Background This study uses data from the World Health Organization’s Study on Global Ageing and Adult Health (SAGE) to examine patterns of hypertension prevalence, awareness, treatment and control for people aged 50 years and over in China, Ghana, India, Mexico, the Russian Federation and South Africa.

Methods The SAGE sample comprises of 35 125 people aged 50 years and older, selected randomly. Hypertension was defined as ≥140 mmHg (systolic blood pressure) or ≥90 mmHg (diastolic blood pressure) or by currently taking antihypertensives. Control of hypertension was defined as blood pressure below 140/90 mmHg on treatment. A person was defined as aware if he/she was hypertensive and self-reported the condition.

Results Prevalence rates in all countries are broadly comparable to those of developed countries (52.9%; range 32.3% in India to 77.9% in South Africa). Hypertension was associated with overweight/obesity and was more common in women, those in the lowest wealth quintile and in heavy alcohol consumers. Awareness was found to be low for all countries, albeit with substantial national variations (48.3%; range 23.3% in Ghana to 72.1% in the Russian Federation). This was also the case for control (10.2%; range 4.1% in Ghana to 14.1% India) and treatment efficacy (26.3%; range 17.4% in the Russian Federation to 55.2% in India). Awareness was associated with increasing age, being female and being overweight or obese. Effective control of hypertension was more likely in older people, women and in the richest quintile. Obesity was associated with poorer control.

Conclusions The high rates of hypertension in low- and middle-income countries are striking. Levels of treatment and control are inadequate despite half those sampled being aware of their condition. Since cardiovascular disease is by far the largest cause of years of life lost in these settings, these findings emphasize the need for new approaches towards control of this major risk factor.

Hypertension among older adults in low- and middle-income countries: prevalence, awareness and control

Objectives Female smoking is predicted to double between 2005 and 2025. There have been numerous calls for action on women9s tobacco use over the past two decades. In the present work, evidence about female tobacco use, progress, challenges and ways forward for developing gendered tobacco control is reviewed. Methods Literature on girls, women and tobacco was reviewed to identify trends and determinants of tobacco use and exposure, the application of gender analysis, tobacco marketing, the impact of tobacco control on girls and women and ways to address these issues particularly in low-income and middle-income countries. Results Global female tobacco use is increasingly complex, involving diverse products and factors including tobacco marketing, globalisation and changes in women9s status. In high-income countries female smoking is declining but is increasingly concentrated among disadvantaged women. In low-income and middle-income countries the pattern is more complex; in several regions the gap between girls9 and boys9 smoking is narrow. Gendered analyses and approaches to tobacco control are uncommon, especially in low-income and middle-income countries. Conclusions Tobacco control has remained largely gender blind, with little recognition of the importance of understanding the context and challenges of girl9s and women9s smoking and secondhand smoke exposure. There has been little integration of gender considerations in research, policy and programmes. The present work makes a case for gender and diversity analyses in tobacco control to reflect and identify intersecting factors affecting women9s tobacco use. This will help animate the WHO Framework Convention on Tobacco Control9s concern for gender specificity and women9s leadership, and reduce the impact of tobacco on women.

https://tobaccocontrol.bmj.com/content/tobaccocontrol/21/2/236.full.pdf

Women and tobacco: a call for including gender in tobacco control research, policy and practice

https://www.onlinecjc.ca/article/S0828-282X(07)70780-8/pdf

Estimate of the benefits of a population-based reduction in dietary sodium additives on hypertension and its related health care costs in Canada.

Context Chronic pancreatitis is common in India. However, its risk factors are not clear. There is sparse data on the current prevalence of tropical pancreatitis in India. Objective To undertake a prospective nationwide study of the risk factors and clinical profile of chronic pancreatitis.

/pdf/chronic-pancreatitis-a-prospective-nationwide-study-of-1-086-2intvy18d9.pdf

Chronic pancreatitis. A prospective nationwide study of 1,086 subjects from India.

Background: There is a growing evidence of increased prevalence of psychological problems (stress, depression, anxiety, and substance abuse) and feelings of burnout among medical professionals all over the world and this has been shown to be associated with lapses in patient care. Data from India in this regard are limited. Aims: To assess the various psychological problems (depression, perceived stress, and burnout) among medical professionals working in a government-funded tertiary care institute of India. Materials and Methods: An online e-mail survey was carried out among resident doctors and faculty members (a total of 1721 doctors). A total of 445 doctors (response rate-27.69%) responded to the survey. The survey included Patient Health Questionnaire-9 (PHQ-9), Cohen's Perceived Stress Scale, and Maslach Burnout Inventory. Results: Of the eligible 1607 participants, 445 responders, 376 (77.75%) were resident doctors and 69 (15.5%) were faculty. As per the PHQ-9, 30.1% of participants were found to have depression and 16.7% of participants reported suicidal ideations. About two-thirds of the sample experienced moderate level of stress (67.2%) and another 13% of participants reported high level of stress. More than 90% of the participants reported some level of burnout. Compared to faculty, higher proportion of the residents reported stress, depression, and burnout. Presence of depression, stress, or burnout was associated with lower indulgence in recreational activities, experiencing verbal or physical abuse in the hand of patients/caregivers, feelings that seniors do not show empathy toward patients, and seniors do not show empathy toward them. Conclusions: The present study suggests that a significantly higher proportion of doctors in Indian setting experience stress, depression, and burnout. The presence of stress, depression, and burnout is associated with long working hours and negative patient-related outcomes, adverse doctor–patient interactions, and interpersonal interactions among the colleagues.

Psychological problems and burnout among medical professionals of a tertiary care hospital of North India: A cross-sectional study.

Tobacco use among medical professionals in Kerala, India: The need for enhanced tobacco cessation and control efforts

BACKGROUND: We reviewed the literature on tobacco use in Kerala and present data from three recently conducted unpublished studies. METHODS: Three cross-sectional studies were conducted; a community-based study of 1,298 individuals aged 15 years and above (mean age 37.4 years, men 630), a school-based study of 1,323 boys (mean age 14.7 years), and a college-based study of 1,254 male students (mean age 18.2 years). Information on tobacco use and sociodemographic variables was collected using pre-tested, structured interview schedules and questionnaires. RESULTS: In the community study, 72% of men and 6% of women had ever used tobacco. Compared to men with > 12 years of schooling, those with 44 years. In the school study, the age at initiation among boys aged or = 16-year-old boys. Boys whose fathers and friends used tobacco were 2 times and 2.9 times more likely to use tobacco (OR 2.0, CI 1.3-3.1 and OR 2.9, CI 1.6-5.1), respectively, compared with their counterparts. In the college study, 29% of the commerce students used tobacco compared with 5.3% of polytechnic students (p < 0.001). CONCLUSION: Survey data suggest that the age at initiation of tobacco use appears to be falling. A series of cross-sectional studies with larger sample sizes of the youth is required to confirm this impression. Tobacco use habits of fathers and peers are significant influences on youth smoking. There is a need to focus on particular types of colleges as these appear to have high-risk tobacco use environments.

Tobacco use in Kerala: findings from three recent studies.

Management of hypertension in low and middle income countries: Challenges and opportunities

https://www.cmaj.ca/content/suppl/2008/05/16/178.11.1458.DC1/top-campbell-f.pdf

Prise en charge de l'hypertension au Canada : De bonnes nouvelles, malgré d'importants obstacles toujours présents

Access to pocket money and low educational performance predict tobacco use among adolescent boys in Kerala, India.

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