Riesgos modificables relacionados a la hipertensión arterial / Modifiable risks related to hypertension arterial

La hipertensión arterial (HTA) es una de las causas de muertes a nivel mundial, esta enfermedad incrementa significativamente los riesgos de sufrir cardiopatías, encefalopatías, nefropatías y otras enfermedades. Su prevalencia está asociada a países de bajos y medianos ingresos, y se consideran factores de riesgos al estrés, alcoholismo, obesidad, tabaquismo, drogas, alimentación, genética, raza, y ciertas patologías como diabetes mellitus, algunas de ellas consideradas como factores de riesgo modificables y que pueden ser medidas de prevención y control en su tratamiento. Objetivo: Recopilar información sobre los transcriptores riesgos modificables relacionados a la hipertensión arterial. Materiales y Métodos: El estudio es del tipo descriptivo, La metodología es una revisión narrativa, con recopilación de literatura referente al tema y disponible en la web, se emplearon los descriptores: hipertensión, factores de riesgo. Resultados: Aporte de información relevante sobre los factores de riesgos modificables entre ellos el consumo de tabaco y alcohol, reducción de peso, alimentación, actividades físicas, reducción del consumo de sal, aumento del consumo de hortalizas y frutas, además de la disminución en el consumo de alimentos grasos, sales, y un control periódico de la tensión arterial, bajo la supervisión médica que son considerados para la prevención y control de la HTA, como métodos alternativos para control y prevención de esta enfermedad. Conclusiones: Los factores de riesgo modificables que predominan son el consumo de grasas, ausencia del control del índice de masa corporal y de la presión arterial, así como el consumo excesivo de sal y presencia de estrés. Los factores de riesgo no modificables que predisponen a hipertensión arterial prevalentemente son los antecedentes familiares de HTA y de obesidad. Se ha determinado que los cambios en el estilo de vida, así como una conducta sana para la prevención y control de riesgos que son modificables atenúan la prevalencia de la misma(AU)

Arterial hypertension (AHT) is one of the causes of death at the Worldwide, this disease significantly increases the risk of heart disease, encephalopathies, nephropathies and other diseases. Its prevalence is associated with countries of low and medium income, and are considered risk factors for stress, alcoholism, obesity, smoking, drugs, food, genetics, race, and certain pathologies such as diabetes mellitus, some of them considered as modifiable risk factors and that can be prevention and control measures in their treatment. Objective: Collect information on transcriptionists modifiable risks related to hypertension arterial. Materials and methods: The study is of the descriptive type, the methodology is a narrative review, with a compilation of literature on the subject and available on the web, used the descriptors: hypertension, risk factors. Results: Contribution of relevant information on modifiable risk factors, including the consumption of tobacco and alcohol, weight reduction, nutrition, physical activities, reduction of salt intake, increased consumption of vegetables and fruits, in addition to the decrease in the consumption of fatty foods, salts, and periodic control of blood pressure, under the medical supervision that are considered for the prevention and control of hypertension, such as alternative methods for control and prevention of this disease. Conclusions: The modifiable risk factors that predominate are the consumption of fats, absence of control of body mass index and blood pressure, as well as excessive consumption of salt and presence of stress. Non-modifiable risk factors that predispose to high blood pressure are predominantly a family history of hypertension and obesity. It has been determined that changes in lifestyle, as well as behavior healthy for the prevention and control of risks that are modifiable attenuate the prevalence ofthe same(AU)

Correlates of hypertension among persons living with HIV at Livingstone Central Hospital: A cross sectional study

Background: Persons living with HIV (PLWH) are more likely to develop hypertension and cardiovascular disease than the HIV-negative population. The new hypertension guidelines by the American Heart Association (AHA) and the American College of Cardiology (ACC) lowered the definition of hypertension from systolic and diastolic blood pressure (BP) of ≥ 140/90mmHg to ≥ 130/80, respectively. This study was aimed at determining the prevalence and factors associated with hypertension in PLWH in Livingstone using the new hypertension diagnostic criteria. Methods: This was a cross-sectional study. We recruited 226 antiretroviral treated PLWH attending routine visits. Socio-demographic, health and clinical data including BP readings were collected. Interviewer-structured questionnaires adapted from the World Health Organization Stepwise approach to Surveillance ( WHO STEPs) and the international physical activity questionnaire (IPAQ) were used to collect data. Statistical evaluations were employed to elucidate relationships between hypertension and all response variables. Results: The prevalence of hypertension using the old and new guidelines was 16% and 42%, respectively. Factors significantly associated with increased and reduced odds of developing hypertension after adjustments in multivariate logistic regression were age, body mass index (BMI), employment status, fasting blood sugar (FBS) and table salt consumption, respectively (p<0.05 for all). Using the new AHA/ACC criteria for hypertension shifted the prevalence from 16% (old criteria) to 42%.Conclusion: The prevalence of hypertension in PLH in Livingstone was 42% and the major risk factors associated with hypertension in PLWH were increasing age, BMI and FBS. We recommend the inclusion of FBS in routine measurements in PLWH. The AHA/ ACC new guidelines should be reenforced in low-cost settings to increase the treatment of hypertension among PLWH.

Acute Myocardial Infarction Patients’ Knowledge Regarding the Modifiable Risk Factors of Heart Disease

Background: Acute myocardial infarction (heart attack) is a condition of the heart that occurs when blood flowto the heart muscles is stopped abruptly. The disruption in blood flow to the heart muscles is usually caused by ablockage of one or several coronary arteries. Heart attacks can be fatal owing to the critical functions performedby blood in the heart. Fatalities arising from heart attacks are witnessed all over the world. The difference infatality rates of heart attacks is highly dependent on the exposure to risk factors such as smoking and obesity.Healthy living populations will rarely encounter high cases of a heart attack. This study was set out to assess anddocument the knowledge level of acute myocardial infarction patients regarding the modifiable risk factors of aheart attack in Saudi Arabia. Patients suffering from a heart attack are at great danger of fatality. Knowledge ofmodifiable factors can promote healthy living habits and behaviors among them. Methods: A cross-sectionalsurvey was developed to assess knowledge levels of acute myocardial infarction patients in the three cities ofRiyadh, Jeddah, and Dammam. A total of 123 participants were recruited through convenient sampling across15 hospitals in the cities. The eligibility criteria for recruitment included a mandatory age of 18 years and SaudiArabian citizenship. Participants were issued with questionnaires containing different questions on modifiablerisk factors (fatty foods, vegetables, fruits, smoking, physical exercise, and obesity). Results: Five out of the sixmodifiable factors represented knowledge levels of less than 50%. Participants were only knowledgeable on therisk factor of obesity which saw 52.8% associating it with a heart attack. Conclusion: There is a need to boosteducation and awareness among acute myocardial infarction patients in Saudi Arabia.

Caracterización clínica-epidemiológica de la hipertensión arterial / Clinical-epidemiological characterization of arterial hypertension

Introducción: La hipertensión arterial constituye uno de los problemas médicos más importantes de la medicina contemporánea en los países desarrollados y se le ha denominado la plaga silenciosa del Siglo XXI. Objetivo: Caracterizar clínica y epidemiológicamente la hipertensión arterial en pacientes hipertensos. Métodos: Se realizó un estudio observacional, descriptivo, de corte longitudinal prospectivo. El universo estuvo constituido por 193 pacientes hipertensos de la población del consultorio 7 del Policlínico: Aleida Fernández Chardiet, en el período comprendido entre enero y diciembre del año 2017. Se utilizaron distribuciones de frecuencias, cálculos porcentuales y medidas de tendencia central. Resultados: Del total de pacientes, 48,7 por ciento pertenecía al grupo de edad 40 y 59 años. Predominaron las féminas (112/58,03 por ciento) y los pacientes de piel negra (36,8 por ciento). El factor de riesgo modificable que predominó fue el tabaquismo, presente en 62,7 por ciento 55,4 por ciento presentó cifras de tensión arterial controladas. La mayoría usaba 2 fármacos antihipertensivos (44,6 por ciento). Conclusiones: La hipertensión arterial en el adulto es mejor controlada a menor edad y cuando se utilizan dos fármacos. El principal factor de riesgo de los hipertensos fue el tabaquismo(AU)

Introduction: Hypertension is one of the most important medical problems of contemporary medicine in developed countries and it has been named the silent plague of the twenty-first century. Objective: To describe clinical and epidemiologically arterial hypertension in hypertensive patients. Methods: An observational, descriptive and prospective longitudinal study was carried out. The sample was of 193 hypertensive patients of the population belonging to the Family Doctor's office num. 7, Aleyda Fernández Chardiet Teaching Polyclinic, in the period between January and December, 2017. Frequency distributions, percentage calculations and measures of central tendency were used. Results: Of the total number of patients, 48.7 percent belonged to the age group from 40 to 59 years. There was a predominance of females (112; 58.03 percent) and patients with black skin (36.8 percent). The predominant modifiable risk factor was smoking habit that was present in the 62.7 percent; while the 55.4 percent presented controlled blood pressure´s numbers. Most of the patients used two antihypertensive drugs (44.6 percent). Conclusions: Hypertension in adults is better controlled at a lower age and when using two drugs. The main risk factor of hypertensive patients was smoking habit(AU)

Modifiable risk factors of noncommunicable diseases in urban adolescents of Girdhar Nagar, Ahmedabad: A cross-sectional study

Background: Noncommunicable diseases (NCDs) have become a major health burden globally. The four main NCDs (heart disease, stroke, diabetes, and cancers and chronic respiratory diseases) share four modifiable risk factors: Tobacco use, harmful alcohol use, physical inactivity, and unhealthy diet. To minimize the burden of NCD epidemic, main risk behaviors common among young people must be curbed. Measurement of NCD risk factors is necessary to plan out the interventions and would also serve as a stepping stone in achieving primordial prevention of NCDs. Objective: The objective of the study was to measure the modifiable risk factors of NCDs among school-going adolescents of urban Ahmedabad. Materials and Methods: This cross-sectional study was conducted from November 2016 to January 2017 among two schools of Girdhar Nagar ward, Ahmedabad. 581 adolescents of a private and a government-run school, studying in class 8th–10th, of ages 12–16 were interviewed using GSBHS tool after taking informed consent. Appropriate anthropometric and blood pressure (BP) measurements were taken. Statistical analysis: Epi info ver. 7.0 and MS Excel 2007 used for analysis. Chi-square test, t-test, and multiple regression were applied. P < 5% was considered significant. Results: 52% (303) of the subject studied were boys and 48% (278) were girls. Among all, 66% (384) were physically inactive, 88% (511) were not consuming ≥5 servings of fruits and vegetables/day, 65% (376) and 78% (452) regularly consumed soft-drinks and fast food, respectively. 1.5% (9) of the subjects smoked and 3%(15) consumed smokeless form of tobacco. No student admitted consuming alcohol. 11% (65) were overweight and 13% (73) were obese. Raised systolic BP (>140 mmHg) was found in 3% (18) and raised diastolic BP (>90 mmHg) was found in 0.5% (3) of study subjects. Conclusion: One or more risk factors were found to be prevalent in all subjects. The presence of one or more modifiable risk factors in every adolescent point toward the dire need of school-based interventions for the prevention of NCDs in future adults.

Factores de riesgo asociados a pie diabético en el hospital PNP Luis N. Saenz, año 2017 / Risk factors associated to diabetic foot at Luis N. Saenz PNP hospital, year 2017

Introducción: El pie diabético es una de las complicaciones más graves y frecuentes de la diabetes mellitus, por tal motivo es importante conocer los factores de riesgo que lo desencadenan. Objetivo:Determinar los factores de riesgo asociados a pie diabético en el hospital PNP Luis N. Sáenz, año 2017. Métodos: Estudio observacional, cuantitativo, retrospectivo, analítico, de casos y controles. La muestra la conformó 165 pacientes (55 casos y 110 controles) atendidos en el servicio de endocrinología en el año 2017. Se estudiaron factores de riesgo, modificables y no modificables, asociados al desarrollo de pie diabético; se recogió la información de las historias clínicas mediante una ficha de recolección de datos, la cual fue analizada mediante el programa SPSS versión 25.0 utilizando los modelos estadísticos de Chi cuadrado y el odds ratios con un nivel de significancia menor a 0.05% y un intervalo de confianza de 95%. Resultados: Los factores de riesgo asociados a pie diabético son tiempo de enfermedad (p: 0,000; OR: 12.77; IC: 4.12 ­ 39.60), hemoglobina glicosilada mal controlada (p: 0.029; OR: 4.55; IC: 1.17 ­ 17.68), onicomicosis (p: 0.014; OR: 7.10; IC: 1.48 ­ 34.07); antecedente de tabaquismo (p: 0.031; OR: 2.66; IC: 1.09 ­ 6.34) y enfermedad renal crónica (p: 0.047; OR: 3.023; IC: 1.01 ­ 9.0). Conclusión: Se concluye que hay asociación estadística significativa entre tiempo de enfermedad, hemoglobina glicosilada mal controlada, onicomicosis, enfermedad renal crónica y antecedente de tabaquismo, con desarrollar pie diabético.

Introduction: Diabetic foot is one of the most serious and frequent complications of diabetes mellitus, for this reason it is important to know the risk factors that trigger it. Objective: To determine the risk factors associated with diabetic foot in the PNP Luis N. Sáenz Hospital, 2017. Methods: Observational, retrospective, analytical, case and control study of 165 patients (55 cases and 110 controls) treated in the endocrinology service in 2017. Modifiable and non-modifiable risk factors associated with the development of diabetic foot were studied; the information of the clinical histories was collected through a data collection form, which was analyzed by means of the SPSS program version 25.0 using the statistical models of Chi square and the odds ratios with a level of significance less than 0.05% and a range of 95% confidence. Results: The risk factors associated with diabetic foot are disease time (p: 0.000, OR: 12.77, CI: 4.12 - 39.60); poorly controlled glycosylated hemoglobin (p: 0.029, OR: 4.55, CI: 1.17 - 17.68); Onychomycosis (p: 0.014, OR: 7.10, CI: 1.48 - 34.07); antecedent of smoking (p: 0.031, OR: 2.66, CI: 1.09 - 6.34) and chronic kidney disease (p: 0.047, OR: 3.023, CI: 1.01 - 9.0). Conclusion: We conclude that there is a statistically significant association between time of illness, poorly controlled glycosylated hemoglobin, onychomycosis, chronic kidney disease, history of smoking and developing diabetic foot.

Prevalence of modifiable risk factors for non-communicable diseases in urban slum: a cross sectional study using WHO STEPS approach

Background: Non communicable diseases (NCDs) represent a cluster of major chronic diseases. Smoking habit, alcoholism, low quality diet intakes, physical inactivity are some of the established risk factors of the NCDs. In developing country like India the problem of lifestyle and its consequent diseases needs to be addressed vigorously by all public health care personnel. Objective of the study was to assess prevalence of modifiable risk factors using the WHO STEPS approach in urban slum.Methods: A community based cross-sectional study was carried out in the field practice area of urban health training centre of the department of community medicine of PCMS and RC, Bhopal using questionnaire.Results: Highest prevalence of modifiable risk factor was inadequate diet (85.2%), followed by smokeless tobacco consumption (59.1%) and low physical activity (46.1%). Tobacco smoking (31.9%) and alcohol (22.6%) were next, followed by high blood pressure (20.1%). Prevalence of least risk factors was overweight (13.9%).Conclusions: It can be concluded from our study that the burden of risk factors for NCDs is quite high. Its prevalence even in the younger age groups is a pointer to the fact that the burden of NCDs is going to rise in near future.

The Risk Factors for Undiagnosed and Known Hypertension among Malaysians

@#Background: The prevalence of known hypertension has resulted from the progression of undiagnosed hypertension. This study is targeted to examine and compare the risk factors based on the estimated odds ratios of modifiable and non-modifiable risk factors on different outcome levels of hypertension. Methods: A nationwide representative secondary data from the Fourth National Health of Morbidity Survey (NHMS IV) which consists of 24,632 non-institutionalised Malaysian population conducted by the Ministry of Health in 2011 has been used. Odds ratio (OR) with 95% confidence interval has been estimated using multinomial logistic regression. Results: Obese and overweight respondents exhibit increased likelihood of having undiagnosed and known hypertension. Physically inactive, ex-smokers and unclassified drinkers are found having higher likelihood to have known hypertension. However, current drinkers are found to have higher likelihood of having undiagnosed hypertension. Elderly, retirees, home makers and lower educated respondents are shown higher odds to have undiagnosed hypertension. Likewise, the likelihood of having known hypertension has been found to increase among the elderly and other Bumiputra. Conclusion: Through this research, significant predictors which consist of obese and overweight respondents, current drinkers, older respondents (above 65 years old) and primary educated respondents are having higher likelihood to have undiagnosed hypertension.

Prevalence of Diabetes Mellitus and its risk factors

Background: The high prevalence of DM may be due to rapid urbanization of the suburban regions. India is also at an early stage of epidemiological transition from communicable to non-communicable diseases because of the gradual adoption of unhealthy lifestyles characterized by increasing intake of high calorie-dense foods and decreased physical inactivity. Aim: To evaluate the prevalence of DM and its associated factors among individuals aged above 15 years. Materials and methods: A cross sectional study was conducted in our hospital for a period of 4 months January-April, 2018 in Department of General Medicine. The sample size was 250 subjects. Informed verbal consent was gathered from each participant. Study done in department of general medicine in subjects identified with hypoglycemia, impaired fasting glucose (IFG), and diabetes were selected for study. Results: A total of 250 participants were included in the study. The prevalence of DM was found to be 6.4%. About one third (32%) of the total (250) participants said that they were frequent alcohol drinkers, whereas 1.2% (3/250) of them reported that they were ex-drinkers. Out of the total study participants, 6.4% of them had ≥126 mg/dl fasting blood glucose level. Conclusion: Age, waist circumference, hypertension, BMI, smoking habit and total cholesterol are significant in prevalence of diabetes mellitus.

Risk Factors Of Newly Diagnosed Hypertension Among Individuals In Malaysia

@#The aim of this study is to examine the influence of risk factors which include modifiable and non-modifiable risk factors on the likelihood of newly diagnosed hypertension among Malaysians. A cross-sectional population-based survey: The Fourth National Health and Morbidity Survey (2011) was conducted by the Ministry of Health, Malaysia in 2011. The sample included 20,095 participants. This study uses binomial logistic regression techniques to predict the likelihood of modifiable and non-modifiable risk factors of newly diagnosed hypertension among the individuals. The analysis has been carried out by estimating odds ratio with 95% confidence interval. This study reveals that obese and overweight respondents as well as current drinkers have increased chances of having newly diagnosed hypertension. In contrast to that, only physically inactive respondents exhibit lower odds of newly diagnosed hypertension. Besides that, the significant predictors, which include older respondents, retirees and home makers, as well as lower educated respondents are respectively found to be more likely to have newly diagnosed hypertension. On the other hand, female respondents, urban dwellers, including the Chinese and Indian respondents, the highest income earners and underweight respondents have been found to have statistically significant lower odds of newly diagnosed hypertension. Through the insightful findings and evidence, this research provides a platform for the early detection and prevention of newly diagnosed hypertension. Hence, this study offers a means to monitor and control the increasing prevalence of newly diagnosed hypertension in Malaysia.

Study on Type of Stroke with Special Preference to Association of Modifiable Risk Factors in Kosi Zone

Background: Stroke is a global health problem and the second most common cause of death. It also entails a high socioeconomic burden due to increased mortality and morbidity. Despite substantial advances for treatment of stroke, effective primary stroke prevention remains the best means for reducing stroke burden. Methods: It was a cross-sectional study including 100 cerebrovascular patients and hundred non-cerebrovascular accident controls(age-sex matched) who were studied to determine the  incidence of various types of stroke and association of various modifiable risk factors with stroke. Results: Incidence of ischaemic stroke was more than haemorrhagic stroke. Also, strong correlation exists between smoking, hypertension, diabetes, dyslipidemia and stroke. Conclusions: Effective management of these common risk factors can reduce the incidence, mortality and morbidity associated with stroke. Hence, primary prevention of stroke is of immense public health importance.

Modifiable Risk Factors Of Cardiovascular Disease Among Adults In Rural Community Of Malaysia: A Cross Sectional Study

Cardiovascular disease (CVD) is the leading cause of death in Malaysia and many parts of the world. Potentially modifiable risk factors for CVD include diabetes mellitus, hypertension, abdominal obesity, smoking and psychosocial stress. Over the last several decades, efforts to prevent or treat CVD risk factors have resulted in significantly lower rates of CVD-related mortality. However, many patients have never achieved adequate control of CVD risk factors despite them being identified. The aims of this study were to measure the prevalence of cardiovascular diseases and to determine its associated factors. A cross sectional study was carried out in a rural area of Malaysia from March 2011 to November 2011 on 1489 respondents aged 18 and above who were selected via convenient sampling. The survey was conducted via a face-to-face interview using a standardized self administered questionnaire. Prevalence of cardiovascular disease identified was 72 cases (4.8%). Overall, the prevalence of modifiable risk factors were predominant compared to non modifiable, with abdominal obesity (51.2%) hypertension (39.5%) and psychosocial stress (33.8%) being among the highest. However, the prevalence of other modifiable risk factors was relatively low with smoking (25.2%), and diabetes mellitus (10.9%) respectively. Respondent with diabetes mellitus and hypertension were 4 times more likely to have cardiovascular disease and those who are obese had associated 2.5 risks towards cardiovascular disease. Therefore, community health intervention measures should be mobilized, specifically on prevention and control of lifestyle-related risk factors.

Genomic Epidemiology of Congestive Heart Disease, Pharmacogenomics and the Relevant Health Education Implications in the Age of Genomic Medicine.

This project investigated genomic epidemiology of congestive heart disease, the clinical and non-invasive techniques for diagnosis and the modifiable and non-modifiable risk factors associated with the disease were explored. Trends in the morbidity and mortality of CHD revealed an increase in the disease frequency with minor drop in its’ trajectory into the twenty-first century. While the modifiable risk factors were discussed with suitable interventions, the non-modifiable risk factors demand prompt medical diagnosis and treatment if any. The genes incriminated were listed. The relevance of pharmacogenomics cannot be overstated in the age of genomic medical science. But by far most important is the consumption of food items rich in phyto-nutrients to maximize public health and minimize the impact of dangerous lipids in our diet.