Abdalla A. Saeed

Prevalence, Awareness, Treatment, and Control of Hypertension among Saudi Adult Population: A National Survey

This cross-sectional study aimed at estimating prevalence, awareness, treatment, control, and predictors of hypertension among Saudi adult population. Multistage stratified sampling was used to select 4758 adult participants. Three blood pressure measurements using an automatic sphygmomanometer, sociodemographics, and antihypertensive modalities were obtained. The overall prevalence of hypertension was 25.5%. Only 44.7% of hypertensives were aware, 71.8% of them received pharmacotherapy, and only 37.0% were controlled. Awareness was significantly associated with gender, age, geographical location, occupation, and comorbidity. Applying drug treatment was significantly more among older patients, but control was significantly higher among younger patients and patients with higher level of physical activity. Significant predictors of hypertension included male gender, urbanization, low education, low physical activity, obesity, diabetes, and hypercholesterolemia. In conclusion prevalence is high, but awareness, treatment, and control levels are low indicating a need to develop a national program for prevention, early detection, and control of hypertension.

Smoking habits of King Saud University students in Riyadh.

The smoking habits of 2264 students at King Saud University were investigated. Thirty-seven percent of the students smoked, and over a half smoked more than 15 cigarettes per day. Cigarettes were the main form of smoking. Most of the smokers knew about the hazards of smoking through the media and wished to stop smoking. Nonsmokers cited religious consideration and nonsmoking parents as the most important reasons for not smoking. A public health campaign is strongly recommended to reduce the prevalence of smoking.

Smoking behaviour and attitudes among adult Saudi nationals in Riyadh City, Saudi Arabia.

OBJECTIVE: To measure the smoking behaviour and attitudes among Saudi adults residing in Riyadh City, the capital of the Kingdom of Saudi Arabia. DESIGN: Cross-sectional survey. SETTING AND SUBJECTS: Primary health care centres (PHCCs) in Riyadh City were selected by stratified random sampling. Subjects resident in each PHCC catchment area were selected by systematic sampling from their records in the PHCCs; 1534 adults aged 15 years and older were interviewed during January to April 1994. MAIN OUTCOME MEASURES: Self-reported smoking prevalence; age of smoking initiation; daily cigarette consumption; duration of smoking; reasons for smoking, not smoking, and quitting smoking; intentions to smoke in the future; and attitudes toward various tobacco control measures. RESULTS: 25.3% of respondents were current smokers, 10.2% were ex-smokers, and 64.5% had never smoked. About 79% of all smokers started smoking between the ages of 15 and 30 years, and 19.5% before age 15. Significantly higher smoking prevalence and daily cigarette consumption were associated with being male, single, and being more highly educated. Relief of psychological tension, boredom, and imitating others were the most important reasons for smoking, whereas health and religious considerations were the most important reasons for not smoking among never-smokers, for quitting among ex-smokers, and for attempting to quit or thinking about quitting among current smokers. About 90% of all subjects thought that they would not smoke in the future. Physicians and religious men were identified as the most effective anti-smoking advocates by a much higher proportion of respondents (44%) than nurses, health educators, and teachers (each less than 5%). Health and religious education were generally cited as more effective in deterring smoking than tobacco control laws and policies. CONCLUSIONS: Cigarette smoking is prevalent among Saudi adults in Riyadh, particularly males, most of whom begin to smoke rather early in life and continue for many years. Health and religious education should be the cornerstone for any organised tobacco control activities, which are urgently needed to combat the expected future epidemic of smoking-related health problems.

Self-medication among primary care patients in Farazdak clinic in Riyadh

Four hundred and thirty new adult patients were interviewed using a questionnaire for their attitudes and practices regarding self-medication. 69% of the patients were males and 40% were Saudis. 58% of the patients attempted self-medication due to the triviality of their symptoms or to save time and money. They used mostly analgesics, vitamins, tonics and oral antibiotics. 41.6% of the patients did not practise self-medication because of lack of information about the drugs or for fear of complications. Self-medication was associated with literacy and morbidity. Literate patients self-medicated significantly more than illiterates. Patients who perceived their symptoms as minor self-medicated significantly more than those who perceived them as major. No association was found between self-medication and age, sex or occupation.

Smoking Habits of Students in Secondary Health Institutes in Riyadh City, Saudi Arabia

The smoking habits of all male and female students enroled in Riyadh Secondary Health Institutes of the Ministry of Health in 1990 were studied using a self-administered questionnaire. The overall smoking prevalence was 22%. Cigarettes were virtually the only form of tobacco used. Males smoked about twice the females in terms of prevalence (24% and 14%) and intensity (14 and 6 cigarettes per day). The majority of smokers for both sexes started the habit at or before the age of 16 years and the majority of them thought seriously about quitting and attempted to quit but only 12% of them were so far successful. Psychologic pressures, smoking contacts and foreign travel were important factors in relapsers. Religious, health and professional considerations were the most important motives for attempting to quit the habit among smokers and for not attempting the habit itself for the non smokers.

Aetiological factors contributing to road traffic accidents in Riyadh City, Saudi Arabia

The study analysed 13,390 police records of road traffic accidents (RTAs) covering a three and a half year period according to different suspected aetiological factors. The majority of the accidents were recorded for vehicles in good condition on well-paved straight roads with well-operating traffic light systems. Adverse weather conditions such as precipitation, fog and dust were of minimal importance, with most of the accidents being reported during sunny days during the rush period of 12 noon to 3 pm. Drivers error was identified as the main contributing factor in about two thirds of all RTAs mainly as reckless driving and excess speeding. About 27% of the drivers were professional drivers and 41% were in the age group 25-35 years in good health with no alcohol or drug intake. Hence, human errors may be attributed to carelessness, experience, lack of knowledge or attention, over-exhaustion or fatigue. The effects of physical stressors on performance of drivers need to be further explored and clarified but this need not under estimate the importance of vehicle and environment since most accidents are multifactoral and a slight change in them may effectively enhance perception and minimise personal error. Recommendations for remedial measures adopting an interdisciplinary approach are presented.

Smoking Habits of Students in College of Allied Medical Sciences, Riyadh

INTRODUCTION PIDEMIOLOGICAL AND research evidence ~ from different parts of the world have stressed the importance of tobacco use particularly cigarette smoking as a cause or as an important factor in the causation and deterioration of many diseases. These include lung cancer, chronic bronchitis, coronary insufficiency, abortion, low birth weight, premature labour, foetal death, peptic ulcer, in addition to cancer of the tongue, larynx, oesophagus, and bladder’. Experimental studies proved the prescence of carcinogenic and irritating materials in tobacco tar. These serious effects of tobacco are not only effecting the smokers alone. There is increasing evidence that inhalation of smoking fumes by non-smokers (passive smokers) is causing them many health problems2~3. On the other hand it has been estimated that 30% of the health care costs among cigarette smokers are directly related to the habit of smoking and 10% of all health care costs are smoking related4. The prevalence and intensity of smoking is decreasing in some developed countries due to the realisation of these facts. Unfortunately the reverse is happening in the developing countries and many authorities warned about the serious implications of the coming smoking epidemic1,s. Well designed and implemented anti-smoking campaigns can be rewarding in controlling such an epidemic if the people participating in them are nonsmokers. One of the most important sectors of any community that can play a key role in anti-smoking measures is the health profession. Unfortunately many health workers are smokers and this greatly handicaps their role as exemplars, motivators and teachers in the prevention of the adoption of the smoking habit or helping in stopping it. This study is an attempt to collect data about the smoking habits and attitudes of Allied Medical students who constitute a large sector of future health workers. The study can help as a pilot study for a much larger scale study on smoking habits among health professionals in Riyadh and Saudi Arabia. The main objective of such studies is to collect reliable information which can help in spelling out strategies for preventing future and present health personnel from acquiring the smoking habit and help those who acquired it to abandon it. Then these non-smoking health workers can act effectively in anti-smoking activities.

Isolated Diastolic Hypertension among Adults in Saudi Arabia: Prevalence, Risk Factors, Predictors and Treatment. Results of a National Survey

BACKGROUND In the past, diastolic hypertension was the main criterion for treatment, but currently, systolic pressure is the main criterion because it was thought that Isolated Diastolic Hypertension (IDH) is not associated with complications. Studies later revealed that IDH carries significant risks. Quantifying the magnitude and risk factors of IDH in the community is essential for all intervention strategies. AIMS This study aims to determine the prevalence, risk factors, predictors, treatment modalities and lifestyle practices of IDH adult patients in the Kingdom of Saudi Arabia (KSA). STUDY DESIGN Cross-sectional study. METHODS A community-based cross-sectional study using STEPwise approach among adults using a multistage, stratified, cluster random sample was carried out. Data were collected using questionnaires which included socio-demographics, blood pressure, biochemical, anthropometric measurements and lifestyle practices. Statistical analysis included calculating means and standard deviations, proportions, univariate and multiple logistic regression analysis. RESULTS Of a total 4562 subjects, 180 (3.95%) suffered from IDH, which was significantly related to age, gender, employment, smoking, diabetes mellitus, obesity and hypercholesterolemia. More than 93% were using some form of treatment, with 77.2% on prescribed drugs, 63% using diet, and 23% using exercise. Significant predictors of IDH were retirement and hypercholesterolemia. CONCLUSION IDH is associated with some sociodemographic characteristics and co-morbidity. Given the risk of cardiovascular disease associated with IDH, the findings of this study emphasize the need for diagnosing the disease in middle-aged persons focusing on the modifiable risk factors of IDH.

Anthropometric risk factors and predictors of hypertension among Saudi adult population - a national survey.

This cross-sectional study aimed at determining the anthropometric predictors of hypertension among adults in Saudi Arabia. Multi-stage stratified sampling was used to select 4758 adult participants. The average of three blood pressure measurements using an automatic sphygmomanometer was considered the real blood pressure. Anthropometric measurements and socio-demographics were obtained from participants. The overall prevalence of hypertension was 25.5%. Hypertension was significantly positively associated with selected anthropometric measurements. Selected anthropometric measures were significant predictors of systolic and diastolic blood pressures except for hip measurements. Waist for height ratio was a significant predictor for isolated diastolic hypertension and combined systolic and diastolic hypertension. Waist circumference was the significant predictor for isolated systolic hypertension. Body mass index was a significant predictor for the combined systolic diastolic type. Waist for Hip Ratio was not a significant predictor for any of the hypertension subtypes. Conclusion: Waist for height ratio is the most important predictor for blood pressure level and hypertension disease.

Pilgrims satisfaction with ambulatory health services in Makkah, 2008.

Objective: The main objective of this study was to assess the level and correlates of patients’ satisfaction with ambulatory health services provided for pilgrims during Hajj period in 2008. Materials and Methods: This was a facility-based, cross-sectional study conducted in the Makkah region during the Hajj season in December 2008. A two-stage technique was used to select 500 patients from those who attended the ambulatory health services. One hundred subjects were selected by systematic random sampling (every fifth) from each of the five hospitals included in the study and asked to fill in a pilot-tested self-administered questionnaire. A total of 487 questionnaires were analyzed. Descriptive statistics and t-test, Mann Whitney test and ANOVA, or Kruskal-Wallis test was used as appropriate after checking for normality. Level of significance level was set to be <0.05 throughout the study. Results: From 478 subjects analyzed, 390 (81.6%) were man, 345 (72.2%) were married, 28.9% had either intermediate or high secondary school education, and 2.4% were skilled laborers. The total satisfaction score for health facilities was 20.45 ± 4.03 of 25. The satisfaction scores were 20.15 ± 4.7 of 25 for patient satisfaction with physicians and 21.35 ± 4.5 for patient satisfaction with paramedical personnel. The overall satisfaction score was 61.5 ± 4.5 of 75 points. There were significant relations between total satisfaction of health facilities with education level and with occupation (P = 0.012, 0.001, respectively). The total satisfaction of patients with physicians was significant only with education level. The overall satisfaction score had a significant relation with occupation (P = 0.03), but a borderline relation with the education level (P = 0.056). Conclusion: Satisfaction with ambulatory Hajj health services is acceptable. Some physicians and waiting area services need special attention to improve satisfaction levels with ambulatory health in the subsequent Hajj seasons.