Hypertension : prevalence, awareness, treatment and control in the personnel of Sudan custom authority and Khartoum Airport

مقدم أطروحة جامعية

Qamar al-Din, al-Tayyib Muhammad al-Tayyib

مشرف أطروحة جامعية

Subahi, Sad
Mustafa, Asim Faruq
Haydar, Uthman

أعضاء اللجنة

al-Khalifah, Muhammad Said
Yusuf, Mirghani Abd al-Rahman
al-Hadiah, Tariq

الجامعة

جامعة أم درمان الإسلامية

الكلية

كلية الصيدلة

دولة الجامعة

السودان

الدرجة العلمية

دكتوراه

تاريخ الدرجة العلمية

2009

الملخص الإنجليزي

Hypertension is a highly prevalent disease worldwide, constituting one of the main risk factors for cardiovascular morbidity and mortality.

Nationwide data for the status of hypertension in the adult Sudanese population are not available.

The aims of this study were to determine the distribution of blood pressure (BP), prevalence, awareness, treatment and control of hypertension in urban Sudanese communities, the association between hypertension and cardiovascular risk factors ; monitoring the prescribing pattern of antihypertensive agents ; and to determine the efficacy of β-blockers, thiazide diuretics and life style modifications in reducing elevated blood pressure in newly diagnosed patients with primary uncomplicated hypertension.

Achieving these objectives could lead to set up the first step towards this ultimate goal, based on pure Sudanese data.

This is a population-based, prospective, cross-sectional, stratified, multistage, randomized study that was carried out in Khartoum State (urban) in 2007.

The study sample consists of institutionalized volunteers, > 17 years of age, recruited to participate in the study from the staff of Sudan Custom Authority and Khartoum Airport.

Recruitment involved clinic visits as well as performing field visits to work sites.

The total number of participants was 833.

The overall age-adjusted and sex-adjusted prevalence of hypertension in this urban community in Khartoum State was 16.8 per cent ; the prevalence among males was 19.2 per cent which was higher than in females (9.2 per cent).

Those with hypertension who were aware of their diagnosis were 37.9 per cent, and 37.1 of them were receiving pharmacologic treatment.

And only 44.2 per cent of the latest group had good control of their BP (i.e overall control of the hypertensive patients is 16.4 per cent) The prescription patterns for antihypertensive drugs for uncomplicated hypertension seem to be inconsistent with the current international clinical guidelines with Ca channels blockers most prescribed; nevertheless the overall BP control is comparable to other studies in this field, with Ca blockers most effective in controlling the BP, followed in descending manner by ACEIs, β-blockers and lastly thiazide diuretics.

No correlation was established between hypertension and smoking/ snuffing, and moderate intake of alcohol, while a significant correlation was acknowledged between HTN and positive family history of hypertension, DM, FHDM, dyslipidemia, hyperuricemia, renal function insufficiency, and obesity.

Almost 50 per cent of the newly diagnosed individuals accepted the diagnosis, with 54.5 per cent of them accepted pharmacotherapeutic intervention, and 22.7% accepted only LSM, with 67.60 per cent adhered to treatment ; whereas 22.7 per cent rejected any BP management. LSM significantly reduced the BP in newly diagnosed hypertensive patients (n = 33), followed by hydrochlorothiazide and lastly atenolol.

Both drugs have minimal metabolic effects with the exception of VLDL-cholesterol that was significantly decreased.

Paradoxically total cholesterol and fasting glucose decreased, K level was increased minimally by both drugs ; Na was reduced by atenolol and increased by hydrochlorothiazide.

LDL-cholesterol, HDL-cholesterol and triglycerides levels increased ; while Ca level was decreased by both drugs, with high rate of atenolol-induced bradycardia, and hydrochlorothiazide-induced gout. The analysis of data was performed using the Statistical Package for Social Sciences 10, Windows 2000.

Using Student t-test and Chi square, with probability values of p less than 0.05 were considered statistically significant.

التخصصات الرئيسية

الطب البشري

الموضوعات

• ارتفاع ضغط الدم
• السودان
• التشخيص

عدد الصفحات

231

قائمة المحتويات

• APA
• MLA
• AMA

لغة النص

الإنجليزية

نوع البيانات

رسائل جامعية

رقم السجل

BIM-364822