Hypotension in Epidemiological Study Assignment Sample

Subject Name : Nursing

Table of Contents

Introduction.
Community of the research:.
Methods of sampling & sample size.
Recovery of data.
Results.
Discussion.
Advantages of the study:.
Limitations of study:.
Disadvantages of the Study.
References.

Introduction to Hypotension in Epidemiological Study

While it is easy to measure blood pressure, it took many decades for us to understand that hypertension is a common global disease. In both developed and emerging countries serious non-communicable diseases play a major role in adults. In most countries, there is a growing spike in the occurrence of chronic conditions such as high blood pressure, diabetes mellitus, etc. Changing lifestyles, obesity and human behaviour patterns are key factors responsible for this the trend[2]. The Joint National Committee studies on high-pressure reduction, diagnosis, assessment and care (JNC – VI & VII) stressed the need for clinicians. The Joint National Committee studies on prevention, identification (Juraschek,, 2017), assessment and management of high blood pressure (JNC – VI & VII) stressed the importance of clinicians’ proper judgement of the patients during diagnosis and treatment (Hansen,, 2020). Further, these recommendations for primary care doctors have been stated in the study. Thus this national guideline should act as a resource to be followed and applied in local and individual scenario.

Community of The Research:

A study population comprising adults 30 years and more resident mostly in the Kancheepuram district of Tamilnadu Mugalivakkam Primary Health Centre. In this sector of the Primary Health Centre, the mid-year population for the year 2016 was 40, 850, 12 051 adults (29.5%) in the 30-year age group living in the area above.

Methods of Sampling & Sample Size:

Cluster-sampling methods were the sampling methods utilised during throughout the analysis. This procedure was employed in accordance with its "Nagar" subdivisions, and the 30 cluster sampling techniques were established. For determining the size of the sample requirement by 18 per cent of the existence of hypertension (Hidayat, 2017), and the design impact of 2, the minimum size of the sample which was required for the analysis was found to be 750 persons, the prevalence of 24% was used for published studies related to the occurence of hypertension in India.

Recovery of Data:

Information for this study have been obtained by visiting the houses in the chosen area from the population. After the sampling took place. If the analysis was conducted throughout the day, a sampling distortion may occur (Li,, 2017). This stidy was kind of a household study and therefore, household questionnaires were sent and the information required to achieve the goals of the study was obtained (Palma, 2017). In accordance with the probability proportionate to the size (PPS) process, the responses were extracted from the 30 selected clusters (Ravindrarajah, 2017). Thus, 25 people were chosen randomly from each cluster to achieve the appropriate sample group of 750 for the analysis. On average for each day of the tour, three families were investigated.

In accordance with the Joint National Committee (JNC) VI recommendations, the following strategies have been employed.

The man had a back-stretched chair with his arms bared and heart-stretched and refrained during the 30 minutes preceding the assessment from nicotine use of some manner or intake of caffeine.
The blood pressure measurement in the supine and standing condition was stated under special circumstances. To ensure correct calculation, the required (RIVA-ROCCI) cuff scale was used. At least 80% of the arm was in the inflable rubber bag inside the cuff. A large adult mango was needed by many adults (Rawlings, 2018). Measures have preferably been taken. A large adult cuff was essential for many adults. Measuring the mercury sphygmomanometer was ideally carried out. Blood pressure was measured both the systolic and the diastolic.
For the purpose of defining systolic blood pressure the very first sound presence [phase I] is applied. The [phase V] sound disappearance is utilized to describe the blood pressure of the diastolic. After 3-5 minutes, two or three readings have been replicated.

If the first two readings vary by over 5 mm Hg, further readings have been collected and averaged. As the result of following measurement guidelined recommended by JNC-VI criteria, the hypertension cateogrization was carried out by JNC-VII guidelines. Hypertension was re-examined after two days similarly to validate the consistency of hypertension (Lane, 2019). The findings from the previous screening were not aware of the individuals. However, the recently identified hypertensive persons were forwarded for further research to the primary health centre.

After 2 days, those with hypertension were similarly tested again to affirm the constancy of hypertension. The findings of the previous screening have not been reported to the individuals. However, the newly identified hypertensive persons were forwarded for further research and management to the primary health centre. The known high blood pressure cases have been highlighted for continued care

Results of Hypotension in Epidemiological Study

Mugalivakkam surveyed 750 individuals (6.2 percent) in 12,051 adults of the age group of 30 years old and older who live under Primary Health Center. 189 (25.2 percent) of 750 people surveyed experienced hypertension, of which 93 were recognised. In the 357 adult male population, 81 (22.6%) and 393 adult female groups, 108 (27.4%) suffered high blood pressure. The bulk of hypertensive drugs (25%) had systemic and diastolic high blood pressure; 20.4% had systolytic high blood pressure and 19.2% had diastolic high blood pressure only. The definition of hypertension is subject both to the systolic and the diastolic stresses. Of the 357 males analysed, 233 (65.26%) were pre-hypertensives, followed up by 61[17.08%] who were phase I hypertensives (140-159 millimetre Hg, diastolic pressure 90-99 millimetre Hg and 20 (5.6%) were phases II (stolic pressure >160 millimetre Hg and diastolic pressure 90-99 mm Hg). Phase II (substantial pressure>160 mm of Hg and diastolic blood pressure >100 of Hg) was hypertensive with 90 to 99 mm diastolic pressure (Hg).

Of the 393 women, 196 (49.87%) were prehypertensive, 67 (17.04%) in stage I (substantial 140-159 mm Hg pressures and diastolic 90-100 mm Hg pressure) and 41(10.4%) were hypertensive in phase II (substantial >160 mms Hg and diastolic >100 mm Hg).

The occurence rate of hypertension has also been found to be upward as age progresses for both men and women. Statistically important was the difference which was obtained from the study.

High blood pressure or hypotension and risk factors indicates that hypertension prevalences of non-smokers are higher among smokers 48 (40.33%) and 141 (22.3%). The statistically important variations were observed. The rate of hypertension for people used to chew tobacco was 33.3 percent higher over 5 years compared to 31.6 percent of fewer than 5 years of habit. Non-tobacco chews showed 23.5% lower incidence of hypertension. 750 people were identified. It was observed that 79 people (10.5%) were drinking alcohol out of 750. Of the drinkers 41 (51.8 percent) those were the pre-hypertensive, only 4(5.0 percent) had hypertension followed by 34 (43.0 percent). Of 189 hypertensives, 75 (39.6%) were of normal/expected proportions of hypertensive people, 20 (10.5%) had weights below, 55 (29.1%), 26(13.7%) had obese class I and 11 (5.8%) were obese class II. Just 2 people saw an extremely substantial p

The maximum number of diabetics found 48 (26.46 percent) to be in phase I and II with high blood pressure, with 30 (6.99 percent) prehypertensive people. Blood pressure was just 11 (8.33 percent). Just 44 (11.9%), among the 393 females surveyed, used oral contraceptive pills. Among these, 41 (93.18%) had oral pills used less than 3 years, whilst the other 3 (6.8%) used oral contraceptive pills for over 3 years. For people who took oral pills longer than three years, the rate of hypertension was 66.6 percent (Wesselink, 2018), while for fewer than three years, it was 46.3 percent. There were 2.4 times for smoker i.e. the smokers have 2.4 more times hypertension risk than non-smokers and statistically substantial differences have been recorded, with equally higher risk of obesity, alcohol use, tobacco chewing, ambient stress, diabetes, anxiety and oral contraceptivity.

Discussion on Hypotension in Epidemiological Study

Hypertension in the advanced and developing world was considered, until recently, just one of the major public health issues. The effect was not sufficiently felt by the prevalence of rampant transmissible illnesses in developed countries. But hypertension is now one of the emerging issues with its consequences for concomitantly rising cardiovascular and renal disease risk with management of communicable disease and an improved life expectance with lifestyle changes. In the current study, 189 persons (including 93 aged high blood pressure cases) from over 750 individuals tested were reported to be hypertensive and 25.2 per cent were identified among both the sexes over all occurence of hypertension. But hypertension frequency among men was 22.6% (81 cases in 357 men), and among women 27.4%. (108 cases in 393 females).

Advantages of The Study:

They are effective between exposure and manifestations of disease in rare diseases or diseases with a long latency time.
It is cheaper and time-consuming; it is beneficial when exposure data are costly or difficult to collect.
It is beneficial to observe complex populations, with which it is impossible to follow up.

Limitations of Study:

Urine and blood tests and ophthalmoscope tests due to diverse limitations could not be conducted out.

Disadvantages of The Study

The selection biases are applicable as only selected age group was analyzed in the study.
For unusual exposures, they are unreliable.
Information on exposure is subject to observation bias.
They usually do not permit incidence measurement (absolute risk).

References for Hypotension in Epidemiological Study

Hansen, K. W., & Christiansen, J. S. (2020). Research methodologies for recording blood pressure in diabetic patients. In Research Methodologies in Human Diabetes Part 2 (pp. 113-124). De Gruyter.

Hidayat, K., Du, X., Zou, S. Y., & Shi, B. M. (2017). Blood pressure and kidney cancer risk: meta-analysis of prospective studies. Journal of hypertension, 35(7), 1333-1344.

Juraschek, S. P., Daya, N., Appel, L. J., Miller, E. R., Windham, B. G., Pompeii, L., ... & Selvin, E. (2017). Orthostatic hypotension in middle-age and risk of falls. American journal of hypertension, 30(2), 188-195.

Lane, C. A., Barnes, J., Nicholas, J. M., Sudre, C. H., Cash, D. M., Parker, T. D., ... & Schott, J. M. (2019). Associations between blood pressure across adulthood and late-life brain structure and pathology in the neuroscience substudy of the 1946 British birth cohort (Insight 46): an epidemiological study. The Lancet Neurology, 18(10), 942-952.

Li, G., Wang, H., Wang, K., Wang, W., Dong, F., Qian, Y., ... & Shan, G. (2017). The association between smoking and blood pressure in men: a cross-sectional study. BMC Public Health, 17(1), 1-6.

Palma, J. A., & Kaufmann, H. (2017). Epidemiology, diagnosis, and management of neurogenic orthostatic hypotension. Movement disorders clinical practice, 4(3), 298-308.

Ravindrarajah, R., Hazra, N. C., Hamada, S., Charlton, J., Jackson, S. H., Dregan, A., & Gulliford, M. C. (2017). Systolic blood pressure trajectory, frailty, and all-cause mortality> 80 years of age: cohort study using electronic health records. Circulation, 135(24), 2357-2368.

Rawlings, A. M., Juraschek, S. P., Heiss, G., Hughes, T., Meyer, M. L., Selvin, E., ... & Gottesman, R. F. (2018). Association of orthostatic hypotension with incident dementia, stroke, and cognitive decline. Neurology, 91(8), e759-e768.

Wesselink, E. M., Kappen, T. H., Torn, H. M., Slooter, A. J. C., & Van Klei, W. A. (2018). Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review. British journal of anaesthesia, 121(4), 706-721.