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  • 1
    Online Resource
    Online Resource
    May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension
    Oxford University Press (OUP) ; 2019
    In:  European Heart Journal Vol. 40, No. 25 ( 2019-07-01), p. 2006-2017
    Details
    In: European Heart Journal, Oxford University Press (OUP), Vol. 40, No. 25 ( 2019-07-01), p. 2006-2017
    Abstract: Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk.
    Type of Medium: Online Resource
    ISSN: 0195-668X , 1522-9645
    URL: Article
    DOI: 10.1093/eurheartj/ehz300
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2001908-7
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  • 2
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    Changes in Blood Pressure Levels and Antihypertensive Medication Use before and after Renal Transplantation among Patients in Nairobi, Kenya: A Comparative Cross-Sectional Study
    Hindawi Limited ; 2016
    In:  International Journal of Hypertension Vol. 2016 ( 2016), p. 1-5
    Details
    In: International Journal of Hypertension, Hindawi Limited, Vol. 2016 ( 2016), p. 1-5
    Abstract: Objectives. To determine the changes in blood pressure levels and antihypertensive medication use in the postrenal transplantation period compared to pretransplantation one. Methods . A comparative cross-sectional study was carried out on renal transplant recipients at the Kenyatta National Hospital, a national referral hospital in Kenya. Sociodemographic details, blood pressure levels, and antihypertensive medication use before and after renal transplantation were noted. Changes in mean blood pressure levels and mean number of antihypertensive medications after renal transplantation were determined using paired t -test. Results . 85 subjects were evaluated. Mean age was 42.4 (SD ± 12.2) years, with a male : female ratio of 1.9 : 1. Compared to the pretransplant period, significantly lower mean systolic and diastolic blood pressure levels after transplantation were noted (mean SBP 144.5 mmHg versus 131.8 mmHg; mean DBP 103.6 mmHg versus 83.5 mmHg in the pre- and posttransplant periods, respectively, p 〈 0.001 ). Mean number of antihypertensive medications also reduced significantly after transplantation, with an average of 3.3 (±1.6) versus 2.1 (±0.9) in the pre- and posttransplant periods, respectively ( p 〈 0.001 ). Conclusion . There is a significant reduction in blood pressure levels and number of antihypertensive medications used after renal transplantation. The positive impact of renal transplantation on blood pressure control should be confirmed using prospective cohort studies of patients with end stage renal disease who then undergo renal transplantation.
    Type of Medium: Online Resource
    ISSN: 2090-0384 , 2090-0392
    URL: Article
    DOI: 10.1155/2016/8450596
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2016
    detail.hit.zdb_id: 2573167-1
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  • 3
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    Burden of prehypertension among adults in Kenya: a retrospective analysis of findings from the Healthy Heart Africa (HHA) Programme
    Springer Science and Business Media LLC ; 2020
    In:  BMC Public Health Vol. 20, No. 1 ( 2020-12)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2020-12)
    Abstract: Hypertension is the leading risk factor for mortality globally. African countries, including Kenya, have a high and rising prevalence of hypertension. Prehypertension is associated with an increased risk of progression to overt hypertension and a higher risk of cardiovascular disease and mortality. Despite this, little is documented on the prevalence and distribution of prehypertension in sub-Saharan Africa. This study sought to estimate the overall burden of prehypertension in Kenyan adults enrolled in a large hypertension control programme, Healthy Heart Africa. The distribution and determinants of prehypertension in the sample were explored as secondary objectives. Methods This was a post hoc analysis of cross-sectional data obtained from population-level blood pressure (BP) screening of adults aged ≥18 years in the community and ambulatory care facilities in 17/47 sub-national administrative units in Kenya. All participants with a complete record for systolic and diastolic BP were included. Descriptive analyses were performed for sociodemographic characteristics. Pearson’s chi-square test was used to assess differences in categorical variables. Multivariate logistic regression analysis was performed to identify factors independently associated with prehypertension. Results Of 5,985,185 participant records that were included in the analysis, 34% were men (mean age: 45 [SD 2.9] years). The majority (63%) lived in rural Kenya. The prevalence of prehypertension was 54.5% and that of hypertension was 20.8%. Characteristics that were independently associated with prehypertension (adjusted odds ratio [95% CI] ) included male sex (1.23 [±0.0023], p   〈   0.001 for all age groups 〉  25 years) and rural residence (1.60 [±0.023], p   〈   0.001). Conclusions Approximately one in every two Kenyan adults has prehypertension. This calls for urgent development and roll-out of a national BP screening and control programme. It also provides a strong basis for the formulation of multisectoral national policies that will ensure implementation of evidence-based, low-cost public health interventions geared towards primary prevention of hypertension, especially in population groups that are traditionally considered at low risk, such as young adults and rural residents.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-020-8363-z
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2041338-5
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  • 4
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    Online Resource
    Strategic Recommendations to Bridge the Gaps in Awareness, Diagnosis and Prevention of Heart Failure in the Middle East Region and Africa
    Saudi Heart Association ; 2022
    In:  Journal of the Saudi Heart Association Vol. 34, No. 1 ( 2022-04-21), p. 53-65
    Details
    In: Journal of the Saudi Heart Association, Saudi Heart Association, Vol. 34, No. 1 ( 2022-04-21), p. 53-65
    Type of Medium: Online Resource
    ISSN: 2212-5043
    URL: Article
    DOI: 10.37616/2212-5043.1294
    Language: English
    Publisher: Saudi Heart Association
    Publication Date: 2022
    detail.hit.zdb_id: 2515647-0
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  • 5
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    Online Resource
    Factors Associated with Uncontrolled Hypertension among Renal Transplant Recipients Attending Nephrology Clinics in Nairobi, Kenya
    Hindawi Limited ; 2015
    In:  Journal of Transplantation Vol. 2015 ( 2015), p. 1-5
    Details
    In: Journal of Transplantation, Hindawi Limited, Vol. 2015 ( 2015), p. 1-5
    Abstract: Objective. To determine the factors associated with poor blood pressure control among renal transplant recipients in a resource-limited setting. Methods . A cross-sectional study was carried out on renal transplant recipients at the Kenyatta National Hospital. Sociodemographic details, blood pressure, urine albumin : creatinine ratio, and adherence using the MMAS-8 questionnaire were noted. Independent factors associated with uncontrolled hypertension were determined using logistic regression analysis. Results . 85 subjects were evaluated. Mean age was 42.4 (SD ± 12.2) years, with a male : female ratio of 1.9 : 1. Fifty-five patients (64.7%) had uncontrolled hypertension (BP ≥ 130/80 mmHg). On univariate analysis, male sex (OR 3.7, 95% CI 1.4–9.5, p = 0.006 ), higher levels of proteinuria ( p = 0.042 ), and nonadherence to antihypertensives (OR 18, 95% CI 5.2–65.7, p 〈 0.001 ) were associated with uncontrolled hypertension. On logistic regression analysis, male sex (adjusted OR 4.6, 95% CI 1.1–19.0, p = 0.034 ) and nonadherence (adjusted OR 33.8, 95% CI 8.6–73.0, p 〈 0.001 ) were independently associated with uncontrolled hypertension. Conclusion . Factors associated with poor blood pressure control in this cohort were male sex and nonadherence to antihypertensives. Emphasis on adherence to antihypertensive therapy must be pursued within this population.
    Type of Medium: Online Resource
    ISSN: 2090-0007 , 2090-0015
    URL: Article
    DOI: 10.1155/2015/746563
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2015
    detail.hit.zdb_id: 2503421-2
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  • 6
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    May Measurement Month 2019: an analysis of blood pressure screening results from Kenya
    Oxford University Press (OUP) ; 2021
    In:  European Heart Journal Supplements Vol. 23, No. Supplement_B ( 2021-05-20), p. B86-B88
    Details
    In: European Heart Journal Supplements, Oxford University Press (OUP), Vol. 23, No. Supplement_B ( 2021-05-20), p. B86-B88
    Abstract: Elevated blood pressure (BP) is the leading cause of global mortality, but control rates remain poor because most patients, especially in Africa, are unaware. May Measurement Month (MMM) is an annual global BP screening campaign that was initiated by the International Society of Hypertension (ISH) in 2017 to raise awareness of raised BP. Following participation in 2017 and 2018, Kenya participated again in 2019 and the results are reported here. Screening was carried out in 30 sites by volunteers coordinated by the Kenya Cardiac Society. Participants had three BP readings by standard methods with the last two being averaged and recorded. Heart rate, weight, height, socio-demographic parameters, and co-morbidities were documented. Hypertension was defined as a systolic BP (SBP) ≥140 mmHg and/or a diastolic BP (DBP) ≥90 mmHg or being on treatment with at least one antihypertensive medication. A total of 33 992 participants were screened, mean age was 42.5 (SD 16.8) years and 58.7% of participants were female. Only 27.3% had their BPs checked within the preceding 12 months. After multiple imputation, 26.1% were hypertensive, of whom 34.5% were aware of their hypertension and 31.5% were on treatment. Of those on treatment, 59.7% were controlled translating to 18.8% of all hypertensives. Being on treatment for hypertension, overweight, obese or having had hypertension in previous pregnancy were associated with increased SBP and DBP, while diabetes was associated with raised SBP. Two-thirds of hypertensives were unaware. Only a third of those aware were on treatment, with about 60% of these controlled. Lack of awareness remains a significant barrier to BP control. Programmes to raise awareness such as MMM are significant in raising population awareness.
    Type of Medium: Online Resource
    ISSN: 1520-765X , 1554-2815
    URL: Article
    DOI: 10.1093/eurheartj/suab040
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2141255-8
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  • 7
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    The burden of unrecognised chronic kidney disease in patients with type 2 diabetes at a county hospital clinic in Kenya: implications to care and need for screening
    Springer Science and Business Media LLC ; 2020
    In:  BMC Nephrology Vol. 21, No. 1 ( 2020-12)
    Details
    In: BMC Nephrology, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2020-12)
    Abstract: Chronic Kidney Disease (CKD) in patients with type 2 diabetes enhances the cardiovascular risk profiles and disease, and is a strong predictor of progression to end-stage kidney disease. Early diagnosis is encouraged for referral to specialist kidney care to initiate active management that would optimize outcomes including forestalling progression to end-stage kidney disease. This study was conducted in a regional referral public health facility in Central Kenya with a high prevalence of type 2 diabetes. It was aimed at finding out the burden of undiagnosed chronic kidney disease in their clinic of ambulatory patients with type 2 diabetes who dwell mainly in the rural area. Methods A cross-sectional study was conducted at the out-patient of Nyeri County hospital. A total of 385 patients were enrolled over 5 months. Informed consent was obtained and clinical evaluation was done, a spot sample of urine obtained for albuminuria and venous blood drawn for HbA1c, Lipids and serum creatinine. Estimated GFR (eGFR) was calculated using the Cockroft-Gault equation. Chronic kidney disease (CKD) was classified on KDIGO scale. Albuminuria was reported as either positive or negative. Descriptive statistics for data summary and regression analysis were employed on SPSS v23. Results A total of 385 participants were included in the study, 252 (65.5%) were females. There were 39.0% (95%CI 34.3–44.2) patients in CKD/KDIGO stages 3, 4 and 5 and 32.7% (95%CI, 27.8–37.4) had Albuminuria. The risk factors that were significantly associated with chronic kidney disease/KDIGO stages 3, 4 and 5 were: age  〉  50 years, long duration with diabetes 〉  5 years and hypertension. Employment and paradoxically, obesity reduced the odds of having CKD, probably as markers of better socio-economic status. Conclusion Unrecognized CKD of KDIGO stages 3,4 and 5 occurred in over 30 % of the study patients. The risk factors of hypertension, age above 50, long duration of diabetes should help identify those at high risk of developing CKD, for screening and linkage to care. They are at high risk of progression to end-stage kidney disease and cardiovascular events. The imperative of screening for chronic kidney disease is availing care in publicly-funded hospitals.
    Type of Medium: Online Resource
    ISSN: 1471-2369
    URL: Article
    DOI: 10.1186/s12882-020-1705-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2041348-8
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  • 8
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    Adequacy of control of cardiovascular risk factors in ambulatory patients with type 2 diabetes attending diabetes out-patients clinic at a county hospital, Kenya
    Springer Science and Business Media LLC ; 2017
    In:  BMC Endocrine Disorders Vol. 17, No. 1 ( 2017-12)
    Details
    In: BMC Endocrine Disorders, Springer Science and Business Media LLC, Vol. 17, No. 1 ( 2017-12)
    Type of Medium: Online Resource
    ISSN: 1472-6823
    URL: Article
    DOI: 10.1186/s12902-017-0223-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2017
    detail.hit.zdb_id: 2091323-0
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  • 9
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    The Pan African Society of Cardiology and its commitment to clinical research training
    Oxford University Press (OUP) ; 2022
    In:  European Heart Journal Vol. 43, No. 28 ( 2022-07-21), p. 2652-2654
    Details
    In: European Heart Journal, Oxford University Press (OUP), Vol. 43, No. 28 ( 2022-07-21), p. 2652-2654
    Type of Medium: Online Resource
    ISSN: 0195-668X , 1522-9645
    URL: Article
    DOI: 10.1093/eurheartj/ehac073
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2001908-7
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  • 10
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    A Retrospective Study on the Adoption of Lipid Management Guidelines in Post-Myocardial Infarction Patients in a Tertiary Care Centre
    Springer Science and Business Media LLC ; 2023
    In:  Cureus
    Details
    In: Cureus, Springer Science and Business Media LLC
    Type of Medium: Online Resource
    ISSN: 2168-8184
    URL: Article
    DOI: 10.7759/cureus.41402
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2747273-5
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