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Rangpur, Bangladesh

Mondal R.N.,Hypertension and Research Center | Alam M.S.,Rangpur Medical College | Haque M.A.,Rangpur Medical College | Jahan S.M.S.,Rangpur Medical College | And 11 more authors.
World Heart Journal | Year: 2015

Background: Hypertension and diabetes are two widespread non-communicable diseases. The co-existence of diabetes and hypertension in the same patient is devastating to the cardiovascular system. Patients with hypertension are at 2–3 times higher risk of developing diabetes than patients with acceptable blood pressure. Subjects and Methods: This case study was carried out at the Hypertension and Research Center, Rangpur, Bangladesh. We selected 384 hypertensive patients from the hypertension registry of Rangpur region, by simple random sampling. Participants were contacted by phone call and invited to take part in this study. Of 384 patients, 310 patients responded, and 298 patients fulfilled the criteria for this study. Results: Of 298 hypertensive patients, 50.7% were females and the mean (±SD) age of the study population was 49.4 ± 10.13 years. In our study 28.8% (n=86) patients had diabetes mellitus (DM), 4.02% (n=12) had diabetes before development of hypertension, and 25.9% (n=74) hypertensive patients were newly detected as having diabetes. The time required to develop diabetes was 3.8 ± 4.0 years. Prevalence of newly developed diabetes was significantly higher in older age (66.67% in ≥65 years, 19.38% in <45 years) (p = 0.0044) and those with central obesity (26.25% vs. 12.5 % (p < 0.001). Among the newly detected diabetes patients, 45.9% were overweight and 12.2% were obese. Newly detected diabetes was higher among beta-blocker users (41.6%) and in those with duration of hypertension more than 5 years (31.9% vs. 23.8%, p = 0.001). 61.67% of newly detected diabetes patients had elevations of both fasting blood glucose (FBG) and blood glucose 2 hours after breakfast (2ABF), 20% had only elevated FBG, and 18.33% had elevated blood glucose 2ABF. Conclusion: One fourth of the hypertensive patients were observed to develop diabetes mellitus. Periodic screening and a blood glucose measurement 2 hours after breakfast, in addition to fasting blood glucose, are necessary to detect diabetes in hypertensive patients. © 2015 Nova Science Publishers, Inc. Source


Mondal R.N.,Hypertension and Research Center | Haque M.A.,Rangpur Medical College | Jahan S.M.S.,Rangpur Medical College | Azad A.K.,Rangpur Medical College | And 11 more authors.
World Heart Journal | Year: 2014

Background: Hypertension has become as an important cause of premature mortality and morbidity due to its major etiologic role in the development of coronary artery disease (CAD), stroke and renal failure. The present study aims to determine the validity of verbal autopsy questionnaire in our setting to find out the causes of death among known hypertensive patients. Subjects Design and Methods: Of 200 decedents approached from July 2013 to December 2013, relatives of only 118 responded for this study. All the families of these victims were contacted individually to find out the cause of deaths by verbal autopsy questionnaire. Every effort was made to find out the closest relative of the victim, who was present at the time of death of the deceased. A trained health worker completed the verbal autopsy questionnaire by asking leading questions in a structured interview. Clinical manifestations of the primary cause of death were collected by the principal investigator by asking leading questions over telephone. Further clinical data and investigations were collected from available records of our center and the board of experts examined all the available clinical data and finalized the cause of death of the victim. In case of available death certificate, mentioned cause of death was reassessed. Students t test and chi square test were used for comparison of the data. Results: Of 118 victims assessed; mean age at the time of death was 62.40 (SD 62.2years). Male victims were greater than females 72.9 vs 27.1%. Majority (71.2%) of the victims died due to hypertension related complications; 33.3% due to stroke, 20.3% CAD and 17.8% chronic kidney disease. Rest 28.82% of the victims died due to other causes unrelated to hypertension, e.g. 10.2% due to malignancy and in 13.6%, the cause could not be determined. Only 15.5% of the victims who died due to hypertension related complications were under regular follow up. The mean follow up blood pressure were 155.54/90.01 (uncontrolled), and mean duration of hypertension at the time of death was 5.77 years. Majority of the subjects were either illiterate or only literate having lower income farmers and house wives. Conclusion: Verbal autopsy accurately determined the causes of deaths in known patients of hypertension. CAD, stroke and chronic kidney disease were common causes of deaths. Majority of the victims were from lower social classes. Ignorance and poor literacy rate appear to be the important risk factors for premature death among these patients. © 2014 Nova Science Publishers, Inc. Source


Mondal R.N.,Hypertension and Research Center | Islam M.J.,Rangpur Medical College | Haque M.A.,Rangpur Medical College | Jahan S.M.S.,Rangpur Medical College | And 12 more authors.
World Heart Journal | Year: 2014

Background: Left ventricular hypertrophy (LVH) increases the risk of ischemic heart disease, stroke, and sudden cardiac death in patients with hypertension. The present study aims to determine the association of LVH in essential hypertensive patients by electrocardiography and echocardiography.Subjects and methods: A case study was carried out in a primary and secondary care Research Centre, during the period from 01 March,2013 to 31st August 2013. Hypertensive patients (n=121) above 18 years, with electrocardiographic criteria of LVH were included in this study.Results: A total 121 cases were studied. Majority of the study population was male (51.2%) illiterate (50.4%) farmers(43.5%), whereas among females, they were housewife (94.9%). LVH by echocardiography was diagnosed among 51.2%.Target organ damage was observed among 52.1% of subjects which was significantly higher among LVH patients (72.58%) compared to subjects without LVH (52.1 vs 23.72%,P = 0.00005441). There was no significant difference in the duration of hypertension in development of LVH (8.1% in those duration of hypertension >10 years and 53.2% in those with duration of hypertension 5-10 years). But frequency of LVH increases with the increase in blood pressure (from control to grade 1 to severe hypertension) (p value 0.00003302).Majority of the of the LVH patients(91.9%) had uncontrolled blood pressure.Conclusion: Echocardiogram appears to be more sensitive for diagnosis of LVH than electrocardiogram and uncontrolled blood pressure is the major cause of LVH in essential hypertension. © 2014 Nova Science Publishers, Inc. Source

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