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      HYPERTENSION IN THE EASTERN PROVINCE OF SAUDI ARABIA: RESULTS OF A SCREENING CAMPAIGN

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          Abstract

          Objective:

          To estimate the prevalence of hypertension through a screening campaign in the Eastern Province of Saudi Arabia, and examine its association with lifestyle factors.

          Research Design and Methods:

          In 2004, all Saudi residents in the Eastern Province, aged 30 years and above were invited to participate in a screening campaign for the early detection of diabetes and hypertension. Blood pressure was recorded by trained nurses using a mercury sphygmomanometer, based on the recommendations of (JNC- VII). A positive screening test for hypertension was defined as systolic and/or diastolic blood pressure of ≥ 140 and 90 mm Hg, respectively. Subjects who had positive screening tests were asked to come on the following day for a confirmation of the reading. Hypertension was considered if there was a persistent reading of systolic and/or diastolic blood pressure of ≥ 140 and 90 mmHg after confirmation, or when there was history of a previous diagnosis.

          Results:

          21% of the sample was positive from previous history or screening. After confirmation, the prevalence of hypertension dropped to 15.6%, pre-hypertension was 3.7%, whereas the prevalence of undiagnosed hypertension was 2.8%. The prevalence rose with age. It was higher in women than in men of all age groups and in all sectors of the eastern province, although the mean systolic and diastolic BP was higher in men than women. It was higher with lower education, in widows and divorcees than others ( P<0.0001).

          Conclusion:

          The yield of the screening for abnormal blood pressure was high. Systematic follow-up of subjects with abnormal screening results is vital.

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          Most cited references21

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          AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update: Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patients Without Coronary or Other Atherosclerotic Vascular Diseases. American Heart Association Science Advisory and Coordinating Committee.

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            Effects of blood-pressure measurement by the doctor on patient's blood pressure and heart rate.

            Changes in blood pressure in 10 or 15 min periods during which a doctor repeatedly measured blood pressure by the cuff method were monitored by a continuous intra-arterial recorder. In almost all the 48 normotensive and hypertensive subjects tested the doctor's arrival at the bedside induced immediate rises in systolic and diastolic blood pressures peaking within 1 to 4 min (mean 26.7 +/- 2.3 mm Hg and 14.9 +/- 1.6 mm Hg above pre-visit values). There were large differences between individuals in the peak response (range, 4--75 mm Hg systolic and 1--36 mm Hg diastolic) unrelated to age, sex, baseline blood pressure, or blood-pressure variability. There was concomitant tachycardia (average peak response 15.9 +/- 1.5 beats/min, range 4--45 beats/min) which was only slightly correlated with the blood-pressure rise. After the peak response blood pressure declined and at the end of the visit was only slightly above the pre-visit level. A second visit by the same doctor did not change the average size of the early pressor response or the slope of its subsequent decline.
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              Genetic variations related to hypertension: a review.

              Hypertension is a complex multifactorial disorder with genetic, environmental and demographic factors contributing to its prevalence. The genetic element contribution to blood pressure variation ranges from 30 to 50%. Therefore, identifying hypertension susceptibility genes will help understanding the pathophysiology of the disease. In addition to the potential impact of genomic information in selecting antihypertensive drug therapy, it may also help in recognizing those at risk of developing the disease, which may lead to new preventive approaches. Several strategies and methods have been used to identify hypertension susceptibility genes. Currently, genetic analysis of such data produced complex results, which makes it difficult to draw final conclusion on the use of genomic data in management of hypertension. This review attempts to summarize present known genetic variations that may be implicated in the pathogenesis of hypertension and to discuss various research strategies used to identify them. It also highlights some of the opportunities and challenges, which may be encountered in interpreting the value of these genetic variations to improve management of hypertension.
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                Author and article information

                Journal
                J Family Community Med
                J Family Community Med
                JFCM
                Journal of Family & Community Medicine
                Medknow Publications & Media Pvt Ltd (India )
                1319-1683
                2229-340X
                Sep-Dec 2008
                : 15
                : 3
                : 95-101
                Affiliations
                [1 ] Directorate of Health Affairs, Ministry of Health, Dammam, Saudi Arabia
                [2 ] College of Medicine, King Faisal University, Dammam, Saudi Arabia
                Author notes
                Correspondence to: Dr. Nadira A. Al-Baghli, P.O. Box 63915, Dammam 31526, Saudi Arabia E-mail: nadiraa@ 123456windowslive.com
                Article
                JFCM-15-95
                3377128
                23012174
                8f1f4535-0306-4b20-85a7-cd8befe18a99
                Copyright: © Journal of Family and Community Medicine

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Categories
                Original Article

                Health & Social care
                screening,hypertension,saudi arabia
                Health & Social care
                screening, hypertension, saudi arabia

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