Socioeconomic inequalities in prevalence, awareness, treatment and control of hypertension: evidence from the PERSIAN cohort study

Background Elevated blood pressure is associated with cardiovascular disease, stroke and chronic kidney disease. In this study, we examined the socioeconomic inequality and its related factors in prevalence, Awareness, Treatment and Control (ATC) of hypertension (HTN) in Iran. Method The study used data from the recruitment phase of The Prospective Epidemiological Research Studies in IrAN (PERSIAN). A sample of 162,842 adults aged > = 35 years was analyzed. HTN was defined according to the Joint National Committee)JNC-7(. socioeconomic inequality was measured using concentration index (Cn) and curve. Results The mean age of participants was 49.38(SD = +/- 9.14) years and 44.74% of the them were men. The prevalence of HTN in the total population was 22.3%(95% CI: 20.6%; 24.1%), and 18.8%(95% CI: 16.8%; 20.9%) and 25.2%(95% CI: 24.2%; 27.7%) in men and women, respectively. The percentage of awareness treatment and control among individuals with HTN were 77.5%(95% CI: 73.3%; 81.8%), 82.2%(95% CI: 70.2%; 81.6%) and 75.9%(95% CI: 70.2%; 81.6%), respectively. The Cn for prevalence of HTN was -0.084. Two factors, age (58.46%) and wealth (32.40%), contributed most to the socioeconomic inequality in the prevalence of HTN. Conclusion The prevalence of HTN was higher among low-SES individuals, who also showed higher levels of awareness. However, treatment and control of HTN were more concentrated among those who had higher levels of SES, indicating that people at a higher risk of adverse event related to HTN (the low SES individuals) are not benefiting from the advantage of treatment and control of HTN. Such a gap between diagnosis (prevalence) and control (treatment and control) of HTN needs to be addressed by public health policymakers

The Effect of Self-Management Program on Adherence to Treatment Regimen in Patients with Hypertension

Background and Aim: Hypertension is a common challenge in many parts of the world. Medical reports have indicated that failure to control blood pressure is due to patients' non-compliance with treatment. One of the health related behaviors which can lead to successful treatment and reduce the negative side effects and severity of the disease is patients' adherence to the treatment regimen. Using a self-management program is one of the ways to manage the disease by the individual. Therefore, this study aimed to investigate the effect of self-management program on adherence to treatment regimen in the pateints with hypertension. Material and Methods: This was a semi-experimental study, which included 70 patients with hypertension in Imam Mohammad Ghazali Clinic in Sanandaj City in 2020. The samples were selected using available sampling method and randomly assigned to two groups, intervention (n=35) and control groups (n=35). The intervention group participated in blood pressure self-management skills training for 2 sessions (45 minutes each session) and the control group was placed in the waiting list. Data collection tools included a demographic information form and a questionnaire of adherence to the treatment regimen of Madanloo patients. Using SPSS-22 software, data were analyzed by Chi-square, Fisher's exact test and repeated measurements. Results: There was no significant difference between the two groups in terms of demographic characteristics (p<0.05). The results of the repeated measures analysis showed a significant difference between the two groups in the different aspects of treatment i.e., diligence in treatment (P=0.039) commitment to treatment (P=0.003) and adherence to treatment (P=0.041). Also, the interaction effects of time and group on diligence in treatment (P=0.000), commitment to treatment (P=0.001) and adherence to treatment (P=0.000) were significant. Comparison between intervention and control groups showed self-management training in the intervention group led to increase in the average scores of adherence to treatment aspects, including diligence in treatment, commitment to treatment, and the overall score of adherence to treatment (P<0.05). Conclusion:  The designed and evaluated self-care educational interventions in the present study increased adherence to the treatment and improved its components in the intervention group. Therefore, improving self-care in the patients with hypertension, can possibly help maintain blood pressure in the normal range and reduce its related complications

TREATMENT OF INFECTED PSEUDOANEURYSM IN DRUG ABUSERS: LIGATION OR RECONSTRUCTION?

Background: Recently, there has been an increase in the incidence of major vascular complications such as infected pseudoaneurysm due to intravenous drug use. Objective: For better understanding of the existing controversies regarding the optimal surgical management of infected pseudoaneurysm, the present study was conducted. Methods: Conclusion: Ligation is the optimal management for infected pseudoaneurysm, because it is easy, cost-effective, and safe. Reconstruction is not recommended, because of an extended infection at the location of pseudoaneurysm and at the artificial graft site