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Issue 7 Statistical News

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Welcome to theseventh

Statistical

Newsletter issued by theStatistical Analysis Section, Planningand Statistical Department. On theoccasion of the World Heart Day,the Statistical Analysis Section hasthe honor to release a StatisticalNewsletter that discussedhypertensive diseases in Dubai,mortality of Cardiovascular diseasesand hypertensive disorders inpregnancy.

Hope the newsletter provesbeneficial with regards to your

profession. Your comments arewelcome.

Publi shed by: Stati stical Analysis SectionI ssue: 7

July - Sep 2006

HHHyyypppeeerrrttteeennnsssiiivvveee DDDiiissseeeaaassseeesss iiinnn DDDuuubbbaaaiii

Raised blood pressure is a massive health problem in almost every country. It is one of themost important underlying riskfactors for morbidity and mortality in the world today, ranking

alongside tobacco in estimates of the worldwide attributableburden of mortality. Populationstudies suggest that blood pressure in excess of 140/90 mmHg is found in nearly 30% ofadults. In addition, Hypertension is already a highly prevalent cardiovascular risk factorworldwide because of increasing longevity and prevalence of contributing factors such asobesity. Whereas the treatment of hypertension has been shown to prevent cardiovasculardiseases and to extend and enhance life, hypertension remains inadequately managedeverywhere

(1-5).

Cardiovascular diseases (CVD) amounted to 28% of all deaths in UAE in 2003. In Dubai, itamounted to 31.4% of all deaths in 2005. Inpatient cardiovascular diseases amounted to3919 (8.49%) of all admitted cases in DOHMS in 2005. Hypertensive diseases constituted9.8% of all the admitted cases of CVD in DOHMS and were more frequent among females(17.0%). It is one of the ten leading causes of death among Emirates in 2005.

There were 386 cases admitted in DOHMS, 147 (38.1%) were Emirates and 61.9% were

Expatriates, (Figure 1). Among the Emirate population, 72 (49.0%) were males and 51.0%were females. The frequency distribution of hypertension increased with increase in age, buthypertension was more prevalent among females in the age group 45-64 years and males inthe age group 65 years and above.

Out of 237055 outpatient cases diagnosed by specialist in DOHMS in 2005, there were 13497cases of CVD with a rate of 5.7%. Hypertensive diseases amounted for more than two fifthsof the cases (43.46%). Studying hypertensive heart diseases among persons diagnosed byspecialist, there were 1132 (45.24%) males and 1371 (54.77%) females. The frequencydistribution of the diseases increased with increase in age. There was a significant differencebetween males and females regarding distribution of hypertensive heart diseases by age,(P=0.02).I nside this issue:

Hypertensive Diseases in Dubai

Cardiovascular Diseases mortality

Hypertensive Disorders in

pregnancy

The mean age for Emirates population was 61.21 13.08. It was 62.62 13.01 years for

males and 60.44 13.07 for females. This difference is significant. The mean number of visitwas 2.44 1.67 visits with no significant difference between males and females. Studying thedistribution of hypertensive diseases by type, essential hypertension amounted to 93.0%,hypertensive heart disease, renal heart disease (3.7%) and secondary hypertension 3.3%,(Figure 2). There was a significant difference between males and females in the distributionof hypertensive heart disease by type.

Figure (2) Distribution of Hyper tensive Heart Diseases in DOHMS

among Emirat e Outpatient s to Specialist Clinics, Dubai 2005

93%

4% 3%

Essent ial Heart & Renal Secondary

Figure (1) Distr ibut ion of Hypertensive Heart Diseases among

Inpat ients in DOHMS by Nationality in 2005

38%

62%

Emirate Expatriate

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Issue 7 Statistical News3

Conclusion:

The results of the study show that Dubai people, those aged 55 years and cerebrovascular disease cases were at anincreased risk of death from CVD. There is a need to developand implement a plan for the management and control of CVDin Dubai

References:

1. Clinical guidelines for the management of hypertensionhttp://www.emro.who.int/publications/Book_Details.asp?ID=191

Table (3) Point Estimate of Cardiovascular Diseases Mortality in

DOHMS by Cert ain Epidem iologi cal Variabl es, Dubai 200 0- 20 06

Variable Point Estimat e P

Age

(55 years v. < 55

years)

2.55(1.53, 4.24) 0.0003

Diagnosis

(CerebrovascularDiseases v. other CVD)

5.83 (4.09, 8.3) 0.001

Dubai PopulationDubai v. OtherEmirates

2.41 (1.47, 3.96) 0.005

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It amounts to 7 per thousand of all admitted cases in 2005 inDOHMS. The mean age of the studied cases was 30.85 5.7years. Pre-existing hypertension amounted to 3.2% of thecases, 24.2% were gestational hypertension, 0.9% eclampsiaand 70.24% were unspecified material hypertension. Emiratesamounted for 54.46% of the cases.

Table (1) shows that hypertensive disorders in pregnancyamounted for 1.98% of all cases admitted in pregnancy,childbirth and puerperium period among those below 35 and3.27% in the age group 35 years and above. This difference issignificant. Expatriates had higher percentage (2.52%) ofhypertension diseases in pregnancy than nationals (1.99%) witha significant difference (P=0.02).

Table (2) shows that pregnant women aged 35 years and abovehad more than one and half times increased risk of hypertensionthan those below 35 years (cOR=1.677 (1.32, 2.14), P=0.0001).Expatriates had more increased risk than Emirates (cOR=1.27(1.02, 1.58), P=0.02). By applying logistic regression model,

adjusted risks associated with those aged 35 years and aboveand Expatriates were significantly increased compared to thedifferent relevant categories, Table (3).

Table (1 ) Summ ary characteristics of Hypert ensive disorders inPregnancy in DOHMS according t o Some Epidemiol ogical

characteristics, Dubai 200 5

Variable Value Significance

Age (% of hypertension)

< 35 years 1.98 x2= 17.72

35 years 3.27 P = 0.000

Nationality (% of hypertension)

Emirates 1.99 x2= 4.78

Expatriates 2.52 P = 0.0288

Table (2) Crude Odds Ratio of Hypertensive disorders inPregnancy in DOHMS hospital by certain Epidemiological

variables, Dubai 2 005

Variable Crud e Odds Ratio x2 P

Age

35 years v. < 35years 1.677 (1.32, 2.14) 17.22 0.0001

Nationality

Expatriates v. Emirates 1.27(1.02, 1.58) 4.78 0.029

Table (3) Point Estimat e of Hypertensive disorders in Pregnancyin DOHMS by Certain Epidemi ological Variabl es, Dubai 20 05

Variable Point Estimat e P

Age

35 years v. < 35 years 1.656 (1.29,2.11) 0.001

Nationality

Emirates v. Expatriates 0.796 (0.64, 0.99) 0.003

http://www.emro.who.int/publications/Book_Details.asp?ID=191http://www.emro.who.int/publications/Book_Details.asp?ID=191