Hypertension and Associated Risk Factors Among the Sudanese Banking Sector in River Nile State: A Descriptive Cross-Sectional Study.

Background Hypertension is a global entity accounting for one of the most modifiable risk factors for all-cause morbidity and mortality. It is associated with a raised risk of cardiovascular disease, particularly in developing countries. Nevertheless, the banking sector profession lifestyle is sedentary and accompanied by high levels of mental stress, thus at a higher risk of developing hypertension. Objective The objective is to assess the prevalence of hypertension among bank employees and the associated risk factors in River Nile State - Sudan. Methods A descriptive cross-sectional study was performed on Atbara and Al-Damar localities' banks in River Nile state from January to March 2020. Data were collected on demographics, BMI, waist circumference (WC), medical history, family history, nutritional habits, physical activities, medications history, work stress, complaints, and blood pressure. Results Ninety-eight bank employees were enrolled, with elevated blood pressure present in 45(45.9%) participants, of whom 18 (40%) were newly diagnosed. 43.9% were in the age group 31-40 years. High blood pressure was significantly associated with older age >40 years, BMI > 30 kg/m2, WC > 90 cm, diabetes mellitus (DM), smoking, family history, salty diet, reduced daily exercise (30 minutes per day), severe stress at work, with overall P-value = <0.005. Conclusion The prevalence of high blood pressure was remarkably high among bank employees. Risk factors were: age (>40 years), obesity, DM, family history, salty diet intake, severe stress levels at work and sedentary lifestyle.

Impact of clinical pharmacist intervention in anticoagulation clinic in Sudan.

Background Many trials have compared anticoagulation management provided by a pharmacist led anticoagulation clinic versus usual physician care showing the role for clinical pharmacist in the management of anticoagulant therapy, and demonstrating excellent outcomes. In Sudan, there is no published research evaluating the role of pharmacist in providing pharmaceutical care for patients taking warfarin. Objective The objective of the study is to assess the role of clinical pharmacist intervention in warfarin patients compared to usual medical care. Setting This study was conducted in Ahmed Gasim cardiac surgery and renal transplant center warfarin clinic. Methods One hundred thirty-five patients were randomly selected from adult patients on warfarin therapy The history of INR records, and adverse effects for the past year, were recorded. Then patients' warfarin dose adjustments according to INR, was done by the clinical pharmacist for one year. Patients received continuous verbal education and written information about warfarin. Main outcome measure The primary outcome for this study was the INR control, while the secondary outcomes were the bleeding events and hospitalization due to warfarin. Results After the clinical pharmacist intervention there was significant (P < 0.01) improvement in INR control and a significant (P < 0.05) reduction in incidence of bleeding after clinical pharmacist intervention. Hospitalization due to warfarin related complications (bleeding, high INR, low INR) was also significantly (P < 0.001) reduced. Conclusion Clinical pharmacists intervention in warfarin therapy improve INR control, reduce bleeding and hospitalization due to warfarin complications.

Impact of isolated systolic hypertension on normalization of left ventricular structure during antihypertensive treatment (the LIFE study).

OBJECTIVE: We tested the impact of isolated systolic hypertension (ISH) on normalization of left ventricular (LV) structure during antihypertensive treatment. METHODS: Baseline and annual echocardiograms were recorded in 873 hypertensive patients with electrocardiographic signs of LV hypertrophy during 4.8 years randomized losartan- or atenolol-based antihypertensive treatment in the Losartan Intervention For Endpoint (LIFE) reduction in hypertension study and classified as having ISH (n = 128) if systolic BP ≥ 160 mmHg and diastolic BP < 90 mmHg, or non-ISH divided into two groups by systolic BP ≥ 160 mmHg (non-ISH ≥ 160 mmHg) (n = 645) and systolic BP < 160 mm Hg (n = 100) (non-ISH < 160 mmHg), respectively. RESULTS: Patients with ISH were older, with higher prevalence of diabetes than non-ISH groups and higher pulse pressure/stroke volume index (all p < 0.05). Baseline systolic blood pressure (BP) differed between groups and was highest in the non-ISH ≥ 160 mmHg group (p < 0.05). Systolic BP reduction was less in the ISH group (p < 0.05). LV geometry did not differ between ISH and non-ISH ≥ 160 mmHg groups at baseline, but ISH had more residual LV hypertrophy of concentric type at the last study visit (p < 0.05). In multivariate analysis, less reduction of LV mass was predicted by ISH (ß = - 0.07) independent of significant associations with baseline LVMi (ß = 0.52) and atenolol-based treatment (ß = - 0.08) and clinical confounders (all p < 0.05). CONCLUSIONS: ISH is associated with impaired normalization of LV mass during systematic antihypertensive treatment. The findings may help explain the higher cardiovascular event rate previously reported in ISH patients.