Association Between Cost-Related Medication Nonadherence and Hypertension Management Among US Adults

2020 ◽  
Vol 33 (9) ◽  
pp. 879-886 ◽  
Author(s):  
Jing Fang ◽  
Tiffany Chang ◽  
Guijing Wang ◽  
Fleetwood Loustalot
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Medication ◽  
Medication Use ◽  
Normal Blood ◽  
Hypertension Management ◽  
Normal Blood Pressure ◽  
Medication Nonadherence ◽  
Financial Barriers ◽  
The Past ◽  
Prevalence Ratios

Abstract BACKGROUND Medication nonadherence is an important element of uncontrolled hypertension. Financial factors frequently contribute to nonadherence. The objective of this study was to examine the association between cost-related medication nonadherence (CRMN) and self-reported antihypertensive medication use and self-reported normal blood pressure among US adults with self-reported hypertension. METHODS Participants with self-reported hypertension from the 2017 National Health Interview Survey were included (n = 7,498). CRMN was defined using standard questions. Hypertension management included: (i) self-reported current antihypertensive medication use and (ii) self-reported normal blood pressure within the past 12 months. Adjusted prevalence and prevalence ratios of hypertension management indicators among those with and without CRMN were estimated. RESULTS Overall, 10.7% reported CRMN, 83.6% reported current antihypertensive medication use, and 67.4% reported normal blood pressure within past 12 months. Adjusted percentages of current antihypertensive medication use (88.6% vs. 82.9%, P < 0.001) and self-reported normal blood pressure (69.8% vs. 59.5%, P = 0.002) were higher among those without CRMN compared with those with CRMN. Adjusted prevalence ratios showed that, compared with those with CRMN, those without CRMN were more likely to report current antihypertensive medication use (odds ratio = 1.08, 95% confidence interval 1.04–1.12) and self-reported normal blood pressure (1.15 (1.07–1.23)). CONCLUSIONS Among US adults with self-reported hypertension, those without CRMN were more likely to report current antihypertensive medication use and normal blood pressure within the past 12 months. Financial barriers to medication adherence persist and impact hypertension management.

Abstract P349: Dietary Sodium Intake according to the Hypertension Management Status: The Fourth Korea National Health and Nutrition Examination Survey.

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Won Joon Lee ◽  
Hyeon Chang Kim ◽  
Sun Min Oh ◽  
Dong Phil Choi ◽  
Hye Min Cho ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Energy Intake ◽  
Sodium Intake ◽  
Normal Blood ◽  
Hypertension Management ◽  
Nutrition Examination Survey ◽  
Normal Blood Pressure ◽  
Health And Nutrition ◽  
Eating Out

Introduction : High sodium intake is an established risk factor for hypertension and cardiovascular diseases. The average sodium intake in Koreans was estimated at 4,645mg/day, which was more than two times compared to the recommended amount, 2000mg/day. We assessed whether people who diagnosed with hypertension or treated for hypertension consume less sodium than those without hypertension. Methods : The present study analyzed data from a total of 6,577 Koreans (3,816 women and 2,761 men) aged 40 years and older, participated in the Korea National Health and Nutrition Examination Survey (KNHANES IV, 2007-2008). Participants were classified into five groups as follows: normal blood pressure, pre-hypertension, hypertension without treatment, hypertension with treatment, and hypertension with complications. The association between sodium intake and hypertension management status was estimated using exponential regression coefficient, adjusted for potential confounders including age, energy intake, body mass index, income, education, marriage, occupation, the frequency of eating out and effort to lower sodium intake. Results : In women, the median sodium intake tended to decrease according to the following groups; 3,708mg in normal blood pressure, 3,515mg in pre-hypertension, 3,191mg in hypertension without treatment, 3,113mg in hypertension with treatment, and 2,862mg in hypertension with complications (P for trend < 0.001). In men, a similar trend was shown, but sodium consumption was the highest in the prehypertension group; 5,099mg in normal blood pressure, 5,353mg in pre-hypertension, 5,118mg in hypertension without treatment, 4,708mg in hypertension with treatment, and 3,798mg in hypertension with complications (P for trend < 0.001). After controlling for potential confounders (energy intake, body mass index, occupation, the frequency of eating out), the trend was not significant both in women (P for trend= 0.887) and men (P for trend=0. 204). Only in men with prehypertension, sodium intake was 1.08 times higher than that in normal blood pressure group (P = 0.025). Conclusions : The present study showed that Korean women and men consumed sodium more than the recommended amount regardless of the presence of, the treatment for, or knowing the complications of hypertension. Moreover, men with prehypertension consumed the highest amount of sodium.

scholarly journals High-normal blood pressure (prehypertension) is associated with PM2.5 exposure in young adults

2021 ◽  
Author(s):  
Huaze Ye ◽  
Jie Tang ◽  
Leiqin Luo ◽  
Tianjian Yang ◽  
Kedi Fan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Young Adults ◽  
Logistic Models ◽  
Normal Blood ◽  
Young Population ◽  
Normal Blood Pressure ◽  
Short Term ◽  
The Past ◽  
The Mean ◽  
Term Fluctuation

Abstract We aimed to examine PM2.5 exposure, blood pressure (SBP and DBP) measurement, hypertension risk factors and to assess the association between PM2.5 exposure and hypertension among young adults. The mean SBP was 117.78 mmHg, with 11.22% high-normal blood pressure (prehypertension) and 2.51% hypertension (≥ 140 mmHg). DBP was 75.48 mmHg with 26.37% prehypertension and 4.53% hypertension (≥ 90 mmHg). The median PM2.5 in the past year was 31.79 µg/m3, with highest in winter (49.33 µg/m3), followed by spring (37.34 µg/m3), autumn (29.64 µg/m3) and summer (24.33 µg/m3). Blood pressure was positively correlated with age, height, weight, BMI, daily smoking, alcohol consumption, mental stress and stay-up in the past 1 year. After adjustment for the covariates, each 10 µg/m3 increase in PM2.5 was associated with SBP (Day 1 = 1.07 mmHg, Day 3 = 1.25 mmHg, Day 5 = 1.01 mmHg) and DBP (Day 1 = 1.06 mmHg, Day 3 = 1.28 mmHg, Day 5 = 1.29 mmHg, Day 15 = 0.87 mmHg, Day 30 = 0.56 mmHg). Exposure in winter was associated with 1.17 mmHg increase in SBP. Logistic models showed for every 1 µg/m3 increase of PM2.5, SBP in Day 1 and Day 5 was increased by 6% and 4%, and DPB by 3% and 16%, respectively. SBP was increased by 13% in spring and 7% in winter, and DBP was increased by 12% in winter. Our data suggest a certain prevalence of pre- or hypertension among young population, which is associated with short-term fluctuation and season-specific exposure of PM2.5.

Influence of melatonin on blood pressure indicators with different severity of desynchronosis

2020 ◽  
pp. 30-40
Author(s):  
M. G. Melnik
Keyword(s):  
Blood Pressure ◽  
Circadian Rhythms ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Home Monitoring ◽  
Normal Blood ◽  
Normal Blood Pressure ◽  
Pronounced Decrease ◽  
The Third ◽  
Pressure Indicators

Purpose. To study the dynamics of blood pressure (BP) indicators under the influence of exogenously administered melatonin (Melatonin-SZ, Severnaya Zvezda, Russia) with various manifestations of desynchronosis of circadian BP rhythms (arterial hypertension – AH, high normal blood pressure) to determine the scheme of their effective compensation. Material and methods. The study included 101 patients with desynchronosis of circadian rhythms of blood pressure – 52 patients with hypertension, constituting the first and second groups, and 49 individuals with high normal blood pressure, representing the third and fourth groups. Patients of the second and fourth groups received conservative therapy, patients of the first and third groups combined it with melatonin. All patients underwent measurements of office blood pressure, home monitoring of blood pressure (ABPM), electrocardiography, 24-hour blood pressure monitoring (ABPM). Results and discussion. In patients of the first and third groups, compared with the traditional treatment groups, by the end of the observation period, a significantly (p < 0.05) decrease in office systolic blood pressure (SBP) / diastolic blood pressure (DBP) was established: in the first group compared with the second – 1.11 / 1.13 times, in the third group compared to the fourth – 1.43 / 1.58 times; significantly more (p < 0.05) pronounced decrease in SBP / DBP during DMAD – by 1.08 / 1.17 and 1.58 / 1.62 times, respectively, Significantly (p < 0.05) more pronounced decrease in average daily, average daily and average nighttime SBP / DBP during ABPM – by 1.13 / 1.20, 1.11 / 1.20, 1.23 / 1.25 and 1.47 / 1.31, 1.42 / 1.19, 1.54 / 1.41 times, respectively; reliably (p < 0.05) more frequent registration of the dipper rhythm type SBP / DBP – 1.6 / 1.4 and 1.6 / 1.4 times, respectively. In addition, the dynamics of patients in the first and third groups showed a significant (p < 0.05) decrease in the mean daily and mean nighttime SBP / DBP variability (SBP in the first group by 27.3 and 41.3 %, respectively; DBP in the first group by 20.1 and 26.3 %, respectively; SBP in the third group by 13.5 and 25.2 %, respectively; DBP in the third group by 12.2 and 28.2 %, respectively). Conclusions. With various manifestations of desynchronosis of circadian rhythms of blood pressure (AH, high normal blood pressure), the prescription of melatonin (Melatonin-SZ, Severnaya Zvezda, Russia) at a dose of 3 mg per day 30–40 minutes before bedtime for a month against the background of non-drug therapy and antihypertensive drugs led to a significantly more effective decrease in blood pressure at its office measurement, DMAD, ABPM with an improvement in the circadian rhythm of blood pressure and normalization of blood pressure variability.

EFFECT OF SUBMAXIMAL EXERCISE ON SYSTOLIC AND DIASTOLIC BLOOD PRESSURE IN YOUNG SEDENTARY NORMOTENSIVE NEPALESE MEDICAL STUDENTS

2003 ◽  
Vol 42 (149) ◽  
pp. 315-6
Author(s):  
Arijit Ghosh ◽  
T Pramanik
Keyword(s):  
Blood Pressure ◽  
Medical Students ◽  
Diastolic Blood Pressure ◽  
Submaximal Exercise ◽  
Muscular Exercise ◽  
Normal Blood ◽  
Normal Blood Pressure ◽  
Standing Posture ◽  
Normal Range ◽  
Exercise Blood Pressure

Higher exercise blood pressure represents low cardiorespiratory status of an individual and vice versa. Thechanges in systolic and diastolic blood pressure in response to rhythmic isotonic muscular exercise in sedentaryyoung normotensive Nepalese students were assessed. Normal blood pressure in standing posture in maleand female subjects are about 115 / 75 mm of Hg. and 106 / 71 mm of Hg. respectively. Just after the exercisesystolic blood pressure increases moderately in both the sexes, whereas diastolic blood pressure remainsunchanged in most of the females. Diastolic blood pressure is found to be decreased slightly in the males,just after exercise. The present study indicates the cardiorespiratory status of the Napalese medical studentsis within normal range.

scholarly journals A longitudinal analysis of the progression from normal blood pressure to stage 2 hypertension: A 12-year Korean cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eun Sun Yu ◽  
Kwan Hong ◽  
Byung Chul Chun
Keyword(s):  
Blood Pressure ◽  
Health Insurance ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Normal Blood ◽  
Normal Blood Pressure ◽  
The Mean ◽  
Stage 1

Abstract Background The study aimed to estimate the incidence of and period of progression to stage 2 hypertension from normal blood pressure. Methods We selected a total of 21,172 normotensive individuals between 2003 and 2004 from the National Health Insurance Service-Health Screening and followed them up until 2015. The criteria for blood pressure were based on the American College of Cardiology/American Heart Association 2017 guideline (normal BP: SBP < 120 and DBP < 80 mmHg, elevated BP: SBP 120–129 and DBP < 80 mmHg, stage 1 hypertension: SBP 130–139 or DBP 80–89 mmHg, stage 2 hypertension: SBP ≥140 or DBP ≥ 90 mmHg). We classified the participants into four courses (Course A: normal BP → elevated BP → stage 1 hypertension→ stage 2 hypertension, Course B: normal BP → elevated BP → stage 2 hypertension, Course C: normal BP → stage 1 hypertension → stage 2 hypertension, Course D: normal BP → stage 2 hypertension) according to their progression from normal blood pressure to stage 2 hypertension. Results During the median 12.23 years of follow-up period, 52.8% (n= 11,168) and 23.6% (n=5004) of the participants had stage 1 and stage 2 hypertension, respectively. In particular, over 60 years old had a 2.8-fold higher incidence of stage 2 hypertension than 40–49 years old. After the follow-up period, 77.5% (n=3879) of participants with stage 2 hypertension were found to be course C (n= 2378) and D (n=1501). After the follow-up period, 77.5% (n=3879) of participants with stage 2 hypertension were found to be course C (n= 2378) and D (n=1501). The mean years of progression from normal blood pressure to stage 2 hypertension were 8.7±2.6 years (course A), 6.1±2.9 years (course B), 7.5±2.8 years (course C) and 3.2±2.0 years, respectively. Conclusions This study found that the incidence of hypertension is associated with the progression at each stage. We suggest that the strategies necessary to prevent progression to stage 2 hypertension need to be set differently for each target course.

[PP.19.09] APELIN AND VISFATIN PLASMA LEVELS IN HEALTHY INDIVIDUALS WITH HIGH NORMAL BLOOD PRESSURE

2016 ◽  
Vol 34 ◽  
pp. e235-e236
Author(s):  
D. Papadopoulos ◽  
E. Sanidas ◽  
D. Perrea ◽  
H. Grassos ◽  
C. Liakos ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Plasma Levels ◽  
Normal Blood ◽  
Normal Blood Pressure ◽  
Healthy Individuals
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