Socioeconomic disparities in intimate partner violence against Native American women: a cross-sectional study

Background

Intimate partner violence (IPV) against women is a global public health problem, yet data on IPV against Native American women are extremely limited. We conducted a cross-sectional study of Native American women to determine prevalence of lifetime and past-year IPV and partner injury; examine IPV in relation to pregnancy; and assess demographic and socioeconomic correlates of past-year IPV.

Methods

Participants were recruited from a tribally-operated clinic serving low-income pregnant and childbearing women in southwest Oklahoma. A self-administered survey was completed by 312 Native American women (96% response rate) attending the clinic from June through August 1997. Lifetime and past-year IPV were measured using modified 18-item Conflict Tactics Scales. A socioeconomic index was created based on partner's education, public assistance receipt, and poverty level.

Results

More than half (58.7%) of participants reported lifetime physical and/or sexual IPV; 39.1% experienced severe physical IPV; 12.2% reported partner-forced sexual activity; and 40.1% reported lifetime partner-perpetrated injuries. A total of 273 women had a spouse or boyfriend during the previous 12 months (although all participants were Native American, 59.0% of partners were non-Native). Among these women, past-year prevalence was 30.1% for physical and/or sexual IPV; 15.8% for severe physical IPV; 3.3% for forced partner-perpetrated sexual activity; and 16.4% for intimate partner injury. Reported IPV prevalence during pregnancy was 9.3%. Pregnancy was not associated with past-year IPV (odds ratio = 0.9). Past-year IPV prevalence was 42.8% among women scoring low on the socioeconomic index, compared with 10.1% among the reference group. After adjusting for age, relationship status, and household size, low socioeconomic index remained strongly associated with past-year IPV (odds ratio = 5.0; 95% confidence interval: 2.4, 10.7).

Conclusions

Native American women in our sample experienced exceptionally high rates of lifetime and past-year IPV. Additionally, within this low-income sample, there was strong evidence of socioeconomic variability in IPV. Further research should determine prevalence of IPV against Native American women from diverse tribes and regions, and examine pathways through which socioeconomic disadvantage may increase their IPV risk.

     

Risk factors for bacterial vaginosis: results from a cross-sectional study having a sample of 53,652 women

The aim of this study was to estimate the risk factors of bacterial vaginosis (BV) among rural married women of childbearing age in Anhui Province of China. A cross-sectional study was conducted and the method of stratified cluster sampling was used to identify a sample of 53,652 married women aged 18–49 years. All women were asked to complete an interviewer-administered standardized questionnaire, covering sociodemographic characteristics, history of menstruation, marriage and procreation, sexual life, personal hygienic behaviors, and reproductive tract infections (RTIs) knowledge, followed by the gynecological examination and laboratory inspection. A total of 53,286 married women aged 18–49 years were included in this analysis. The prevalence of BV was 11.99 % (6,391/53,286). Risk factors for BV included the minority nationality, women’s lower education levels, husband’s elder age, over 35 days of menstrual cycle, less than 3 days of menstruation, dysmenorrhea, usage of an intrauterine device (IUD), lack of RTIs knowledge, higher frequency of washing genitals before having sex with husband and changing underwear, lower frequency of sexual intercourse per month, and suffering from other RTIs. The results suggest that BV can be affected by many factors among rural married women of reproductive age, so comprehensive, scheduled programs at healthcare educations should be provided for women in order to prevent BV.     

Central obesity is associated with nonatopic but not atopic asthma in a representative population sample

BACKGROUND: Epidemiologic studies have consistently demonstrated the association between high body mass index (BMI) and asthma, yet the relationship between asthma and the alternative central obesity phenotypes, waist circumference (WC) and waist-to-hip ratio (WHR), has not been assessed in a representative population sample. OBJECTIVE: To determine the strength of the association of WC and WHR with current asthma and whether the association is modified by atopic status in a representative population sample. METHODS: The North West Adelaide Health Study, a biomedical population study of n = 4060, assessed current asthma, respiratory symptoms, and participant demographics by self-completed questionnaire. Clinic assessment included measures of WC and WHR, spirometry, and skin prick tests to a panel of allergens. RESULTS: Logistic regression analysis showed a significant, marginal increased adjusted risk of asthma associated with obese levels of WC and WHR and BMI > or =35.0 kg/m2 in female subjects only. When the association was considered stratified according to atopic status, the relationship between obese levels of WC and WHR with asthma held only for the nonatopic population in both males (WC: odds ratio [OR] 5.7, 95% confidence interval [CI] 1.1-28.8; WHR: OR 6.2, 95% CI, 1.1-32.9) and females (WC: OR 2.3, 95% CI, 1.2-4.4; WHR: OR 3.0, 95% CI, 1.5-5.9). BMI > or =35.0 kg/m2 showed an inconsistent pattern in the association with asthma. CONCLUSION: Central obesity was significantly associated with an increased risk of nonatopic asthma only. The causal pathway is unknown, but this study suggests the involvement of different pathophysiological mechanisms requiring further investigation. CLINICAL IMPLICATIONS: Asthma should be considered in older, nonatopic, centrally obese, symptomatic individuals.     

Epidemiological study of hyperlipemia in a Lebanese population

An epidemiological study was conducted on 500 persons (60% women and 40% men) from the medico-technical staff of the "H?tel-Dieu de France" (Lebanon center for hospitalization and medical formation) in order to establish the lipid profile of the Lebanese population. The following results were obtained (mean values): total cholesterol 5.27 mmol/l (SD = 1.04), HDLc 1.28 mmol/l (SD = 0.40), LDLc 3, 31mmol/l (SD = 0.94), Triglycerides 1.55 mmol/l (SD = 1.55), glucose 5 mmol/l (SD = 0.80), Fibrinogen 3.09 g/l (SD = 0.67) and Lipoprotein (a) 0.20 g/l (SD = 0.253) with 20% of the population having Lp(a) values greater than 0.3 g/l. The distribution of these parameters in regard to the sex, age, Lebanese regions origin, body mass index and the waist to hips ratio, as well as tobacco consumption, alimentary habits, personal and familial history of dyslipidemia or coronary diseases, are reported. The results of Lp(a) measurements and correlations to other parameters confirm its importance as an independent risk factor for coronary problems. The significant percentage of subjects with lipid levels higher than those recommended by the NCEP, 19% for total cholesterol, 27% for LDL cholesterol and 20% for Lp(a), has to be seriously considered.     

Factors associated with viral non-suppression among adolescents living with HIV in Cambodia: a cross-sectional study

Background

Adolescents living with HIV on antiretroviral therapy (ART) have worse treatment adherence, viral suppression, and mortality rates compared to adults. This study investigated factors associated with viral non-suppression among adolescents living with HIV in Cambodia.

Methods

A cross-sectional study was conducted in August 2016 among 328 adolescents living with HIV aged 15–17 years who were randomly selected from 11 ART clinics in the capital city of Phnom Penh and 10 other provinces. Clinical and immunological data, including CD4 count and viral load, were obtained from medical records at ART clinics. Adolescents were categorized as having achieved viral suppression if their latest viral load count was <?1000 ribonucleic acid (RNA) copies/mL. Multivariate logistic regression analysis was performed to identify factors independently associated with viral non-suppression.

Results

The mean age of the participants was 15.9 years (SD?=?0.8), and 48.5% were female. Median duration on ART was 8.6 (interquartile range?=?6.0–10.6) years. Of total, 76.8% of the participants had achieved viral suppression. After adjustment for other covariates, the likelihood of having viral non-suppression remained significantly lower among adolescents who were: older/aged 17 (AOR?=?0.46, 95% CI 0.21–0.98), had been on ART for more than 9 years (AOR?=?0.35, 95% CI 0.19–0.64), had most recent CD4 count of >?672 (AOR?=?0.47, 95% CI 0.26–0.86), had a relative as the main daily caregiver (AOR?=?0.37, 95% CI 0.17–0.80), and did not believe that there is a cure for AIDS (AOR?=?0.40, 95% CI 0.21–0.75) compared to their reference group. The likelihood of having viral non-suppression also remained significantly higher among adolescents who had first viral load >?628 RNA copies/mL (AOR?=?1.81, 95% CI 1.05–4.08) and among those who were receiving HIV care and treatment from an adult clinic (AOR?=?2.95, 95% CI 1.56–5.59).

Conclusions

The proportion of adolescents living with HIV with viral suppression in this study was relatively high at 76.8%, but falls short of the global target of 90%. Programs targeting younger adolescents and adolescents in transition from pediatric to adult care with a range of interventions including psychosocial support and treatment literacy could further improve viral suppression outcomes.

     

Domestic violence against women in Sivas, Turkey: survey study

Aim

To determine the self-reported prevalence of domestic violence and associated risk factors in the Sivas province of Turkey.

Method

Five hundred and eighty-three households were chosen by the method of stratified random sampling. The average age among women was 28.65 ± 4.64. A total of 45.3% of women were in 30-34 age-group, 76.5% were housewives, and 91.2% were married. The data were gathered by performing face-to-face interviews in participants’ homes. Demographic data were obtained by fill-in forms.

Results

We found a statistically significant relationship among the types of violence and annual income, type of family, education and occupation level of women, education level of perpetrators, watching violent films, and childhood experience of emotional abuse or negligence. Fifty-two percent of women were exposed to at least one type of violence. Verbal violence was the most frequent type of violence (53.8%), followed by physical violence (38.3%). About 45% of women exposed to violence were in the 30-34 age group, 41.6% completed only primary schools, 73.6% were housewives, 91.7% were married, 71.0% had been exposed to violence during their childhood, and 45.2%, had been exposed to violence several times in a month. Economic problems were reported as the most important reason for domestic violence (31.4%).

Conclusion

Our study found higher prevalence of domestic violence than expected. As an important public health problem, domestic violence requires multidisciplinary approach to understand its causes and plan preventive measures.Domestic violence against women is a serious public health concern in every community and culture (1). Domestic violence against women has drawn attention from the medical community because it has a negative and harmful impact on the mental, physical, and social health of women (2-5). World Health Organization (WHO) has defined domestic violence as “the range of sexually, psychologically, and physically coercive acts used against adult and adolescent women by current or former male intimate partners” (6,7). It is often difficult to conduct research on violence against women, since most women are reluctant to disclose information they consider confidential and intimate. They often feel shame, fear, guilt, and do not want to be disloyal to their partners (8). Besides this, differences in prevalence patterns can occur, because of different survey methods.Violence cannot be attributed to a single cause. According to the ecological model, factors related to violence are covered under four subtitles: 1) biological and personal factors; 2) close relationships, intimate partner; 3) the community context; and 4) the broad societal factors (3,9,10). However, this model only is not sufficient to explain violence and its characteristics.There is a number of studies highlighting the problem of domestic violence in the developing countries (8,10-13). Some studies showed a strong association between socioeconomic status and domestic violence, indicating a significant inverse relation between the income or education level of the male partner and violence (14). Some studies reported that women with greater autonomy, higher educational level, and control over economical resources are more protected against violence (3). However, in many families the husband is the sole decision-maker and the only one in control over financial matters (2,3,15,16). Experiencing abuse or witnessing domestic violence in childhood often turns individuals into either victims or perpetrators, thus closing the vicious circle of domestic violence. According to some studies, large families or larger number of children is associated with a reduced risk of domestic violence (11,17).It has been reported that one out of five women in South Australia has been exposed to domestic violence in forms of physical and/or sexual abuse (18). Violence against women in North America is still prevalent, with lifetime prevalence of 40%-51% (19). The rate of physical violence is higher in developing than in developed countries. The rate of women who are exposed to violence by their husbands is 45% in India, 47% in Philippines, 52% in Kenya (20). In Arab and Islamic countries, domestic violence is not yet considered a major concern, although its frequency is quite high. Surveys carried out in those countries have shown that the ratio of women who have been exposed to violence by their husbands is at least one in three women (21).Domestic violence is an increasingly important issue in Turkey as in the rest of the world. It has gained its importance since 1970, and in the mid 1980s it was brought to the public agenda for discussion. The first collective reaction of women against violence was the march of “No Violence” campaign performed in 1987. This was followed by reactions in “Kariye Women Festival” in 1987. In Turkey, violence is perceived as a discipline tool, which lead to legitimization of violence within the family and society that reproduces and camouflages violence. There are legal provisions accepting the legitimacy of domestic violence. In Turkish Criminal Law, there is no special provision for domestic violence. It is easier for a woman to complain to the formal authorities about violence in the street than about domestic violence.A study including 300 married women treated in the psychiatric outpatient clinic of the Hospital of Cumhuriyet University showed that domestic violence against women was highly prevalent and that women were trying to hide it (22). The study determined that 57% of women in the 16-29 age group were exposed to physical violence. The prevalence of emotional violence was 36%, economical 32%, sexual 30.7%, and verbal 29.3%.According to data from the Institution of Family Research (23), 35% of women in Turkey experienced physical violence from their husbands. According to the research, domestic violence was common to all socio-economical levels both in urban and rural areas. Among the causes of domestic violence reported, there were economical difficulties, temperament of the husbands, and provocation of husbands by their relatives. However, we do exactly not know which factors affect the prevalence of domestic violence in Turkey. As far as we know, there is no study investigating the relationship between domestic violence and childhood traumas. In this study, we aimed to determine the self-reported prevalence of domestic violence and the associated risk factors in the Sivas province in Turkey.     

Serum total IgE levels in a representative sample of a Greek population

The distribution of IgE in a large randomly stratified Greek population sample was determined in 1187 subjects (793 men and 394 women) aged between 20 and 60 years. Skin prick testing was performed and serum total IgE expressed in iu/ml was measured by Phadebas PRIST: the data are presented as the geometric mean. Subjects were classified as atopic (257 men, 118 women) and nonatopic (536 men, 276 women) according to the results of skin testing with various aeroallergens. At any age, atopic males (120.5 vs 38 iu/ml) and females (99.8 vs 29.3 iu/ml) had higher mean IgE levels, as compared to nonatopic subjects ( P <0.0001). In our adult nonatopic sample, IgE levels did not differ with age ( P >0.05). At any age, nonatopic males had higher (38 iu/ml) mean IgE levels than nonatopic females (29.3 iu/ml) ( P <0.05). The comparison of normal IgE values (nonatopic subjects) from this study with those reported by other investigators revealed that Greek adult males and females had higher IgE levels than populations from other nations. Our results represent the first report on reference values regarding serum total IgE in Greek adults.     

Climacteric symptoms in a representative Dutch population sample as measured with the Greene Climacteric Scale

OBJECTIVE: To measure climacteric symptoms in a population-based survey as assessed by the Greene Climacteric Scale and to obtain normative data for the total score and subscales (psychological, somatic, vasomotor, and sexual) of the Greene Climacteric Scale. METHODS: A sample representative of the Dutch female population is interviewed. The sample was drawn from the NIPO-Telepanel (with 269 women aged 45-65 years) and from the NIPO-CAPI@HOME database (a sample of 235 women aged 45-65 years). They all filled in the 21 items of the Greene Climacteric Scale. The women were divided in four groups according their menopausal status: premenopausal, perimenopausal, postmenopausal and posthysterectomy. RESULTS: The total score of the Greene Climacteric Scale (mean; SD) was in premenopausal women 10.53 +/- 7.36). The score in perimenopausal women (15.78 +/- 9.09) and postmenopausal women (15.33 +/- 9.01) were significant higher than in the premenopause. The same significant difference between pre and peri/postmenopausal women was observed in the psychological, somatic and vasomotor subscales. The depression subscale did not change significantly during the menopausal transition. Hysterectomized women had the same score as postmenopausal women, reflecting the rather high mean age of the hysterectomized women (55.8 years). CONCLUSIONS: Prevalence and intensity of climacteric symptoms as expressed in the Greene Climacteric Scale do increase during the menopausal transition and stay high during the postmenopause. Data presented can be considered normative for the Greene Climacteric Scale in a mainly Caucasian population.     

Osteopenia is associated with glycemic levels and blood pressure in Chinese postmenopausal women: a cross-sectional study

The aim of present study was to explore the relationships between osteopenia and dyslipidemia, glycemic levels or blood pressure in postmenopausal Chinese women. A total of 4080 women aged 42–85 years were enrolled in this cross-sectional study, which was nested in an ongoing longitudinal (REACTION) study. Calcaneus quantitative ultrasound (QUS) was performed and QUS T score was calculated to assess bone mineral density. Osteopenia was defined as a T score ≤?1.0. The relationship between osteopenia and dyslipidemia, glycemic levels or blood pressure was investigated. The prevalence of osteopenia was significantly lower in subjects with systolic blood pressure (SBP) ≥140 mmHg, fasting blood glucose (FBG) ≥8.0 mmol/L, postprandial blood glucose (PBG) ≥15.0 mmol/L, hemoglobin A1c (HbA1C) 6.5–7.5 %, HbA1C ≥7.5 %. These relationships remained significant after controlling for multiple factors. Moreover, significant trend between osteopenia and SBP, FBG, PBG and HbA1C was observed in women. In contrast, no significant associations between osteopenia and diastolic blood pressure (DBP), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) were found, and no significant trend relationship between osteopenia and DBP, TC, TG, HDL-C, LDL-C was found in postmenopausal Chinese women. The present study showed a relationship between SBP, FBG, PBG, HbA1C and osteopenia in postmenopausal Chinese women, while no significant relationship was observed between dyslipidemia, DBP and osteopenia, even after controlling for multiple confounding factors.     

Factors associated with enablement in general practice: cross-sectional study using routinely-collected data.

BACKGROUND: Quality-improvement activities are most often focused on clinical quality indicators. However, patient evaluations are important additional indicators of the quality of general practice consultations, including measures of satisfaction or enablement (that is, the extent to which the consultation enhances the patient's feelings of confidence and ability to cope). There is limited evidence concerning factors associated with enablement in UK general practice. AIM: To identify patient and practice characteristics associated with enablement scores following general practice consultations. DESIGN OF STUDY: Cross-sectional survey using a large routinely-collected dataset of patient evaluations of general practice (190,038 individual patient responses). SETTING: A total of 1031 UK general practices. METHOD: Relationships between health, demographic factors, evaluations of general practice care, and patient self-reported enablement were estimated using multiple regression. RESULTS: The primary predictor of enablement was positive patient evaluation of the GPs' communication. Reported continuity of care accounted for a lower proportion of the variance. Of the included patient demographic variables, ethnicity was a key predictor, with patients from minority ethnic groups reporting greater enablement once other factors were controlled. CONCLUSION: The current results provide support for the construct validity of the enablement measure. However, if enablement is to become a valid and useful measure of quality, it is necessary to understand the mechanisms by which enablement is increased in certain patients and practices. Detailed qualitative research may also be required to explain the relatively high scores of ethnic minority responders, despite lower overall satisfaction scores, and to understand why some items included in the enablement measure are regarded as 'not applicable' by a substantial minority of patients.     

Factors associated with insomnia symptoms: A cross-sectional study during a Covid-19 fully restrictive lockdown

Insomnia is the most frequent sleep disorder and a public health concern that increased during the Covid 19 pandemic. Fully restrictive lockdowns during Covid are interesting periods to examine the impact of environmental and behavioural changes on the emergence of insomnia symptoms. In this cross-sectional study we aimed to (1) determine the main factors associated with insomnia symptoms during a Covid-19 fully restrictive lockdown examining the associated daily life alterations and (2) create a predictive model of insomnia symptoms. We used the data drawn from the “Covid-RythmE” study that reached volunteers from the general French population through an online survey during the last 2 weeks of the 2 month full lockdown. Associations with insomnia symptoms were tested and significant associations were entered in a Backward Stepwise Logistic Regression (BSLR) to assess the best combination to classify individuals with or without insomnia symptoms. From the 1624 participants, 50.64% suffered from mild to severe insomnia symptoms as assessed by the ISI. The best combination for explaining insomnia symptoms with 74.26% of accuracy included: age (OR = 1.15), females (OR = 1.26), smaller home sizes (OR = 0.77), environmental noises (OR = 1.59), anxiety symptoms (OR = 1.24), depressive symptoms (OR = 1.15), regularity of sleep–wake schedules (OR = 1.25), exposure to screen during the morning (OR = 1.13), and LED light during the evening (OR = 1.17). Thus, lifestyle schedule and exposure to natural synchronizers such as light, are primordial in considering in insomnia physiopathology, prevention and treatment, as well as the associated mental health status.     

Factors associated with serum CA19-9 levels among healthy children: a cross-sectional study

Background

CA19-9 is a tumor marker mainly used for biliary tract, pancreas and colorectum. Since the marker applies usually for adults, the normal range of serum CA19-9 among children has been rarely reported. This is the first study reporting the distribution of serum CA19-9 levels among cancer-free children as well as their parents, taking into account the Lewis and secretor gene polymorphism and physical growth.

Methods

Study subjects were 972 apparently healthy Japanese Brazilians including 476 children aged from 1 to 19 years.

Results

The comparisons in five-year age groups demonstrated that the mean values of serum CA19-9 was lower in the boys than in the girls, and higher in younger age groups; 22.5 U/ml for 1–4 year-old (n=13), 17.4 U/ml for 5–9 year-old (n=36), 15.5 U/ml for 10–14 year-old (n=96) and 10.2 U/ml for 15–19 year-old (n=74) in boys, and 25.3 U/ml (n=11), 27.1 U/ml (n=50), 17.7 U/ml (n=105) and 13.5 U/ml (n=59) in girls, respectively. The difference in those geometric means was statistically significant among four age groups (p=0.006, ANOVA adjusted for sex). After Lewis and secretor genotypes, which are definitive factors of serum CA19-9, were taken into account, geometric mean of serum CA19-9 was associated with any of BMI (p<0.001), height (p<0.001) and weight (p<0.001) among children excluding those with le/le genotype. The associations were still significant when age was adjusted.

Conclusions

Serum CA19-9 values were higher among children than among adults, and influenced by sex, height, weight, and BMI even after the adjustment for age as well as Le and Se genotypes.

     

An experimental COVID-19 messaging study in a representative sample of the Scottish population: Increasing physical distancing intentions through self-efficacy

Objectives

Self-efficacy is important for adherence to transmission-reducing behaviours (e.g., physical distancing) as also shown in the CHARIS project. We aimed to show that a theory-based short message can increase physical distancing self-efficacy and intentions to keep physical distance.

Design

Structured telephone surveys with a randomly selected nationally representative sample of adults in Scotland (N = 497).

Methods

Participants were randomly assigned to one of two experimental conditions: message condition (short message to increase self-efficacy via vicarious experiences, verbal persuasion and emotional arousal) or control condition (no message). Followed by measures for self-efficacy and intention for physical distancing on 4-point scales. Adherence to physical distancing was assessed on a 5-point frequency scale (never – always).

Results

Using mediation analyses with bootstrapping procedures, we first confirmed that self-efficacy was associated indirectly with adherence, via higher intentions in a partial mediation (unstandardized indirect effect .21, 95% CI .18–.25). The message increased self-efficacy; participants receiving the message reported higher self-efficacy (M = 4.23, SD = .80) compared to participants in the control condition (M = 4.08, SD = .77; standardized regression coefficient = .19, p < .05) and self-efficacy affected intention (.48, p < .001). There was a small significant indirect effect of the message on intention via self-efficacy (unstandardized indirect effect .07, CI .01–.14).

Conclusions

Increasing self-efficacy for physical distancing with a short message can successfully increase intention to physical distance via increased self-efficacy. As both self-efficacy and intentions are important predictors of adherence to transmission-reducing behaviours short messages have potential to limit the spread of COVID-19.     

Determinants of elevated blood pressure in women around menopause: results from a cross-sectional study in Italy

OBJECTIVE: To analyse the determinants of high blood pressure in women around menopause. METHODS: Eligible women were consecutively identified among patients who asked for a visit of their general practitioner during the period March November 1997. A total of 22919 women aged 44-66 years (median age 55 years), were identified. Women whose mean of the second and third of the three measures of diastolic blood pressure values performed during interview was > 90 mm of mercury and/or reporting any type of current pharmacological treatment for elevated blood pressure were considered hypertensive. RESULTS: In comparison with women aged 40-50 years, the multivariate odds ratio (OR) of elevated blood pressure were 1.4 in women aged 51-55, 2.0 in those aged 56-60 and 2.7 in those aged > or = 61. In comparison with women with a body mass index (kg m(-2)) < 25, the OR of elevated blood pressure was 1.7 and 2.7, respectively, for women with a BMI of 25 28 and > or = 29. In comparison with women reporting a low level of physical activity, the OR of elevated blood pressure were 0.9 (95%, confidence interval, CI 0.7-1.0) and 0.7 (95% CI 0.4-0.9), respectively, for those reporting an intermediate or high level of activity. In comparison with premenopausal women, the OR of elevated blood pressure was, after taking into account the confounding effect of age, 1.6 (95% CI 1.0-1.4) in post menopausal ones. The OR of elevated blood pressure was 0.8 (95% CI 0.7-0.9), for current users of hormone replacement therapy (HRT), but no clear association emerged with duration of HRT pressure. CONCLUSIONS: This study suggests that, after taking into account the effect of age, post-menopausal women are at higher risk of the condition, and current HRT use decreases the risk. Other main determinants of risk of elevated blood pressure were overweight and low physical activity.