Department of Physiology

Permanent URI for this collectionhttps://ugspace.ug.edu.gh/handle/123456789/42317

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    Blood Pressure Variability Indices and Self-Reported Quality of Sleep Among Adolescents Living with HIV
    (University of Ghana, 2023) Kofi,A.
    Background: Children and adolescents living with HIV (ALHIV) are highly prone to develop cardiovascular diseases (CVDs) in the future. Blood pressure is a predictor for future development of cardiovascular diseases. Ambulatory Blood pressure indices predicts changes in blood pressure better than Office blood pressure. However, most healthcare facilities in Ghana use Office BP and Ambulatory blood pressure has not been used a lot. Most research evaluating the relation between HIV and blood pressure (BP) measurements have mainly focused on the conventional sphygmomanometric method, which carries a significant risk of human error and inaccuracy and does not accurately reflect the blood pressure characteristics of HIV positive patients BP variability Ambulatory blood pressure monitoring (ABPM), is a key instrument for evaluating blood pressure variability (BPV) which is a predictor of hypertensive end-organ damage. This study is a novel study and there is scanty literature on evaluating Blood pressure variability among ALHIV. This study may provide data and literature on blood pressure variability indices and self-reported sleep to help in the management of cardiovascular risk among ALHIV. Cardiovascular disorders among children and adolescents may also be contributed by poor sleep quality. Blood pressure changes over a 24-hour period might occur in HIV positive patients who have sleep disturbances. Lack of sleep may cause sympathetic activity to rise, which could raise blood pressure. General aim of study: The study aims to investigate the relationship between 24-hour ambulatory blood pressure variability indices and self-reported sleep quality among adolescents living with HIV. Methods: A cross-sectional study design was employed for this study. A cluster-randomized sampling technique was used to recruit health facilities and 122 adolescents living with HIV (ALHIV). A 24-hour ABPM was performed using a validated portable ABPM 50 device with the BP readings set at 15 minutes intervals, from 7 am to 10 pm for daytime, and 20 minutes intervals during the night, from 10 pm to 6 am. The Pittsburg Sleep Quality Index (PSQI) Questionnaire was used to assess the quality of sleep. Anthropometric measurement of participants was also conducted. Body weight (in kilograms) and height (in meters) were taken for the calculation of Body mass index (BMI). Variables such as Self-reported sleep quality, BMI, and ART regimen was held as independent variables while Beat-to-beat BPV variables and circadian variability variables were held as dependent variables Results: Ages of participants were from 6 years to 19 years; with a mean age of 13.6 ± 3.2 years. The males were (N=56(45.9%)) and the females were (N=66 (54.1%)). Most of the females (N=32(48.5%)) were aged 14 years and above. Females (N=21(31.8%)) had a healthier BMI compared to males (N=18(32.1%)). There was no significant relationship between gender and BMI of participants, p value= 0.25. Relationship between gender and antiretroviral therapy (ART) regimen was not significant, p-value=0.304. For sleep quality comparison among genders, most females reported poor sleep quality, (N=18(27.3%)). Most females had good sleep quality (N=48(72.7%)). Hypertension was reported among (N=13 (10.6)) of which (N=2 (1.64%) reported Hypertension stage 1 (>=pct90 and (pct99+5 mmHg/ 0.05. The p-value for the association between self-reported sleep and circadian variability (Nocturnal dip, p value=0.984, BP surge, p-value = 0.695). Findings from this study showed a significant association between cardiovascular outcomes and blood pressure variability. Cardiovascular outcomes of ALHIV was determined by ambulatory systolic blood pressure and office systolic blood pressure levels. For Ambulatory BP levels, study showed Blood pressure variability; Awake SD BPV increases with increasing ambulatory and office blood pressure, at an R-Squared value = 0.038 and p-value =0.03. Conclusion: Blood pressure variability may have a relationship with cardiovascular outcomes among ALHIV. Findings from this study shows that, as blood pressure variability increases, there is a tendency for blood pressure to also rise. Self-reported sleep quality did not have any significant association with short term blood pressure variability and circadian variability. ART and BMI showed some association with blood pressure variability. The study showed that most ALHIV have elevated blood pressure.
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    Metabolic Syndrome And Generalized Anxiety Disorder Among Young Adult Ghanaians
    (University of Ghana, 2020-11) Baah, R.A.
    Background: Mental health has been associated with cardiovascular diseases (CVDs) in several studies. Negative affective disorders like generalized anxiety disorders (GAD) and depression are common in patients with CVDs. Depression and GAD can be screen in epidemiological studies using simple standardized questionnaires, GAD-7 and patient health quaestionnaire (PHQ)-9. Metabolic syndrome is the clustering of risk factors for CVDs such as obesity, insulin resistance, hyperglycaemia, hypertension and dyslipidaemia in an individual. The presence MetS is a strong predictor of future development of CVDs. The relationship between MetS and GAD has not been reported in the Ghanaian population. This study investigates MetS in young Ghanaian adults and its relationship with GAD and depression. General Aim: The aim of this study is to investigate the association between MetS and GAD as well as depression in young adults. Methodology: The study was a cross-sectional design involving 364 young adults, aged 20- 30 years, and recruited from Jamestown in the Accra Metropolis. The gender composition of the study participants were 174 (47.8%) males and 190 (52.2%) females. The study participants were interviewed using a structured questionnaire for socio-demographic and lifestyle information. GAD-7 and PHQ-9 instruments were used to screen GAD and depression, respectively. Anthropometric indices such as body fat, visceral fat, weight, height, waist and hip circumferences were measured. Blood pressure was measured using semiautomated blood pressure monitor. 10 millilitres of venous blood was collected and analysed for fasting plasma glucose, lipids and triglyceride. MetS was defined using the harmonized joint interim statement criteria. Results: The overall prevalence of MetS among the participants was 27.96%, with the female participants showing a higher prevalence of metabolic syndrome as compared to their male counterparts (37.4% vs 18.4%, p<0.001). Compared to the female participants, the male participants had high current alcohol use (33.9% vs 9.5%, p<0.001) as well as high current smoking status (13.2% vs 1.6%, p<0.001). The female participants had higher levels of systolic (119 }13 vs 113 }11, p< 0.001), diastolic (76 }10 vs 74 }8 p=0.002), pulse (76 }10 vs 74 }8, p=0.002) and mean (91 }10 vs 87 }8 p<0.001) as compared to their male counterparts. The prevalence of GAD was 39.6 % in all study participants, with females having more representation in mild anxiety category and males being presented more in moderate anxiety category. MetS was independently associated with mild [odd ratio (OR)=3.16 (1.04 – 9.59), p=0.042] and moderate [OR=1.57 (1.08 – 2.68), p=0.034] in multinominal logistic regression models. No association between depression and MetS was found. Conclusion: There is high prevalence of MetS in our study participants, with more females having MetS compared to males. GAD was also common among young adults and it is independently associated with MetS in the study population.