Moving from sick care to well care: A paradigm shift is needed to reduce cardiovascular disease and improve hypertension control

2022 ◽  
Author(s):  
Bernadette Mazurek Melnyk
Keyword(s):  
Cardiovascular Disease ◽  
Paradigm Shift ◽  
Hypertension Control

scholarly journals Hypertension control and cardiovascular disease – Authors' reply

The Lancet ◽  
2017 ◽  
Vol 389 (10065) ◽  
pp. 154-155
Author(s):  
Jacques Blacher ◽  
Bernard I Levy ◽  
Jean-Jacques Mourad ◽  
Michel E Safar ◽  
George Bakris
Keyword(s):  
Cardiovascular Disease ◽  
Hypertension Control

scholarly journals Association Between Early Hypertension Control and Cardiovascular Disease Incidence in Veterans With Diabetes

Diabetes Care ◽  
2019 ◽  
Vol 42 (10) ◽  
pp. 1995-2003
Author(s):  
Sridharan Raghavan ◽  
Yuk-Lam Ho ◽  
Vinay Kini ◽  
Mary K. Rhee ◽  
Jason L. Vassy ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Disease Incidence ◽  
Hypertension Control ◽  
Cardiovascular Disease Incidence

Abstract P318: Neighborhood Environment Characteristics and Control of Cardiovascular Disease Risk Factors in a Primary Care Patient Sample

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
M. Maya McDoom-Echebiri ◽  
Yea-Jen Hsu ◽  
Lisa A Cooper ◽  
Rachel J Thornton
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Primary Care ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Diabetes Control ◽  
Neighborhood Environment ◽  
Care Organization ◽  
Hypertension Control ◽  
Physician Characteristics

Introduction: Hypertension and diabetes control are leading modifiable risk factors for cardiovascular disease (CVD) risk. Contemporary epidemiological research suggests that individual and health system characteristics are associated with control. Yet, there is little evidence examining how the neighborhood environment influences hypertension or diabetes control among patients engaged in primary care. Methods: We analyzed data of adult patients (n = 5,711) with hypertension or diabetes who received primary care at 1 of 3 clinics of a statewide health care organization in Baltimore, MD and lived within the Baltimore city limits. The neighborhood environment exposures were tertiles of neighborhood socioeconomic status (SES), crime, and healthy food availability index (HFAI) assessed at the census tract level. Separate multivariate logistic regression models were constructed to estimate the odds ratio (OR) for each of these neighborhood environment characteristics and hypertension and diabetes control, adjusting for patient demographics, and health behaviors; and for physician demographic characteristics. Results: The overall mean age was 57.8 ± 14.3 years, 67.2% were female, and 89.6% were Black. There were 5,325 patients with hypertension and 2,094 patients with diabetes (not mutually exclusive). In bivariate analyses, high neighborhood SES (p= 0.030) and low crime (p= 0.006) were associated with hypertension control, and none of the neighborhood exposures were associated with diabetes control. In fully adjusted analyses, being Black was significantly associated with decreased odds of hypertension control in all models (OR range: 0.63 – 0.65), independent of neighborhood exposures. Among those with hypertension, living in a low or moderate SES neighborhood or a high crime neighborhood was associated with lower odds of hypertension control; however, these associations were attenuated in adjusted models. None of the neighborhood exposures were significantly associated with odds of diabetes control in models that adjusted for patient characteristics. Yet, compared to high SES neighborhoods, living in a low or moderate SES neighborhood (OR=0.74, 95% CI: 0.57 - 0.97 and OR=0.75, 95% CI: 0.57 - 0.98, respectively) was associated with reduced diabetes control after adjusting for both patient and physician characteristics. Conclusion: Exposure to neighborhood disadvantage may contribute to poor diabetes and hypertension control among patients in primary care, independent of patient and physician characteristics. Patient-centered risk assessments including measures of social need and preventive interventions adapted to neighborhood environments could be useful for optimizing hypertension and diabetes control in clinical settings.

scholarly journals Hypertension control and cardiovascular disease

The Lancet ◽  
2017 ◽  
Vol 389 (10065) ◽  
pp. 153 ◽  
Author(s):  
Franz H Messerli ◽  
Urs Fischer ◽  
Stefano F Rimoldi ◽  
Sripal Bangalore
Keyword(s):  
Cardiovascular Disease ◽  
Hypertension Control
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