Dr Vivek Baliga - Chronic Disease Management In Heart Failure And DiabetesDr Vivek Baliga
Dr Vivek Baliga, Consultant Internal Medicine at Baliga Diagnostics discusses the management of 2 common problems in medical practice - heart failure and type 2 diabetes, including the link between the two. For more articles for patients, visit http://heartsense.in/author/dr-vivek-baliga-b/. For scientific articles and short reviews, visit http://drvivekbaliga.net/
Certain diabetes drugs may increase the risk of heart failure in patients by 14%, according to a study of 95,000 patients. The risk was directly associated with the type of drug used, as some drugs carried a higher risk than others or standard care. While some drugs increased the risk, intensive weight loss strategies showed a trend toward lower heart failure risk. The study also found that for every 1 kilogram of weight gain linked to a diabetes drug, there was a 7% higher risk of associated heart failure. The results could change how high-risk diabetes patients are managed going forward.
The document discusses hypertension in teenage years. It begins with an introduction and overview of the magnitude of the problem. It then defines teenage hypertension and reviews international data on prevalence rates. The document also describes results from screening programs for hypertension and obesity in high schools in Bahrain. It concludes that primary hypertension is increasingly being identified in children and adolescents where it is usually mild and associated with factors like family history and overweight.
Naturopathic Treatmentfor the Prevention ofCardiovascular Disease: A Randomized Pragmatic TrialCCNM – Journal Club Sept 30th, 2010Dugald Seely, ND, MScDirector; Research & Clinical EpidemiologyThe Canadian College of Naturopathic Medicine
This study examined blood levels of homocysteine, vitamin B12, and folic acid in patients with metabolic syndrome compared to controls. The study found that patients with metabolic syndrome had significantly higher levels of homocysteine (2.6 times higher) and significantly lower levels of vitamin B12 (only 53% of controls) and folic acid (only 61% of controls). Lower levels of these vitamins were also associated with higher weight, BMI, blood sugar, and lipid levels. The study concludes that Indian patients with metabolic syndrome have a strong association with abnormal levels of these metabolites, suggesting they may play a greater role in Asians with metabolic syndrome than other populations.
Interdisciplinary care plan7 class nur3400ssuserd93c47
This document provides background information on an interdisciplinary care plan for a patient named McKay Johnson who has been diagnosed with diabetes and heart disease. It includes details about Johnson's medical history and current condition based on examinations and lab results. It then outlines the nursing interventions and treatment goals that are part of Johnson's interdisciplinary care plan to manage his diabetes and heart condition. The care plan involves monitoring Johnson's symptoms, administering and adjusting his medications, educating him on his conditions and treatment, and ensuring he follows a healthy diet and lifestyle to control his health issues. The overarching goal is to lower Johnson's blood glucose, BMI, and other marker levels through this collaborative treatment approach.
7. scientific rationale for preventive practices in hypertensive cardiovascularHibaAnis2
This document discusses scientific rationale for preventive practices in hypertensive cardiovascular disease. It covers non-modifiable risk factors like family history, age, race, and obesity. Lifestyle modifications that can help prevent and treat hypertension include weight loss, following a healthy diet like DASH, reducing sodium intake, limiting alcohol consumption, and engaging in physical activity and stress reduction techniques.
Hypertension is a major global health problem and leading risk factor for cardiovascular disease. Control remains poor despite being largely controllable. The diagnosis of hypertension is based on office blood pressure measurements, but out-of-office measurements such as ambulatory or home monitoring are recommended to confirm the diagnosis. Lifestyle changes are key to non-pharmacological treatment, while first-line pharmacological treatments include ACE inhibitors, ARBs, calcium channel blockers, and diuretics. Despite efforts, rates of awareness, treatment and control of hypertension remain disappointingly low globally.
Dr Vivek Baliga - Chronic Disease Management In Heart Failure And DiabetesDr Vivek Baliga
Dr Vivek Baliga, Consultant Internal Medicine at Baliga Diagnostics discusses the management of 2 common problems in medical practice - heart failure and type 2 diabetes, including the link between the two. For more articles for patients, visit http://heartsense.in/author/dr-vivek-baliga-b/. For scientific articles and short reviews, visit http://drvivekbaliga.net/
Certain diabetes drugs may increase the risk of heart failure in patients by 14%, according to a study of 95,000 patients. The risk was directly associated with the type of drug used, as some drugs carried a higher risk than others or standard care. While some drugs increased the risk, intensive weight loss strategies showed a trend toward lower heart failure risk. The study also found that for every 1 kilogram of weight gain linked to a diabetes drug, there was a 7% higher risk of associated heart failure. The results could change how high-risk diabetes patients are managed going forward.
The document discusses hypertension in teenage years. It begins with an introduction and overview of the magnitude of the problem. It then defines teenage hypertension and reviews international data on prevalence rates. The document also describes results from screening programs for hypertension and obesity in high schools in Bahrain. It concludes that primary hypertension is increasingly being identified in children and adolescents where it is usually mild and associated with factors like family history and overweight.
Naturopathic Treatmentfor the Prevention ofCardiovascular Disease: A Randomized Pragmatic TrialCCNM – Journal Club Sept 30th, 2010Dugald Seely, ND, MScDirector; Research & Clinical EpidemiologyThe Canadian College of Naturopathic Medicine
This study examined blood levels of homocysteine, vitamin B12, and folic acid in patients with metabolic syndrome compared to controls. The study found that patients with metabolic syndrome had significantly higher levels of homocysteine (2.6 times higher) and significantly lower levels of vitamin B12 (only 53% of controls) and folic acid (only 61% of controls). Lower levels of these vitamins were also associated with higher weight, BMI, blood sugar, and lipid levels. The study concludes that Indian patients with metabolic syndrome have a strong association with abnormal levels of these metabolites, suggesting they may play a greater role in Asians with metabolic syndrome than other populations.
Interdisciplinary care plan7 class nur3400ssuserd93c47
This document provides background information on an interdisciplinary care plan for a patient named McKay Johnson who has been diagnosed with diabetes and heart disease. It includes details about Johnson's medical history and current condition based on examinations and lab results. It then outlines the nursing interventions and treatment goals that are part of Johnson's interdisciplinary care plan to manage his diabetes and heart condition. The care plan involves monitoring Johnson's symptoms, administering and adjusting his medications, educating him on his conditions and treatment, and ensuring he follows a healthy diet and lifestyle to control his health issues. The overarching goal is to lower Johnson's blood glucose, BMI, and other marker levels through this collaborative treatment approach.
7. scientific rationale for preventive practices in hypertensive cardiovascularHibaAnis2
This document discusses scientific rationale for preventive practices in hypertensive cardiovascular disease. It covers non-modifiable risk factors like family history, age, race, and obesity. Lifestyle modifications that can help prevent and treat hypertension include weight loss, following a healthy diet like DASH, reducing sodium intake, limiting alcohol consumption, and engaging in physical activity and stress reduction techniques.
Hypertension is a major global health problem and leading risk factor for cardiovascular disease. Control remains poor despite being largely controllable. The diagnosis of hypertension is based on office blood pressure measurements, but out-of-office measurements such as ambulatory or home monitoring are recommended to confirm the diagnosis. Lifestyle changes are key to non-pharmacological treatment, while first-line pharmacological treatments include ACE inhibitors, ARBs, calcium channel blockers, and diuretics. Despite efforts, rates of awareness, treatment and control of hypertension remain disappointingly low globally.
The prevalence of hypertension in children is reported to be 1–3%. In recent years, the prevalence of hypertension
in school-aged children appears to be increasing, perhaps as a result of the increased prevalence of obesity (Sorof JM,
Lai D, Turner J, Poffenbarger T, Portman PJ. Overweight, ethnicity and the prevalence of hypertension in school-aged
children. Pediatrics . The majority of these children have mild hypertension, most often primary.
However, secondary causes of hypertension such as renal parenchymal diseases and renovascular disorders still
remain the leading cause of paediatric hypertension, particularly in children < 12 years of age. Regardless of its
cause, the significant elevation of blood pressure can lead to acute organ dysfunction, and hypertensive child almost
always warrants a diagnostic evaluation.
DCCT/EDIC - Type 1 diabetes - cardiovascular risk with interventionPeninsulaEndocrine
This document summarizes a study examining the effects of intensive versus conventional diabetes treatment on cardiovascular outcomes in patients with type 1 diabetes over 17 years of follow up. The study found that intensive diabetes treatment during the Diabetes Control and Complications Trial (DCCT) period resulted in lower HbA1c levels and was associated with a lower risk of cardiovascular events over the subsequent 17 years of follow up in the Epidemiology of Diabetes Interventions and Complications (EDIC) study, even as HbA1c levels between the groups converged during EDIC. The "metabolic memory" of intensive control during DCCT appeared to continue protecting against cardiovascular risk long term.
Interdisciplinary care plan7 class nur3400ssuser337fce
This document presents an interdisciplinary care plan for a patient named McKay Johnson who has been diagnosed with diabetes and heart disease. It provides background information on Johnson's medical history and current condition. The care plan involves monitoring Johnson's glucose levels, blood pressure, physical activity, and medication regimen. The goal is to control his diabetes and heart disease by maintaining normal levels for glucose, BMI, hemoglobin A1C, and other lab results. The care will be provided by an interdisciplinary team to effectively treat both of Johnson's conditions.
An Evidence Based Approach To HypertensionAline Chammas
This document summarizes evidence for an evidence-based approach to hypertension treatment. It finds that diuretics should be the first-line treatment according to major guidelines, as they have been shown in multiple trials including ALLHAT to reduce cardiovascular events like stroke and heart disease more than other drugs. While both SBP and DBP are important, SBP control is particularly challenging and reducing it by even 10 mmHg provides substantial benefits. Global hypertension prevalence is increasing and control remains inadequate in most of the world.
Hypertension is very common in patients with type 2 diabetes, affecting around half of patients at diagnosis. Strict control of blood pressure, with a target of below 130/80 mmHg, is important for reducing cardiovascular risks in diabetic patients. Several classes of antihypertensive drugs can be used effectively for this purpose, including diuretics, beta-blockers, calcium channel blockers, ACE inhibitors, and angiotensin receptor blockers. Aggressive treatment of hypertension is recommended for diabetic patients, especially those with kidney disease, in order to prevent complications and disease progression.
This document summarizes guidelines for screening and treatment related to gynecologic health in menopausal women. It discusses recommendations and risks for cervical and breast cancer screening, as well as guidelines for and risks of hormone replacement therapy. It also reports on non-hormonal options for treating post-menopausal symptoms like hot flashes. The document provides this information through a series of clinical vignettes and recommendations based on evidence from sources like the USPSTF.
Aim: The aim of the present study was to perform the set of standard autonomic function
tests in children with a family history of hypertension and compare the results with
children of normotensive parents.
Background: Hypertension is considered one of the highest causes of morbidity
worldwide and it becomes one of the leading causes of death due to cardiovascular and
renal failure. Hypertension can be especially hard to manage when combined with other
disorders, such as diabetes or obesity. Most of the children with a family history of
hypertension forms the risk factor for being hypertensive in future life.
Results: The study included 60 young and healthy children. Out of them, 30 children were
selected based on their family history of hypertension while the remaining were the
children of normotensive parents. Thesubjects were selected based on exclusion-inclusion
criteria. All the children underwent for a set of autonomic function tests which are noninvasive, simple and comfortable. Results showed that children with a family history of
hypertension have abnormal values on autonomicfunction testing, when compared with
children of normotensive parents. The results were obtained using ANOVA and student‘t’
–test, to study the significance of autonomic parameters.
Conclusion: This study stated that the children with family history of hypertension
experienced mild to moderate autonomic fluctuations in early age which may make them
more susceptible to hypertension in their future life
The document discusses hypertension in Malaysia, including:
1) The prevalence of hypertension in Malaysia is 25.7% overall, affecting 1 in 4 adults aged 25-64, with known hypertensives numbering 1.4 million and newly diagnosed at 1.7 million.
2) Control rates remain low with only 8% of hypertensives in Malaysia achieving blood pressure control, compared to over 30% in the United States.
3) Recommendations are made to improve management of hypertension through risk stratification, emphasis on first-line therapies such as ACE inhibitors, ARBs, diuretics and calcium channel blockers, and addressing concomitant conditions through appropriate drug selections.
- Hypertension (HTN) affects 4-5% of children and is a major risk factor for cardiovascular disease in adulthood. Early identification and treatment of HTN in children is important.
- The document discusses definitions of HTN in children, risk factors, evaluation, causes, and management of HTN in children. Evaluation involves taking medical history, physical exam, and lab tests to identify underlying causes.
- Treatment involves lifestyle changes like diet and exercise as first-line treatment. Medication may be used for more severe HTN or if target organ damage is present. Control of HTN in high-risk groups like children with chronic kidney disease can reduce morbidity and mortality.
journal club is one of the important academic activity during MD/MS courses. Present PPT is a journal club presented on an article that compare two antihypertensives and the presentation also includes critical analysis of the article.
1. The Diabetes Prevention Program (DPP) found that an intensive lifestyle intervention aimed at 7% weight loss was more effective than metformin or placebo at preventing diabetes in patients with prediabetes over 3 years, with a 58% reduction in relative risk.
2. For Mrs. K, an intensive lifestyle intervention targeting at least 7% weight loss would be the recommended first-line evidence-based approach based on the DPP findings.
3. After 1 year of lifestyle changes, Mrs. K had achieved 6% weight loss and normal fasting glucose and A1C levels, indicating response to treatment. However, 12 months later with 10 pounds regained, her glucose levels have
Maternal Cardiovascular Hemodynamics in Normal and Preeclamptic Pregnancies U...CrimsonPublishers-PRM
Maternal Cardiovascular Hemodynamics in Normal and Preeclamptic Pregnancies Using Echocardiography by Sonali S Somani in Perceptions in Reproductive Medicine_Crimson Publishers: Journal of Reproductive Health
This study assessed self-care practices and associated factors among 392 hypertensive patients in Debre Tabor Referral Hospital, Ethiopia. The self-care practice was found to be 54.1%. Urban residency, social support, good knowledge, age 40-64 years or ≥65 years, and stress control were positively associated with better self-care. The study concluded that about half of patients had good self-care practices and identified factors that can help improve hypertension management.
Hypertension is a major public health problem and important area of research due to its high prevalence and being major risk factor for cardiovascular diseases and other complications. Objectives 1. To assess the prevalence of hypertension and its associated factors and 2. to estimate awareness, treatment, and adequacy of control of hypertension among study subjects. According to the Joint National Committee 7 JNC7 , normal blood pressure is a systolic BP 120 mmHg and diastolic BP 80 mm Hg. Hypertension is defined as systolic BP level of =140 mmHg and or diastolic BP level = 90 mmHg. A number of factors increase BP, including 1 obesity, 2 insulin resistance, 3 high alcohol intake, 4 high salt intake in salt sensitive patients , 5 aging and perhaps 6 sedentary lifestyle, 7 stress, 8 low potassium intake, and 9 low calcium intake. Shweta Pawar | Sujit Kakde | Ashok Bhosale "A Review: Hypertension" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd42416.pdf Paper URL: https://www.ijtsrd.commedicine/other/42416/a-review-hypertension/shweta-pawar
Cardiovascular disease in diabetes mellitusYung-Tsai Chu
Reference: 2018 ADA guideline. Topics: hypertension management(drug choice and combination), indications for hyperlipidemia treatment, atherosclerosis disease prevention with antiplatelet agents and issues about coronary artery diseases.
This document discusses prehypertension and hypertension in children. It defines prehypertension as blood pressure levels between the 90th and 95th percentiles, and hypertension as levels at or above the 95th percentile. Risk factors for developing hypertension in childhood include obesity, family history, lack of exercise, and certain medical conditions. The document provides prevalence rates for prehypertension and hypertension from various studies worldwide. It outlines guidelines for evaluating and diagnosing hypertension in children, and discusses potential complications and treatment approaches.
3-2. Hypertension in CKD. Francesco Emma (eng)KidneyOrgRu
This document discusses hypertension in children with chronic kidney disease. It provides information on the epidemiology of hypertension in CKD, complications such as increased risk of cardiovascular disease and left ventricular hypertrophy, and treatment targets for blood pressure. The management of hypertension in CKD involves therapeutic lifestyle changes and medications such as ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, and diuretics. The goal of treatment is to reduce blood pressure and prevent or reverse left ventricular hypertrophy and other target organ damage.
This study analyzed data from over 21,000 Japanese patients to investigate the relationship between blood pressure measurements and cardiovascular outcomes. The results showed that morning home systolic blood pressure was a stronger predictor of coronary artery disease events than clinic blood pressure. There was a graded association between higher morning home systolic blood pressure and increased risk of coronary events. Neither home nor clinic blood pressure measurements showed a J-shaped curve relationship with stroke or coronary artery disease risk.
Here are my recommendations for the 56 year old woman with subclinical hypothyroidism:
1. Her diagnosis is subclinical hypothyroidism based on an elevated TSH of 7.1 and normal free T4.
2. Given her age (56), fatigue, and 3-4 lb weight gain, I would recommend a trial of levothyroxine therapy. Treatment is reasonable for patients with TSH >10 or positive thyroid antibodies, which she does not have data for. However, treatment may modestly improve her lipids and symptoms.
3. She should be monitored every 6 months with TSH checks to ensure her TSH is maintained between 0.5-2.0 and that she does not
Non-pharmacological interventions help reduce the daily dose of antihypertensive medication and delay the progression from prehypertension to hypertension stage. Non-pharmacological interventions include lifestyle modifications like dietary modifications, exercise, avoiding stress, and minimizing alcohol consumption.
Alexander the Great was born in 356 BC in Pella, Macedonia. He became the king of Macedonia after his father's death and went on to conquer the vast Persian Empire. Considered a military genius, Alexander the Great established one of the largest empires in ancient history before his death in 323 BC, possibly due to poisoning.
The prevalence of hypertension in children is reported to be 1–3%. In recent years, the prevalence of hypertension
in school-aged children appears to be increasing, perhaps as a result of the increased prevalence of obesity (Sorof JM,
Lai D, Turner J, Poffenbarger T, Portman PJ. Overweight, ethnicity and the prevalence of hypertension in school-aged
children. Pediatrics . The majority of these children have mild hypertension, most often primary.
However, secondary causes of hypertension such as renal parenchymal diseases and renovascular disorders still
remain the leading cause of paediatric hypertension, particularly in children < 12 years of age. Regardless of its
cause, the significant elevation of blood pressure can lead to acute organ dysfunction, and hypertensive child almost
always warrants a diagnostic evaluation.
DCCT/EDIC - Type 1 diabetes - cardiovascular risk with interventionPeninsulaEndocrine
This document summarizes a study examining the effects of intensive versus conventional diabetes treatment on cardiovascular outcomes in patients with type 1 diabetes over 17 years of follow up. The study found that intensive diabetes treatment during the Diabetes Control and Complications Trial (DCCT) period resulted in lower HbA1c levels and was associated with a lower risk of cardiovascular events over the subsequent 17 years of follow up in the Epidemiology of Diabetes Interventions and Complications (EDIC) study, even as HbA1c levels between the groups converged during EDIC. The "metabolic memory" of intensive control during DCCT appeared to continue protecting against cardiovascular risk long term.
Interdisciplinary care plan7 class nur3400ssuser337fce
This document presents an interdisciplinary care plan for a patient named McKay Johnson who has been diagnosed with diabetes and heart disease. It provides background information on Johnson's medical history and current condition. The care plan involves monitoring Johnson's glucose levels, blood pressure, physical activity, and medication regimen. The goal is to control his diabetes and heart disease by maintaining normal levels for glucose, BMI, hemoglobin A1C, and other lab results. The care will be provided by an interdisciplinary team to effectively treat both of Johnson's conditions.
An Evidence Based Approach To HypertensionAline Chammas
This document summarizes evidence for an evidence-based approach to hypertension treatment. It finds that diuretics should be the first-line treatment according to major guidelines, as they have been shown in multiple trials including ALLHAT to reduce cardiovascular events like stroke and heart disease more than other drugs. While both SBP and DBP are important, SBP control is particularly challenging and reducing it by even 10 mmHg provides substantial benefits. Global hypertension prevalence is increasing and control remains inadequate in most of the world.
Hypertension is very common in patients with type 2 diabetes, affecting around half of patients at diagnosis. Strict control of blood pressure, with a target of below 130/80 mmHg, is important for reducing cardiovascular risks in diabetic patients. Several classes of antihypertensive drugs can be used effectively for this purpose, including diuretics, beta-blockers, calcium channel blockers, ACE inhibitors, and angiotensin receptor blockers. Aggressive treatment of hypertension is recommended for diabetic patients, especially those with kidney disease, in order to prevent complications and disease progression.
This document summarizes guidelines for screening and treatment related to gynecologic health in menopausal women. It discusses recommendations and risks for cervical and breast cancer screening, as well as guidelines for and risks of hormone replacement therapy. It also reports on non-hormonal options for treating post-menopausal symptoms like hot flashes. The document provides this information through a series of clinical vignettes and recommendations based on evidence from sources like the USPSTF.
Aim: The aim of the present study was to perform the set of standard autonomic function
tests in children with a family history of hypertension and compare the results with
children of normotensive parents.
Background: Hypertension is considered one of the highest causes of morbidity
worldwide and it becomes one of the leading causes of death due to cardiovascular and
renal failure. Hypertension can be especially hard to manage when combined with other
disorders, such as diabetes or obesity. Most of the children with a family history of
hypertension forms the risk factor for being hypertensive in future life.
Results: The study included 60 young and healthy children. Out of them, 30 children were
selected based on their family history of hypertension while the remaining were the
children of normotensive parents. Thesubjects were selected based on exclusion-inclusion
criteria. All the children underwent for a set of autonomic function tests which are noninvasive, simple and comfortable. Results showed that children with a family history of
hypertension have abnormal values on autonomicfunction testing, when compared with
children of normotensive parents. The results were obtained using ANOVA and student‘t’
–test, to study the significance of autonomic parameters.
Conclusion: This study stated that the children with family history of hypertension
experienced mild to moderate autonomic fluctuations in early age which may make them
more susceptible to hypertension in their future life
The document discusses hypertension in Malaysia, including:
1) The prevalence of hypertension in Malaysia is 25.7% overall, affecting 1 in 4 adults aged 25-64, with known hypertensives numbering 1.4 million and newly diagnosed at 1.7 million.
2) Control rates remain low with only 8% of hypertensives in Malaysia achieving blood pressure control, compared to over 30% in the United States.
3) Recommendations are made to improve management of hypertension through risk stratification, emphasis on first-line therapies such as ACE inhibitors, ARBs, diuretics and calcium channel blockers, and addressing concomitant conditions through appropriate drug selections.
- Hypertension (HTN) affects 4-5% of children and is a major risk factor for cardiovascular disease in adulthood. Early identification and treatment of HTN in children is important.
- The document discusses definitions of HTN in children, risk factors, evaluation, causes, and management of HTN in children. Evaluation involves taking medical history, physical exam, and lab tests to identify underlying causes.
- Treatment involves lifestyle changes like diet and exercise as first-line treatment. Medication may be used for more severe HTN or if target organ damage is present. Control of HTN in high-risk groups like children with chronic kidney disease can reduce morbidity and mortality.
journal club is one of the important academic activity during MD/MS courses. Present PPT is a journal club presented on an article that compare two antihypertensives and the presentation also includes critical analysis of the article.
1. The Diabetes Prevention Program (DPP) found that an intensive lifestyle intervention aimed at 7% weight loss was more effective than metformin or placebo at preventing diabetes in patients with prediabetes over 3 years, with a 58% reduction in relative risk.
2. For Mrs. K, an intensive lifestyle intervention targeting at least 7% weight loss would be the recommended first-line evidence-based approach based on the DPP findings.
3. After 1 year of lifestyle changes, Mrs. K had achieved 6% weight loss and normal fasting glucose and A1C levels, indicating response to treatment. However, 12 months later with 10 pounds regained, her glucose levels have
Maternal Cardiovascular Hemodynamics in Normal and Preeclamptic Pregnancies U...CrimsonPublishers-PRM
Maternal Cardiovascular Hemodynamics in Normal and Preeclamptic Pregnancies Using Echocardiography by Sonali S Somani in Perceptions in Reproductive Medicine_Crimson Publishers: Journal of Reproductive Health
This study assessed self-care practices and associated factors among 392 hypertensive patients in Debre Tabor Referral Hospital, Ethiopia. The self-care practice was found to be 54.1%. Urban residency, social support, good knowledge, age 40-64 years or ≥65 years, and stress control were positively associated with better self-care. The study concluded that about half of patients had good self-care practices and identified factors that can help improve hypertension management.
Hypertension is a major public health problem and important area of research due to its high prevalence and being major risk factor for cardiovascular diseases and other complications. Objectives 1. To assess the prevalence of hypertension and its associated factors and 2. to estimate awareness, treatment, and adequacy of control of hypertension among study subjects. According to the Joint National Committee 7 JNC7 , normal blood pressure is a systolic BP 120 mmHg and diastolic BP 80 mm Hg. Hypertension is defined as systolic BP level of =140 mmHg and or diastolic BP level = 90 mmHg. A number of factors increase BP, including 1 obesity, 2 insulin resistance, 3 high alcohol intake, 4 high salt intake in salt sensitive patients , 5 aging and perhaps 6 sedentary lifestyle, 7 stress, 8 low potassium intake, and 9 low calcium intake. Shweta Pawar | Sujit Kakde | Ashok Bhosale "A Review: Hypertension" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd42416.pdf Paper URL: https://www.ijtsrd.commedicine/other/42416/a-review-hypertension/shweta-pawar
Cardiovascular disease in diabetes mellitusYung-Tsai Chu
Reference: 2018 ADA guideline. Topics: hypertension management(drug choice and combination), indications for hyperlipidemia treatment, atherosclerosis disease prevention with antiplatelet agents and issues about coronary artery diseases.
This document discusses prehypertension and hypertension in children. It defines prehypertension as blood pressure levels between the 90th and 95th percentiles, and hypertension as levels at or above the 95th percentile. Risk factors for developing hypertension in childhood include obesity, family history, lack of exercise, and certain medical conditions. The document provides prevalence rates for prehypertension and hypertension from various studies worldwide. It outlines guidelines for evaluating and diagnosing hypertension in children, and discusses potential complications and treatment approaches.
3-2. Hypertension in CKD. Francesco Emma (eng)KidneyOrgRu
This document discusses hypertension in children with chronic kidney disease. It provides information on the epidemiology of hypertension in CKD, complications such as increased risk of cardiovascular disease and left ventricular hypertrophy, and treatment targets for blood pressure. The management of hypertension in CKD involves therapeutic lifestyle changes and medications such as ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, and diuretics. The goal of treatment is to reduce blood pressure and prevent or reverse left ventricular hypertrophy and other target organ damage.
This study analyzed data from over 21,000 Japanese patients to investigate the relationship between blood pressure measurements and cardiovascular outcomes. The results showed that morning home systolic blood pressure was a stronger predictor of coronary artery disease events than clinic blood pressure. There was a graded association between higher morning home systolic blood pressure and increased risk of coronary events. Neither home nor clinic blood pressure measurements showed a J-shaped curve relationship with stroke or coronary artery disease risk.
Here are my recommendations for the 56 year old woman with subclinical hypothyroidism:
1. Her diagnosis is subclinical hypothyroidism based on an elevated TSH of 7.1 and normal free T4.
2. Given her age (56), fatigue, and 3-4 lb weight gain, I would recommend a trial of levothyroxine therapy. Treatment is reasonable for patients with TSH >10 or positive thyroid antibodies, which she does not have data for. However, treatment may modestly improve her lipids and symptoms.
3. She should be monitored every 6 months with TSH checks to ensure her TSH is maintained between 0.5-2.0 and that she does not
Non-pharmacological interventions help reduce the daily dose of antihypertensive medication and delay the progression from prehypertension to hypertension stage. Non-pharmacological interventions include lifestyle modifications like dietary modifications, exercise, avoiding stress, and minimizing alcohol consumption.
Alexander the Great was born in 356 BC in Pella, Macedonia. He became the king of Macedonia after his father's death and went on to conquer the vast Persian Empire. Considered a military genius, Alexander the Great established one of the largest empires in ancient history before his death in 323 BC, possibly due to poisoning.
This document is an advertisement for apartments called IITL-Nimbus located in Sector 168 of Noida Expressway. It provides the address and contact details for C.LAL Realtors, the real estate agency handling sales for the apartments. Interested customers can call or visit the listed contact number and address for more information.
How communication can support the debt management during the crisis - the cas...viviana cozi
The communication campaign for the launch and placement of a new bond designed for the retail market. An innovative product that millions of italian private citizens started loving in 2012... in spite of the crisis. The role of communication of the Italian Treasury to inform retail investors and support private savings.
The world has changed. Whether you want to believe it or not, your career success depends upon your ability to sell and persuade. In this webinar you will learn why sales is important, the proper beliefs to sell from a place of integrity, and specific tools to help you be successful.
5 basic social media moves to improve your career iasa 2016 presentationSt. Nick Media Services
This presentation narrows the ways in which insurance professionals can and should be using social media, highlights typical pitfalls, and suggests ways to improve visibility, build expertise and increase personal brand recognition.
This document examines the identity of the Antichrist and argues that it is Mohammed and Islam. It provides biblical evidence that Jesus is God incarnate, while Mohammed denies this and claims Jesus was not crucified. It then discusses the great tribulation as the period from Jesus' ascension to his return, and argues we may currently be in the millennium reign described in Revelation. In conclusion, it declares the great tribulation over but warns Christians to continue occupying all things until Jesus' physical return to earth.
The document describes a student's daily morning routine, which includes waking up at 5 AM, making their bed, taking a shower, getting dressed in their school uniform, brushing their teeth after breakfast, and leaving for school at 6:03 AM. After school ends at 12:15 PM, the student has lunch with their mom between 2:30-3 PM, does homework from 3-7 PM, and watches TV from 7-8 PM before going to sleep to rest for the next day.
Tutorial de portafolio de evaluación docente - Parte IIAndrés Cisterna
El documento proporciona sugerencias y consejos para el desarrollo del portafolio docente, incluyendo apoyos disponibles, cómo mostrar el mejor desempeño, y qué se evalúa en cada módulo. Se destacan consejos sobre objetivos, actividades de aprendizaje, interacción con estudiantes, y trabajo colaborativo con otros profesores.
St. Paul's College, Kalamassery - Philatelic Exposition, Pride of India Colle...Justine George
Philatelic Exposition - Pride of India Collection
Prof. V. C. Antony
Venue: Seminar Hall, St Paul’s College, Kalamassery
Time & Date: 2.00 P.M, 2/7/2012
The audited financial statements are for Spider Resources Inc. for the years ending December 31, 2009 and 2008. The auditors issued an unqualified opinion stating the financial statements fairly represent the financial position of the company.
Net losses for 2009 and 2008 were $748,277 and $716,861 respectively, with a cumulative deficit from inception of $16,949,367. Cash decreased from $3,205,855 in 2008 to $2,716,778 in 2009.
- Spider Resources Inc. is a development stage mining company that prepares interim financial statements on a quarterly basis.
- The interim financial statements for the three months ended March 31, 2010 were prepared by management who is responsible for their content.
- For the three month period, the company reported a net loss of $316,801 and an accumulated deficit of $17,266,168.
This document discusses hypertension (HTN) in children, including:
1. The prevalence of HTN and elevated blood pressure in children is between 3.5-11%, and is increasing due to rising childhood obesity rates.
2. A study in Iran found a 7% obesity rate and 11.8% HTN rate in children, with blood pressure associated with higher BMI.
3. A meta-analysis of Iranian studies found an overall 8.9% HTN prevalence in children and adolescents, slightly higher in boys at 10.3% than girls at 9.1%.
This study analyzed epidemiological data on hypertension collected from 53 patients at a tertiary hospital in India. The results showed that hypertension was more prevalent in males than females, and most common in the 40-60 year old age group. Risk factors like urban living, lower education, higher BMI, smoking, drinking, sedentary lifestyle and comorbid conditions were associated with higher rates of hypertension. The most commonly prescribed medication for hypertension was a combination of atenolol and amlodipine.
This study analyzed epidemiological data on hypertension collected from 53 patients at a tertiary hospital in India. The results showed that hypertension was more prevalent in males than females, and most common in the 40-60 year old age group. Risk factors like urban living, lower education, higher BMI, smoking, drinking, sedentary lifestyle and comorbid conditions were associated with higher rates of hypertension. The most commonly prescribed medication for hypertension was a combination of atenolol and amlodipine.
A prevalence of common risk factors of hypertension among young generation li...SriramNagarajan16
Hypertension is one of the upward health related challenge in Bangladesh and hypertension in young generation is increasing
but there is a shortage of data about the risk factors in this age group. The aim was to evaluate and approximation the
frequency of some common risk factors of hypertension among young generation living in Dhaka city. It was a crosssectional study; conducted during March 2016 to June 2016 in Dhaka city. Data were collected by face-to-face interview after
verbal informed consent by a survey questionnaire and stress was measured by Perceived Stress Scale and analyzed by SPSS
version 16. The study was conducted on 150 (n=150) young adults where 76% were male and 24% were female and their
mean age was 22.13 and 23.33% of them were overweight and only 1(n=1) was obese and 44% of them took average amount
of junk food while 14% took huge amounts and 59.33% of them had family history of hypertension and 70.66% of them were
in high stress. The mentioned age range shows a good amount of predominance of hypertension probably indicating a hidden
epidemic. It is needed to improve the measures of key anticipation and early detection of hypertension among young
generation
This study examined the prevalence of diabetes mellitus (DM) and related socio-demographic factors among adults in northern Iran. The study found that 8.3% of participants had DM, with 25% of cases being undiagnosed. Prevalence was higher in women, older age groups, urban residents, those with central obesity or higher BMI. Lower physical activity, illiteracy, and central obesity were associated with greater risk of DM. The study concluded that DM poses a major health problem in northern Iran, with nearly half of cases going undiagnosed.
This study examined the prevalence of atopic dermatitis symptoms among students in Kurdistan, Iran. A survey was conducted of 3,890 students ages 6-7 and 13-14 using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The results found that the prevalence of itchy rashes in the past 12 months was 8.9%, and was higher in boys than girls and in the older age group of 13-14. The prevalence of flexural rashes was 10.3%. The study aims to understand the epidemiology of atopic dermatitis in the region to help guide public health planning and identify potential environmental factors.
This study assessed the prevalence of risk factors for non-communicable diseases among adolescents in Parsa District, Nepal. Nearly half of males and one-third of females were using substances like tobacco, alcohol or drugs. Overweight and obesity levels were high, with 66% of males and 15.5% of females overweight by BMI criteria. Blood pressure measurements found 12% pre-hypertensive and 5% hypertensive. Risk factors like overweight/obesity were associated with increased blood pressure. The study suggests urgent health programs are needed for primordial prevention of non-communicable diseases in this population.
Epidemiology of Hypertension among Adults in Al-Azhary Area in Khartoum-State...inventionjournals
Hypertension (HT) is one of the most important risk factors in cardiovascular disease which causes early death in adults. Hypertension is a common disease associated with high mortality and morbidity. Hypertension a silent killer as it is symptomless and remains undiagnosed, and not controlled if diagnosed. This is a descriptive cross - sectional community based study was conducted in Al-Azhary area in Khartoum StateSudan, with aim to estimate the prevalence of hypertension and to identify the possible risk factors associated with hypertension among adults. Data were collected from 303 participants (53.5% females and 46.5% males) using structured pretested questionnaire and blood pressure. The prevalence of hypertension was 19.1% (95% CI 0.61-1.93).There was no significant sex difference in the prevalence rate OR 1.09 (95% CI 0.61-1.93, P = 0.767). The results showed there was strong association between age group and hypertension (P = 0.0001), also there was statistical association between marital status, family history and hypertension positivity P.values =(0.0001 and 0.027) respectively. There was a significantly higher prevalence of hypertension among participants with diabetes, Vascular diseases and kidneys problems OR= (5.44(95% CI 1.89- 15.69, P = 0.017), 4.4(95% CI 0.86 - 2.39, P = 0.074) and 3.56 (95% CI 0.92-13.68, P = 0.05) respectively. Conclusion: one out of every five respondents of the study had hypertensive (19.1%). Age group, marital status, family history, history of (diabetes, vascular diseases and kidneys problems)were statistically significant predictors of hypertension positivity.
The prevalence and severity of obesity is increasing dramatically
among children and adolescents in many parts of the
world, whereas prevalence rates are estimated to increase in
the next decades [1]. In children, excess body fat appears to
be strongly associated with the clustering of risk factors, such
as hyperglycemia, dyslipidemia, and hypertension, which
play a key role in the pathogenesis of the metabolic syndrome
(MetS) [2].
Obesity and the MetS risk in children have been
recently associated with systemic inflammatory markers,
in particular C-reactive protein (CRP) [3, 4], implying
that low-grade inflammation can already exist in childhood
and may be a potential link between the obesity and the
MetS. Among behavioral variables, cardiorespiratory fitness
has a protective role in MetS and inflammatory factors;
however, it is not entirely clear if the interrelations among
cardiorespiratory fitness, MetS risk, and inflammation in
children are independent or partly due to the mediating
effect of obesity, since the existing data are limited and
equivocal [5, 6].
Recent evidence indicates that the prevalence rates
of childhood obesity in Greece remain high [1, 7] and
often coexist with low cardiorespiratory fitness [8] and
an unfavorable cardiometabolic risk profile [9]. For the
Greek pediatric population these data suggest an increased
cardiovascular morbidity in adulthood, given that highrisk
children and adolescents are likely to become highrisk
adults [10]. Although the relationship among obesity
and dyslipidemia in Greek children has been thoroughly
investigated [9, 11], there is a paucity of data regarding the
clustering of metabolic risk factors, inflammation, and their
relationship with cardiorespiratory fitness. The present study
was undertaken in an attempt to investigate the prevalence of
theMetS and examine the associations among cardiorespiratory
fitness, MetS risk, and CRP in 11-year-old children.
This study examined the prevalence of metabolic syndrome (MS) among 200 obese patients in Yemen. The overall prevalence of MS was 46%, with no significant difference between men and women. High blood pressure was the most common comorbidity, present in 68% of patients with MS. Other common comorbidities included high triglycerides (66%), low HDL cholesterol (64%), and high fasting blood glucose (41%). The results indicate a high prevalence of MS and its components among obese Yemeni patients, highlighting an urgent need for strategies to prevent and treat MS and related conditions like cardiovascular disease and diabetes.
Nutritional assessment status of adult patients with multiple sclerosis: A na...Innspub Net
No previous research has assessed the nongenetic factors, especially the nutrition status of MS patients in Arab countries. Hence, this study aims to assess the nutritional status of MS patients among Arab adults. This study is a nationally representative cross-sectional study using a structured, online self-administered, validated quantitative food frequency questionnaire (FFQ) from 13 Arab countries. All data analyses were performed using STATA 16.0 and R for statistical computing version 4.0.4. A total of 813 participants were surveyed, most of the MS participants were female (68.4%), married (58.5%), non-smoker (72.6%) and 53.3% were diagnosed with MS for up to five years. MS participants did not consume the DRI of both the macro and the micronutrients including the energy requirements, except the dietary intake of the sodium which was insignificantly different from the DRI. Results also showed that most participants rarely consumed the main food items including bread, cereals, and most types of meat. While, more than 50% of the participants consumed fruit, vegetables, all types of chicken, fish, fresh soup, rice, and egg up to 3 times per month. On the other hand, milk and milkshake were consumed rarely; while, tea and herbal teas were the most common beverages. Nutrient deficiencies are very common among MS Arab patients. The finding of this study can establish a base for the development of a nutritional program for MS patients in accordance with the recommended DRI.
This study reviewed published studies on the prevalence of hypertension worldwide from 1980-2003. It found that the prevalence varied widely, from as low as 3.4% in rural Indian men to as high as 72.5% in Polish women. In developed countries the prevalence ranged from 20-50%, while it was generally lower in developing regions. Awareness of hypertension also varied significantly, from 25.2% in Korea to 75% in Barbados. Treatment and control of hypertension was inadequate in many areas. The study concludes that hypertension is a major public health challenge worldwide due to its high prevalence and increased risk of disease.
This document reports on a study that assessed the prevalence of asthma symptoms among elementary and middle school students in Kurdistan Province, Iran. A questionnaire was distributed to 4,000 students aged 6-7 and 13-14 years, with a 97% response rate. The prevalence of wheezing in the past 12 months was found to be 26.5% overall. The prevalence of physician-diagnosed asthma was 3.9%. There were statistically significant differences in prevalence rates between different cities in the province. The study found a relatively high prevalence of wheezing and asthma among students in Kurdistan province compared to other similar studies.
Article Type: Editorial
Title: Challenges Met by Healthcare Professionals (Nurses) at the time of Covid-19 Pandemic
Year: 2021; Volume: 1; Issue: 2; Page No: 3 – 4
Author: Sumathi Senthilvel
DOI: 10.55349/ijmsnr.20211234
Affiliation: Associate Editor, IJMSNR, Formerly Assistant Professor in Nursing, Department of Fundamental Nursing, Amrita College of Nursing. Ponekkara, Kochi, Kerala. Email ID: AssociateEditor@ijmsnr.com
Article Summary: Submitted : 26-October-2021
Revised : 10-November-2021
Accepted : 02-December-2021
Published : 31-December-2021
Background: Diabetic Retinopathy is a non-communicable disease and metabolic disorder. It is a public health problem in Worldwide. In this paper, finding influencing factors and how much probability to development of DR among known T2DM patients.
Materials and Methods: This was a hospital-based cross-sectional and observational study among T2DM patients, with and without DR in the diabetes clinic with sample of 150 patients. Statistical analysis used chi-square and binary logistic regression analysis was used to identify correlates of DR after controlling of confounders.
Results: In this present study, among 150 patients, 39 (26%) patients had DR. Smoking habit was strongly associated with development of DR (AOR=15.39, p=0.002), patients had history of hypertension was associated with DR (AOR=1.10, p=0.016), medication, in that insulin users were strongly associated with DR (AOR=5.72, p=0.002), duration of diabetes mellitus with >10 years was associated with DR (AOR=1.18, p=0.001), total cholesterol with abnormal was 5-fold more increase in risk with the development of DR (AOR=5.86, p=0.065) but not significant, high hba1c with >6.5% was associated with the progression of DR (AOR=1.34, p=0.035), and fasting blood sugar with abnormal was associated with the progression of DR (AOR=1.01, p=0.027) except age but, showed positive association with DR. Probability of developing DR in a T2DM patient was 98%.
Conclusion: From this study, we revealed that influencing variables were hba1c, smoking habit, intake of tablet/insulin, duration of DM, history of hypertension and fasting blood sugar. The chance/probability of developing retinopathy was very high among known diabetes patients those who had longer duration of DM. Hence, we have recommended a periodic eye screening is mandatory in T2DM patients.
Keywords: diabetes mellitus, diabetic retinopathy, influencing factors, probability, multivariate analysis
This systematic review examines evidence on screening children and adolescents for hypertension to prevent cardiovascular disease. The review found:
1) No studies evaluated whether screening reduces adverse health outcomes.
2) Studies of screening test accuracy showed moderate sensitivity and specificity.
3) Association between childhood hypertension and adult hypertension/outcomes was inconsistent across studies.
4) Drug interventions effectively lowered blood pressure in adolescents in the short-term, but longer-term studies are needed.
Correlation between Blood group, Hypertension, Obesity, Diabetes, and combina...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This document discusses a study that assessed cancer awareness among university students in Turkey. It found that:
- Students studying health sciences had significantly higher knowledge about cancer risks and symptoms than students studying social sciences. For example, more health science students knew that smoking and obesity can cause cancer.
- Among all students, most knew smoking causes cancer but about 10% of each group thought cancer was communicable. Health science students displayed more accurate knowledge of common cancer types.
- Characteristics like age, gender, and family cancer history impacted students' cancer knowledge to some degree depending on their field of study. For example, younger social science students better knew breast cancer is most common in women.
- The study concluded
Prevalence of Type II Diabetes and Metabolic Syndrome among Overweight School...DMS Library
This study examined the prevalence of type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) among overweight school children in Khon Kaen, Thailand. The researchers analyzed height, weight, and BMI measurements from 2,156 school children aged 10-15 years. They identified 594 (27.6%) overweight children, of whom 186 participated further. The study found T2DM in 4 children (2.2%) and MetS in 6 children (3.2%). Additionally, 46.8% of overweight children had at least one type of dyslipidemia. The study concluded that T2DM and MetS are common among overweight school children in the region and preventive interventions are needed.
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A Study of the Risk Factors and the Prevalence of Hypertension in the Adolescent School Boys of Ahmedabad City
1. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH
How to cite this article:
KHAN M I, LALA M K, PATIL R, MATHUR H N, CHAUHAN NT. A STUDY OF THE RISK
FACTORS AND THE PREVALENCE OF HYPERTENSION IN THE ADOLESCENT SCHOOL BOYS
OF AHMEDABAD CITY. Journal of Clinical and Diagnostic Research [serial online] 2010
December [cited: 2010 December 20]; 4:3348-3354.
Available from
http://www.jcdr.in/article_fulltext.asp?issn=0973-
709x&year=2010&volume=&issue=&page=&issn=0973-709x&id=822
2. Khan M I, et al, Risk factors and Prevalence of Hypertension in Adolescent boys
ORIGINAL ARTICLE
A Study Of The Risk Factors And The Prevalence Of
Hypertension In The Adolescent School Boys Of Ahmedabad City
KHAN M I1, LALA M K2, PATIL R 3, MATHUR H N4, CHAUHAN NT5
ABSTRACT
Background: Hypertension is one of the diseases which is less commonly diagnosed and
treated, but its actual prevalence is high. The association between the presence of risk
factors and the development of disease has been well documented. The present study was
conducted to find out the risk factors and to evaluate the prevalence of hypertension among
the adolescent school boys of Ahmedabad city.
Aims: 1.To study the distribution of blood pressure among the adolescent boys who were
aged 12-19 years.
2. To find out the association between the prevalence of hypertension and it’s risk
factors.
Settings and Design: A cross sectional study was conducted from Feb. 2007 to August 2008
in secondary and higher secondary schools in 5 zones of the Ahmedabad Municipal
Corporation.
Methods and Material: A predesigned and pretested proforma was filled by the students
after the purpose of the study was explained to them. Anthropometric measurements and
blood pressure were recorded as per the standard WHO guidelines.1093 proformas were
analyzed after excluding the incomplete proformas. Hypertension was diagnosed when the BP
exceeded two standard deviations (i.e.95th percentile) above the mean pressure for the
population. BMI was used as a measure of obesity and it was derived by using the standard
formula for it.
Statistical Analysis: The collected information was analyzed by using the Microsoft Excel
and the Epi info 3.4 software. Chi-square test was used for analysis.
Results and Conclusions:
Out of 1093 adolescent boys, 107 (9.78 %) were found to be hypertensive. The highest
prevalence was found at 19 years of age (21.7 %). Of the 107 hypertensive boys, 42 (39.2 %)
had both systolic and diastolic hypertension. The mean SBP among the participants was 109.6
mm Hg and the mean DBP was 69.3 mmHg. The family history of HT and the presence of
overweight and obesity in boys were found to be associated significantly. No association was
found between hypertension and other risk factors like added salt, junk food and the
socioeconomic class. Among the hypertensive adolescents, the risk factors which were found
to have the highest prevalence were the intake of junk food (90.6%), followed by higher
3348 Journal of Clinical and Diagnostic Research. 2010 December;(4):3348-3354
3. Khan M I, et al, Risk factors and Prevalence of Hypertension in Adolescent boys
socio-economic class (48.5%), extra salt in the diet (29.9%) and overweight and obesity
(20.3%).
Key Words: Adolescent, Hypertension, Obesity, BMI
____________________________
1
Assistant Professor, Department of Government Medical College, Bhavnagar,
Community Medicine, Geetanjali Medical Gujarat.
2
College, Udaipur, Rajasthan; Associate Address for correspondence:
Professor, Department of Community Medicine, Dr. M. Iqbal Khan
B J Medical College, Ahmedabad, Gujarat; Assistant Professor, Department of Community
3
Associate Professor, Department of Community Medicine,
Medicine, Geetanjali Medical College, Udaipur, Geetanjali Medical College, Manwa Kheda ,NH-
4
Rajasthan; Professor, Department of 8 By-pass
Community Medicine, Geetanjali Medical Udaipur, 313001
5
College, Udaipur, Rajasthan; Assistant Rajasthan.
Professor, Department of Community Medicine, E-mail:iqbalnaaz14@yahoo.co.in
Mobile No.09314378778,09352647198
Introduction
Most of the non-communicable diseases are Aims and Objectives
undiagnosed in the community because of their 1.
asymptomatic nature in the earlier phases of the To study the distribution of blood pressure
disease. Patients report to the health facility in among the adolescent boys aged 12-19
the advanced stage with complications. years.
Hypertension is one of the diseases which is 2. To find out the risk factors playing a role in
diagnosed and treated in 25% of the cases hypertension in adolescent boys.
according to Rule of Half.[1] Studies have 3. To find out the association between the
documented that hypertension may begin in prevalence of hypertension and factors like
adolescence, perhaps even in childhood.[2]-[4] obesity, diet and the family history of
The prevalence of hypertension is reported as NCDs, etc.
being 1-30% among adults in different age 4. To provide health education to school
groups.[5] and the prevalence of hypertension in children and their teachers on adolescent
children is reported to range from less than 1% hypertension.
to 16.2%. [6]-[7] The relationship between
adolescent and adult BP is demonstrated by the Material and Methods
“tracking” phenomenon [8] (Those children and A cross sectional study was conducted from Feb.
adolescents who’s BP were at the upper 2007 to August 2008 in secondary and higher
percentiles, would have their BP staying at the secondary schools in 5 zones of the Ahmedabad
same range after their growth and development). Municipal Corporation. From a total of 249
Risk factor identification is an established schools, 40 schools were selected by the simple
strategy to apply primordial prevention to reduce random sampling method (8 schools from each
the incidence of hypertension in the community. zone). Prior permission for the study was taken
The association between the presence of risk from the school authorities. From each school,
factors and the development of the disease has 30 boys from class 8th to 12th were selected
been well documented. The present study was randomly. A predesigned and pretested
conducted to find out the risk factors and to proforma was filled by the students after the
evaluate the prevalence of hypertension among purpose of the study was explained to them.
the adolescent school boys of Ahmedabad city. Anthropometric measurements and the blood
pressure were recorded by the investigators as
3349 Journal of Clinical and Diagnostic Research. 2010 December;(4):3348-3354
4. Khan M I, et al, Risk factors and Prevalence of Hypertension in Adolescent boys
per the standard WHO guidelines. A total of between the 5th percentile to less than the 85th
1200 apparently healthy adolescent school boys percentile was taken as normal, the 85th to less
aged 12-19 years were taken as the study than the 95th percentile was taken as overweight
subjects. 1093 proformas were analyzed after and that which was equal to or above the 95th
excluding the incomplete proformas. The percentile was taken as obese. Socioeconomic
measurements included height (cm) and weight status was determined by Modified Prasad’s
(kg). The students were made to rest and relax classification scale.
before measuring their BP for 10 minutes. Their
BP was taken in the sitting position, by using a
mercury sphygmomanometer. The cuff was
applied evenly and snugly on the bare right arm
with the lower edge at 2.5 cm above the
antecubital fossa (as per WHO guidelines).The
cuff was inflated rapidly and deflated slowly.
The point of the onset of the first tapping sound
was taken to indicate systolic blood pressure
(SBP) and the diastolic BP (DBP) reading was
taken when the fifth Korotkoff (K5) sound
disappeared. For each subject, two recordings
were taken at an interval of 30 minutes and the
average of two readings was taken and it was
considered to be the final reading.
The 5th to 99th percentiles for systolic and
diastolic blood pressure were calculated
separately for the respective age groups from 13
to 19 years. The children were considered to be
hypertensive if their systolic or diastolic blood
pressure or both were equal to or more than the
[Table/Fig 2]: Prevalence of Hypertension
95th percentile for age and sex [9] and their according to Age
distribution is clearly shown in [Table/Fig 1] and
[Table/Fig 3]. The collected information was analyzed by
using the Microsoft Excel and the Epi info 3.4
software. Chi-square test was used to find out
any significant association between the risk
factors which were studied and hypertension.
Observation and Results
Among 1093 boys, the highest no. of students
were from class 10th (35.95%), followed by
those from class 12th (30.55%). The students
were in the age group of 12 to 19 years. Their
mean age was 15.75 years (SD: 1.38). The
[Table/Fig 1]: Distribution of Type of highest no. of students belonged to the 15 years
Hypertension in Adolescent boys age group (27.3%), followed by the 17 years age
group (25.8%). The maximum numbers of
BMI was used as a measure of obesity and it students were from the socio-economic class II
was derived by using the standard formula for it. (35.4%), followed by those from the socio-
9 economic class III (28.1%) and class IV
BMI percentiles were calculated for each
respective age group. The BMI percentile (17.2%).
3350 Journal of Clinical and Diagnostic Research. 2010 December;(4):3348-3354
5. Khan M I, et al, Risk factors and Prevalence of Hypertension in Adolescent boys
The mean SBP among the participants was
In boys, the 5th and the 95th percentile of BMI in 109.6 mm Hg and the mean DBP was 69.3
the age group of 13 years were 14.06 and 26.03 mmHg [Table/Fig 4].
respectively, while in the age group of 19 years,
it was 15.66 and 24.35 respectively. The 5th and
95th percentiles of BMI in the middle order age [Table/Fig 4]: Age wise Distribution of Mean BP
groups (15, 16 and 17 years) were almost the and
S.D.
same. Out of the 1093 students who were
examined, 114 (10.44 %) were found to be
overweight and 63 (5.77 %) were obese
according to the BMI percentile criteria. The
remaining 865 (79.14 %) had healthy weight and
49 (4.48 %) were underweight.
A nomogram was constructed for the study
population (12-19 years). The 5th to 99th
percentiles for systolic and diastolic blood
pressure were calculated for the respective age
groups of 13 to 19 years [Table/Fig 3].
*Only two students in this age
Out of 1093 adolescent boys, 107 (9.78 %) were
found to be hypertensive. The highest
prevalence was found in the 19 years age group
(21.7 %), followed by the 13 years age group
(14.3 %) [Table/Fig 2]. Of the 107 hypertensive
boys, 39.2 %( 42) had both systolic and diastolic
hypertension[Table/Fig1].Among the adolescent
boys, the most common risk factor was the
intake of junk food (90.9%). [Table/Fig 5]
[Table/Fig 3]: Distribution of BP Percentiles
according to age in adolescent boys
*Only two subjects in 12 years of age, so they were
excluded
3351 Journal of Clinical and Diagnostic Research. 2010 December;(4):3348-3354
6. Khan M I, et al, Risk factors and Prevalence of Hypertension in Adolescent boys
[Table/Fig 5]: Prevalence of Risk Factors of
Hypertension in Adolescents boys
The family history of HT and the presence of
overweight and obesity in the boys both were
found to be associated significantly [Table/Fig
6] and [Table/Fig 7]. No association was found
between hypertension and other risk factors like
added salt, junk food and the socioeconomic
class [Table/Fig 7]. Among the hypertensive
adolescents, the risk factor which had the
highest prevalence was found to be the intake
of junk food (90.6%), followed by higher socio-
economic class (48.5%), extra salt in the diet
(29.9%) and overweight and obesity (20.3%).
[Table/Fig 7]: Prevalence of Risk Factors among
Hypertensive Adolescent boys
Discussion
Hypertension is a major risk factor for
cardiovascular and cerebrovascular diseases.
Most of the studies of BP which were carried out
in different populations have shown a rise of BP
with age. [10] The insidious and the steady
course of hypertension in adults indicates that it
may have had its roots in childhood and the
adolescent age group (“Tracking phenomenon”),
[Table/Fig 6]: Association between Family History but had probably gone undetected. [11] In
of Non-Communicable Disease and Hypertension some studies, the prevalence of hypertension in
in Adolescent boys
children was reported to range from less than 1.0
to 16.2%.[12] In the present study, the
prevalence of sustained hypertension in urban
school going boys between the ages of 12 to 19
years was found to be 9.78%, which was quite
high as compared to 0.5-2% in other studies.
[11],[12] It also reflects the changing lifestyle
and environmental interaction as the major
3352 Journal of Clinical and Diagnostic Research. 2010 December;(4):3348-3354
7. Khan M I, et al, Risk factors and Prevalence of Hypertension in Adolescent boys
causative factors for the prevalence of no significant association was found between the
hypertension in school going children. upper and lower socio-economic classes and
hypertension (X2=0.14, P>0.05).
In present study, 37.4% of the hypertensives
were Isolated Systolic Hypertension cases In the present study, the subjects in whom a
[Table/Fig 1]. Isolated Systolic Hypertension positive family history of hypertension was
deserves attention as it is an important risk elicited had higher blood pressure. The
factor of coronary heart disease and stroke, prevalence of hypertension was also higher in
independent of the diastolic status of the them (19.9%) [Table/Fig 6]. This suggests that
individual [13], [14]. there is a genetic role to play in the development
of hypertension. A familial tendency for
The tendency of the blood pressure to rise with developing high blood pressure is well known.
age is supported by the findings from a Turkish A positive parental history of high blood
study among the age group of 13-18 years [15] pressure was associated with higher SBP and
and a study on Zambian school children (7-16 DBP and this could provide a clue to the target
years) [16]. In the present study, both mean SBP population for blood pressure screening. No
and mean DBP rose with age [Table/Fig 4]. significant association was found between a
family history of diabetes mellitus, coronary
By the BMI criteria, 10.44% boys were found to heart disease and the occurrence of
be overweight and 5.77% were obese. By using hypertension.
similar criteria, Shah et al had reported the
prevalence of overweight and obesity to be Since comparative height adjusted values of
9.25% and 5.55% respectively in an urban area blood pressure were not available for the Indian
of Bhavnagar city, Gujarat. [17] Obesity in population, we have used the non-height
children is associated with an increased adjusted values and also follow up was not done.
incidence of hypertension, diabetes, coronary This is a limitation in the study.
artery disease, osteoarthritis and an overall
increase in morbidity and mortality during adult Both the teachers and parents were advised
life. [18] The relationship between hypertension about the appropriate treatment of those students
and obesity in childhood has been noted, though who were diagnosed as hypertensive according
it has been less extensively evaluated. to the diagnostic criteria which were used in this
Hypertension in obese children may occur due to study.
increased cardiac output, excessive sodium In the present study, 31.7% of the boys were
intake, increased steroid production and found to be consuming added salt or extra salt in
alteration in the reception for various pressure their diets. However, no significant association
substances. [19] was found between the use of extra salt intake
and hypertension (X2=0.19, P>0.05) among the
It is evident from this school based hypertensive boys.
epidemiological study, that increase in BMI
predisposes the adolescent individual to higher Finally, a changing trend towards the higher
blood pressure and subsequently, hypertension. prevalence of hypertension in school going
A statistical significance was found between children reflects the changing scenario of
overweight/obesity and hypertension in the cardiovascular diseases in the current era due to
present study. A similar finding was also the changing lifestyles and dietary patterns and
reported elsewhere in India [20]. Such an decreased physical activity and increase in
association in early childhood with SBP alone obesity. It also highlights the importance of
was reported by Sinaiko et.al [21] and Hardy screening adolescents for the detection of
et.al [22]. Lifestyle modification between the hypertension.
upper and lower socio-economic classes could
have had an indirect bearing on the blood
pressure levels. However, in the present study,
3353 Journal of Clinical and Diagnostic Research. 2010 December;(4):3348-3354
8. Khan M I, et al, Risk factors and Prevalence of Hypertension in Adolescent boys
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[12] Chadha SL, Tandon R, Shekhawat S, Gopinath N. Acknowledgement
An epidemiological study of blood pressure in We would like to thank the school authorities
school children (5-14 years) in Delhi. Indian
Heart J 1999; 51: 178-182. and the students for participating in our study.
[13] Borghi C, Dormi A, L’Italien G et.al. The relation We are also thankful to the Dean, B.J. Medical
between systolic blood pressure and College,Ahmedabad for giving us permission to
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26;25-9.
3354 Journal of Clinical and Diagnostic Research. 2010 December;(4):3348-3354