scholarly journals Prevalence of Use of Preventive Services in Poland: Result from a Population-Based Nationwide Study

2021 ◽  
Vol 10 (10) ◽  
pp. 2084
Author(s):  
Siddarth Agrawal ◽  
Justyna Gołębiowska ◽  
Sebastian Makuch ◽  
Grzegorz Mazur
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Preventive Services ◽  
Population Based ◽  
Remote Access ◽  
System Level ◽  
Computer Assisted ◽  
Preventive Interventions ◽  
Cross Sectional ◽  
Blood Pressure Screening

Systematic reviews of scientific evidence have identified clinical services that prevent or ameliorate illness and reduce mortality. This study aimed to assess the prevalence of all recommended evidence-based preventive services in a publicly funded healthcare setting. We conducted a population-based nationwide cross-sectional computer-assisted telephone survey of 1000 Polish adults (response rate 42%). The self-reported use of all recommended clinical preventive services was assessed, including mammography, colonoscopy, blood glucose screening, vaccination, blood pressure screening, and preventive counselling. The results showed that only 6.4% of adults had received all recommended preventive screening, whereas only 4.3% had received appropriate counselling. General practitioner (GP) visits, blood pressure screening, blood glucose screening, and cervical smear were among the most commonly provisioned interventions, while flu vaccination, PSA assessment, and preventive counselling were among the least prevalent services. Despite the low uptake of preventive interventions, over 75% is interested in remote access to preventive services using telemedicine platforms and e-consultations. Our findings suggest that there are significant gaps in the receipt of preventive interventions. Further improvements require not only changes in the incentive system for healthcare providers, but also system-level innovation such as telemedicine solutions to deliver preventive services remotely and engage individuals in the monitoring process.

scholarly journals Delivery of High-Priority Recommended Clinical Preventive Services: Result from a Population-Based Nationwide Study

2020 ◽  
Author(s):  
Siddarth Agrawal ◽  
Justyna Gołębiowska ◽  
Grzegorz Mazur
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Preventive Services ◽  
Population Based ◽  
System Level ◽  
Computer Assisted ◽  
Preventive Strategy ◽  
Preventive Interventions ◽  
Clinical Preventive Services ◽  
Blood Pressure Screening

Abstract Background Systematic reviews of scientific evidence have identified clinical services that prevent or ameliorate illness and reduce mortality. Most prior studies have considered the provision of a single domain of preventive services such as vaccination or cardiac care and failed to evaluate a systemic approach to preventative care. The study aimed to assess the level of delivery of all high-priority evidence-based preventive services in a publicly funded healthcare setting. MethodsWe conducted a population-based nationwide cross-sectional computer-assisted telephone survey of 1000 Polish adults. Self-reported use of all high-priority clinical preventive services was assessed, including mammography, colonoscopy, blood glucose screening, vaccination, blood pressure screening, and preventive counselling. ResultsOnly 6.4% (95% confidence interval (CI): 4.88, 7.92) of adults had received all recommended preventive screening, whereas only 4.3% (95% CI: 3.04, 5.56) had received appropriate counselling. GP visits, blood pressure screening, blood glucose screening, and cervical smear were among the most commonly provisioned interventions, at more than 60%, while flu vaccination, PSA assessment, and preventive counselling were among the least frequently delivered services. Despite the low uptake of preventive interventions, nearly three-quarters of the respondents expect the public health system to provide access to these services, and over 75% is interested in remote access to preventive services using telemedicine platforms and e-consultations.ConclusionOur findings suggest that there are significant gaps in the receipt of high-priority preventive interventions. Services that are most commonly not being delivered, such as preventive counselling, need to be emphasized to achieve greater coverage of the population. Further improvements require not only changes in the incentive system for healthcare providers, but also system-level innovation such as telemedicine solutions to deliver preventive services remotely and engage individuals in the monitoring process. The effective preventive strategy will attain the multiple objectives of improving the quality of life, extending the human lifespan, and making the best use of scarce resources.

scholarly journals Association between Blood Pressure and Serum Thyroid-Stimulating Hormone Concentration within the Reference Range: A Population-Based Study

2007 ◽  
Vol 92 (3) ◽  
pp. 841-845 ◽  
Author(s):  
Bjørn O. Åsvold ◽  
Trine Bjøro ◽  
Tom I. L. Nilsen ◽  
Lars J. Vatten
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Outcome Measures ◽  
Odds Ratio ◽  
Reference Range ◽  
Positive Association ◽  
Population Based ◽  
Thyroid Stimulating Hormone ◽  
Cross Sectional ◽  
Population Based Study

Abstract Context: The association between thyroid function and blood pressure is insufficiently studied. Objective: The objective of the investigation was to study the association between TSH within the reference range and blood pressure. Design and Setting: This was a cross-sectional, population-based study. Subjects: A total of 30,728 individuals without previously known thyroid disease were studied. Main Outcome Measures: The main outcome measures were mean systolic and diastolic blood pressure and pulse pressure and odds ratio for hypertension (>140/90 mm Hg or current or previous use of antihypertensive medication), according to categories of TSH. Results: Within the reference range of TSH (0.50–3.5 mU/liter), there was a linear increase in blood pressure with increasing TSH. The average increase in systolic blood pressure was 2.0 mm Hg [95% confidence interval (CI) 1.4–2.6 mm Hg] per milliunit per liter increase in TSH among men, and 1.8 mm Hg (95% CI 1.4–2.3 mm Hg) in women. The corresponding increase in diastolic blood pressure was 1.6 mm Hg (95% CI 1.2–2.0 mm Hg) in men and 1.1 mm Hg (95% CI 0.8–1.3 mm Hg) in women. Comparing TSH of 3.0–3.5 mU/liter (upper part of the reference) with TSH of 0.50–0.99 mU/liter (lower part of the reference), the odds ratio for hypertension was 1.98 (95% CI 1.56–2.53) in men and 1.23 (95% CI 1.04–1.46) in women. Conclusion: Within the reference range of TSH, we found a linear positive association between TSH and systolic and diastolic blood pressure that may have long-term implications for cardiovascular health.

Association Between Ambulatory 24-Hour Blood Pressure Levels and Cognitive Performance: A Cross-Sectional Elderly Population-Based Study

2010 ◽  
Vol 13 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Oliver Beauchet ◽  
François R. Herrmann ◽  
Cédric Annweiler ◽  
Judith Kerlerouch ◽  
Philippe Gosse ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Performance ◽  
Elderly Population ◽  
Population Based ◽  
Cross Sectional ◽  
Population Based Study

scholarly journals METS-IR, a novel score to evaluate insulin sensitivity, is associated with the urinary albumin–creatinine ratio in Chinese adults: A cross-sectional REACTION study

2021 ◽  
Author(s):  
Wanlu Su ◽  
Jie Wang ◽  
Songyan Yu ◽  
Kang Chen ◽  
Wenhua Yan ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Urinary Albumin ◽  
Postprandial Blood Glucose ◽  
Creatinine Ratio ◽  
Discriminative Ability ◽  
Cross Sectional ◽  
Albumin Creatinine Ratio

Abstract BackgroundThe metabolic score for insulin resistance (METS-IR) is a novel noninsulin-based metabolic index used as a substitution marker of insulin resistance. However, whether METS-IR is associated with the urinary albumin–creatinine ratio (UACR) is not well known. Therefore, we explored the associations between METS-IR and UACR and compared the discriminative ability of METS-IR and its components for elevated UACR. MethodsThis study included 37,290 subjects. METS-IR was calculated as follows: (Ln [2 × fasting blood glucose (FBG) + fasting triglyceride level (TG 0 )] × body mass index (BMI))/[Ln (high-density lipoprotein cholesterol (HDL-C))]. Participants were divided into four groups on the basis of METS-IR: <25%, 25%–49%, 50%–74%, and ≥75%. Logistic regression analyses were conducted to determine the associations between METS-IR vs. its components (FBG, TG 0 , BMI, and HDL-C) with UACR. ResultsParticipants with the highest quartile METS-IR presented a more significant trend towards elevated UACR than towards its components (odds ratio [OR]: 1.260, 95% CI: 1.152–1.378, P < 0.001 in all subjects; OR: 1.321, 95% CI: 1.104–1.579, P = 0.002 in men; OR: 1.201, 95% CI: 1.083–1.330, P < 0.001 in women). There were significant associations between METS-IR and UACR in younger participants (<65 years for women and 55–64 years for men). Increased METS-IR was significantly associated with UACR in men with FBG ≥ 5.6 mmol/L or postprandial blood glucose ≥ 7.8 mmol/L and systolic blood pressure ≥ 120 mmHg or diastolic blood pressure ≥ 80 mmHg. The relationships were significant in women with diabetes and hypertension.ConclusionsIncreased METS-IR was significantly associated with elevated UACR, and its discriminative power for elevated UACR was superior to that of its components. This findings support the clinical significance of METS-IR for evaluating renal function damage.

Abstract P047: Circulating Levels of the DDT Metabolite p,p'-DDE are Related to Prevalent Hypertension in the Elderly

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Monica Lind ◽  
Samira Salihovic ◽  
Bert v Bavel ◽  
Lars Lind
Keyword(s):  
Blood Pressure ◽  
High Resolution ◽  
High Resolution Mass Spectrometry ◽  
The Elderly ◽  
Population Based ◽  
Continuous Variables ◽  
Cross Sectional ◽  
Experimental Findings ◽  
Sectional Analysis ◽  
Circulating Levels

Background: Exposure to PCBs and dioxin to experimental animals increase blood pressure. We therefore investigated if circulating levels of persistent organic pollutants (POPs) were related to hypertension in a population-based sample. Methods: 1016 subjects aged 70 years were investigated in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. Hypertension was defined as either use of antihypertensive treatment or blood pressure > 140/90 mmHg. Twenty-one different POPs, including 16 PCBs, three pesticides (HCB, DDE and TNK), one dioxin (OCDD) and one brominated compound (BDE47) were analyzed by high-resolution chromatography coupled to high-resolution mass spectrometry (HRGC/ HRMS) at age 70. Results: 732 subjects (72%) showed hypertension. When the POPs were treated as continuous variables and adjusted for gender only, several of the PCBs with a low number of chlorine atoms (PCB74, 99, 105, 118 and 138) were related to prevalent hypertension. Also the OC pesticides, HCB, TNK, pp-DDE, and the brominated compound BDE47 were related to hypertension. The strongest of these associations were seen for pp-DDE (OR 1.35 for a SD change, 95%CI 1.17-1.56, p<0.0001). Following further adjustment for serum cholesterol and triglycerides, BMI, smoking, education and exercise habits, only pp-DDE was still significant (OR 1.23 for a SD change, 95%CI 1.06- 1.43, p=0.006). Conclusion: In this cross-sectional analysis of an elderly population, high levels of circulating levels of pp-DDE were associated with prevalent hypertension, further strengthening the experimental findings that POPs might influence blood pressure.

Abstract 412: Obesity is an Independent Predictor Of Arterial Stiffness

Hypertension ◽  
2013 ◽  
Vol 62 (suppl_1) ◽  
Author(s):  
Mohan Thanikachalam ◽  
Shasha Bai ◽  
Vijayakumar Harivanzan ◽  
Ragavendra R Baliga ◽  
William T Abraham ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Regression Analysis ◽  
Arterial Stiffness ◽  
Multivariate Regression ◽  
Independent Predictor ◽  
Density Lipoprotein ◽  
Multivariate Regression Analysis ◽  
Population Based ◽  
Cross Sectional Survey ◽  
Cross Sectional

Background Arterial stiffness assessed by carotid-femoral pulse wave velocity (PWV) is an independent predictor of cardiovascular morbidity and mortality. We aimed to investigate how various measures of obesity affect arterial stiffness. Methods We conducted a population-based cross-sectional survey in 8,042 South Indians above the age of 20 years. Following completion of a detailed medical history questionnaire, all participants underwent haemodynamic screening including brachial and central blood pressure, and PWV measurements using a high-fidelity applanation tonometry. The study included anthropometric measurements and fasting blood for total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) and blood glucose (BG) levels. After the exclusion of people with previous history of diabetes, hypertension and dyslipidemia on drug therapy, 5,841 subjects (mean age 41.6 years; 58% women) constituted the study sample Results In an univariate analysis, PWV correlated positively with age, mean blood pressure (MAP), heart rate (HR), body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), body fat percent (BF%), TC, TG, LDL and BG levels (P <0.001) and negatively with HDL levels (P=0.005). In a multivariate regression analysis, majority of the PWV variability in the model was accounted for by MAP and age, (cumulative adjusted R2 change of 32.79% as compared to the total adjusted R2 change of 35.25%). However, BMI (β= 0.042; adjusted R2 change=2.83%; p<0.001) independently correlated with PWV and its contribution to the PWV variability was far more significant compared to LDL, BG and TG (cumulative adjusted R2 change=1.08%). Multivariate regression analysis using the WC, WHR, or BF% instead of the BMI continued to demonstrate a significant independent effect of obesity parameters on PWV. Conclusion: In a large a population-based cross-sectional survey the study demonstrates a positive, independent association between obesity parameters and increased arterial stiffness.

Abstract P303: Use of Community Health Workers for Community-based Hypertension Screening in Urban Haiti

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Caleigh Smith ◽  
Vanessa Rivera ◽  
Jean Joscar Victor ◽  
Lookens Pierre ◽  
Fabyola Preval ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Linkage To Care ◽  
Median Number ◽  
Population Based ◽  
Age Group ◽  
Cvd Risk ◽  
Blood Pressure Screening

Background: Cardiovascular disease is the leading cause of mortality among Haitian adults, and hypertension (HTN) is the most important CVD risk factor, as in other resource-poor countries. The majority of Haitians have never been screened for hypertension and access to clinic-based services is limited. Methods: Twenty-eight Haitian community health workers (CHW) conducted household-based HTN screening within a population-based longitudinal cohort study of 3,000 adults in metropolitan Port-au-Prince. Randomly selected GPS locations across census blocks were selected in proportion to the estimated population of each block. One household at each waypoint was selected systematically and CHW collected household information and conducted three blood pressure measurements the same day on all adult household members (≥ 18 years) present at the time of the survey using AHA guidelines. Adults with HTN were referred to the GHESKIO clinic for repeat BP measurement and treatment. Results: Between March and September 2019, 585 households provided verbal consent for surveys and BP screening (97% response rate). These households had a total of 2542 people (1777 adults) with the median number of adults per household being 3 (IQR 2-4; range 1-9). A total of 913 adults (51%) were present at the time of survey, and all agreed to blood pressure screening. The majority were women (70%) with a median age of 36 years (IQR 27-52). Hypertension prevalence (SBP > 140 and/or DBP > 90) was 25.3% (15.5% Stage I, 9.8% Stage II). Figure 1 reports HTN prevalence by age group (18-30, 31-45, 46-60, >60) and by sex, with HTN increasing by age group but without significant variation by sex. Conclusion: Community blood pressure screening is feasible and highly acceptable in Port-au-Prince, Haiti. Preliminary results show high rates of HTN among a population with limited access to screening, diagnosis and treatment. Further research is urgently needed to design linkage to care strategies and effective treatment interventions to curb the HTN epidemic in Haiti.

scholarly journals Relationship between sleep duration and hypertension in northeast China: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023916 ◽  
Author(s):  
Meng Li ◽  
Shoumeng Yan ◽  
Shan Jiang ◽  
Xiaoyu Ma ◽  
Tianyu Gao ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sleep Duration ◽  
Northeast China ◽  
Total Sample ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Sectional Study ◽  
Short Sleep Duration ◽  
Cross Sectional

ObjectivesPrevious studies have reported that sleep duration might increase the risk of hypertension. However, the results have been conflicting. We investigated whether sleep duration is independently associated with hypertension. We aimed to assess the relationship between sleep duration and hypertension in a population-based cross-sectional study.MethodsIn this study we used multistage stratified cluster sampling. A total of 19 407 adults aged 18–79 years were enrolled in the study. The participants were divided into three groups (<7 hours/day, 7–8 hours/day and >8 hours/day) according to self-reported sleep duration. Hypertension was defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or the use of anti-hypertensive medications. Univariate and multivariate logistic regressions were performed to determine the association between hypertension and sleep duration adjusted for sociodemographic, body mass index, and lifestyle covariates.ResultsThe overall prevalence of hypertension was 32.6%. Among participants aged 18–44 years, individuals sleeping less than 7 hours per day had a higher risk of hypertension (OR=1.24, 95% CI: 1.05 to 1.46), compared with those who slept 7–8 hours per day. There were no significant associations between sleep duration and hypertension in the total sample, among middle-aged adults (45–59 years) or older adults (60–79 years).ConclusionsOur study demonstrates that short sleep duration was significantly associated with hypertension among people aged 18–44 years in northeast China.

scholarly journals Examining the prevalence, correlates and inequalities of undiagnosed hypertension in Nepal: a population-based cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037592
Author(s):  
Md. Mehedi Hasan ◽  
Fariha Tasnim ◽  
Md. Tariqujjaman ◽  
Sayem Ahmed ◽  
Anne Cleary ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Concentration Index ◽  
Social Health Insurance ◽  
Wealth Quintile ◽  
Population Based ◽  
Cross Sectional Study ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional ◽  
Ecological Zones ◽  
Undiagnosed Hypertension

ObjectiveTo examine the prevalence, correlates and sociodemographic inequalities of undiagnosed hypertension in Nepal.DesignThis study used cross-sectional 2016 Nepal Demographic and Health Survey (NDHS) data. Undiagnosed patients with hypertension were defined as an NDHS respondent who was diagnosed as hypertensive (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg) during the survey, but never took any prescribed anti-hypertensive medicine to lower/control blood pressure and was never identified as having hypertension by a health professional prior the survey. Multiple binary logistic regression analysis was performed, and Concentration Index was measured.SettingNepal.ParticipantsAdult patients with hypertension.ResultsAmong 3334 patients with hypertension, 50.4% remained undiagnosed during the survey in Nepal. Adjusted model reveals that patients who were male, belonged to households other than the highest wealth quintile, and lived in province 4 and province 5 were at higher risk of remaining undiagnosed for hypertension. Patients who were ≥65 years of age and were overweight/obese were at lower risk of remaining undiagnosed for hypertension. The poor-rich gap was 24.6 percentage points (Q1=64.1% vs Q5=39.6%) and poor:rich ratio was 1.6 (Q1/Q5=1.6) in the prevalence of undiagnosed hypertension. Undiagnosed hypertension was disproportionately higher among lower socioeconomic status groups (Concentration Index, C=−0.18). Inequalities in the prevalence of undiagnosed hypertension further varied across other geographic locations, including place of residence, ecological zones and administrative provinces.ConclusionsUndiagnosed hypertension was highly prevalent in Nepal and there were substantial inequalities by sociodemographics and subnational levels. Increasing awareness, strengthening routine screening to diagnose hypertension at primary health service facilities and enactment of social health insurance policy may help Nepal to prevent and control this burden.

scholarly journals Eligibility of the Systolic Blood Pressure Intervention Trial (SPRINT) to the Chinese Adults

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Liping Chen ◽  
Yiyan Zhang ◽  
Juan Jin ◽  
Nannan Li ◽  
Dan Liu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Antihypertensive Medication ◽  
Population Based ◽  
Intervention Trial ◽  
Treatment Intensification ◽  
Chinese Adults ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Framingham Risk

Objective. To explore the proportion and characteristic of Chinese adults meeting The Systolic Blood Pressure Intervention Trial (SPRINT) eligibility criteria and assess its generalizability. Method. Our study was based on a cross-sectional, population-based survey with a sample of 26,093 participants aged over 20 years. The SPRINT eligibility criteria were age ≥ 50 years, elevated SBP of 130 to 180 mmHg depending on the number of antihypertensive medication classes being taken, and increased cardiovascular disease (CVD) but without diabetes, history of stroke and estimated glomerular filtration rate < 20   ml / min / 1.73   m 2 , or receiving dialysis. Results. Overall, we estimated that 4,036 (15.5%) participants would meet the SPRINT eligibility criteria. They were generally older, likely to be female, lower educational level, tended to be more overweight, and had higher Framingham risk score compared with overall population or subjects aged ≥ 50 years. Of participants eligible for SPRINT, most (56.2%) of them were not treated for hypertension, and 542 (13.4%) were not previously considered to have hypertension or need for antihypertension therapy. Among the 11,637 adults with hypertension, 3,494 (30.0%) would potentially benefit from treatment intensification. The most common antihypertensive medication class being taken was diuretic agents. Conclusion. A substantial percentage of Chinese subjects meet the SPRINT eligibility criteria. Further studies are needed to assess the cost-effectiveness from treatment intensification in Chinese setting.

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