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      Burden of Hypertension in the Capital of Afghanistan: A Cross-Sectional Study in Kabul City, 2015

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      International Journal of Hypertension
      Hindawi Publishing Corporation

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          Abstract

          Background. This study had the objective to assess the prevalence and associated factors of hypertension in an urban setting, Kabul city, Afghanistan. Materials and Methods. The World Health Organization's STEP-wise approach was adopted and used in Kabul in November 2015. The study analyzed a sample of 1172 adults in the age group of 25–70 years. Demographic, socioeconomic, and behavior data were collected using a structured questionnaire. Fasting venous blood sample was collected to assess the lipid profile and fasting blood sugar. Results. The study showed that the prevalence of hypertension among adult Kabul citizens was 32.3%. From this figure, 599 (51.1%) were females and 573 (48.9%) males with a mean age of 38.6 ± 12.2 years. Illiteracy rate was 49.6% and 77.5% were married. Smoking in adults were 8.1% and mouth snuff users were 9.8%. More than half (57.6%) of the study respondents were overweight and obese and 9.1% were recorded having raised blood sugar. In the multivariate logistic regression analysis, age, general obesity, central obesity, smoking, moderate physical activity, and taking fruits 3 days or less weekly were statistically significant predictors of hypertension. Conclusions. Burden of hypertension is increasing in main urban settings in Afghanistan. Integrated intervention focusing in main modifiable risk factors is needed to detect and prevent hypertension.

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          Most cited references27

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          Obesity preventing and managing the global epidemic

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            2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension.

            Hypertension is estimated to cause 4.5% of current global disease burden and is as prevalent in many developing countries, as in the developed world. Blood pressure-induced cardiovascular risk rises continuously across the whole blood pressure range. Countries vary widely in capacity for management of hypertension, but worldwide the majority of diagnosed hypertensives are inadequately controlled. This statement addresses the ascertainment of overall cardiovascular risk to establish thresholds for initiation and goals of treatment, appropriate treatment strategies for non-drug and drug therapies, and cost-effectiveness of treatment. Since publication of the WHO/ISH Guidelines for the Management of Hypertension in 1999, more evidence has become available to support a systolic blood pressure threshold of 140 mmHg for even 'low-risk' patients. In high-risk patients there is evidence for lower thresholds. Lifestyle modification is recommended for all individuals. There is evidence that specific agents have benefits for patients with particular compelling indications, and that monotherapy is inadequate for the majority of patients. For patients without a compelling indication for a particular drug class, on the basis of comparative trial data, availability, and cost, a low dose of diuretic should be considered for initiation of therapy. In most places a thiazide diuretic is the cheapest option and thus most cost effective, but for compelling indications where other classes provide additional benefits, even if more expensive, they may be more cost effective. In high-risk patients who attain large benefits from treatment, expensive drugs may be cost effective, but in low-risk patients treatment may not be cost-effective unless the drugs are cheap.
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              Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010.

              No systematic attempts have been made to estimate the global and regional prevalence of amphetamine, cannabis, cocaine, and opioid dependence, and quantify their burden. We aimed to assess the prevalence and burden of drug dependence, as measured in years of life lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs). We conducted systematic reviews of the epidemiology of drug dependence, and analysed results with Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) Bayesian meta-regression technique (DisMod-MR) to estimate population-level prevalence of dependence and use. GBD 2010 calculated new disability weights by use of representative community surveys and an internet-based survey. We combined estimates of dependence with disability weights to calculate prevalent YLDs, YLLs, and DALYs, and estimated YLDs, YLLs, and DALYs attributable to drug use as a risk factor for other health outcomes. Illicit drug dependence directly accounted for 20·0 million DALYs (95% UI 15·3-25·4 million) in 2010, accounting for 0·8% (0·6-1·0) of global all-cause DALYs. Worldwide, more people were dependent on opioids and amphetamines than other drugs. Opioid dependence was the largest contributor to the direct burden of DALYs (9·2 million, 95% UI 7·1-11·4). The proportion of all-cause DALYs attributed to drug dependence was 20 times higher in some regions than others, with an increased proportion of burden in countries with the highest incomes. Injecting drug use as a risk factor for HIV accounted for 2·1 million DALYs (95% UI 1·1-3·6 million) and as a risk factor for hepatitis C accounted for 502,000 DALYs (286,000-891,000). Suicide as a risk of amphetamine dependence accounted for 854,000 DALYs (291,000-1,791,000), as a risk of opioid dependence for 671,000 DALYs (329,000-1,730,000), and as a risk of cocaine dependence for 324,000 DALYs (109,000-682,000). Countries with the highest rate of burden (>650 DALYs per 100,000 population) included the USA, UK, Russia, and Australia. Illicit drug use is an important contributor to the global burden of disease. Efficient strategies to reduce disease burden of opioid dependence and injecting drug use, such as delivery of opioid substitution treatment and needle and syringe programmes, are needed to reduce this burden at a population scale. Australian National Health and Medical Research Council, Australian Government Department of Health and Ageing, Bill & Melinda Gates Foundation. Copyright © 2013 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Int J Hypertens
                Int J Hypertens
                IJHY
                International Journal of Hypertension
                Hindawi Publishing Corporation
                2090-0384
                2090-0392
                2017
                3 January 2017
                : 2017
                : 3483872
                Affiliations
                Grant and Service Contract Management Unit (GCMU), Ministry of Public Health, Kabul, Afghanistan
                Author notes
                *Khwaja Mir Islam Saeed: kmislamsaeed@ 123456gmail.com

                Academic Editor: Roberto Pontremoli

                Author information
                http://orcid.org/0000-0002-8799-4604
                Article
                10.1155/2017/3483872
                5239979
                28127468
                36115612-7ca1-465a-bf8e-bfcd39c877d2
                Copyright © 2017 Khwaja Mir Islam Saeed.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 September 2016
                : 13 December 2016
                : 18 December 2016
                Categories
                Research Article

                Cardiovascular Medicine
                Cardiovascular Medicine

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