Loung V Umedani, Muhammad Ishaq Aiwan, Usman Ahmad, Vikram K Mehraj, Philippe M Frossard.
Prevalence of cardiovascular diseases and essential hypertension in the desert area of Thar.
Pak J Med Res Jan ;49(3):63-70.

Background: Globally essential hypertension and cardiovascular diseases are associated with high morbidity and mortality due to unhealthy life styles and lack of preventative measures. In some ethnicities these factors are insignificant due to genetic makeup favoring protection against these diseases. Objectives: To study the prevalence of risk factors for essential hypertension in the Pakistani population of a desert area of Thar. Subjects and Methods: A random cross sectional study was done from 2002 to 2008 on 276 subjects (126 males, 150 females) in Islamkot-Thar, the desert area of Sindh. Data for anthropometric, demographic, socioeconomic, dietary pattern, basal metabolic index, body fat content, antihypertensive use and psychosocial factors were recorded. Three consecutive readings for blood pressure were taken in 15 minutes. Any systolic blood pressure of over 140mm Hg and diastolic of over 90mm Hg in all 3 readings was taken as hypertension. Study population was divided in hypertensives (patients) and non hypertensives (controls). Data were analyzed in two steps clinically, descriptively and inferentially using SPSS version 14, first for entire population and second by breaking this population into two sub ethnicities having no consanguinity in them. Results: Hypertension was seen in (10.9%) cases while 88.4 % were normotensive. Hypertensive group showed increased association of risk factors e.g. male gender, old age, marriage, moderately high monthly income, lack of exercise, low leisure time activity, prolonged tobacco exposure, parental history, high basal metabolic index profile, intermediate body fat content and stressful job. However, this group showed lack of association of factors like alcohol, extra salt, scarce education and stress. Decrease association with saturated fat was seen as compared to oil (20.7% versus 79.3%). Subethnicity analysis of the two communities, both having no consanguinity showed one group to be suffering from essential hypertension (17%) and its comorbids like diabetes mellitus (11.4%), asthma (6.5%) and stroke (0.6%) while the other group lacked all these findings. Conclusions: Despite similar coexisting conditions different genetic makeups predispose one subethnicity to normal and the other to hypertensive phenotype. Molecular studies on this population are needed to reconfirm the present clinical conclusion.

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