Determinants of diabetes and hypertension control in ambulatory healthcare in Al Ain, United Arab Emirates

This study aims to study determinants for the control of diabetes and hypertension in Al Ain Ambulatory Healthcare patients. This is a cross sectional observational study of patients attending ambulatory healthcare centers in Al Ain, United Arab Emirates in 2009. From a yearly audit evaluating the care of patients with diabetes and hypertension, the determinants for improved diabetes and hypertension outcomes were identified from a total of 512 patients and its association with glycemic and blood pressure control were studied. From all variables studied, only the clinic where the patient was treated helped predict both improved blood sugar and blood pressure control. For patients with diabetes, poor control the year before [p<0.001], the number of chronic disease clinic visits [p=0.042] and triglyceride levels [p=0.007] predicted worse control of diabetes. A predictor of poor control of blood pressure [p<0.001] for patients with hypertension was poor control of blood pressure in the year before. In this population, the healthcare system and the team played major roles as determinants in the control of patient's diabetes and blood pressure more than any of the other factors examined

Plasma endothelin-1, homocysteine, and nitric oxide levels in a multiethnic hypertensive cohort from the United Arab Emirates

Hypertension is a major cause of morbidity and mortality in the United Arab Emirates [UAE]. However, little is known regarding vasoactive biomarkers and lipid profiles in hypertensives versus normotensives in this heterogeneous ethnic population. This study aimed to evaluate plasma endothelin-1 [ET-1], homocysteine [Hcy], nitric oxide [NO], and lipid parameters among hypertensive subjects and normotensives controls in a heterogeneous ethnic population from the UAE. We collected venous samples from 164 hypertensive and 112 normotensive subjects matched for age, gender and ethnicity to determine their plasma levels of ET-1, Hcy and NO as well as their lipid profile. Hypertensive subjects displayed significantly higher plasma levels of ET-1 [p < 0.001] and NO [p < 0.001] but lower insulin levels [P<0.006] than normotensives. In contrast, there was no statistically significant difference with regard to Hcy concentrations. Very low-density lipoprotein [VLDL] and triglycerides [TG] levels were significantly [p < 0.01] higher in hypertensives than controls. Total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], and non-esterified fatty acids [NEFA] were significantly lower [p < 0.01] in hypertensives than normotensives. In our heterogeneous ethnic population, levels of ET-1 and NO, but not of Hcy, were found to be associated with hypertension and may possibly contribute to an increased systemic vascular resistance among hypertensives. Whether the elevated ET-1 results are because of overproduction or decreased clearance remains to be ascertained Elevated levels of TG and VLDL, alongside with unaltered TC levels, seem to indicate the presence of type IV hypertriglyceridaemia

Refusal to participate in blood testing in a study of childhood immunizations and atopic disorders: characteristics of non-participants and assessment of possible bias

Assessing characteristics of non-participation in epidemiological studies is often complicated by lacking information. The aim was to assess characteristics of nonparticipants in blood testing and possible nonparticipation bias in our previous study on the impact of vaccinations on atopic disorders. In a previously conducted study on vaccinations and allergy we now used multivariable logistic regression to assess characteristics of non-participants in blood testing, an optional part of the study protocol. Possible bias due to this non-participation was assessed by an analysis weighted with the inverse of the probability of being a participant and by a sensitivity analysis. Having refused consent to consult vaccination registration data [OR: 4.7, CI95%: 2.9-7.6], not having disclosed income, lower school class, lower birth order, not having a history of pertussis, and eating less vegetables were significant determinants of non-participation in blood testing. Weighted analysis and sensitivity analysis yielded results similar to those in the original study. We found that refusal to participate in blood testing was related to reluctance to disclose private information in general and to sensitivity on the subject of vaccinations in particular. Also, parents of younger children with less older siblings, without a history of pertussis, and consuming less frequently vegetables, were more likely to be a non-participant. Selective participation in blood testing may have affected our assessment of the reliability of the reported vaccination status, but leaves our conclusion from the original study, that there is no positive association between the DTP-IPV vaccination and atopy, unaffected