Ten-year incidence of hypertension in a Swiss population-based sample Incidence of hypertension in Switzerland.

Few studies assessed incidence and determinants of hypertension. We assessed the incidence and determinants of hypertension in a cohort of healthy adults aged 35-75 years living in Lausanne, Switzerland. Baseline data were collected from 2003 to 2006. Follow-ups were conducted in 2009-2012 and 2014-2017. Incident hypertension, defined as a systolic BP ≥140 mm Hg or a diastolic BP ≥90 mm Hg or anti-hypertensive medication, was assessed at 1) second follow-up only; 2) first and/or second follow-up. After 10.9 years, incident hypertension was 26.8% (analysis 1, N = 3299) and 30.3% (analysis 2, N = 3728). After multivariate adjustment, the variables associated with increased hypertension incidence were male gender [incident-rate ratio (IRR) and (95% confidence interval)]: 1.20 (1.07-1.35) and 1.24 (1.13-1.37) for analyses 1 and 2, respectively; increasing age (p for trend < 0.001) and body mass index (p for trend < 0.001) and history of cardiovascular disease (CVD). Being physically active was negatively associated with incident hypertension: 0.88 (0.78-0.98) and 0.92 (0.83-1.01) for analyses 1 and 2, respectively. Except for male gender, these associations remained after adjusting for baseline BP levels, with incident rate ratios for physical activity of 0.86 (0.77-0.96) and 0.91 (0.83-0.99) for analyses 1 and 2, respectively. No association was found for education, alcohol consumption or smoking status. We conclude that over 10.9 years, between 1/4 and 1/3 of the Swiss population aged 35-75 developed hypertension. Male gender, history of CVD, increasing age and higher BMI increase the risk of hypertension, while being physically active reduces the risk

Validity of self-reported hypertension: findings from the Thai Cohort Study compared to physician telephone interview.

Surveys for chronic diseases, and large epidemiological studies of their determinants, often acquire data through self-report since it is feasible and efficient. We examined validity and associations of self-reported hypertension, as verified by physician telephone interview among participants in a large ongoing Thai Cohort Study (TCS). The TCS investigates the health-risk transition among distance learning Open University students living all over Thailand. It began in 2005 and at 4-year follow-up, 60 569 self-reported having or not having doctor diagnosed hypertension. Two hundred and forty participants were randomly selected from each of the "hypertension" and "normotension" self-report groups. A Thai physician conducted a structured telephone interview with the sampled participants and classified them as having hypertension or normotension. The sensitivity, specificity, positive and negative predictive value (PPV and NPV) and overall accuracy of self-report were calculated. The sensitivity of self-reported hypertension was 82.4% and the specificity was 70.7%. As true prevalence was simulated to vary from 1% to 50% the overall accuracy of self-report varied little from 71% to 75%. High sensitivity and negative predictive value related to female gender, younger age (?40 years), higher education attainment and not visiting a physician in the last 12 months. High specificity and positive predictive value related to female gender, older age, higher education attainment and visiting a doctor in the previous year. Self-report of hypertension had high sensitivity and good overall accuracy. This is acceptable for use in large studies of hypertension, and for estimating its population prevalence to help formulate health policy in Thailand

Health-risk factors and the prevalence of hypertension: cross-sectional findings from a national cohort of 87,143 Thai Open University students

Thailand is undergoing a health-risk transition which increases chronic diseases, particularly hypertension, as a result of a rapid transition from a developing to a developed country. This study analyzes the effect of health-risk factors such as demography, socioeconomic status (SES) and body mass index (BMI) on the prevalence of hypertension. This was a cross-sectional analysis using data obtained in 2005 from 87,143 Sukhothai Thammathirat Open University (STOU) students participating in the Thai Cohort Study (mean age 30.5 years, 54.7% female). Adjusted odds ratios of the association between risk factors and hypertension were analysed across two age groups by sex, after controlling for the confounding factors such as SES and BMI. The prevalence of hypertension in men was approximately twice as high as that in women (6.9% vs 2.6%). Hypertension was associated with ageing, a lower education attainment, a higher BMI and having underlying diseases in both sexes. In men, hypertension was associated with being single, having a high income, spending more time on screens (TV & PC), cigarette smoking and drinking alcohol. In women, it was directly correlated with instant and roasted or smoked food consumption. Hypertension was highly associated with obesity and having underlying disease. The Thai health-risk transition is in a later stage. Thais should now be educated about the danger of high blood pressure and the protective power of a low fat and low salt diet, and a normal BMI. Cessation of smoking and moderation in alcohol intake should be promoted

Validity of self-reported diabetes in a cohort of Thai adults

BACKGROUND: Much of South East Asia is experiencing an epidemiological transition. In Thailand, chronic disease has emerged and the prevalence of diabetes has tripled. As part of a large cohort study of the Thai transition to chronic disease, we gathered data on self-reported diabetes. Epidemiological studies commonly ascertain such data by self-report but the validity of this method has not been assessed in Thailand. Therefore, we aimed to investigate the validity of self-reported type 2 diabetes (T2DM) in Thai adults participating in the Thai Cohort Study (TCS). METHODS: Data were collected by mailed questionnaire from adults involved in the TCS, a nationwide community-based longitudinal health study of distance learning adult students enrolled at Sukhothai Thammathirat Open University. Participants were surveyed in 2005, 2009 and 2013. We sampled all participants with self-reported T2DM status (878 cases) for telephone interview with our study physician along with a random selection of 650 participants who self-reported not having diabetes in all three TCS surveys. These physician telephone interviews allowed us to validate self-reported questionnaire responses. RESULTS: Questionnaire self-report of diabetes slightly over-estimated the incidence of T2DM in this cohort; the overall proportion of confirmed T2DM cases was 78%. Participants with a consistent pattern of diabetes reporting at the 2009 and 2013 questionnaire follow-ups had the highest validity of self-reported responses (96%; 95%CI 92.9-99.1).The lowest proportion of confirmed T2DM cases was recorded among participants who reported diabetes in 2009 and not in 2013 (32%)(95%CI 22.6-41.4), mostly young women with transient (gestational) diabetes. CONCLUSIONS: Our results, derived mainly from young, educated Thai adults nationwide, show that self-reported doctor diagnosed T2DM is a feasible and acceptable method for assessing diabetes in epidemiological studies.</p

Validity of self-reported diabetes in a cohort of Thai adults

BACKGROUND: Much of South East Asia is experiencing an epidemiological transition. In Thailand, chronic disease has emerged and the prevalence of diabetes has tripled. As part of a large cohort study of the Thai transition to chronic disease, we gathered data on self-reported diabetes. Epidemiological studies commonly ascertain such data by self-report but the validity of this method has not been assessed in Thailand. Therefore, we aimed to investigate the validity of self-reported type 2 diabetes (T2DM) in Thai adults participating in the Thai Cohort Study (TCS). METHODS: Data were collected by mailed questionnaire from adults involved in the TCS, a nationwide community-based longitudinal health study of distance learning adult students enrolled at Sukhothai Thammathirat Open University. Participants were surveyed in 2005, 2009 and 2013. We sampled all participants with self-reported T2DM status (878 cases) for telephone interview with our study physician along with a random selection of 650 participants who self-reported not having diabetes in all three TCS surveys. These physician telephone interviews allowed us to validate self-reported questionnaire responses. RESULTS: Questionnaire self-report of diabetes slightly over-estimated the incidence of T2DM in this cohort; the overall proportion of confirmed T2DM cases was 78%. Participants with a consistent pattern of diabetes reporting at the 2009 and 2013 questionnaire follow-ups had the highest validity of self-reported responses (96%; 95%CI 92.9-99.1).The lowest proportion of confirmed T2DM cases was recorded among participants who reported diabetes in 2009 and not in 2013 (32%)(95%CI 22.6-41.4), mostly young women with transient (gestational) diabetes. CONCLUSIONS: Our results, derived mainly from young, educated Thai adults nationwide, show that self-reported doctor diagnosed T2DM is a feasible and acceptable method for assessing diabetes in epidemiological studies.</p

Health-Risk Factors and the Prevalence of Chronic Kidney Disease: Cross-Sectional Findings from a National Cohort of 87 143 Thai Open University Students.

Chronic kidney disease (CKD) is becoming a major health challenge worldwide as its aetiology has transferred from predominantly infectious disease to emerging chronic diseases, especially diabetes and hypertension. A rapid health-risk transition driven by economic development is transforming Thailand which is now becoming an ageing country where chronic diseases are a major health burden

Mixed treatment comparison of a two-compound formulation (TCF) product containing calcipotriol and betamethasone dipropionate with other topical treatments in psoriasis vulgaris.

Item does not contain fulltextOBJECTIVE: The efficacy of the two-compound formulation (TCF) product containing calcipotriol and betamethasone dipropionate applied once daily in psoriasis has been demonstrated in phase III trials but no randomised clinical trial comparing all commonly used topical treatments exists. The aim of the study was to compare the efficacy of once-daily use of the TCF product relative to other commonly used topical agents in plaque psoriasis. RESEARCH DESIGN AND METHODS: Data on change in Psoriasis Area and Severity Index (PASI) score from baseline and PASI 75 (percentage of patients achieving a 75% reduction in PASI score), after 4 weeks of treatment were obtained by means of a systematic literature review of randomised controlled trials and synthesised with a Bayesian mixed treatment comparison meta-analysis. RESULTS: Relative to all active interventions, except for the unlicensed twice-daily application of the TCF product, the TCF once daily showed a greater efficacy based on PASI 75 response (relative risk ranging from 1.22 to 3.18) and improvement in PASI score from baseline (difference in % CFB PASI between TCF once daily and other active interventions ranged from 4.01 to 49.68). CONCLUSION: Among topical therapies evaluated, TCF once daily can be considered the most efficacious treatment for plaque psoriasis.1 januari 201

Improved adherence in older patients with hypertension: An observational study of a community-based intervention

© 2019 John Wiley & Sons Ltd Aims and objectives: This study sought to assess the effect of a community-based intervention influencing adherence status at baseline, 1, 3 and 6 months, and to evaluate the impact that a community-based intervention and socio-economic factors have on adherence. Background: Although high-quality treatment and modern hypertension clinical practice guidelines have been developed worldwide, the outcomes of patients with hypertension in Thailand are not optimal. Implementing a person-centred and integrated health services model to improve hypertension management, such as a community-based intervention, is challenging for healthcare providers in Thailand. Design: An observational study of a community-based intervention. Methods: The study comprised residents in 17 villages in one province of Thailand. A sample of 156 participants was allocated into the intervention and the control groups. Inclusion criteria were people aged 60 years or older diagnosed with hypertension. Exclusion criteria included the latest record of extreme hypertension and having a documented history of cognitive impairment. The intervention group received the 4-week community-based intervention programme. Multiple linear regression was applied to predict the adherence status at each phase. Multiple logistic regression was then implemented to predict influencing factors between the groups. Results: Patients who received the intervention had significantly lower adherence scores (reflecting a higher level of adherence) at 3 and 6 months after intervention by 1.66 and 1.45 times, respectively, when adjusting for other variables. After 6 months, the intervention was associated with a significant improvement in adherence when adjusting for other variables. Conclusion: This study provides evidence to support the use of community-based interventions as an effective adjunct to hospital-based care of hypertension patients in Thailand. Implications for practice: Understanding factors between health outcomes and social determinants of health is crucial for informing the development of culturally appropriate interventions