scholarly journals Phenotypes of Hypertensive Ambulatory Blood Pressure Patterns: Design and Rationale of the ECHORN Hypertension Study

2019 ◽  
Vol 29 (4) ◽  
pp. 535-544
Author(s):  
Erica S. Spatz ◽  
Josefa L. Martinez-Brockman ◽  
Baylah Tessier-Sherman ◽  
Bobak Mortazavi ◽  
Brita Roy ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Contextual Factors ◽  
Blood Pressure Measurement ◽  
Virgin Islands ◽  
Self Report ◽  
Research Network ◽  
Clustering Methods ◽  
Social Stressors ◽  
Us Virgin Islands ◽  
Factors Associated

Objective: To describe the rationale and design of a prospective study of ambula­tory blood pressure measurement (ABPM) combined with measurement of contextual factors to identify hypertensive phenotypes in a Caribbean population with high rates of HTN and cardiovascular disease.Design: Prospective, multi-center sub-study.Setting: Eastern Caribbean Health Outcomes Research Network Cohort (ECHORN) Study, with study sites in Puerto Rico, the US Virgin Islands, Trinidad and Tobago, and Barbados.Participants: Community-residing adults without a diagnosis of HTN and not taking antihypertensive medication.Intervention: Ambulatory BP patterns are assessed using 24-hour ABPM. Contextual factors are assessed with: ecological mo­mentary assessment (7-item survey of expe­riences, exposures and responses associated with daytime BP measurements); actigra­phy (capturing physical activity and sleep quality); and self-report surveys (assessing physical and social health, environmental and social stressors and supports).Main Outcome Measures: Phenotypes of contextual factors associated with hyperten­sive BP patterns (sustained HTN, masked HTN, and nocturnal non-dipping)Methods and Results: This study will enroll 500 participants; assessments of blood pressure and contextual factors will be conducted during Waves 2 and 3 of the ECHORN parent study, occurring 2 years apart. In Wave 2, we will assess the associa­tion between contextual factors and ABPM patterns. Using advanced analytic clustering methods, we will identify phenotypes of contextual factors associated with hyper­tensive ABPM patterns. We will then test the stability of these phenotypes and their ability to predict change in ABPM patterns between Waves 2 and 3.Conclusions: Assessment of ABPM, and the contextual factors influencing ABPM, can identify unique phenotypes of HTN, which can then be used to develop more preci­sion-based approaches to the prevention, detection and treatment of HTN in high-risk populations.Ethn Dis. 2019;29(4):535-544; doi:10.18865/ed.29.4.535

Information Loss in Harmonizing Granular Race and Ethnicity Data: Descriptive Study of Standards (Preprint)

2019 ◽  
Author(s):  
Karen Wang ◽  
Holly Grossetta Nardini ◽  
Lori Post ◽  
Todd Edwards ◽  
Marcella Nunez-Smith ◽  
...  
Keyword(s):  
Race And Ethnicity ◽  
Virgin Islands ◽  
Research Network ◽  
Multidisciplinary Teams ◽  
Data Standards ◽  
Us Virgin Islands ◽  
Marginalized Communities ◽  
Health Equity Research ◽  
Multiethnic Populations ◽  
Ethnicity Data

BACKGROUND Data standards for race and ethnicity have significant implications for health equity research. OBJECTIVE We aim to describe a challenge encountered when working with a multiple–race and ethnicity assessment in the Eastern Caribbean Health Outcomes Research Network (ECHORN), a research collaborative of Barbados, Puerto Rico, Trinidad and Tobago, and the US Virgin Islands. METHODS We examined the data standards guiding harmonization of race and ethnicity data for multiracial and multiethnic populations, using the Office of Management and Budget (OMB) Statistical Policy Directive No. 15. RESULTS Of 1211 participants in the ECHORN cohort study, 901 (74.40%) selected 1 racial category. Of those that selected 1 category, 13.0% (117/901) selected Caribbean; 6.4% (58/901), Puerto Rican or Boricua; and 13.5% (122/901), the mixed or multiracial category. A total of 17.84% (216/1211) of participants selected 2 or more categories, with 15.19% (184/1211) selecting 2 categories and 2.64% (32/1211) selecting 3 or more categories. With aggregation of ECHORN data into OMB categories, 27.91% (338/1211) of the participants can be placed in the “more than one race” category. CONCLUSIONS This analysis exposes the fundamental informatics challenges that current race and ethnicity data standards present to meaningful collection, organization, and dissemination of granular data about subgroup populations in diverse and marginalized communities. Current standards should reflect the science of measuring race and ethnicity and the need for multidisciplinary teams to improve evolving standards throughout the data life cycle.

scholarly journals Factors associated with screening for preeclampsia in the Democratic Republic of Congo: evidence from a nationwide cross-sectional study

2021 ◽  
Author(s):  
Dalau Mukadi Nkamba ◽  
Gilbert Wembodinga ◽  
Pierre Bernard ◽  
Annie Robert
Keyword(s):  
Blood Pressure ◽  
Rural Areas ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Blood Pressure Measurement ◽  
Signs And Symptoms ◽  
Warning Signs ◽  
Cross Sectional ◽  
Republic Of Congo ◽  
Factors Associated

Abstract BackgroundDelays in identification of women with preeclampsia is a contributing factor to maternal deaths in developing countries. We conducted this study to assess the prevalence of screening for preeclampsia in the Democratic Republic of Congo (DRC), and to identify factors associated with the screening. Methods We used data from the 2017-2018 DRC Service Provision Assessment survey, a nationwide survey that samples services, including antenatal care (ANC), in representative health facilities. A pregnant woman was deemed screened for preeclampsia if she had received the two following services: blood pressure measurement and assessment for warning signs of preeclampsia. We used multiple logistic regression, with generalized estimating equations, to identify factors associated with screening for preeclampsia.ResultsOf the 3763 pregnant women, 719 (19.1%; 95% CI, 15.8% – 22.9%) were screened for preeclampsia, 815 (21.7%; 95% CI, 18.2% - 25.6%) were assessed for preeclampsia-related warning signs and symptoms, and 2941 (78.2%; 95% CI 73.6 – 82.1%) had their blood pressure checked.In multivariable analyses, the percentage of women receiving screening for preeclampsia was significantly higher among women with a secondary level of schooling or above (adjusted odds ratio [AOR] = 1.21; 95% CI, 1.04-1.42; P=0.016) and among women having a subsequent ANC visit (AOR = 1.39; 95% CI, 1.20-1.62; P<0.001). It was also higher among women receiving care in facilities with a low number of women attended per day (AOR = 1.28; 95% CI, 1.09-1.51; P=0.003) and in urban settings (AOR = 1.36; 95% CI, 1.02-1.82; P=0.036). There was a regional variation in the screening for preeclampsia, with the lowest prevalence observed in the Central (10.7%) and the highest in the Eastern provinces (22.5%). ConclusionOur study shows that screening for preeclampsia during ANC visits in DRC is not systematic, with disparities between provinces. We found that a low schooling level, a low number of ANC visits, rural areas, province of residence, and a high volume of ANC visits at the facility were associated with a low screening for preeclampsia. These factors should be considered for setting up strategies in order to increase the screening for preeclampsia during ANC visits in provinces of DRC with too low screening.

scholarly journals Information Loss in Harmonizing Granular Race and Ethnicity Data: Descriptive Study of Standards

10.2196/14591 ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. e14591
Author(s):  
Karen Wang ◽  
Holly Grossetta Nardini ◽  
Lori Post ◽  
Todd Edwards ◽  
Marcella Nunez-Smith ◽  
...  
Keyword(s):  
Race And Ethnicity ◽  
Virgin Islands ◽  
Research Network ◽  
Multidisciplinary Teams ◽  
Data Standards ◽  
Us Virgin Islands ◽  
Marginalized Communities ◽  
Health Equity Research ◽  
Multiethnic Populations ◽  
Ethnicity Data

Background Data standards for race and ethnicity have significant implications for health equity research. Objective We aim to describe a challenge encountered when working with a multiple–race and ethnicity assessment in the Eastern Caribbean Health Outcomes Research Network (ECHORN), a research collaborative of Barbados, Puerto Rico, Trinidad and Tobago, and the US Virgin Islands. Methods We examined the data standards guiding harmonization of race and ethnicity data for multiracial and multiethnic populations, using the Office of Management and Budget (OMB) Statistical Policy Directive No. 15. Results Of 1211 participants in the ECHORN cohort study, 901 (74.40%) selected 1 racial category. Of those that selected 1 category, 13.0% (117/901) selected Caribbean; 6.4% (58/901), Puerto Rican or Boricua; and 13.5% (122/901), the mixed or multiracial category. A total of 17.84% (216/1211) of participants selected 2 or more categories, with 15.19% (184/1211) selecting 2 categories and 2.64% (32/1211) selecting 3 or more categories. With aggregation of ECHORN data into OMB categories, 27.91% (338/1211) of the participants can be placed in the “more than one race” category. Conclusions This analysis exposes the fundamental informatics challenges that current race and ethnicity data standards present to meaningful collection, organization, and dissemination of granular data about subgroup populations in diverse and marginalized communities. Current standards should reflect the science of measuring race and ethnicity and the need for multidisciplinary teams to improve evolving standards throughout the data life cycle.

Evaluation of two methods of teaching blood pressure measurement

1988 ◽  
Vol 52 (9) ◽  
pp. 519-521
Author(s):  
NK Nordstrom ◽  
S Longenecker ◽  
HL Whitacre ◽  
FM Beck
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement

Effects of Fear Induction on Heart Period Variability

1999 ◽  
Vol 13 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Rudolf Stark ◽  
Alfons Hamm ◽  
Anne Schienle ◽  
Bertram Walter ◽  
Dieter Vaitl
Keyword(s):  
Blood Pressure ◽  
Trait Anxiety ◽  
State Anxiety ◽  
Self Report ◽  
Emotional States ◽  
Heart Period ◽  
Experimental Conditions ◽  
Heart Period Variability ◽  
Physiological Variables ◽  
Period Variability

Abstract The present study investigated the influence of contextual fear in comparison to relaxation on heart period variability (HPV), and analyzed differences in HPV between low and high anxious, nonclinical subjects. Fifty-three women participated in the study. Each subject underwent four experimental conditions (control, fear, relaxation, and a combined fear-relaxation condition), lasting 10 min each. Fear was provoked by an unpredictable aversive human scream. Relaxation should be induced with the aid of verbal instructions. To control for respiratory effects on HPV, breathing was paced at 0.2 Hz using an indirect light source. Besides physiological measures (HPV measures, ECG, respiration, forearm EMG, blood pressure), emotional states (pleasure, arousal, dominance, state anxiety) were assessed by subjects' self-reports. Since relaxation instructions did not have any effect neither on the subjective nor on the physiological variables, the present paper focuses on the comparison of the control and the fear condition. The scream reliably induced changes in both physiological and self-report measures. During the fear condition, subjects reported more arousal and state anxiety as well as less pleasure and dominance. Heart period decreased, while EMG and diastolic blood pressure showed a tendency to increase. HPV remained largely unaltered with the exception of the LF component, which slightly decreased under fear induction. Replicating previous findings, trait anxiety was negatively associated with HPV, but there were no treatment-specific differences between subjects with low and high trait anxiety.

EFEKTIVITAS PEMBERIAN HYDROTHERAPI RENDAM KAKI PADA PENDERITA HIPERTENSI DI BANJAR SRI MANDALA, KELURAHAN DAUHWARU KABUPATEN JEMBRANA

2019 ◽  
Vol 10 (01) ◽  
pp. 33-44
Author(s):  
N.L.G. Sudaryati ◽  
I P. Sudiartawan ◽  
Dwi Mertha Adnyana
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Reduce Blood Pressure ◽  
Second Grade ◽  
Control Group ◽  
Hypertensive Patients ◽  
First Category

The aim of the study was to determine the effectiveness of giving hydrotherapi foot soak in hypertensive patients. The study was conducted with one group pretestposttest design without a control group by measuring blood pressure (pretest) before being given an intervention in the form of foot soak hydrotherm against 15 people with hypertension in Banjar Sri Mandala, Dauhwaru Village, Jembrana Subregency. Then do the blood pressure measurement again (posttest) after finishing the intervention. After the study was completed, the results showed that before the hydrotherapi foot bath intervention, there were 0% of patients classified as normal, 13.32% in prehypertension category, 60.08% in hypertension category I and 26.60% in hypertension category II. After the intervention was given, there were 13.32% of the patients classified as normal, 66.68% in the prehypertension category, 20.00% in the first category of hypertension and no patients belonging to the second grade hypertension category. There is a decrease of 20-30 mmHg for systolic blood pressure and 0-10 mmHg for diastolic blood pressure after intervention. Based on the results of the study it can be concluded that the hydrotherapi foot bath is effectively used to reduce blood pressure in hypertensive patients in the Banjar Sri Mandala, Dauhwaru Village, Jembrana District.

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