scholarly journals Trajectory of systolic blood pressure in a low-income, racial-ethnic minority cohort with diabetes and baseline uncontrolled hypertension

2017 ◽  
Vol 19 (7) ◽  
pp. 722-730 ◽  
Author(s):  
Leah L. Zullig ◽  
Yuanyuan Liang ◽  
Shruthi Vale Arismendez ◽  
Aron Trevino ◽  
Hayden B. Bosworth ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Ethnic Minority ◽  
Low Income ◽  
Uncontrolled Hypertension ◽  
Racial Ethnic

Abstract 091: Improved Blood Pressure Control and High Adherence to a Novel Management Model of Hypertension Care in a West African Population

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Isaac Owusu ◽  
Fred Adomako-Boateng ◽  
Fred Kueffer ◽  
Molly Guy ◽  
Chemuttaai Lang’at ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Pressure Control ◽  
Management Plan ◽  
West African ◽  
Sub Saharan Africa ◽  
Management Model ◽  
Uncontrolled Hypertension ◽  
Hypertension Management ◽  
Software Application

Background: Logistic and socioeconomic barriers limit effective blood pressure (BP) control in many parts of Sub-Saharan Africa, including the Republic of Ghana. We tested a novel hypertension management model of care designed for resource-limited settings. Methods and Results: The “Akoma Pa” model was developed using human-centered design methodology involving patients, physicians, and nurses. The model consisted of a mobile tablet, BP machine and a novel software application in a unique platform to allow for longitudinal patient management. Patients were provided with a tailored hypertension management plan based on their enrollment comorbidities and risk factors. A cohort of 150 hypertensive patients (57±8 years; 73% female) accessed regular blood pressure assessments at a local pharmacy and received real-time automated feedback based on their individualized plan. On the mobile application, clinicians were able to view patient data, provide patients with feedback via SMS on their condition, and write electronic prescriptions which could be accessed by participating pharmacies. Average baseline BP was 135±18/84±10 mmHg in the overall cohort and 153±13/90±11 mmHg in the subgroup with uncontrolled hypertension (n=58). After 6 months of voluntary weekly monitoring, systolic blood pressure decreased significantly (p<0.01) in the overall cohort (-4.7±18.7 mmHg) and in the uncontrolled subgroup (-15.2±17.6mmHg). Systolic blood pressure remained constant in the sub group with controlled pressure at baseline. The proportion of the population with uncontrolled hypertension decreased from 39% to 27% (p=0.01). Patient compliance with weekly BP assessments was 61% and 2,855 BP assessments were conducted. During 33 of the 2,855 BP assessments (1% of pharmacy visits), the software application directly referred patients to a health facility (33 visits in 25 patients). Improvement in overall health awareness was reported in 82% of the participants and 95% of participants indicated a desire to continue using this model in the future. Conclusions: Compliance and satisfaction with this multifaceted hypertension care model were high and led to significant and sustained decreases in blood pressure in this West African hypertensive population.

scholarly journals Managing hypertension in 2018: which guideline to follow?

Heart Asia ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. e011127 ◽  
Author(s):  
Fabio Angeli ◽  
Gianpaolo Reboldi ◽  
Monica Trapasso ◽  
Adolfo Aita ◽  
Paolo Verdecchia
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Low Income ◽  
Asian Population ◽  
Public Health Issue ◽  
Global Public Health ◽  
Asian Countries ◽  
Western Countries ◽  
Asian Populations ◽  
The Impact

Hypertension is a global public health issue and a major cause of morbidity and mortality. Its prevalence is increasing in many Asian countries, with a number of countries with blood pressure above the global average. Although the average systolic blood pressure is decreasing worldwide since the 1980s at the rate of about 1 mm Hg systolic blood pressure per decade, it is increasing in low-income and middle-income countries, especially in the East and South Asian population. Of note, the much larger base Asian population results in a considerably larger absolute number of individuals affected. When compared with Western countries, hypertension among Asian populations has unique features in terms of its onset, clustering of associated cardiovascular risk factors, complications and outcomes. Moreover, only a minority of hypertensive individuals are receiving treatment and achieving control. Projected number of deaths related to hypertension dramatically increased in the last 25 years in some Asian regions with a disproportionately high mortality and morbidity from stroke compared with Western countries. The relation between blood pressure and the risk of stroke is stronger in Asia than in Western regions. Although new Guidelines for hypertension diagnosis and management have been recently released from Europe and North America, the unique features of Asian hypertensive patients raise concerns on the clinical applicability of Western Guidelines to Asian populations. To this purpose, we critically reviewed key elements from the most updated Guidelines. We also discussed their core concepts to verify the impact on hypertension prevention and management in Asian countries.

scholarly journals Factors That Matter to Low-Income and Racial/Ethnic Minority Mothers When Choosing a Pediatric Practice: a Mixed Methods Analysis

2017 ◽  
Vol 4 (6) ◽  
pp. 1051-1060 ◽  
Author(s):  
Sarah L. Goff ◽  
Kathleen M. Mazor ◽  
Haley Guhn-Knight ◽  
Yara Youssef Budway ◽  
Lorna Murphy ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Ethnic Minority ◽  
Low Income ◽  
Pediatric Practice ◽  
Racial Ethnic

Effects of Full-Day Kindergarten on the Long-Term Health Prospects of Children in Low-Income and Racial/Ethnic-Minority Populations

2014 ◽  
Vol 46 (3) ◽  
pp. 312-323 ◽  
Author(s):  
Robert A. Hahn ◽  
Veda Rammohan ◽  
Benedict I. Truman ◽  
Bobby Milstein ◽  
Robert L. Johnson ◽  
...  
Keyword(s):  
Ethnic Minority ◽  
Low Income ◽  
Minority Populations ◽  
Full Day Kindergarten ◽  
Ethnic Minority Populations ◽  
Full Day ◽  
Racial Ethnic

scholarly journals A successful approach to minimizing attrition in racial/ethnic minority, low-income populations

2017 ◽  
Vol 5 ◽  
pp. 168-174 ◽  
Author(s):  
Glenn Flores ◽  
Alberto Portillo ◽  
Hua Lin ◽  
Candy Walker ◽  
Marco Fierro ◽  
...  
Keyword(s):  
Ethnic Minority ◽  
Low Income ◽  
Successful Approach ◽  
Racial Ethnic

scholarly journals Characteristics of Low-income Racial/Ethnic Minority Pregnant Women Screening Positive for Alcohol Risk

2015 ◽  
Vol 18 (4) ◽  
pp. 850-855 ◽  
Author(s):  
Yukiko Washio ◽  
Amy A. Mericle ◽  
Heather Cassey ◽  
Angela M. Daubert ◽  
Kimberly C. Kirby
Keyword(s):  
Pregnant Women ◽  
Ethnic Minority ◽  
Low Income ◽  
Racial Ethnic ◽  
Alcohol Risk

Abstract 3113: Uncontrolled Hypertension, Systolic and Diastolic Blood Pressure and Development of Symptomatic Peripheral Arterial Disease in the Women’s Health Study

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Tiffany M Powell ◽  
Robert J Glynn ◽  
Mark A Creager ◽  
Paul M Ridker ◽  
Aruna D Pradhan
Keyword(s):  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Arterial Disease ◽  
Uncontrolled Hypertension ◽  
Health Study ◽  
Adjusted Risk ◽  
Treatment Status ◽  
Peripheral Arterial

Background : Prospective data pertaining to risk factors for peripheral arterial disease (PAD) in women are sparse. Few studies have evaluated blood pressure, including uncontrolled hypertension, and PAD onset in women. Methods and Results : We examined the relationship between blood pressure and development of confirmed symptomatic PAD (n=116 events) in a prospective cohort study of 39,261 female health professionals aged ≤ 45 years without diagnosed vascular disease at baseline. Median follow-up was 11.4 years. Women were first grouped according to baseline presence of uncontrolled hypertension, defined as reported systolic blood pressure (SBP)≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg, and pharmacologic treatment status. SBP and DBP were then modeled as continuous and categorical exposures irrespective of treatment status. Pulse pressure (PP) and mean arterial pressure (MAP) were also assessed. Age-adjusted and multivariable-adjusted risk estimates were derived from Cox proportional hazards models. Women with treated but uncontrolled hypertension had the highest risk of symptomatic PAD (0.67 events per 1000 person-years). Adjusted hazard ratios (HRs) compared to women without hypertension were 1.1 (95% CI, 0.5–2.3) for women who were treated and controlled, 1.7 (95% CI, 1.0 –3.0) for women untreated and uncontrolled, and 2.3 (95% CI, 1.4 – 4.0) for women treated and uncontrolled (p-trend<0.001). When hypertension was examined using continuous and categorical measures, there was a 33% increase in risk per 10 mmHg of SBP (95% CI, 18 to 47%) and a positive gradient in multivariable-adjusted risk according to SBP category (<120, 120 –139, 140 –159, and ≤ 160 mmHg); HRs were 1.0, 1.6, 2.8, and 4.3 (p-trend<0.001), respectively. We also considered DBP, PP, and MAP. While individually predictive, none was a stronger predictor than SBP with none adding predictive ability beyond SBP. Conclusions : Uncontrolled hypertension is associated with incident symptomatic PAD in women. Among blood pressure variables assessed, SBP is the best single predictor. These data support a strong prognostic role for systolic blood pressure in the development of peripheral atherosclerosis in women.

Sign in / Sign up

Export Citation Format

Share Document