Beyond the Shaker: Quantifying Salt Intake in Tirana through Urinary Sodium Analysis

Background: High salt intake is associated with high blood pressure and adverse cardiovascular health. To figure out average salt intake, we investigated the dietary salt intake from 24-h urinary sodium excretion with a random adult sample from Tirana, the capital city of Albania. Materials and Methods: One hundred and fifty adults aged 18–75 years were randomly selected from a sample of 100000 people from 2 quarters of Tirana’s adult population. Anthropometric measures and sodium excretion in a 24-h urine collection were measured. The accuracy of urine collections was verified using creatinine excretion in relation to weight. Results: The mean Na excretions over 24 h were 202.54 (standard deviation [SD] 93.56) mmol/day. Urinary sodium excretion was significantly higher in men (223.85 [SD 106.51] mmol Na/day) than in women (190.80 [SD 83.96] mmol Na/d); P = 0,045. Average salt intake was 11.8 (SD 5.48) g/d, higher in men than in women (13.08 [SD 6.23] vs. 11,09 [SD 4.92] g/d, respectively). Salt intake increases slightly with increasing age, but there was no significant correlation between age and salt intake. It was also seen that salt consumption increased with increasing body mass index (r = 0.183, P = 0.001). Conclusion: Dietary salt intake in Tirana adults was high, which exceeds the World Health Organization recommended population nutrient intake. Reducing the intake of table salt and traditionally processed foods will be an important strategy to reduce sodium intake among our adults. A national program for reducing salt intake in Albania needs to be conducted through systematic efforts, including public education and involving the health-care sector and the food industry

Evidence of a higher burden of multimorbidity among female patients in Albania

Aim: The purpose of this study was to assess sex-differences in the prevalence of multimorbidity and the number of comorbid conditions among hospitalized patients in Tirana, the capital of Albania, a transitional country in Southeastern Europe. Methods: The current study was a case-series, which was carried out in the period August 2013–June 2014. Overall, 974 patients were enrolled (46.6% men with a mean age of 61.2±13.8 years, and 53.4% women with a mean age of 61.3±13.1 years), who were admitted at the Service of Internal Medicine and Hypertension, University Hospital Center “Mother Teresa” in Tirana. A comprehensive clinical profile was assembled for all patients in addition to socio-demographic data and information on lifestyle factors. General linear model was used to assess the association between multimorbidity (total number of diseases/conditions) and sex of the patients, controlling for socio-demographic characteristics and lifestyle factors.     Results: In crude (unadjusted) models and in age-adjusted models, female patients had a higher mean value of diseases/conditions compared to males (for both: 4.4 vs. 4.1, respectively, P=0.03). Likewise, upon adjustment for all socio-demographic characteristics, the mean number of disease/conditions was significantly higher in female patients compared to their male counterparts (4.2 vs. 3.9, respectively; P=0.03). After additional adjustment for lifestyle factors, the association between sex and number diseases/conditions was not significant anymore (p=0.16), notwithstanding the evidence of a higher mean value in women compared to men (4.2 vs. 4.0).  Conclusion: Current evidence from transitional Albania suggests a higher burden of multimorbidity among female patients compared to males, which is a cause of concern. These findings should raise the awareness of health professionals and particularly policymakers and decision-makers in order to address gender issues and inequity gaps in health outcomes and burden of disease of the Albanian population.   &nbsp

Evidence of a higher burden of multimorbidity among female patients in Albania

Aim: The purpose of this study was to assess sex-differences in the prevalence of multimorbidity and the number of comorbid conditions among hospitalized patients in Tirana, the capital of Albania, a transitional country in Southeastern Europe.Methods: The current study was a case-series, which was carried out in the period August 2013–June 2014. Overall, 974 patients were enrolled (46.6% men with a mean age of 61.2±13.8 years, and 53.4% women with a mean age of 61.3±13.1 years), who were admitted at the Service of Internal Medicine and Hypertension, University Hospital Center “Mother Teresa” in Tirana. A comprehensive clinical profile was assembled for all patients in addition to socio-demographic data and information on lifestyle factors. General linear model was used to assess the association between multimorbidity (total number of diseases/conditions) and sex of the patients, controlling for socio-demographic characteristics and lifestyle factors.    Results: In crude (unadjusted) models and in age-adjusted models, female patients had a higher mean value of diseases/conditions compared to males (for both: 4.4 vs. 4.1, respectively, P=0.03). Likewise, upon adjustment for all socio-demographic characteristics, the mean number of disease/conditions was significantly higher in female patients compared to their male counterparts (4.2 vs. 3.9, respectively; P=0.03). After additional adjustment for lifestyle factors, the association between sex and number diseases/conditions was not significant anymore (p=0.16), notwithstanding the evidence of a higher mean value in women compared to men (4.2 vs. 4.0). Conclusion: Current evidence from transitional Albania suggests a higher burden of multimorbidity among female patients compared to males, which is a cause of concern. These findings should raise the awareness of health professionals and particularly policymakers and decision-makers in order to address gender issues and inequity gaps in health outcomes and burden of disease of the Albanian population.   

Evidence of a higher burden of multimorbidity among female patients in Albania

Aim: The purpose of this study was to assess sex-differences in the prevalence of multimorbidity and the number of comorbid conditions among hospitalized patients in Tirana, the capital of Albania, a transitional country in Southeastern Europe.Methods: The current study was a case-series, which was carried out in the period August 2013–June 2014. Overall, 974 patients were enrolled (46.6% men with a mean age of 61.2±13.8 years, and 53.4% women with a mean age of 61.3±13.1 years), who were admitted at the Service of Internal Medicine and Hypertension, University Hospital Center “Mother Teresa” in Tirana. A comprehensive clinical profile was assembled for all patients in addition to socio-demographic data and information on lifestyle factors. General linear model was used to assess the association between multimorbidity (total number of diseases/conditions) and sex of the patients, controlling for socio-demographic characteristics and lifestyle factors.    Results: In crude (unadjusted) models and in age-adjusted models, female patients had a higher mean value of diseases/conditions compared to males (for both: 4.4 vs. 4.1, respectively, P=0.03). Likewise, upon adjustment for all socio-demographic characteristics, the mean number of disease/conditions was significantly higher in female patients compared to their male counterparts (4.2 vs. 3.9, respectively; P=0.03). After additional adjustment for lifestyle factors, the association between sex and number diseases/conditions was not significant anymore (p=0.16), notwithstanding the evidence of a higher mean value in women compared to men (4.2 vs. 4.0). Conclusion: Current evidence from transitional Albania suggests a higher burden of multimorbidity among female patients compared to males, which is a cause of concern. These findings should raise the awareness of health professionals and particularly policymakers and decision-makers in order to address gender issues and inequity gaps in health outcomes and burden of disease of the Albanian population.   

Evidence of a higher burden of multimorbidity among female patients in Albania

Aim: The purpose of this study was to assess sex-differences in the prevalence of multimorbidity and the number of comorbid conditions among hospitalized patients in Tirana, the capital of Albania, a transitional country in Southeastern Europe. Methods: The current study was a case-series, which was carried out in the period August 2013–June 2014. Overall, 974 patients were enrolled (46.6% men with a mean age of 61.2±13.8 years, and 53.4% women with a mean age of 61.3±13.1 years), who were admitted at the Service of Internal Medicine and Hypertension, University Hospital Center “Mother Teresa” in Tirana. A comprehensive clinical profile was assembled for all patients in addition to socio-demographic data and information on lifestyle factors. General linear model was used to assess the association between multimorbidity (total number of diseases/conditions) and sex of the patients, controlling for socio-demographic characteristics and lifestyle factors.     Results: In crude (unadjusted) models and in age-adjusted models, female patients had a higher mean value of diseases/conditions compared to males (for both: 4.4 vs. 4.1, respectively, P=0.03). Likewise, upon adjustment for all socio-demographic characteristics, the mean number of disease/conditions was significantly higher in female patients compared to their male counterparts (4.2 vs. 3.9, respectively; P=0.03). After additional adjustment for lifestyle factors, the association between sex and number diseases/conditions was not significant anymore (p=0.16), notwithstanding the evidence of a higher mean value in women compared to men (4.2 vs. 4.0).  Conclusion: Current evidence from transitional Albania suggests a higher burden of multimorbidity among female patients compared to males, which is a cause of concern. These findings should raise the awareness of health professionals and particularly policymakers and decision-makers in order to address gender issues and inequity gaps in health outcomes and burden of disease of the Albanian population

COMORBIDITATEA ȘI POLIMORBIDITATEA LA PACIENȚII ADULȚI DIN ALBANIA

Background: Our aim was to assess the prevalence and “predictors” of comorbidity and multimorbidity in adult patients in Albania, a former communist country in the Western Balkans. Methods: This was a case-series study conducted during August 2013–June 2014 including 974 patients (46.6% men aged 61.2±13.8 years and 53.4% women aged 61.3±13.1 years) admitted at the Service of Internal Medicine and Hypertension, University Hospital Center “Mother Teresa”, Tirana. Data on socio-demographic factors, lifestyle characteristics and a detailed clinical profile was collected for all study participants. Binary logistic regression was used to assess the association between comorbidity and multimorbidity with socio-demographic characteristics and lifestyle factors.    Results: About 54% of the patients were ≥61 years old; about 38% of participants were residing in Tirana; and about 46% of the patients were currently employed. Overall, the prevalence of smoking was 16% (30.4% in men vs. 3.5% in women, PContext: Scopul studiului a fost de a evalua prevalența și "predictorii" comorbidității și polimorbidității la pacienții adulți din Albania, o fostă țară comunistă din Balcanii de Vest. Metode: A fost realizat un studiu de serii de caz în perioada august 2013 - iunie 2014, și a inclus 974 pacienți (46,6% bărbați cu vârste de 61,2 ± 13,8 ani și 53,4% femei cu vârste de 61,3 ± 13,1 ani) internați în Serviciul de Medicină Internă și Hipertensiune arterială a Centrului "Maica Teresa" din Spitalul Universitar, Tirana. Au fost colectate pentru toți participanții la studiu date privind factorii socio-demografici, caracteristicile stilului de viață și profilul clinic detaliat. A fost utilizată regresia logistică binară pentru a evalua asocierea dintre comorbiditate și polimorbiditate cu caracteristicile socio-demografice și a stilului de viață. Rezultate: Aproximativ 54% dintre pacienți aveau vârsta de ≥61 ani; aproximativ 38% dintre participanți locuiau în Tirana și aproximativ 46% dintre pacienți erau angajați la momentul studiului. În general, prevalența fumatului a fost de 16% (30,4% la bărbați versus 3,5% la femei, P <0,001), în timp ce prevalența consumului de alcool a fost de 9% (17,4% la bărbați față de 1,7% la femei, P <0,001 ). După ajustarea multivariată a tuturor caracteristicilor socio-demografice și a factorilor legați de stilul de viață, doar grupa de vârstă a participanților la studiu a reprezentat un "predictor" puternic și semnificativ statistic al comorbidității și polimorbidității (OR = 4,3, 95% IC = 2,0-9,1). Concluzii: Acest studiu oferă informații despre prevalența și factorii determinanți selectivi ai comorbidității și polimorbidității în rândul pacienților spitalizați din Albania. Rezultatele studiului  arată că povara comorbidității și polimorbidității este mai mare în special în rândul pacienții albanezi în vârstă. Studiile viitoare vor trebui să estimeze importanța și distribuția comorbidității și polimorbidității în populația generală din Albania.   Cuvinte cheie: Albania, comorbiditate, afecțiuni asociate, medicină internă, polimorbiditat