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The Management of hypertension in ethnic minorities

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769018/

According to research carried out by Jaward m khan and D Gareth Beevers showed that there are various medical and lifestyle approaches that are used by Asian women to manage and control diabetes. A number of these methods are discussed below.

Firstly, most of the Asian women have employed lifestyle based mechanisms to manage the level of blood sugar. Among these methods includes exercising which has been proved to reduce the body weight. This is a great step forward given the fact that even a slight drop in the body weight by 3.18 Kg, can significantly reduce blood sugar. Most of the women have also adopted a diet rich in potassium. Scientifically, potassium has been proved to significantly reduce the blood sugar, especially in normokalaemic hypertensive patients. This is made possible by the nautriutic factor of potassium. Furthermore, a good number of hypertensive women, have adopted a salt-free diet, where their intake of salt does not exceed 6g per day. However, this reduced salt intake has been substituted by taking food rich in sodium; to replace the sodium intake forgone. Other women have also adopted a diet free of unsaturated fat. This is because unsaturated fat is known to accelerate blood pressure.

Besides the lifestyle changes, treatment with antihypertensive drugs also prays a major role in controlling hypertension. Diuretics are widely used unless there is a serious contradiction such as gout. Hydrochlorothiazide has also proven to be a good choice. But I should be noted that if the concentration of serum is 2mg/dl or more, thiazide diuretics are inappropriate, but instead, a loop type diuretic should be used instead. Calcium channel blockers are also widely used. Angiotensin converting enzyme (ACE) inhibitors together with beta-blockers and angiotensin receptor antagonists are also used by some women. Another widely used method is the ALLHAT (antihypertensive and lipid-lowering treatment to prevent heart attack)

Conclusion

High blood pressure is associated with both morbidity and high death rate; these can be significantly reduced by employing hypertension reduction methods. Hence, effective control and management methods should be employed to curb the menace of high blood pressure especially in women, who are highly predisposed to hypertension.

Yang, W., Lu, J., Weng, J., Jia, W., Ji, L., Xiao, J., …& He, J. (2010). Prevalence of diabetes among men and women in China.New England Journal of Medicine, 362(12), 1090-1101.

Cardiovascular ailments have of late led to the loss of lives to many citizens of China. Diabetes is a major predisposing factor in cardiovascular diseases, and its incidence is high and rising each day in China. A national survey in 1994 where 224351 population was tested, ranging between25-64 years, from 19 provinces, revealed that the prevalence of hypertension and abnormal glucose tolerance were 2.5% and 3.2% respectively. These figures were significantly higher(by a factor of 3) compared to the figures obtained in 1980.In the survey carried out in 2000-2001, where a sample of 1540 adults of between 35-74 years was used, the prevalence of hypertension and dysfunctional fasting glucose were 5.5% and 7.3% respectively. From the surveys, we conclude that the prevalence of diabetes has been rising over the years. But it is worth noting that direct comparison is still impossible, owing to the variations in the methodology used and the parity in the sampling criteria.

Results

The comparative prevalence of overall diabetes(initially diagnosed and initially undiagnosed ) and pre-diabetes were 9.7% and 15.5%, respectively.However, it was noted that the age-standardized incidence of hypertension was significantly higher among men than women (p<0.001).

Metabolic risk factors

The adjusted average fasting glucose level, body-weight index, waistsize, serum triglyceride level and the systolic blood pressure were noted to vary significantly, where they were higher in men than in women. Also, the high-density

Lipoproteincholesterollevel was lower in men compared to the women.

Short comings

Firstly, women were over sampled, and there was a lower response rate among men. These issues were taken into consideration when calculating statistical weights. However, the response level was above 80% in men, and there was little selection bias caused by non-response.

Secondly, diet and work-related physical work were not used in the study. Thismeans it was not possible to correlate these factors to diabetes prevalence.

Gupta, R., Pandey, R. M., Misra, A., Agrawal, A., Misra, P., Dey, S., …&Guptha, S. (2012). High prevalence and low awareness, treatment and control of hypertension in Asian Indian women.Journal of human hypertension, 26(10), 585-593.

Hypertension is a critical public health concern in India. This is the reason a national wide survey was conducted to determine its prevalence so as to determine the mitigating methods more so among women. This was specifical among women aged between 35-70 years. The parameters were demographic details, health history, diet, physical exercise and blood pressure. The results of the stratified sampling carried out showed that out of the 4608 population comprising of 2604 rural and 2004 urban women, showed that age-adjusted prevalence of blood pressure (known or bp>140/>90mmhg) was noted in 1672 women(39.2%)(rural 746,31.5%; urban 926,48.2%)the primary determinants of hypertension were urban location,literacy, fattyfoods, lowfiber level I diet and obesity.(p,0.01)it was noted that 727(42.8%)women had hypertension awareness, of these more, were from urban(529,56.8%)than in rural(198,24.6%)of these 38.6% were under medication(urban 35.7 ,rural 46.5).it was also noted that of those treated, controlled blood pressure(,140and,90mmhg) was noted in 21.5%(urban 28.3vs 10.2)

hypersensitive women, 18.3% wereunder treatment (13.1 rural compare to, 22.5 urban) and control in3.9 %( rural 1.3, urban 5.9) rural location was noted to be a significant determinant of little awareness, treatmentandcontrol (multivariate adjusted<0.05)

Conclusion

There is a high prevalence of hypertension in miIDle-aged Asian Indian women. Very little awareness treatment and control efforts are evident.

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