaneous coronary intervention [PCI], but has its own limitations. Several studies have suggested intravenous enoxaparin as a safe and effective alternative but most of them are uncontrolled. Our main goal was to evaluate the safety of enoxaparin over UFH in PCI patients undergoing coronary stenting by drug eluting stents [DES].We randomly assigned 195 patients undergoing PCI using DES to receive either 0.75 mg enoxaparin per kilogram of body weight or 10000 IU unfractioned heparin. The primary end point was the incidence of major or minor bleeding. The secondary end point was the incidence of acute coronary events [ST-elevation myocardial infarction, non ST-elevation myocardial infarction,and unstable angina] in the first 24 hours after PCI. The rate of major and minor bleedings was similar in the first 24 hours after procedure between enoxaparin group and UFH group [P value>0.05]. The incidence of acute coronary events and mortality was also similar between two arms.In DES based PCI, a single intravenous bolus of 0.75 mg of enoxaparin per kilogram is associated with similar rate of bleeding as compaired with UFH. Also the rates of ischemic events are not different for enoxaparin and UFH however larger trials are needed for definit conclusion

Knowledge, attitude and practice of general physicians in treatment and complications of hypertension in Fars province, southern Iran

Hypertension as a community health problem, showing an increasing trend in many parts of the world. Controlling the disease depends on knowledge, attitude and practice [KAP] of general physicians as the main health providers in the community. In this study, the impact of KAP of general physicians on hypertension, as the first line of treatment of hypertension was evaluated. In a cross-sectional study, 300 general physicians working in health and treatment sectors of Fars Province, southern Iran were entered in our study and their KAP were determined utilizing a validated and reliable questionnaire. The questionnaire consisted of 52 items incorporated in four sections. The mean age of general physicians was 38.2 +/- 3.6 years. 64.2%, 20.3%, and 26.5% of general physicians were visited by four to eight, more than eight, and less than four hypertensive patients per week respectively. Although 99% of physicians believed in the importance of hypertension as a community health problem, but 12% had requested for appropriate paraclinical tests and 20% could handle hypertensive patients properly. Only 45% of physicians had measured their own blood pressure within the last year of practice. Scientific meetings and educational programs were more important than information provided by drug companies and journals in promotion of knowledge, attitude and practice of general physicians. Since the physician's knowledge, attitude and practice are important issues in controlling and prevention of hypertension, promotion of their knowledge on hypertension seems necessary in prevention of subsequent complications