PSBH PROJECT

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PSBH PROJECT
HYPERTENSION SMOKING OR SEDENTARY LIFE-SYTLE?
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INTRODUCTION

• Ø   An elevated arterial pressure is probably the
  most important public health problem in developed
  and developing countries as well.
• Ø   It is common, asymptomatic, readily
  detectable, usually easily treatable, and often
  leads to lethal complications if left untreated.
• Ø   By definition it is difficult and by
  necessity arbitrary
• Ø   There is a direct relation between
  cardiovascular risk and blood pressure. The
  higher the blood pressure the higher the risk of
  both stroke and coronary events.

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• The reason for choosing the project is mainly
  because hypertension is major factor in
  cardiovascular mortality, which accounts for 30
  of the deaths in the community.
• Ø   The aim while choosing the project was to
  bring an awakening among us about the possible
  interventions, which can help, in controlling
  this end organ disease.
• Ø   The goal of the hypothesis is to determine
  association of the modifiable risk factors like
  sedentary life style and smoking.

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Aims and objectives

• Aim
• v  To the association of modifiable risk factors
  namely sedentary life style and smoking with
  hypertension in patients coming to V.S. OPD of
  Ahmedabad city.
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• Objective
• Analysis of the data according
• o     To Age and Gender
• o     Smoking, and its details of years of
  smoking and number of cigarette smoked per day
• o     Sedentary life style
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• Comparison between the patients having smoking
  history and sedentary life style.
•  

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  Research question       Q a study of
association of modifiable risk factors
(smoking and sedentary life style) with
hypertension in the patients coming to V.S. OPD
from June 23rd to July 10th  
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TIME LINE CHART

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Review of The literature

• In todays world, most of the deaths are due to
  the non-communicable diseases (32 millions) and
  half of these have been due to cardiovascular
  diseases.
• In India an estimated 2.7 million died due to
  cardiovascular disease in 1990 and the toll is
  estimated to rise very steeply in the 21st
  century with hypertension being one the major
  causes of cardiovascular diseases.
• Thus looking at the problem the hypertension is
  itself a major problem, which also causes other
  morbid conditions like stroke, renal disease.
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  Risk factors     Non-modifiable risk factors
include        Age        Sex        Genetic
factors        Ethnicity   Modifiable risk
factors include        Obesity        Salt
intake        Saturated fats        Dietary
fiber        Alcohol        Socioeconomic
status        Smoking        Sedentary life
style        Stress        Others  
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Hypertension

• It is an iceberg disease. It became evident in
  the early 1970s tat only about half of the
  hypertensive subjects in the general population
  of most developed countries were aware of the
  condition, only half of those aware of the
  problem were being treated and only half of those
  treated were considered adequately treated.
•  
• The regarding the prevalence of the disease it is
  found to be present in 59.9 and 69.9 per 1000 in
  males and females respectively in urban while
  35.5 and 35.9 per 1000 in males and females
  respectively in rural population. (REF 2)
•  

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Sedentary life style

• Sedentary life style has crept into the lives of
  urban population. A normal workingman of a city
  hardly does any exercise which can be helpful to
  him so as keep him fit and healthy.
• More over the sedentary life style is also
  responsible for causing obesity, which again is a
  major risk factor for hypertension.
• Researches have showed that a person doing
  regular exercise can actually be free from most
  of the non communicable disease and this is a
  major break through for primordial prevention of
  most of the non-communicable diseases in the
  western world and with increasing prevalence of
  the diseases in India as well it would be really
  helpful in deciding the future trends.
•  
•  

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Smoking

• Smoking which is now looked as one of the style
  statements among people in India mainly those in
  the younger age groups and this is more alarming
  then any other preventable causes of many morbid
  conditions.
• Apart from causing lung cancer for which the
  association is already proved it also is a major
  cause of hypertension.
• Smoking causes carbon monoxide induced
  atherogenesis,
• Nicotine stimulation of adrenergic drive raising
  the blood pressure.
• It also causes decreased levels of High Density
  Lipoproteins, which are again very important.
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Methodology   Design of study this is a cross
sectional study as there was no follow up. Also,
this was a descriptive study as only the data
collected was analyzed. Study area the area of
study was V.S. General Hospital Out Patient
Dept. Subject known cases of hypertension, which
came for, follow up visit Sample size 200
hypertensives Sampling procedure randomly
selected first 200 known cases of hypertension
Study period 23rd June to 10th July Study
material we had pre-designed questionnaire to
include the history of risk factors under
study. Procedure After a taking permission from
concerned authorities, data was collected by
interviewing each patient, individually. By
data thus collected was compiled and after
compiling the data was computerized, refined and
analyzed using SPSS. Ethical considerations as
consent was taken from Dean of the college, Head
of Preventive and Social Medicine, Superintendent
of V.S. General Hospital. Limitation of study
the exact degree of hypertension wasnt known
since the patients were already taking the
anti-hypertensive drugs.                          
   
                                   

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      Observation  
Statistics  
      Above is the table under which the
collected data is analyzed upon i.e. the
variables, which we took under consideration.    
   
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  Hypertension and age wise distribution  
     
The pie chart above shows the percentage age
wise distribution of hypertensive patients The
maximum hypertensive patients are in age group in
50-60yrs. This goes to show relation of age with
hypertension.  
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Hypertension and sex wise distribution     SEX  
The Male Female ratio in case of hypertensive
patients is 1.381
The Male Female ratio in case of hypertensive
patients is 1.381
The Male Female ratio in case of hypertensive
patients is 1.381
     
The Male Female ratio in case of hypertensive
patients is 1.381
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  Hypertension and smoking  
The smoker non-smoker is ratio in hypertensive
patients is 37        
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  Hypertension among smokers and number of
cigarette/day  
     
The chart here shows that the hypertensive
patients among the group of gt20 cig/day is
maximum
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Hypertension among smokers and duration of
smoking      
The pie-chart here shows maximum no. of
hypertensive patients in the group of gt10yrs of
cig. Smoking
         
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Hypertension and sedentary life-style      
    The maximum no. of hypertensive patients are
those who are not doing any physical exercise the
ratio of exercising to sedentary life style being
322  
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  Statistics on smokers and sedentary life-style
among the study group      
    In percentages that is    
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      The table shows that people having
sedentary life-style and non-smokers are the
maximum in percentage The people who are having
no risk factor under study (sedentary life
style/smoking) are just 2 showing that these
people are those in whom there will be other risk
factor associated  
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For males the data is as follows
  In percentage that is    
    The interpretation here is that males are
having hypertension more than female in the study
because as we can see the percentage of males
having both the risk factors is 34.5 which is
much higher when compared with the whole group
(20)
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Discussion   FROM ABOVE DATA AND THE
OBSERVATIONS WE CAN CONCLUDE FOLLOWING
THINGS     ü                       THE
PREVALANCE OF HYPERTENSION AMONG THE STUDY GROUP,
IN THE TERMS OF GENDER WISE DISTRIBUTION IS 58
IN MALES AND 42 IN FEMALES.THE REASON FOR THIS
HIGH PREVALANCE AMONG MALES AS WE CAN SEE IS
BECAUSE OF MALES HAVING BOTH THE RISK FACTORS
IS MORE AND THUS GOES TO SHOW THAT THOUGH THE
NORMAL SEX DISTRIBUTION OF HYPERTENSION AS
DESCRIBED BEFORE SHOWS MORE FEMALE HYPERTENSIVES
FOR OUR STUDY GROUP THE SEX DISTRIBUTION IS
CHANGED WITH NO. OF MALE HYPERTENSIVES BEING
MORE. ü                       THE PREVALANCE OF
HYPERTENSIVES WHO HAVE A H/O SMOKING COMES OUT TO
BE JUST 30 WHILE THE REST 70 HYPERTENSIVES DO
NOT HAVE A H/O SMOKING                 
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ü                       MOREOVER TAKING INTO THE
CONSIDERATION THAT FEMALES WHO WERE HYPERTENSIVE
DID NOT HAVE A H/O SMOKING WE CONCLUDE THAT OF
ALL 116 MALES 60 HAVE A POSITIVE H/O SMOKING SO
51.72 OF THEM HAVE BEEN SMOKING ü                
       AMONG SMOKERS IF WE SEE THE ANALYSIS WE
CAN CLEARLY SEE THAT THE NUMBER OF SMOKERS WHO
HAVE BEEN SMOKING FOR MORE THAN 10 YEARS IS THE
HIGHEST. ü                       SIMILARLY THE
PEOPLE WHO HAVE BEEN SMOKING OVER 20 CIGARETTE A
DAY IS MORE THAN THE OTHER GROUPS.
ü                       THE PERCENTAGE OF
HYPERTENSIVE WITH SEDENTARY LIFE STYLE IS 88
WHICH IS MUCH HIGHER THAN THE PERCENTAGE OF THOSE
WHO ARE SMOKING. ü                       ALSO
WHEN WE SEE THE DATA IT IS CLEARLY EVIDENT THAT
THE STUDY GROUP HAS JUST 2 PEOPLE WHO HAD NO
RISK FACTOR INCLUDED IN THE STUDY SHOWING THAT
THE RISK FACTORS UNDER STUDY ARE SO VERY COMMON
AMONG THE POPULATION. ü                       THE
FEMALES OF THE STUDY GROUP HAD NO H/O SMOKING BUT
STILL WE SEE THAT THERE IS A CONSIDERABLE NO. OF
FEMALES WHO ARE HYPERTENSIVE BECAUSE MOST OF THE
FEMALES ARE HAVING SEDENTARY LIFE STYLE.
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RECOMENDATIONS   v  THE STUDY WAS TAKING UNDER
CONSIDERATIONS THE RISK FACTORS FOR HYPERTENSION
AND THUS ITS QUITE EVIDENT THAT RISK FACTORS
SHOULD BE CURBED DOWN SO AS TO DECREASE THE
OCCURENCE OF HYPERTENSION IN THE COMMUNITY. v 
THE IMPORTANT THING THAT WE INTERPRETED WAS THAT
MORE THAN SMOKING SEDENTARY LIFE STYLE IS A
MAJOR FACTOR FOR HAVING HYPERTENSION. v  THUS IF
WE MAKE DUE CHANGES IN OUR LIFE STYLE BY DOING
REGULAR EXERCISE WHICH CAN BE IN FORM OF
WALKING/JOGGING FOR MORE THAN HALF AN HOUR DAY,
THEN WE CAN HAVE A GREAT CHANGE IN THE PREVALNCE
OF HYPERTENSION. v  WELL ABOUT SMOKING WE CAN
JUST SAY SOME PEOPLE COMMIT SUICIDE AND OTHER
JUST SMOKE v  SMOKING IN ANY FORM CAN HAZARDOUS
TO THE HEALTH. THUS MORE EFFORTS ABOUT THE
AWARENESS OF THE SMOKING HAZARDS.  
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Bibliography            REF.1 Harrisons Text
book on Internal Medicine        REF.2 Text
book on Preventive and Social Medicine James
park    
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ANNEXURE         Ø   NAME Ø   AGE Ø   SEX Ø  
OCCUPATION Ø   RELIGION Ø   SMOKING IF YES NO.
OF CIGARETTES/DAY 1-10 11-20 gt20 DURATION
SMOKING 1-5 5-10 gt10 Ø   PHYSICAL EXECISE
(AS A MEASURE OF SEDENTARY LIFE STYLE)