PubMed Health⌕ Search

Biomedical subjects

Naureen Tareen

Publications and source records attributed to Naureen Tareen.

10 recordsLinked to original sources
PubMed2006

The association of poverty with the prevalence of albuminuria: data from the Third National Health and Nutrition Examination Survey (NHANES III).

BACKGROUND: Albuminuria is a major risk factor for the development and progression of chronic kidney disease (CKD) and cardiovascular disease. Socioeconomic factors also have been reported to modify CKD and cardiovascular risk factors and clinical outcomes. The extent to which poverty influences the prevalence of albuminuria, particularly among racial/ethnic minority populations, is not well established. The influence of poverty on the prevalence of albuminuria and the implication of this relationship for the racial and/or ethnic differences in the prevalence of albuminuria were examined. METHODS: We examined data from 6,850 male and 7,634 female adults from a national probability survey conducted between 1988 and 1994. RESULTS: In univariate analysis, poverty, defined as less than 200% federal poverty level (FPL), was associated with the presence of both microalbuminuria (odds ratio [OR], 1.35; 95% confidence interval, 1.22 to 1.49) and macroalbuminuria (OR, 1.78; 95% confidence interval, 1.40 to 2.26). The association of less than 200% FPL with microalbuminuria persisted in a multivariate model controlling for age, sex, race, education, obesity, hypertension, diabetes, reduced glomerular filtration rate, and medication use (OR, 1.18; 95% confidence interval, 1.05 to 1.33). FPL less than 200% was not associated with macroalbuminuria in the multivariate model. When multivariate analysis is stratified by FPL (<200% and > or =200%), differences in ORs for microalbuminuria and macroalbuminuria among racial/ethnic minority participants compared with whites were more apparent among the less affluent participants in the FPL-less-than-200% stratum. CONCLUSION: FPL less than 200% is associated with microalbuminuria, and differences in FPL levels may account for some of the observed differences in prevalence of albuminuria between racial/ethnic minority participants and their white counterparts.

Adult↗
PubMed2005

Management of early chronic kidney disease in indigenous populations and ethnic minorities.

The rate of treated end-stage renal disease (ESRD) continues to increase globally. The disproportionately high rate of ESRD among the many growing indigenous populations and racial/ethnic minorities in the United States highlights the need to reassess present treatment strategies to more appropriately identify and manage chronic kidney disease in diverse communities. Similar projections have been noted worldwide. This discrepancy between ESRD rates among racial and ethnic minority groups, and treatment strategies is due to several factors, many of which are modifiable. These include the individual, the health care provider/system, and limited participation in controlled clinical trials. Although it is unfortunate that this disparity continues to exist, a thoughtful and compassionate approach to addressing the role of diverse biobehavioral and sociocultural factors might be the key to effective translation of emerging scientific advances into improved clinical outcomes for all patients with chronic kidney disease.

California↗
PubMed2005

Chronic kidney disease in African American and Mexican American populations.

African Americans and Mexican Americans suffer from disproportionately high rates of end-stage renal disease in comparison with whites from the United States. An improved understanding of both classic and novel chronic kidney disease risk factors among racial/ethnic minorities may help to facilitate improved prevention, screening, and early intervention strategies for all patients at risk for chronic kidney disease-not only in the United States, but on a global level. The economic implications are equally important to inform health policy recommendations and ensure cost-effective allocation of limited resources.

Black or African American↗
PubMed2005

Sodium disorders in the elderly.

Disorders of sodium imbalance are commonly encountered in clinical practice and can have a substantial impact on the prognosis of the patient. These disorders are more common in the elderly. Sodium disorders can cause serious neurologic symptoms and even death, particularly among hospitalized patients. The identification of sodium abnormalities and appropriate clinical intervention are critical for improving patient outcomes. Early recognition of hyponatremia and hypernatremia can provide a clue to an underlying disorder. In this update, we have summarized age-related homeostatic changes that impair sodium balance, medications that alter salt and water handling, and the recognition and management of sodium disorders in elderly patients.

Age Factors↗
PubMed2005

The prevalence of hypovitaminosis D among US adults: data from the NHANES III.

OBJECTIVE: Several epidemiologic and mechanistic studies suggest that 25(OH) D3 levels should be maintained above 70 nmol/L for a positive effect on the health of adults. Prior studies have noted low 25(OH) D3 levels in subsets of minority populations. The objective of this study is to examine the prevalence of adequate 25(OH) D3 levels among US adults. METHOD: Using data from the third National Health and Nutrition Examination Survey (NHANES III), we evaluated serum levels of 25(OH) D3 (nmol/L) among 15,390 adult participants > or = 18 years of age. Racial/ethnic grouping was by self-identification as White, Black or African American, and Hispanic. RESULTS: The mean levels of 25(OH) D3 were lower among the female than male participants (71.1 vs 78.7; P=.003) and among the elderly (> or = 65 years of age vs 40-59 and 18-39) than young participants. White men and women (83.0 and 76.0) had higher mean levels of vitamin D than Hispanic men and women (68.3 and 56.7; P<.0001) and than Black men and women (52.2 and 45.3; P<.0001), respectively. The prevalence of both mild-moderate and severe deficiency of vitamin D is higher among women (P<.0001) and minority populations (P<.0001). However, even among White men, 34% had low vitamin D levels. CONCLUSION: Serum levels of 25(OH) D3 are below the recommended levels for a large portion of the general adult population and in most minorities. Need exists for a critical review and probable revision of current recommendations for adult vitamin D intake to maintain adequate 25(OH) D3 levels.

Adolescent↗
PubMed2005

The impact of routine vitamin supplementation on serum levels of 25 (OH) D3 among the general adult population and patients with chronic kidney disease.

BACKGROUND: Vitamin D supplementation is recommended to maintain bone health in the general population and in particular in patients with chronic kidney disease (CKD). While the nutritional status of vitamin D is assessed by circulating levels of 25 (OH) D3, it is not routinely measured to ensure the adequacy of vitamin D supplementation. Current recommendations require the maintenance of serum levels of 25 (OH) D3 > or = 70 nmol/L. The objective of this study is to assess the effect of routine vitamin supplements on the serum levels of 25 (OH) D3 in the general population and among persons with CKD. METHOD: Using data from the third National Health and Nutrition Examination Survey (NHANES III) we assessed the adequacy of routine vitamin supplementation by assessing serum levels of 25 (OH) D3 among 15,390 adult participants, both with and without CKD. RESULTS: In the general population the participants with vitamin supplements had higher serum level of 25 (OH) D3 (79.47 vs 74.38 nmol/L) and a lower prevalence of vitamin D deficiency (39% vs 48%) than participants not taking any supplements. In the CKD subgroup, the prevalence of vitamin D deficiency was lower with supplements (49%), while greater without supplements (59%). Vitamin D deficiency was higher among women, elderly, and minorities as previously reported. In an adjusted regression model the odds of severe vitamin D deficiency (<25 nmol/L) was 1.43 (P=.0032) among CKD patients, with a trend toward higher rates among patients not taking vitamin supplements (odds ratio 1.47, P=.0557). CONCLUSION: Vitamin supplementation is associated with a lower prevalence of vitamin D deficiency and higher serum levels of 25 (OH) D3. However, the current dose of vitamin D in routine vitamin supplements is still insufficient to maintain adequate serum 25 (OH) D3 levels in a substantial portion of both the general and CKD populations. We must re-asses the dose of vitamin D in routine vitamin supplements in the United States.

Adult↗
PubMed2004

Education, motivation and medication for African Americans: bringing hypertension guidelines to practice.

African Americans suffer from high rates of hypertension and hypertension-related complications. While racial/ethnic differences in blood pressure response to pharmacologic therapy have been described, most randomized hypertension trials with substantial enrollment of African Americans receiving standardized medical care do not support class-specific racial/ethnic differences in key clinical outcomes. Understanding health care systems and the socio-economic and demographic factors that impair access can enhance the ability of the provider to enlist and engage the patient for optimal blood pressure control and end organ protection.

Black or African American↗
PubMed2004

Calcium antagonists: a more expansive role in treating persons with reduced kidney function?

Most recent studies have supported inhibition of the renin-angiotensin-aldosterone system (RAAS) with diuretic as initial hypertensive therapy in patients with chronic kidney disease (CKD). The recommended role of calcium channel blockers (CCB) in CKD patients had diminished due to class-specific differences in antiproteinuric effects and lesser efficacy in reducing composite renal clinical outcomes when compared to RAAS inhibition. However, the demonstrated safety and efficacy of CCB in combination with RAAS inhibition, and the recognized need for effective antihypertensive agents to achieve the low target blood pressures, has prompted a more expanded use of calcium channel blockers in this difficult to treat CKD population.

Black or African American↗
PubMed2002

The relationship between body mass index and pulse pressure in older adults with isolated systolic hypertension.

BACKGROUND: Many longitudinal studies have reported excess cardiovascular mortality among lean hypertensive subjects, suggesting that obesity may mitigate the cardiovascular risk of hypertension. Available evidence also suggests that in middle-aged and older hypertensive subjects, pulse pressure may be a better predictor of cardiovascular complications. However, there are limited data on the relationship between body mass index (BMI) and pulse pressure. METHODS: Using data from the Third National Health and Nutrition Examination Survey we assessed the convergence validity of pulse pressure as a predictor of cardiovascular complications and examined the relationship between BMI and pulse pressure in 1192 older adults with isolated systolic hypertension who were not receiving blood pressure medicine. RESULTS: There was a good concordance between high pulse pressure and most of the selected cardiovascular risk factors examined in this study. Pulse pressure is higher in the lean (BMI < 25) than in the overweight (BMI > or = 25; 79 mm Hg vs 74 mm Hg, P < .001) and decreases significantly from 82 mm Hg in the first BMI quintile to 76 mm Hg in the fifth BMI quintile. Pulse pressure continues to decrease with increasing BMI until the index exceeds 30.1. This negative correlation persists in a multivariate model with statistical adjustment for age, sex, diabetes mellitus, and hypercholesterolemia. CONCLUSION: The inverse relation between BMI and pulse pressure observed here may help to explain previous reports of increased cardiovascular risk among lean versus obese subjects with isolated systolic hypertension.

Aged↗