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PubMed1992

Perception of malocclusion in 11-year-old children: a comparison between personal and parental awareness.

In orthodontic counselling an understanding of how individuals perceive their occlusal features is important to ensure effective communication and for provision of adequate advice on treatment need. The purpose of the present study was to assess personal and parental awareness of malocclusion in children, and to examine whether agreement existed between children and their parents on assessments of malocclusion traits. Of 104 randomly selected fourth-grade children 99 presented themselves at a public dental clinic. Ninety-three accompanying parents attended. Awareness was assessed by comparing the opinion of parents and children on the presence or absence of anterior malocclusion with direct measurements on dental study casts. The subjects' abilities to identify a polaroid of the child's dentition in a panel of 17 alternative photographs were also used as a measure of awareness. The findings revealed a moderate level of awareness among both the children and their parents. About half of the children and the parents identified the child's photograph on the first attempt. About three-quarters of the traits recorded as marked/severe malocclusion and about half of the mild/moderate traits were recognized. A significant association existed between the number of correct reports on traits given by the children and the parents. However, agreement across professional, child, and parental assessments varied for the different traits. The results indicated that the individual's comprehension of professional terms may be unclear and that professionally defined cut-off points often do not coincide with norms existing within the actual family unit.

Attitude to Health↗

PubMed2005

Environmental tobacco smoke in Norwegian homes, 1995 and 2001: changes in children's exposure and parents attitudes and health risk awareness.

BACKGROUND: The aims of the present study were to assess changes between 1995 and 2001 in the prevalence of child exposure to environmental tobacco smoke (ETS), attitudes towards ETS among parents of small children and awareness among parents regarding the potential hazards of passive smoking to children. METHOD: A questionnaire, along with a stamped, addressed envelope, was sent to a stratified random sample of 1000 households in Norway containing children aged 3 years old at the time of the investigation (May 1995 and August 2001). RESULTS: The prevalence of households containing smokers was similar in the two study periods. However, households reporting exposure of children to ETS fell from 32% in 1995 to 18% in 2001. Health-risk awareness had significantly increased in households containing smokers. In both surveys, the probability of children being exposed to ETS was positively correlated with the number of parents smoking, and inversely correlated to strength of health-risk awareness, negative attitudes towards ETS and length of household education. CONCLUSIONS: Increasing parents' awareness of the health risk of ETS exposure to children may significantly reduce children's ETS exposure.

Adult↗

PubMed1988

Community size differences in service awareness among elderly adults.

This article presents findings on community size differences in the awareness of eight services for a sample of 600 elderly persons living in two countries containing a continuum of locales ranging from nonmetropolitan farm areas to the central city of a metropolitan area. The data were collected via indepth personal interviews, and indicate that the total number of services known by elderly persons is related directly to community size. Multiple-regression analysis revealed that community size is the strongest predictor of overall service awareness. However, variation in the awareness of individual services found for elderly residents of different community sizes suggests that the role this variable plays in service awareness is not as straightforward as is often assumed.

Aged↗

PubMed1997

Awareness of deficit in Alzheimer's disease: relation to caregiver burden.

Patients with Alzheimer's disease (AD) show varying degrees of awareness of their deficits. To examine the impact of this phenomenon upon the distress experienced by family caregivers of AD patients, we analyzed caregiver burden in relation to patient awareness of deficit in three different functional domains. The relationship of burden to selected sociodemographic variables was also explored. Results of multiple regression analyses suggested that caregiver burden was associated with impaired patient awareness of memory deficit independent of disease stage and dementia severity. The findings suggest that impaired awareness may be an important mediator of caregiver burden, a concern in the management of AD.

Activities of Daily Living↗

PubMed2001

Stages of change, psychological factors and awareness of physical activity levels in The Netherlands.

The purpose of this study was to investigate physical activity levels, stages of change, awareness, and differences in psychological factors relating to physical activity in an adult Dutch population, in order to identify specific objectives for physical activity promotion. Physical activity levels, self-rated physical activity, stages of change, awareness, attitudes, social influences and self-efficacy relating to physical activity were assessed among a random sample of 2608 adults using structured questionnaires. Almost 60% of the respondents did not meet the recommended target for physical activity to promote health. Half of these respondents were in the pre-contemplation stage, and >60% were overestimating their physical activity level. Furthermore, respondents who were not aware of their inadequate physical activity level had a less positive intention to increase their level of physical activity than those who rated their own physical activity level as low. Respondents in the pre-contemplation and maintenance stages had a less positive attitude, perceived less social support and had lower self-efficacy expectations towards increasing physical activity than those in the contemplation, preparation and action stages. The results suggest that interventions aimed at increasing physical activity in the studied population should be aimed at increasing awareness of personal activity levels and should be stage-matched.

Adolescent↗

PubMed2005

Fertility awareness, intentions concerning childbearing, and attitudes towards parenthood among female and male academics.

BACKGROUND: Postponing childbirth is becoming increasingly common in Western countries, especially among groups with higher education qualifications. It is relatively unknown to what extent women and men are aware of the age-related decline in female fertility. The aim was to investigate university students' intentions and attitudes to future parenthood and their awareness regarding female fertility. METHODS: Postal survey of a randomly selected sample of 222 female (74% response) and 179 male (60% response) university students. RESULTS: Female and male university students in Sweden have largely positive attitudes towards parenthood and want to have children. Women, in comparison to men, were significantly more concerned about problems related to combining work and children. Both women and men had overly optimistic perceptions of women's chances of becoming pregnant. About half of women intended to have children after age 35 years and were not sufficiently aware of the age-related decline of female fecundity in the late 30s. CONCLUSIONS: University students plan to have children at ages when female fertility is decreased without being sufficiently aware of the age-related decline in fertility. This increases the risk of involuntary infertility in this group, which is alarming in view of the great importance they put on parenthood.

Age Factors↗

PubMed1998

Initial disturbances of consciousness and resultant impaired awareness in Spanish patients with traumatic brain injury.

The purpose of this prospective, between-subjects study was to look at impaired awareness cross-culturally in patients with traumatic brain injury (TBI) and to relate impaired awareness after injury to the initial estimates of disturbed consciousness at time of injury. The study was conducted in community and inpatient and outpatient rehabilitation centers in Barcelona and Madrid. Participants were 30 persons with primarily moderate to severe TBI who could complete a written questionnaire concerning their functioning and 28 age- and gender-matched controls. A Spanish translation of the Patient Competency Rating Scale (PCRS) was administered to each participant. Relatives or significant others also completed this scale on each participant using the relative's version (PCRS-R). Difference scores, obtained by subtracting PCRS-R from PCRS-P (PCRS-P minus PCRS-R), were used as a marker of impaired awareness. Individuals with TBI were rated (by self and significant others) as being less competent than controls. Forty percent of Spanish patients with TBI who suffered severe injuries tended to overestimate their behavioral competencies. The PCRS-P minus the PCRS-R difference scores tended to correlate with admitting Glasgow Coma Scale (GCS) scores and retrospective estimates of posttraumatic amnesia (PTA). Initial disturbances of consciousness, one measure of severity of brain injury, appeared to relate to later measures of impaired self-awareness in Spanish patients with TBI. Non-brain-injured controls did not tend to report levels of competency that differed from their relatives' reports.

Adult↗

PubMedDate not supplied

Executive function and self-awareness of "real-world" behavior and attention deficits following traumatic brain injury.

OBJECTIVE: To investigate the relationship between executive function and awareness of real-world behavioral and attentional dysfunction in persons with moderate and severe traumatic brain injury (TBI) and uninjured controls. DESIGN: Observational 2-group study. PARTICIPANTS: Thirty-six persons with moderate to severe TBI and residual cognitive deficits, recruited from therapy programs and the community, and 30 uninjured control participants of similar age, education, gender, and race. MEASURES: Eight clinical measures of executive function were combined in a composite score, the Executive Composite (EC). Awareness of behavioral and attentional lapses in everyday life was estimated using Self and Significant Other (SO) ratings on the Dysexecutive (DEX) Questionnaire and the Cognitive Failures Questionnaire (CFQ). RESULTS: Participants with TBI scored significantly worse on the EC than control participants and exhibited impaired self-awareness (ISA) compared to controls. Control participants agreed closely with their SOs on both the DEX and CFQ scales, whereas the SOs of TBI participants reported significantly greater degrees of difficulty on both scales than was endorsed by participants with TBI. Low-EC scorers within the TBI group had significantly worse ISA than controls, lending support to the hypothesis that executive function is related to ISA in chronic, moderate to severe TBI. Executive function and discrepancy scores demonstrated a modest but statistically significant association across the sample. CONCLUSION: Although executive function was associated with ISA in this sample, further research is needed to determine whether executive function deficits contribute in a causal fashion to ISA, and which of the cognitive operations within executive function are responsible for supporting self-awareness.

Adolescent↗

PubMedDate not supplied

Colorectal cancer prevention and screening: a Health Belief Model-based research study to increase disease awareness.

The purpose of this quasi-experimental study was to evaluate the effects of a Health Belief Model-based colorectal cancer (CRC) education session on adult participants. Education sessions were conducted at a site chosen by the participants, such as their homes, in a mid-sized, mid-Western city. Thirty-one Caucasian adults participated. Eleven were men (35%) and 20 were women (65%). Study results reveal that the education sessions were an effective way to promote awareness of CRC prevention and screening. The participants' responses reflected a positive and significant (p < .0001) improvement in all areas except beliefs regarding maintenance of a healthy weight (p = .0574). The greatest effect was on men, current smokers, and those with a high school education or less. Education sessions were equally effective for auditory and visual learners. The 31 participants planned to share the information with at least 32 other individuals. The participants acquired an increased awareness of CRC prevention and screening. Willingness to discuss CRC after the education sessions may be significant, especially because the others may, in turn, share the information. Nurses need to be aware of CRC screening guidelines. The impact of patient teaching on this health promotion effort may reach beyond the patients who were in contact with the nurses. Public awareness might be further increased when patients share this information with others.

Aged↗

PubMed1989

Patient experiences during respirator treatment--reason for intermittent positive-pressure ventilation treatment and patient awareness in the intensive care unit.

Patient awareness of intermittent positive-pressure ventilation (IPPV) treatment in the ICU was studied in 304 patients. These ICU patients were divided into three groups: those treated for internal medical diseases (IMD; n = 129), patients admitted after major surgical procedures (MSP; n = 126), and patients treated for trauma (T; n = 49). All patients were interviewed 2 months to 4 yr after IPPV treatment. The IPPV period was recalled by 52% of all patients. The awareness of the treatment was similar in the IMD (51%) and MSP (59%) groups, but was significantly lower in the T group (37%; p less than .01). The ability to recall the IPPV treatment was reduced in patients with head injuries, those unconscious on admittance, and in elderly individuals. Treatment awareness was found to increase with the duration of the IPPV period in the IMD and T groups. Preoperative information of the treatment, given to elective surgical patients in the MSP group, did not increase treatment awareness.

Adult↗

PubMed1993

Clinical and medicolegal aspects of conscious awareness during anesthesia.

In summary, regarding the legal aspects of awareness during anesthesia, the questions for the court to answer are: Was the patient aware? If probably yes, did the anesthesia technique cause or materially contribute to the awareness? Alternatively, if res ipsa loquitur applies, can the anesthesiologist show that the technique was not negligent, if necessary by showing that it would have been acceptable to at least a responsible minority of practitioners? It will be clear from the foregoing that good recordkeeping cannot be overemphasized. Apart from the fact that a precise and clear record tends to convince the court that they are dealing with a careful practitioner, the most important factor is that the more you have recorded about the anesthesia course, the more you will be able to tell the court about it. Finally, if you are unfortunate enough to lose and the patient is awarded damages, how much will the patient get? In the United Kingdom recently, $20,000 was awarded to patients for awareness in orthopedic and obstetric cases--perhaps a modest amount by U.S. standards. If the patient develops posttraumatic stress disorder, a much larger award is likely, especially if the patient is unable to work as a result of it; loss of earnings always increases an award, and it could easily reach $750,000 for a big earner. Insurance or other indemnity should cover this, of course, but it pays to remember one's likely exposure to risk in the event of failing to pay one's premium.

Anesthesia, General↗

PubMed1994

Prevalence, awareness, treatment and control of hypertension in a population over the age of 65 years: results from the Starnberg Study on Epidemiology of Parkinsonism and Hypertension in the Elderly (STEPHY).

OBJECTIVE: To assess the prevalence of hypertension and isolated systolic hypertension and the level of awareness, treatment and control of hypertension, in a population aged over 65 years. DESIGN: Cross-sectional survey of the total population aged > or = 65 years of two Bavarian villages with a representative age distribution. PATIENTS: From a total of 1190 inhabitants aged > or = 65 years, 982 (394 male, 588 female) participated (response rate 82.5%). METHODS: All of the participants were visited at home by physician observers. After a standardized questionnaire, blood pressure was measured three times on one occasion with the subject in the sitting position, using a standard mercury sphygmomanometer. 'Actual' hypertension was defined as systolic blood pressure (SBP) > or = 160 or diastolic blood pressure (DBP) > or = 95 mmHg, or both, or current use of antihypertensive drugs given for the indication hypertension in patients with blood pressure < 160/95 mmHg. Isolated systolic hypertension was defined as SBP > or = 160 and DBP < 90 mmHg. All 'actual' hypertensives were further classified as 'unaware' of hypertension, 'aware' (but not treated), 'treated' (current use of antihypertensive drugs for the indication hypertension and blood pressure > or = 160/95 mmHg) or 'controlled' (treated and blood pressure < 160/95 mmHg). RESULTS: Mean +/- SD blood pressure was 154.5 +/- 24.4/84.9 +/- 11.6 mmHg (when 52 institutionalized participants were excluded, 155.6 +/- 24.4/85.3 +/- 11.6 mmHg). The SBP was significantly higher in females than in males and increased up to the age group 80-84 years both in males and in females. The DBP decreased with age. The prevalence of 'actual' hypertension was 53% and increased up to the age group 75-79 years in males and 80-84 years in females. The prevalence of isolated systolic hypertension was 17% (with patients currently using antihypertensive drugs excluded). Of the patients with 'actual' hypertension, 34% were 'unaware' of the diagnosis, 12% 'aware', 32% 'treated' and 22% 'controlled'. CONCLUSIONS: In central Europe hypertension, with a prevalence of > 50%, remains the most common cardiovascular risk factor in the elderly. Although most elderly hypertensives are currently treated with antihypertensive agents, less than one-quarter are controlled, and more than one-third are still unaware of the diagnosis. These levels of awareness and control call for better strategies in the diagnosis and treatment of hypertension in the elderly.

Age Factors↗

PubMed1997

Sex differences in awareness and control of hypertension in France.

OBJECTIVE: To assess the prevalence, awareness, treatment and control of hypertension for men and women living in three French regions. DESIGN: A cross-sectional population survey. SETTING: Subjects in the World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease population surveys of Bas-Rhin, the urban community of Lille and Haute-Garonne, France. SUBJECTS: We studied 1924 men and 1874 women aged 35-64 years. MAIN OUTCOME MEASURES: Hypertension was defined as a systolic blood pressure > or = 160 mmHg, a diastolic blood pressure > or = 95 mmHg, being administered antihypertensive drug treatment or any combination of the foregoing. Treated hypertensive subjects were considered controlled if their systolic blood pressure was < 160 mmHg and their diastolic blood pressure was < 95 mmHg. RESULTS: The prevalence of hypertension was 40.2, 43.8 and 27.7% among men in Lille, Bas-Rhin and Haute-Garonne, respectively. For women, the corresponding values were 31.5, 33.8 and 18.9%. Among hypertensive men, 51.8% were aware of their condition, 30.0% were being administered drug treatment and 9.2% were controlled; the respective values for hypertensive women were 69.8, 51.2 and 25.3% (P < 0.001). Awareness of hypertension was associated with antihypertensive treatment more commonly in Haute-Garonne (81.0% for men and 84.7% for women). The percentages of treated subjects in whom adequate control of the blood pressure had been achieved were only 30.7% for men and 49.4% for women. CONCLUSION: Women have a better awareness of hypertension than do men and their hypertension is controlled better but the low rate of control for both sexes calls for further improvements.

Adult↗

PubMed2002

Prevalence, awareness, treatment and control of hypertension in a Canarian population. Relationship with glucose tolerance categories. The Guía Study.

OBJECTIVE: To estimate the prevalence, awareness, treatment and control of hypertension in a Canarian population; and their relationship with the glucose tolerance categories. DESIGN: From a population of 6355 subjects over 29 years old, 690 were chosen in a random sampling. Blood pressure measurements, a standard oral glucose tolerance test (excluding known diabetic patients), and a questionnaire on diabetes and hypertension history and medication use was performed. RESULTS: The total prevalence of hypertension was 50.3%; 62.0% of the hypertensive subjects were aware of their condition; 60.6% had their diastolic and 11.0% their systolic blood pressure controlled and 8.6% had both. For diabetic, glucose intolerant and normoglycemic subjects, the respective prevalences of hypertension were 79.4, 60.2 and 43.1% (higher in diabetic subjects, P < 0.001); the awareness of hypertension was 66.7, 61.8 and 59.5% (differences not significant); systolic blood pressure control was 4.8, 14.7 and 13.7% (lower in diabetic subjects, P = 0.017 versus glucose intolerant and P = 0.011 versus normoglycemic subjects); diastolic blood pressure control was 50.4, 72.1 and 63.2% (lower in diabetic subjects, P = 0.004 versus glucose intolerant and P = 0.025 versus normoglycemic subjects). There were no differences in the number and type of antihypertensive drugs among the different glucose tolerance categories. CONCLUSIONS: Blood pressure was comparable in our population and in other European populations. The prevalence of hypertension was higher, the awareness was similar, and control was worse in diabetic than in non-diabetic subjects; the drug treatment pattern was not different.

Adrenergic alpha-Antagonists↗

PubMed1996

The awareness-to-adherence model of the steps to clinical guideline compliance. The case of pediatric vaccine recommendations.

OBJECTIVES: This article proposes, tests, and explores the potential applications of a model of the cognitive and behavioral steps physicians take when they comply with national clinical practice guidelines. The authors propose that when physicians comply with practice guidelines, they must first become aware of the guidelines, then intellectually agree with them, then decide to adopt them in the care they provide, then regularly adhere to them at appropriate times. METHODS: Data used to test this model address physicians' responses to national pediatric vaccine recommendations. Questionnaires were mailed to 3,014 family physicians and pediatricians who were working in communities of various sizes in nine states. RESULTS: The survey response rate was 66.2%. In the case of the recommendation to provide hepatitis B vaccine to all infants, guideline awareness among respondents was 98.4%, agreement 70.4%, adoption 77.7%, and adherence 30.1%. The data for 87.9% of physicians fit the model at every step. Significant deviation from the model occurred only for the 11% of all physicians who adopted the hepatitis B recommendation without agreeing with it. In the case of the recommendation to provide the acellular variety of the pertussis vaccine for children's fourth and fifth pertussis doses, guideline awareness among respondents was 89.8%, agreement 66.5%, adoption 46.3%, and adherence 35.2%. Data fit the model at every step for 90.6% of physicians. Greater likelihood of movement from each step to the next in the path to adherence was found for physicians with certain characteristics, information sources, and beliefs about the vaccines, and those in certain types of practice settings. Specific physician and practice characteristics typically predicted movement along only one or two of the steps to adherence to either the hepatitis B or acellular pertussis recommendations. CONCLUSIONS: These data on physicians' use of pediatric vaccine recommendations generally support the awareness-to-adherence model. This model may prove useful in identifying ways to improve physicians' adherence to a variety of guidelines by demonstrating where physicians fall off the path to adherence, which physicians are at greatest risk for not attaining each step in the path, and factors associated with a greater likelihood of attaining each step toward guideline adherence.

Awareness↗

PubMed2004

Public awareness of risk factors and screening for colorectal cancer in Europe.

Colorectal cancer (CRC) is the commonest site for malignancy in Europe. The Commissioner for Health wishes to promote screening for colorectal, breast and cervical cancer in Europe. The aim of this study was to assess public knowledge of CRC in Europe and likely take up of free screening. To this end 20710 members of the public from 21 European countries were interviewed by means of a regular survey amongst consumers (Omnibus survey) using 13 stem questions. Forty-eight per cent thought the population were at equal risk of CRC, only 57% were aware of age and 54% of family history as risk factors. Although 70% were aware of dietary factors, only 30% knew that lack of exercise might be a risk factor. Only 51% had knowledge of CRC screening but 75% were 'very', or 'quite interested, in taking up faecal occult blood (FOB) screening if offered free. Barriers to screening were lack of awareness of risk (31%), youth (22%) and an un-anaesthetic test (19%). There was a big cultural difference in willingness of the public to discuss bowel symptoms: there was a major barrier in Finland (91%), Britain (84%), Luxembourg (82%), Poland (81%) and Portugal (80%); less of a barrier in Spain (49%), Italy (44%) and Iceland (39%). In conclusion, the challenge of achieving high compliance for CRC screening must be a major objective amongst EU member states and non-aligned countries of Europe in the next decade, because it is known that the non-compliant group are those at greatest risk of death from CRC. This study has shown that awareness of CRC is low in Europe and that an educational programme will be essential to achieve high compliance for CRC screening as a means of reducing deaths from bowel cancer.

Adult↗

PubMed2005

Prevalence, awareness, treatment, and control of hypertension among Black Surinamese, South Asian Surinamese and White Dutch in Amsterdam, The Netherlands: the SUNSET study.

OBJECTIVE: To assess ethnic differences in prevalence, levels of awareness, treatment and control of hypertension among Dutch ethnic groups and to determine whether these differences are consistent with the UK findings. DESIGN: Cross-sectional survey. SETTING: South-east Amsterdam, The Netherlands. PARTICIPANTS: A random sample of 1383 non-institutional adults aged 35-60 years. Of these, 36.7% were White, 42% were Black and 21.3% were South Asian people. MAIN OUTCOME MEASURES: Prevalence of hypertension, rates of awareness, treatment, and control of hypertension. RESULTS: The Black and South Asian subjects had a higher prevalence of hypertension compared with White people. After adjustments for age, the odds ratios (95% confidence interval) for being hypertensive were 2.2 (1.4-3.4; P < 0.0001) and 3.8 (2.6-5.7; P < 0.0001) for Black men and women, respectively, and 1.7 (1.0-2.6; P = 0.039) and 2.8 (1.8-4.5; P < 0.0001) for South Asian men and women, compared with White people. There were no differences in awareness and pharmacological treatment of hypertension between the groups. However, Black hypertensive men 0.3 (0.1-0.7; P < 0.01) and women 0.5 (0.3-0.9; P < 0.05) were less likely to have their blood pressure adequately controlled compared with White people. CONCLUSION: The higher prevalence of hypertension found among Black and South Asian people in The Netherlands is consistent with the UK studies. However, the lower control rates and the similar levels of awareness and treatment of hypertension in Black Surinamese contrast with the higher rates reported in African Caribbeans in the UK. The rates for the South Asians in The Netherlands were relatively favourable compared to similar South Asian groups in the UK. These findings underscore the urgent need to develop strategies aimed at improving the prevention and control of hypertension, especially among Black people, in The Netherlands.

Adult↗

PubMed2006

Hypertension prevalence, awareness, control and association with metabolic abnormalities in the San Marino population: the SMOOTH study.

BACKGROUND: The aim of the SMOOTH (San Marino Observational Outlooking Trial on Hypertension) study was to explore hypertension awareness, treatment and control and the associated metabolic abnormalities and risk factors in the population of San Marino, a small state in the Mediterranean area, for which limited evidence is available. METHODS: Nine general practitioners enrolled 4590 consecutive subjects (44% of the San Marino population age 40-75 years), seen in their office by collecting history, physical and laboratory data and office blood pressure (BP) measurements. RESULTS: Of these subjects, 2446 were normotensive and 2144 hypertensive; 62.3% of hypertensive patients were aware of their condition, 58.6% were treated (monotherapy 31.5%, combination therapy 27.1%), and 21.7% were controlled. Hypertension awareness and treatment were more frequent above age 50 and in females; BP control was similarly low in both genders. As compared to normotensives, hypertensive subjects were less frequently smokers (20.1 versus 27.8%), had greater body mass index (28.1 +/- 4.5 versus 25.8 +/- 3.7 g/m), and a higher prevalence of diabetes mellitus (15.8 versus 6.3%), lower high-density lipoprotein (HDL) cholesterol and higher prevalence of increased blood total cholesterol (66.1 versus 51.3%), triglycerides and serum uric acid. Values of subjects with 'high-normal' blood pressure were closer to those of hypertensive subjects. The prevalence of metabolic syndrome was higher in hypertensive than in normotensive subjects, and in treated than in untreated hypertensives. CONCLUSIONS: Even in a small Mediterranean country with high health-care standards, hypertension awareness, treatment and control are inadequate and hypertension clusters with metabolic abnormalities and risk factors as in non-Mediterranean areas.

Adult↗