Background and Aims: Young person is a vulnerable group for developing about all life-style related diseases. The present cross-sectional survey was conducted to measure the determiners of blood force per unit area among entry twelvemonth pupils in a medical university in Ajman, United Arab Emirates.
Methods: One hundred and 10 pupils from Gulf Medical University, Ajman, UAE participated in the survey. A pretested structured questionnaire was used for informations aggregation. Predictive Analytic Software 17 was used for informations analysis. Chi-square trial, Univariate and multivariate logistic arrested development were used.
Consequences: Variables such as baccy usage, continuance of slumber, Body Mass Index, and gender were considered to measure the association with blood force per unit area. The average age of the pupils was 19 old ages with a SD of 1.9 old ages. The average systolic and diastolic blood force per unit area was 113.5 ( SD 12. ) and 73.7 ( SD 11.2 ) severally with average BMI of 24.9 ( SD 5.7 ) . A statistically important association was observed between gender and blood force per unit area ( p & A ; lt ; 0.05 ) . The petroleum Odds Ratio ( OR ) observed for sleep continuance and blood force per unit area was found statistically important ( p & A ; lt ; 0.05 ) , but the adjusted OR was non statistically important. Of the participants who sleep for more than 6 hours, bulk ( 70 % ) have normal blood force per unit area. About half of the participants who slept for less than 6 hours have pre-hypertension and/ or high blood pressure. There was statistically important ( p & A ; lt ; 0.005 ) association between Body Mass Index ( BMI ) and blood force per unit area ( BP ) . The average BMI among those with normal BP was 23.25 kg/m2 with a SD of 4.6 and those with pre-hypertension and/ or high blood pressure was 27.6 kg/m2with a SD of 6.5.
Decision: Gender and BMI are the important factors associated with Blood force per unit area. The findings may be used to make schemes to leave consciousness of the dangers of increased blood force per unit area among corpulent and non corpulent pupils.
Introduction:
High blood pressure is a major public wellness job of concern across the universe because of its association with increased hazard of cardiovascular diseases. Youth ( 15 to 24 old ages ) is an of import period of growing and ripening, and most of the alterations that occur during this period are continued into adulthood1.
Essential high blood pressure may hold its beginnings in early life and its co-morbidities are surely a major load on resources, and they cut down the productiveness of those affected with hypertension2. Prospective surveies have established increased left ventricular mass and peripheral opposition, with high blood force per unit area in childhood3-4. Raised BP in childhood has been recognized as one of the most of import forecasters of grownup high blood pressure. This has generated an involvement among research workers to look into the form of blood force per unit area and its determiners in childhood and adolescence5-6.
Several surveies have shown that the degree and form of blood force per unit area among kids and striplings vary from population to population7. Growth patterns, age and gender have strong influence on blood pressure7. It has been estimated that by 2010, 1.2 billion people will endure from high blood pressure worldwide8. The prevalence of high blood pressure norms 26 % and it affects about 125 million persons, in the Eastern Mediterranean Region9.
The United Arab Emirates ( UAE ) is in a period of passage. Equally tardily as the 1960s mobile Bedouin Arabs were the population of UAE. The find of oil in 1970s has made a dramatic alteration in the demographic profile with exiles representing more than 80 % of the population and in the life style of its people. Now the UAE is a modern, affluent society, to a great extent influenced by Western life forms, including a sedentary life style with high Cardiovascular Diseases ( CVD ) hazard profiles10. Indeed, CVDs are known to be the taking cause of morbidity and mortality in the UAE among both the subjects and expatriates11. Of peculiar concern is the prevalence of fleshiness, which reaches about 24 % among medical students12 with reported high emphasis degrees ( 65 % ) , unhealthy diets ( 50 % ) and low degrees of physical activity ( 77 % ) which is possibly attributable to cultural and climatic restrictions13. Smoking has increased among men14-16. High blood pressure is besides common with a reported prevalence of 19-25 % 17, 15.3 % in urban and 10.6 % rural population 18. The 15-24 old ages age is an of import developmental phase in the life span of persons as it is a passage period to maturity.
In Ajman, there is a deficiency of informations about determiners of high blood pressure among young person. This information is of import in be aftering life manner alterations. Therefore, the present survey was an effort to measure the determiners of blood force per unit area such as gender, academic programme in which enrolled, baccy usage, figure of repasts and BMI among pupils in a medical university in Ajman, United Arab Emirates.
Methodology:
This survey was conducted among entry twelvemonth pupils in a Medical University of Ajman, United Arab Emirates. Students enrolled in Medicine, Dental Medicine, and Allied ( Pharmacy and Physical Therapy ) academic programmes during the twelvemonth 2009-2010 were included in the survey. Among 160 entry degree pupils 110 pupils participated in the survey with a reponse rate of 69 % . Verbal consent was obtained from the participants before the survey. A self-administered questionnaire was distributed among them to obtain information on socio-demographic features, physical activity, wonts, diet history, day-to-day kiping wonts and household history of metabolic upsets. Their tallness, weight and blood force per unit area were recorded. The tallness was measured on a perpendicular graduated table with heels, natess, and occiput against the wall and caput in Frankfurt plane, to the nearest 0.5 centimeter. Weight was measured on a weighing graduated table with standard lower limit vesture to the nearest 0.5 kilogram. Body Mass Index was calculated utilizing the expression - weight ( in kilogram. ) divided by height2 ( in mtr. ) . Classification of BMI was done based on the World Health Organisation ( WHO ) criteria into three classs: normal ( BMI = 18.5-24.9 kg m-2 ) , fleshy ( BMI = 25-29.9 kg m-2 ) and corpulent ( BMI i‚? 30 kg m-2 ) . Blood force per unit area was measured by same squad and interpreted as per the blood force per unit area guidelines, issued in 2003 by the National Heart, Lung, and Blood Institute as shown below19.
Class
Systolic Blood Pressure millimeter of Hg
Diastolic Blood Pressure in millimeter of Hg
Normal
120 less than
80 less than
Prehypertension
139-120
89-80
1stage High blood pressure
159-140
99-90
2Hypertension phase
160 more than
100 more than
Descriptive statistics such as agencies, standard divergence were used to sum up the quantitative variables. Proportions and per centums were used to sum up categorical variables. Chi-square trial examined the relationship between biological variables such as corpulence, fleshiness and non-biological factors. A p-value? 0.05 was considered as statistically important.
Consequences:
Table-1
Distribution of Blood Pressure harmonizing to different variables
Variables
Group
Blood Pressure
Entire
Significance
Normal
Pre/Hypertension
No.
%
No.
%
Gender
Female
59
70.2
25
29.8
84
& A ; lt ; 0.05
Male
10
38.5
16
61.5
26
Program
MBBS
28
54.9
23
45.1
51
Nitrogen
Allied
24
77.4
7
22.6
31
Doctor of dental medicine
17
60.7
11
39.3
28
Sleep continuance
& A ; lt ; 6 hour
20
50.0
20
50.0
40
& A ; lt ; 0.05
& A ; gt ; =6 hrs
49
70.0
21
30.0
70
Tobacco usage
Yes
3
37.5
5
62.5
8
Nitrogen
No
66
64.7
36
35.3
102
Number of repasts
2 repasts
35
61.4
22
38.6
57
Nitrogen
& A ; gt ; 2 repasts
34
64.2
19
35.8
53
Body mass index
& A ; lt ; =30
63
68.5
29
31.5
92
& A ; lt ; 0.005
& A ; gt ; 30
6
33.3
12
66.7
18
Table 1 shows the distribution of blood force per unit area harmonizing to different variables. With respect to gender, 29.8 % females and 61.5 % males were either pre-hypertensive or hypertensive. There was a statistically important association between gender and blood force per unit area ( p & A ; lt ; 0.05 ) . The association between continuance of slumber and blood force per unit area was found to be statistically important ( p & A ; lt ; 0.05 ) . 70 % of those who slept for 6 hours or more and 50 % of those who slept for less than 6 hours had normal blood force per unit area. There was no statistically important difference in the blood force per unit area of pupils from the different academic programmes. Tobacco usage and figure of repasts consumed besides did non demo statistically important association with blood force per unit area. However, there were merely eight baccy users of whom five had pre-hypertension or high blood pressure while among the non users, three were holding pre-hypertension or high blood pressure. Among the participants with BMI & A ; gt ; 30, 66.7 % had pre-hypertension or high blood pressure whereas among those with BMI & A ; lt ; 30, merely 31.5 % were pre-hypertensive or hypertensive. The association between BMI and blood force per unit area was statistically important ( p & A ; lt ; 0.005 ) . The average BMI among those with normal BP was 23.25 with a SD of 4.6, while among those with pre-hypertension or high blood pressure was 27.6 with a SD of 6.5.
Table 2
Multivariate logistic arrested development analysis of factors associated with high blood pressure
Factors
Group
Number
Adjusted Oddss Ratio
95 % CI
P value
Body mass index
110
1.14
1.05 - 1.23
& A ; lt ; 0.002
Gender
Female
84
1
--
Male
26
3.30
1.24 - 8.78
& A ; lt ; 0.02
Sleep continuance
& A ; gt ; 6 hour
70
1
--
& A ; lt ; 6 hour
40
1.90
0.78 - 4.64
Nitrogen
For farther analysis, the important variables from the chi-square trial such as BMI, gender, and sleep continuance were included. Logistic arrested development analysis was performed to happen the petroleum and adjusted odds ratio ( OR ) . BMI was taken every bit uninterrupted variable and gender and sleep continuance as categorical variables. The adjusted odds ratio for BMI was 1.14 which was statistically important. There is 14 % increased opportunity for acquiring pre-hypertension or high blood pressure for a unit addition in BMI. Among the male gender, the adjusted odds ratio was 3.3 which was statistically important. The opportunity of acquiring pre-hypertension and/ or high blood pressure for male gender was 3.3 times more compared to female gender. The petroleum odds ratio for sleep continuance was 2.3 and was statistically important but when adjusted with other factors it was non statistically important. Table 2 shows the inside informations of logistic arrested development analysis.
Discussion:
Surveies have reported sex differences in BP with males holding higher BP than females during stripling and early adulthood20-21. Smith and Rinderknecht study that older male childs have significantly higher BP than girls22. Kusuma et Al and Schall observed that work forces possess higher BP degrees than females23-24. The present survey besides supports the observation made by other writers in this regard. Gender difference in the infective mechanisms in indispensable high blood pressure is available in the literature. The high prevalence of high blood pressure in younger work forces compared to adult females is explained on the footing of the deficiency of endogenous estrogen. Evidence suggests that estrogen may modulate vascular endothelial map, doing vasodilatation. This may be one ground for adult females holding lower blood force per unit area compared to men25.
Previous surveies demonstrated that high blood pressure increased significantly as BMI increased26-29. Srinivasan et al reported that BMI or cardinal adiposeness are the cardinal determiners of high blood force per unit area which appear at an early age. The survey besides emphasizes the function of weight decrease in the bar of hypertension30. A survey conducted among striplings observed that BMI is associated with arterial hypertension31. Reich et al. study that BMI is a strong forecaster of high blood pressure than waist-hip ratio32. Study by Berenson et Al. observed high BMI as one of the strongest hazard factors for hypertension33. The present survey besides supports the observation made by other writers with respect to BMI. Presently, there is small direct grounds to explicate the function of fleshiness in high blood pressure. Davy and Hall point out that high BP in corpulent worlds may be due to higher degree of adiposity34. BMI measures fleshiness and is associated with increased arterial stiffness and assorted hemodynamic alterations that may lend to hypertension35-38.
Jervase et Al. reported differences in BP between males and females, with males holding higher systolic and diastolic BP than the females. The survey besides observed that gender and BMI were the important determiners of high blood pressure among university students39. A survey by Chirinos et Al. reported that increasing BMI was associated with a significantly increased hazard of high blood pressure and the Odds Ratio for high blood pressure, for every 5-unit addition in BMI, was 1.58. The survey concluded that younger individuals with high blood pressure were more likely to be corpulent compared with older individuals with hypertension40. In the present survey OR for high blood pressure was 1.14, which revealed that for every one unit addition in BMI, the opportunity of high blood pressure is 14 % more, which is similar to the findings of Chirinos et Al.
In the present survey, when analyzing the association between BMI and high blood pressure, physical activity may be a contradictory factor, but physical activity was non taken in to account in this survey. There was no association between blood force per unit area and other hazard factors like baccy usage and sleep continuance. With respect to kip continuance, before seting to other confusing variables, the petroleum odds ratio of 2.33 was observed, but the adjusted OR observed was non statistically important. Gangwisch et al41 reported that less sleep continuance significantly increased the hazard of high blood pressure in topics 32 to 59 old ages of age. Gottlieb et al42 observed that sleep continuance per dark is associated with an increased hazard of high blood pressure, which is non supported by the findings of the present survey. This consequence may non be representative of all university pupils as the present survey involves merely one university and the little sample size. This probe highlights the demand for a countrywide survey among young person.
Decision:
The consequences of this survey provide an penetration into the apprehension of the association between gender, BMI and blood force per unit area among our entry degree pupils. The consequences may be used to develop messages to raise consciousness about the dangers of high blood force per unit area and its determiners among pupils. This consequence may non be representative of all university pupils as the present survey involves merely one university. This probe highlights the demand for a countrywide survey among young person.
