Obstructive sleep apnea and associated factors among hypertensive patients attending a tertiary cardiac center in Tanzania: a comparative cross-sectional study

Pallangyo, Pedro; Mgopa, Lucy R.; Mkojera, Zabella; Komba, Makrina; Millinga, Jalack; Misidai, Nsajigwa; Swai, Happiness J.; Mayala, Henry; Bhalia, Smita; Wibonela, Salma; Janabi, Mohamed

doi:10.1186/s41606-021-00069-z

Cited by 3 publications

(1 citation statement)

References 110 publications

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“…57,96,97 Moreover, quite worrying rates of modifiable lifestyle risks documented by recent community and hospital-based studies from Tanzania calls for a resilient multisectoral approach and urgent evaluation of policies implemented to combat hypertension and other NCDs. 95,[98][99][100][101][102][103] Improved and sustained BP control is pivotal in reduction of CVD morbidity and mortality. Regardless of the modest adherence rates witnessed in this study, less than a half of participants had achieved BP control.…”

Section: Discussionmentioning

confidence: 99%

Medication Adherence and Blood Pressure Control Among Hypertensive Outpatients Attending a Tertiary Cardiovascular Hospital in Tanzania: A Cross-Sectional Study

Pallangyo¹,

Komba²,

Mkojera³

et al. 2022

IBPC

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Background: Notwithstanding the availability of effective treatments, asymptomatic nature and the interminable treatment length, adherence to medication remains a substantial challenge among patients with hypertension. Suboptimal adherence to BP-lowering agents is a growing global concern that is associated with the substantial worsening of disease, increased service utilization and healthcare cost escalation. This study aimed to explore medication adherence and its associated factors among hypertension outpatients attending a tertiary-level cardiovascular hospital in Tanzania. Methods: The pill count adherence ratio (PCAR) was used to compute adherence rate. In descriptive analyses, adherence was dichotomized and consumption of less than 80% of the prescribed medications was used to denote poor adherence. Logistic regression analyses was used to determine factors associated with adherence. Results: A total of 849 outpatients taking antihypertensive drugs for ≥1 month prior to recruitment were randomly enrolled in this study. The mean age was 59.9 years and about two-thirds were females. Overall, a total of 653 (76.9%) participants had good adherence and 367 (43.2%) had their blood pressure controlled. Multivariate logistic regression analysis showed; lack of a health insurance (OR 0.5, 95% CI 0.3-0.7, p<0.01), last BP measurement >1 week (OR 0.6, 95% CI 0.4-0.8, p<0.01), last clinic attendance >1 month (OR 0.4, 95% CI 0.3-0.6, p<0.001), frequent unavailability of drugs (OR 0.6, 95% CI 0.3-0.9, p = 0.03), running out of medication before the next appointment (OR 0.6, 95% CI 0.4-0.9, p = 0.01) and stopping medications when asymptomatic (OR 0.6, 95% CI 0.4-0.8, p<0.001) to be independent associated factors for poor adherence. Conclusion: A substantial proportion of hypertensive outpatients in this tertiary-level setting had good medication adherence. Nonetheless, observed suboptimal blood pressure control regardless of a fairly satisfactory adherence rate suggests that lifestyle modification plays a central role in hypertension management.

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Section: Discussionmentioning

confidence: 99%

Medication Adherence and Blood Pressure Control Among Hypertensive Outpatients Attending a Tertiary Cardiovascular Hospital in Tanzania: A Cross-Sectional Study

Pallangyo¹,

Komba²,

Mkojera³

et al. 2022

IBPC

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Public knowledge of risk factors and warning signs of heart attack and stroke

Pallangyo,

Mkojera,

Komba

et al. 2024

Egypt J Neurol Psychiatry Neurosurg

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Background Knowledge of the predisposing risk factors and prompt recognition of the warning signs for heart attack and stroke is fundamental in modification of lifestyle behaviors and an imperative precursor to health-seeking behavior. In view of an existing knowledge gap amidst increasing incidence of heart attack and stroke in Tanzania, we conducted this community-based cross-sectional study among residents of Dar es Salaam city. Results A total of 1759 respondents were enrolled in this study. The mean age was 45.4 years, females constituted over a half of participants and over two-thirds had attained at least secondary school education. Regarding risk factors, just over 2% of participants displayed satisfactory awareness and only stress was recognized by at least half of participants. With regard to warning signs, barely 1% of participants had satisfactory knowledge for either of the conditions while nearly three-quarters of participants failed to mention even a single warning sign for heart attack. Recognized by about two-thirds of respondents, sudden numbness or weakness in face, arm or leg was the most acknowledged stroke symptom; however, other symptoms were familiar to less than a third of participants. Although over a half of respondents acknowledged going to a hospital as their first resort, over one-tenth of respondents expressed inappropriate reactions towards heart attack and stroke victims. Old age, higher level of education, positive history of heart attack or stroke, high blood pressure and history of dyslipidemia showed association with both risk factors and warning signs knowledge during bivariate analyses. Conclusions Public knowledge of common risk factors and typical warning signs for heart attack and stroke was critically suboptimal. These findings herald an utmost need for public health efforts to increase community awareness of risk factors and typical signs of the two conditions to curb the rising prevalence and associated morbimortality.

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Sleep Disordered Breathing and Neurocognitive Disorders

Ogbu,

Menon,

Chahil

et al. 2024

JCM

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Sleep-disordered breathing (SDB), which includes conditions such as obstructive sleep apnea (OSA) and central sleep apnea (CSA), is an independent risk factor for cerebral small vessel disease (CSVD), stroke, heart failure, arrhythmias, and other cardiovascular disorders. The influence of OSA on brain structure and cognitive function has become an essential focus in the heart-brain axis, given its potential role in developing neurocognitive abnormalities. In this review, we found that OSA plays a significant role in the cardio-neural pathway that leads to the development of cerebral small vessel disease and neurocognitive decline. Although data is still limited on this topic, understanding the critical role of OSA in the heart-brain axis could lead to the utilization of imaging modalities to simultaneously identify early signs of pathology in both organ systems based on the known OSA-driven pathological pathways that result in a disease state in both the cardiovascular and cerebrovascular systems. This narrative review aims to summarize the current link between OSA and neurocognitive disorders, cardio-neural pathophysiology, and the treatment options available for patients with OSA-related neurocognitive disorders.

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Obstructive sleep apnea and associated factors among hypertensive patients attending a tertiary cardiac center in Tanzania: a comparative cross-sectional study

Cited by 3 publications

References 110 publications

Medication Adherence and Blood Pressure Control Among Hypertensive Outpatients Attending a Tertiary Cardiovascular Hospital in Tanzania: A Cross-Sectional Study

Medication Adherence and Blood Pressure Control Among Hypertensive Outpatients Attending a Tertiary Cardiovascular Hospital in Tanzania: A Cross-Sectional Study

Public knowledge of risk factors and warning signs of heart attack and stroke

Sleep Disordered Breathing and Neurocognitive Disorders

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