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      Awareness of Physicians in Yemen Toward High Blood Pressure Management According to the Eighth Joint National Committee (JNC 8) Guideline

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          Abstract

          Background

          Hypertension is a common public health problem that impacts more than one-third of the world population. Awareness of physicians towards the guidelines of high blood pressure management is an essential step to reduce the consequences of high blood pressure.

          Objective

          This study was aimed to assess the awareness of physicians towards high blood pressure treatment according to the recent report of the Joint National Committee (JNC8) guideline.

          Methods

          A self-administered questionnaire was distributed to 400 physicians during the period from February to April 2017. Physicians were recruited from public and private hospitals as well as clinics. A validated questionnaire that incorporated the changes seen in JNC 8, as well as the specific modality of hypertension management based on other guidelines, was administered to the participating physicians.

          Results

          Three hundred and eighty-nine physicians completed the questionnaire; with all the interviewed physicians have ever heard about JNC 8. The practice of general practitioners (GPs) was significantly deviated from the recommended guideline of blood pressure management as compared to consultants, specialists, and residents. Additionally, certain variations were found among consultants, specialists, and residents with slight superiority of consultants towards most aspects.

          Conclusion

          The finding of this study highlights an inadequate knowledge of GPs in Yemen towards high blood pressure management guidelines. The findings of this study emphasize the necessity for continuous medical education programs that are specially designed to target GPs. Continued update of medical curricula in Yemeni universities is also needed.

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          Most cited references 23

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          Effects of blood pressure lowering with perindopril and indapamide therapy on dementia and cognitive decline in patients with cerebrovascular disease.

          High blood pressure and stroke are associated with increased risks of dementia and cognitive impairment. This study aimed to determine whether blood pressure lowering would reduce the risks of dementia and cognitive decline among individuals with cerebrovascular disease. The Perindopril Protection Against Recurrent Stroke Study (PROGRESS) was a randomized, double-blind, placebo-controlled trial conducted among 6105 people with prior stroke or transient ischemic attack. Participants were assigned to either active treatment (perindopril for all participants and indapamide for those with neither an indication for nor a contraindication to a diuretic) or matching placebo(s). The primary outcomes for these analyses were dementia (using DSM-IV criteria) and cognitive decline (a decline of 3 or more points in the Mini-Mental State Examination score). During a mean follow-up of 3.9 years, dementia was documented in 193 (6.3%) of the 3051 randomized participants in the actively treated group and 217 (7.1%) of the 3054 randomized participants in the placebo group (relative risk reduction, 12% [95% confidence interval, -8% to 28%]; P =.2). Cognitive decline occurred in 9.1% of the actively treated group and 11.0% of the placebo group (risk reduction, 19% [95% confidence interval, 4% to 32%]; P =.01). The risks of the composite outcomes of dementia with recurrent stroke and of cognitive decline with recurrent stroke were reduced by 34% (95% confidence interval, 3% to 55%) (P =.03) and 45% (95% confidence interval, 21% to 61%) (P<.001), respectively, with no clear effect on either dementia or cognitive decline in the absence of recurrent stroke. Active treatment was associated with reduced risks of dementia and cognitive decline associated with recurrent stroke. These findings further support the recommendation that blood pressure lowering with perindopril and indapamide therapy be considered for all patients with cerebrovascular disease.
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            Global burden of cardiovascular disease and stroke: hypertension at the core.

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              Prevalence of cardiovascular risk factors in the Middle East: a systematic review.

              The aim of this study was to determine the prevalence of key cardiovascular risk factors in the Middle East region. We conducted a systematic review of the literature through searches in the MEDLINE/PubMed and PARLINE databases between January 1980 and April 2005. Cohort studies published from 1980, in English, which included at least 1000 participants that reported the prevalence of at least one of the following; diabetes mellitus, obesity (body mass index > or =30 kg/m(2)), hypertension, hyperlipidemia, and smoking in the Middle East region. Data were abstracted using standardized data abstraction forms. Studies were combined using random-effect models. In total, 51 studies (267 537 participants) were included. On the basis of a random-effect model, the overall prevalence of obesity was 24.5% [95% confidence interval (CI): 21.8-27.5; I(2): 99.3%; 24 studies], diabetes mellitus was 10.5% (95% CI: 8.6-12.7%; I(2): 99.4%; 24 studies), hypertension was 21.7% (95% CI: 18.7-24.9; I(2): 99.5%; 24 studies), smoking was 15.6% (95% CI: 12.3-19.6%; I(2): 99.7%; 21 studies). Smoking was more common in men than women, whereas obesity and hypertension were more common in women. The overall prevalence was not calculated because of marked variations in the definition of dyslipidemia among studies. There is a high prevalence of diabetes mellitus, obesity, hypertension, and smoking in the Middle East. The prevalence of obesity and hypertension was higher in women, whereas prevalence of smoking was higher in men. These data suggest that cardiovascular disease will be a major health problem in the Middle East.
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                Author and article information

                Journal
                Int J Gen Med
                Int J Gen Med
                ijgm
                ijgm
                International Journal of General Medicine
                Dove
                1178-7074
                21 August 2020
                2020
                : 13
                : 529-537
                Affiliations
                [1 ]Departments of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Science and Technology , Sana’a, Yemen
                [2 ]Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology , Irbid, Jordan
                [3 ]Department of Clinical Pharmacy, Faculty of Pharmacy, Near East University , Nicosia, Cyprus, Turkey
                Author notes
                Correspondence: Mohammed M Battah Tel +967-777404880 Email mmalbattah@gmail.com
                Article
                265118
                10.2147/IJGM.S265118
                7450413
                © 2020 Halboup et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 0, Tables: 14, References: 38, Pages: 9
                Categories
                Original Research

                Medicine

                guidelines, yemen, physicians, hypertension, practitioners

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