Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension

Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools

Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension

Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools

Scrub typhus among patients with acute febrile illness in Bhutan: A cross‐sectional study

Abstract Introduction Early diagnosis and treatment plays an important role in preventing mortality in scrub typhus infection. In districts situated in the subtropical region of Bhutan, scrub typhus remains an important aetiology among those with acute febrile illness. Zhemgang is one district at 572 m above sea level with warm humid climate, and the majority of population are involved in farming and livestock rearing. Methods This was a cross‐sectional study among patients with acute febrile illness in Zhemgang district, Bhutan, tested for scrub typhus rapid diagnostic kits. Variables were extracted from the laboratory registers for tests conducted between January 2019 and December 2020. Risk factors associated with scrub typhus were assessed using logistic regression. This study was approved by the Research Ethics Board of Health, Bhutan. Results There were 922 tests conducted for scrub typhus. The test positivity rate was 8.2% (n = 76) with the highest reported in Panbang Hospital (43, 56.6%) followed by Yebilaptsa Hospital (27, 35.5%) and Zhemgang Hospital (6, 7.9%). A higher number of cases were detected in females (44, 57.9%) and in the month of September (17, 16.3%). The factors associated with scrub typhus positivity rates were hospitals located in lower altitudes, age, sex and seasons (spring, summer, autumn and winter). Conclusions One tenth of patients with acute febrile illness tested positive for scrub typhus with the adequate volume of tests prescribed by the clinicians. Our study shows that summer months recorded higher proportions of scrub typhus infection

PSYCHOLOGICAL STATUS DURING COVID-19 PANDEMIC AMONG THE GENERAL POPULATION IN BHUTAN

Background: Since the outbreak of the novel coronavirus disease-19 (COVID-19) on 31 December 2019 in Wuhan (Hubei, China), an increasing amount of information, concern, and restrictive public health measures put on to contain the spread of infection have impacted the mental health of the people. The psychological status of the Bhutanese population during this novel coronavirus disease-19 (COVID-19) pandemic is unknown.Aim: To measure the levels of stress, anxiety, and depression in Bhutanese population during the COVID-19 pandemic. The study also aimed to explore the potential differences in psychological status between the demographic variables.Methods and material: A cross-sectional web-based survey was done using a non-probabilistic snowball sampling methodology. Data were collected using the socio-demographic data questionnaire and the Depression Anxiety and Stress scale-21 (DASS-21). Descriptive statistics were used to describe the data, and independent t-tests and analyses of variance (ANOVAs) were used to compare the psychological status among different groups.Results: A total of 663 respondents were recruited. Of them, 21.27% of the participants reported mild to severe levels of depression, 25.04% reported mild to severe levels of anxiety, and 10.56% were stressed. Young and those unemployed during the pandemic showed greater negative psychological symptoms.Conclusion: The results show that psychological problems are prevalent during the COVID-19 pandemic. The findings can help government and health professionals safeguard the psychological wellbeing of the community in the face of COVID-19 outbreak in Bhutan and worldwide

Cerebral cysticercosis in a wild Bengal tiger (Panthera tigris tigris) in Bhutan: a first report in non-domestic felids

The endangered Bengal tiger (Panthera tigris tigris) is a keystone species playing an essential role in ecology as well as in the social and spiritual lives of the Himalayan people. The latest estimate of the Bengal tiger population in Bhutan accounts for 103 individuals. Infectious organisms, including zoonotic parasites causing high burden in human health, have received little attention as a cause of mortality in tigers. Taeniosis/cysticercosis, caused by the cestode Taenia solium, is considered one of the major neglected tropical diseases in Southeast Asia. We present here a case of neurocysticercosis in a Bengal tiger showing advanced neurological disease outside Thimphu, the capital city of Bhutan. After palliative care, the animal died, and necropsy revealed multiple small cysts in the brain. Here we show the presence of two genetic variants of T. solium in the parasite material collected based on PCR and sequencing of the complete cox1 and cytB genes. The sequences form a discrete branch within the Asia plus Madagascar cluster of the parasite. On other hand, tests for feline morbillivirus, feline calicivirus, canine distemper virus, Nipah, rabies, Japanese encephalitis, feline leukaemia and feline immunodeficiency virus were negative. In contrast, PCR for feline herpesvirus was positive and a latex agglutination test revealed an elevated antibody titer against Toxoplasma gondii (titer 1:256). The molecular examination of taeniid eggs isolated from the tiger faeces produced sequences for which the highest homology in GenBank is between 92% and 94% with T. regis and T. hydatigena. This fatal case of T. solium neurocysticercosis, a disease previously unrecorded in tigers or other non-domestic felids, demonstrates an anthropogenically driven transmission of a deadly pathogen which could become a serious threat to the tiger population

New Herpetofaunal Records from the Kingdom of Bhutan Obtained through Citizen Science

Social media has, in the past decade, emerged unexpectedly as a powerful tool in citizen science (Liberatore et al. 2018). Whether unintended or formally integrated, it offers, among other benefits, mass participation in activities such as data collection in inventories, monitoring, or natural history observations (Tulloch 2013). It can be argued that such activities often do not consume taxpayers’ contributions, as formal research projects tend to do, and can provide a cost-effective means of data collection (Goldstien et al. 2014). The vast number of (and rapidly rising) online resources and virtual specialists available to identify samples serve as references and reviewers of such data, increasing the speed over traditional forms of data collection (e.g., scientific publishing) and providing the capacity to absorb multiple opinions. Nonetheless, challenges that remain in citizen science programs are directing the data towards priority scientific objectives and needs, and achieving high standards in data quality (Ambrose-Oji et al. 2014)

Lifestyle management of hypertension : International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension

Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliates “Fadi Charchar, Priscilla Prestes, Britt Klein, Colette Browning, Olutope Akinnibosun and Shane Thomas” are provided in this record*

Lifestyle management of hypertension : International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension

Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools