Predictors of hypertension in Oman

Background: According to the Oman World Health Survey in 2008, the prevalence of hypertension in Oman is about 40%. Hypertension is associated with old people, male gender, smoker and impaired glucose tolerance. The objective of the study was to find out the important predictors of hypertension in Oman.Methods: A cross sectional study in Omani adults more than 18 years of age was conducted. Blood pressure was measured and participants were classified as having hypertension. Height and weight was measured and body mass index was used to classify obesity by WHO guidelines. Multiple logistic regression was used to find the predictors of hypertension.Results: Increase in age and body mass index were found to be important covariates of hypertension. People in the age group of 30 to 50 years were at high risk of hypertension (OR 1.6, p<0.05); likelihood increased to three times in more than 50 years age group (p<0.01) in univariate analysis. Overweight had almost 2 times (p<0.05) and obese had five times (p<0.01) more likelihood of hypertension than normal weight people. People with less education had more likelihood of hypertension. Smokers (OR 2.9, p<0.01) and males (OR 1.5, p<0.05) were at a higher risk of hypertension than non-smokers and females in multivariate analysis. Percentage accuracy of classification was 67.4%.Conclusions: Age more than 50 years, male gender, BMI more than 30 and smoking were important predictors of hypertension in the study population

Which is a better marker for overweight: waist height ratio or waist circumference?

Background: The global prevalence of obesity has been increasing. Body mass index, waist circumference and waist height ratio have been widely used for nutritional assessment. Waist height ratio has the advantage of taking into account abdominal obesity as well as height associated with body fat accumulation or distribution. The objective of this study was to suggest cut off points for waist circumference and waist height ratio to identify overweight in Omani adults.Methods: Weight, height, waist circumference and waist height ratio were measured for all participants. Pearson’s correlation was used to determine correlation of BMI with waist circumference and waist height ratio. ROC curve was used to identify AUC and specific cut off point for anthropometric indicators.Results: The largest proportion of overweight was picked up by waist height ratio across both the genders. Correlation of BMI with waist height ratio was stronger (r=0.699) than correlation with waist circumference (r=0.589) for both the genders. Maximum AUC was for waist height ratio in males (AUC=0.833, 95% CI=0.791-0.875). The specific cut off point for waist circumference in males and females was 89.5cm and 87.6cm respectively. The specific cut off point for waist height ratio in males and females was 0.53 and 0.57 respectively.Conclusions: Maximum participants were found overweight by waist height ratio followed by waist circumference and the least by BMI. The higher cut off points should be used in this population for identifying overweight people.

Morphometric Evaluation of Foramen Magnum in Dry Human Skulls.

The foramen magnum is an important landmark in the posterior part of the cranial base, which is largely formed by the occipital bone. The dimensions of the foramen magnum are clinically important because of the vital structures passing through it. We studied thirty six dry human skulls of known sex and measured anteroposterior and transverse diameters with the help of Vernier caliper. Additionally, surface area and Index of foramen magnum were also calculated. Oval shape is the main type of morphological variant found in this study. The transverse diameter of the foramen magnum was in a range of 25.75-34.25mm in males, whereas it was between 26-31.75mm in females. The anteroposterior diameter was in a range of 35 to 39.75mm inmales while it was 29.5 to 34.75mm in females. The mean area of foramen magnum in males was 876.88±88.83mm whereas it was 776.87±68.51mm in females. In contrast to the area, the mean foramen magnum index was higher in females (89.01±6.84mm) compared tomales (81.75±5.99mm) and this difference was also statistically significant (p<0.01). The prospective study will help surgeon for reference value for determining feasibility of transcondylar surgical approach, which are being done in an increasing trend in recent times for brain stem lesion.