A descriptive cross sectional study comparing barriers and determinants of physical activity of Sri Lankan middle aged and older adults.

BACKGROUND: Benefits of physical activities are numerous. Barriers for physical exercise may differ among middle aged and older adults. Therefore, identifying and comparing the barriers for participating in regular physical exercises among middle aged and older adults will be useful in designing age specific physical exercise programmes. METHODS: This descriptive cross sectional study was carried out among 206 Sri Lankan adults in the age range of 40-84 years in the Colombo North region of Sri Lanka using culturally validated questionnaires to determine and compare the barriers and factors associated with regular physical activity participation. Majority were males (56%) and 54% were < 60 years. People in the age range of 40-59 years were considered as middle age and ≥ 60 years as older adults. Bivariate analysis and multivariate analysis was carried out to determine the significant factors that are associated with regular physical activity participation. RESULTS: Lack of free time (52%), feeling too lazy (26%) and bad weather (29%) were the main barriers for the participants. In < 60 years, high level of income (p = 0.008) and in ≥ 60 years, being a male (p = 0.016), having a high level of education (P = 0.002) and a high BMI (p = 0.002) had a significant negative association with the level of physical activities. CONCLUSIONS: Contrary to findings from surveys in several developed countries, this study showed that having a high level of education and being a male were strongly related with lack of physical activity participation.

Prevalence of coronary artery disease in a semi urban population in Southern Sri Lanka

Introduction: Prevalence of coronary artery disease (CAD) is on the rise in Sri Lanka resulting in high hospital mortality rates. Because of paucity of community based data on CAD we carried out this study to assess prevalence of CAD and associated factors in a suburban population in Southern Sri Lanka. Methods: A cross sectional descriptive study was carried out among community living adults aged 30 years or more in Bope-Poddala Medical Officer of Health (MOH) area. Total of 1000 eligible individuals were recruited using cluster sampling. Cardiovascular Questionnaire of London School of Hygiene was administered to each participant by trained data collectors. CAD was diagnosed using criteria by Epstein and colleagues and electrocardiograms were classified according to the Minnesota code by a Cardiologist blinded to participant details Results: Total of 579 (57.9%) females and 421 (42.1%) males were studied. Mean age of the group was 53 years. Among the participants 32% had cardiovascular risk related non communicable diseases (NCDs) and 22.2% had a family history of the same. Prevalence of CAD was 6.9% (95% CI: 5.33 - 0.47) and silent ischaemia was 2.2% (95% CI: 1.29 - 3.11). Only gender and past history of cardiovascular risk related NCDs emerged as predictors of CAD Conclusions: CAD was more prevalent among males and those with past history of cardiovascular risk related NCDs. Community based preventive programmes should be implemented to minimize the adverse impact of CAD.

Acebutolol, atenolol, and propranolol and metabolic responses to acute hypoglycaemia in diabetics.

In a double-blind crossover study the symptomatic and metabolic effects of propranolol, acebutolol, and atenolol were studied during insulin-induced hypoglycaemia in diabetics treated with diet or hypoglycaemic tablets. All the drugs prevented tachycardia, but did not affect the other symptoms of hypoglycaemia. Propranolol delayed the recovery of the blood glucose concentration and impaired the secondary rise in the concentrations of blood lactate and non-esterified fatty acids in diet-treated diabetics. Acebutolol potentiated the hypoglycaemic effect of insulin in tablet-treated diabetics (mean difference of blood glucose concentration 0.7 mmol/l (12.6 mg/100 ml)) and this difference was maintained during the recovery phase4 the blood lactate response was also impaired. Atenolol did not differ perceptibly from placebo in its effect on the metabolic responses to acute hypoglycaemia. The results may be explained by differences in the known pharmacological actions of these drugs. They support the hypothesis that beta-adrenoreceptor blocking drugs that are highly beta1 specific and without membrane-stabilising activity should be safer than the non-selective drugs when used in diabetic patients at risk from hypoglycaemia.