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OBJECTIVE: To evaluate paroxysmal atrial fibrillation (AF) prevalence in Indian adults who completed 24-Hour Holter monitoring. METHODS: A total of 23,847 patients (36.9 % women) were analyzed for AF duration using a software algorithm. RESULTS: AF was diagnosed in 4153 (17.4 %) patients with a median AF duration of 13 min and 55 s. CONCLUSION: AF prevalence was high and largely untreated. The short duration of AF episodes indicates a low likelihood of detection during clinical visits, highlighting its potential underestimation in Indian healthcare.
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OBJECTIVE: The objective of this study is to identify 24-h blood pressure (BP) characteristics after acute stroke in Indian hospitalized patients. METHODS: In total, 769 patients [284 women (36.9%)] admitted at a hospital in South India were analyzed. Of these, 364 patients (47.3%) had recently experienced stroke. All patients underwent ambulatory blood pressure measurement (ABPM) so that ABPM patterns and ABPM risk parameters of stroke and non-stroke patients could be compared. Additionally, to investigate the relationship between ABPM parameters and stroke, a stepwise logistic regression analysis was employed. RESULTS: Stroke patients had significantly higher BP than non-stroke patients (24-h ABP: 145.0â ±â 22.1 vs. 133.7â ±â 20.5â mmHg, Pâ <â 0.001), with similar dipping status. ABPM parameters mostly associated with stroke (all Pâ <â 0.001) were: nighttime [odds ratios (OR): 1.587, 95% confidence interval (95% CI): 1.341-1.885], 24-h (1.584, 1.34-1.881), minimum nighttime (1.582, 1.339-1.879), daytime (1.540, 1.304-1.827), and morning SBP (1.517, 1.287-1.797). Non-dipping status was relatively more common in stroke patients (79% vs. 71%, Pâ <â 0.05) but dipping percentage did not show a significant linear relationship with stroke. CONCLUSION: Several ABPM characteristics were strongly associated with stroke in Indian hospitalized patients. Specifically, minimum nighttime and average morning SBP may be considered as important and practical parameters for its relationship with stroke.
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Blood Pressure Monitoring, Ambulatory , Stroke , Humans , Female , Blood Pressure , Asian People , Blood Pressure DeterminationABSTRACT
PURPOSE: To assess the prescribing practices for overactive bladder (OAB) pharmacotherapy based on the prescription trend analysis across different specialties of India. METHOD: s: IQVIA (Quintiles and IMS Health) secondary sales audit (SSA), as well as a prescription audit for antimuscarinics and beta-3 adrenoceptor agonists (mirabegron) from 2014 to 2021, were analyzed. The data includes SSA data of various antimuscarinics like solifenacin, oxybutynin, tolterodine, darifenacin, trospium and mirabegron change in the prescription trend of antimuscarinics and mirabegron across different specialties; prescribers overlap analysis for solifenacin and mirabegron among Indian urologists were also analyzed. RESULTS: Urologists prescription rates of OAB drugs were 65% in 2016 and 54% in 2021. The rate of OAB medication prescription by non-urologist was highest from the surgeon (11%), followed by gynecologists (9%) and consultant physicians (8%) in 2021. In addition, among OAB medication prescription rates for antimuscarinics were 100% in 2016 and 58% in 2021 whereas for mirabegron, it was 0% in 2016 and 42% in 2021. Solifenacin was most frequently prescribed anticholinergics, followed by oxybutynin, tolterodine, darifenacin, and trospium. The proportion of prescribers of OAB medication among urologists was 38% in 2016 and 33% in 2021. Exclusive prescribers of solifenacin were 748 in 2018 and 739 in 2021 at the urologist, whereas for mirabegron, it was 961 in 2018 and 934 in 2021. The compound annual growth rate for prescription of the last 6 years (from 2016-2021) for solifenacin and mirabegron was -3% and 8% respectively. CONCLUSIONS: Urology remained a top prescribing specialty for OAB drugs, although prescription share increased at surgeon and consultant physician. OAB medicines prescriptions by urologists are shifting from leading antimuscarinic solifenacin to beta-agonist mirabegron. Data from this study will ultimately lead to the OAB medication preference by the specialist that could lead to more advanced OAB management.
