scholarly journals Benefits and Harms of Hypertension and High-Normal Labels: A Randomized Experiment

2021 ◽  
Author(s):  
Danielle Marie Muscat ◽  
Georgina May Morris ◽  
Katy Bell ◽  
Erin Cvejic ◽  
Jenna Smith ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Perceptions ◽  
Disease Risk ◽  
Absolute Risk ◽  
Cardiovascular Disease Risk ◽  
Psychosocial Outcomes ◽  
National Sample ◽  
Randomized Experiment ◽  
Unique Identifier ◽  
Willingness To Change

Background: Recent US guidelines lowered the threshold for diagnosing hypertension while other international guidelines use alternative/no labels for the same group (blood pressure [BP], <140/90 mm Hg). We investigated potential benefits and harms of hypertension and high-normal BP labels, compared with control, among people at lower risk of cardiovascular disease. Methods: We conducted a randomized experiment using a national sample of Australians (n=1318) 40 to 50 years of age recruited from an online panel. Participants were randomized to 1 of 3 hypothetical scenarios where a general practitioner told them they had a BP reading of 135/85 mm Hg, using either hypertension/high-normal BP/control (general BP description) labels. Participants were then randomized to receive an additional absolute risk description or nothing. Primary outcomes were willingness to change diet and worry. Secondary outcomes included exercise/medication intentions, risk perceptions, and other psychosocial outcomes. Results: There was no difference in willingness to change diet across label groups ( P =0.22). The hypertension label (mean difference [MD], 0.74 [95% CI, 0.41–1.06]; P <0.001) and high-normal BP label (MD, 0.45 [95% CI, 0.12–0.78]; P =0.008) had increased worry about cardiovascular disease risk compared with control. There was no evidence that either label increased willingness to exercise ( P =0.80). However, the hypertension (MD, 0.20 [95% CI, 0.04–0.36]; P =0.014), but not high-normal label (MD, 0.06 [95% CI, −0.10 to 0.21]; P =0.49), increased willingness to accept BP-lowering medication compared with control. Psychosocial differences including lower control, higher risk perceptions, and more negative affect were found for the hypertension and high-normal labels compared with control. Providing absolute risk information decreased willingness to change diet (MD, 0.25 [95% CI, 0.10–0.41]; P =0.001) and increase exercise (MD, 0.28 [95% CI, 0.11–0.45]; P =0.001) in the hypertension group. Conclusions: Neither hypertension nor high-normal labels motivated participants to change their diet or exercise more than control, but both labels had adverse psychosocial outcomes. Labeling people with systolic BP of 130 to 140 mm Hg, who are otherwise at low risk of cardiovascular disease, may cause harms that outweigh benefit. Registration: URL: http://www.anzctr.org.au/ ; Unique identifier: ACTRN12618001700224.

scholarly journals Community-driven citizen science approach to explore cardiovascular disease risk perception, and develop prevention advocacy strategies in sub-Saharan Africa: a programme protocol

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kufre Joseph Okop ◽  
Kathy Murphy ◽  
Estelle Victoria Lambert ◽  
Kiya Kedir ◽  
Hailemichael Getachew ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Citizen Science ◽  
Risk Perceptions ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Data Gathering ◽  
Lessons Learned ◽  
Sub Saharan Africa ◽  
Rural And Urban ◽  
Sub Saharan

Abstract Background In sub-Saharan Africa (SSA), which experiences a disproportionately high cardiovascular disease (CVD) burden, population-based screening and prevention measures are hampered by low levels of knowledge about CVD and associated risk factors, and inaccurate perceptions of severity of risk. Methods This protocol describes the planned processes for implementing community-driven participatory research, using a citizen science method to explore CVD risk perceptions and to develop community-specific advocacy and prevention strategies in the rural and urban SSA settings. Multi-disciplinary research teams in four selected African countries will engage with and train community members living in rural and urban communities as citizen scientists to facilitate conceptualization, co-designing of research, data gathering, and co-creation of knowledge that can lead to a shared agenda to support collaborative participation in community-engaged science. The emphasis is on robust community engagement, using mobile technology to support data gathering, participatory learning, and co-creation of knowledge and disease prevention advocacy. Discussion Contextual processes applied and lessons learned in specific settings will support redefining or disassembling boundaries in participatory science to foster effective implementation of sustainable prevention intervention programmes in Low- and Middle-income countries.

scholarly journals Cardiovascular disease risk perceptions and tobacco use among Appalachian youth

2021 ◽  
Vol 3 (November) ◽  
pp. 1-9
Author(s):  
Osayande Agbonlahor ◽  
Jayesh Rai ◽  
Delvon Mattingly ◽  
Joy Hart ◽  
Kandi Walker
Keyword(s):  
Cardiovascular Disease ◽  
Tobacco Use ◽  
Risk Perceptions ◽  
Disease Risk ◽  
Cardiovascular Disease Risk

scholarly journals Association of the Novel Inflammatory Marker GlycA and Incident Heart Failure and Its Subtypes of Preserved and Reduced Ejection Fraction

2020 ◽  
Vol 13 (8) ◽  
Author(s):  
Sunyoung Jang ◽  
Oluseye Ogunmoroti ◽  
Chiadi E. Ndumele ◽  
Di Zhao ◽  
Vishal N. Rao ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Ejection Fraction ◽  
Disease Risk ◽  
Inflammatory Marker ◽  
Cardiovascular Disease Risk ◽  
Unique Identifier ◽  
Acute Phase Reactants ◽  
Reduced Ejection Fraction ◽  
Increased Risk

Background: GlycA, a nuclear magnetic resonance composite marker of systemic inflammation, reflects serum concentration and glycosylation state of main acute phase reactants. Prior studies have shown plasma GlycA levels were associated with cardiovascular disease even after adjusting for other inflammatory markers. However, little is known about the association of GlycA with the heart failure (HF) subtypes: heart failure with preserved ejection fraction (HFpEF) or heart failure with reduced ejection fraction. We examined the association of GlycA with incident HF and its subtypes in a multiethnic cohort. Methods: We studied 6507 Multi-Ethnic Study of Atherosclerosis participants aged 45 to 84 without baseline cardiovascular disease or HF who had data on GlycA and incident hospitalized HF. We used multivariable-adjusted Cox hazards models to evaluate the association of GlycA with incident total HF, HFpEF, and heart failure with reduced ejection fraction. Models were adjusted for sociodemographics, cardiovascular disease risk factors, and inflammatory biomarkers. Results: The mean (SD) for age was 62 (10) years and for GlycA was 375 (82) μmol/L; 53% women. Over a median follow-up of 14.0 years, participants in the highest quartile of GlycA, compared with the lowest, experienced increased risk of developing any HF (hazard ratio, 1.48 [95% CI, 1.01–2.18]) in fully adjusted models. However, this increased risk was only seen for HFpEF (2.18 [1.15–4.13]) and not heart failure with reduced ejection fraction [1.06 (0.63–1.79)]. There was no significant interaction by sex, age, or race/ethnicity. Conclusions: GlycA was associated with an increased risk of any HF, and in particular, HFpEF. Future studies should examine mechanisms that might explain differential association of GlycA with HF subtypes, and whether therapeutic lowering of GlycA can prevent HFpEF development. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00005487.

scholarly journals Nighttime Blood Pressure Phenotype and Cardiovascular Prognosis

Circulation ◽  
2020 ◽  
Vol 142 (19) ◽  
pp. 1810-1820 ◽  
Author(s):  
Kazuomi Kario ◽  
Satoshi Hoshide ◽  
Hiroyuki Mizuno ◽  
Tomoyuki Kabutoya ◽  
Masafumi Nishizawa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cardiovascular Events ◽  
Disease Risk ◽  
Blood Pressure Monitoring ◽  
Cardiovascular Disease Risk ◽  
Atherosclerotic Cardiovascular Disease ◽  
Unique Identifier ◽  
Ambulatory Bp Monitoring ◽  
Nighttime Blood Pressure

Background: Ambulatory and home blood pressure (BP) monitoring parameters are better predictors of cardiovascular events than are office BP monitoring parameters, but there is a lack of robust data and little information on heart failure (HF) risk. The JAMP study (Japan Ambulatory Blood Pressure Monitoring Prospective) used the same ambulatory BP monitoring device, measurement schedule, and diary-based approach to data processing across all study centers and determined the association between both nocturnal hypertension and nighttime BP dipping patterns and the occurrence of cardiovascular events, including HF, in patients with hypertension. Methods: This practitioner-based, nationwide, multicenter, prospective, observational study included patients with at least 1 cardiovascular risk factor, mostly hypertension, and free of symptomatic cardiovascular disease at baseline. All patients underwent 24-hour ambulatory BP monitoring at baseline. Patients were followed annually to determine the occurrence of primary end point cardiovascular events (atherosclerotic cardiovascular disease and HF). Results: A total of 6,359 patients (68.6±11.7 years of age, 48% men) were included in the final analysis. During a mean±SD follow-up of 4.5±2.4 years, there were 306 cardiovascular events (119 stroke, 99 coronary artery disease, 88 HF). Nighttime systolic BP was significantly associated with the risk of atherosclerotic cardiovascular disease and HF (hazard ratio adjusted for demographic and clinical risk factors per 20-mm Hg increase: 1.21 [95% CI, 1.03–1.41], P =0.017; and 1.36 [95% CI, 1.08–1.71], P =0.009, respectively). Disrupted circadian BP rhythm (riser pattern, nighttime BP higher than daytime BP) was significantly associated with higher overall cardiovascular disease risk (1.48 [95% CI, 1.05–2.08]; P =0.024), and especially HF (2.45 [95% CI, 1.34–4.48]; P =0.004) compared with normal circadian rhythm. Conclusions: Nighttime BP levels and a riser pattern were independently associated with the total cardiovascular event rate, in particular for HF. These findings suggest the importance of antihypertensive strategies targeting nighttime systolic BP. Registration: URL: https://www.umin.ac.jp/ctr/ ; Unique identifier: UMIN000020377.

scholarly journals Cardiovascular Disease Risk and Barriers to Physical Activity

2015 ◽  
Vol 7 (1) ◽  
pp. 43
Author(s):  
Lisa Aditama ◽  
Dewi Rahmawati ◽  
Nani Parfati ◽  
Astrid Pratidina
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Risk Perceptions ◽  
Disease Risk ◽  
Adult Population ◽  
Cardiovascular Disease Risk ◽  
Stage Of Change ◽  
Cvd Risk ◽  
Medium Risk ◽  
Prevalence Of Obesity

BACKGROUND: The prevalence of obesity is increasing and tends to be higher in adult population groups who are also more educated and employed as a civil/military/police/oficers. This study aims to analyze cardiovascular disease (CVD) risk, perceptions about physical activity and barriers experienced to perform physical activity, also stage of change to physical activity.METHODS: The study design was an observational study, use qualitative methods with in-depth interviews and quantitative analysis CVD risk also stage of change to physical activity questionnaire.RESULTS: Framingham 10-years CVD risk of obese men in University of Surabaya was 11.97% (1.70 to 29.90) based on lipid profile and 13.90% (2.30 to 30.00) based on body mass index. Perception of obese men in University of Surabaya regarding physical activity had findings several barriers that can be grouped into time constraint, facility constraint, low motivation, and knowledge about physical activities.CONCLUSION: In this study we found that 10-years CVD risk of obese men in University of Surabaya can be categorized as medium risk. There are several barriers regarding life style modification for physical activity and exercise, whereas the subjects included in this study are quite ready to start the program, but improvement for the readiness before starting the program will still be needed.KEYWORDS: CVD risk, obese men, physical activity

scholarly journals Future Cardiovascular Disease Risk for Women With Gestational Hypertension: A Systematic Review and Meta‐Analysis

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Charmaine Chu Wen Lo ◽  
Andre C. Q. Lo ◽  
Shu Hui Leow ◽  
Grace Fisher ◽  
Beth Corker ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Events ◽  
Disease Risk ◽  
Gestational Hypertension ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Unique Identifier

Background Inconsistent findings have been found among studies evaluating the risk of cardiovascular disease for women who have had pregnancies complicated by gestational hypertension (the new onset of high blood pressure without proteinuria during pregnancy). We provide a comprehensive review of studies to quantify the association between gestational hypertension and cardiovascular events in women. Methods and Results We conducted a systematic search of PubMed, Embase, and Web of Science in March 2019 for studies examining the association between gestational hypertension and any cardiovascular event. Two reviewers independently assessed the abstracts and full‐text articles. Study characteristics and the relative risk (RR) of cardiovascular events associated with gestational hypertension were extracted from the eligible studies. Where appropriate, the estimates were pooled with inverse variance weighted random‐effects meta‐analysis. A total of 21 studies involving 3 60 1192 women (127 913 with gestational hypertension) were identified. Gestational hypertension in the first pregnancy was associated with a greater risk of overall cardiovascular disease (RR, 1.45; 95% CI, 1.17–1.80) and coronary heart disease (RR, 1.46; 95% CI, 1.23–1.73), but not stroke (RR, 1.26; 95% CI, 0.96–1.65) or thromboembolic events (RR, 0.88; 95% CI, 0.73–1.07). Women with 1 or more pregnancies affected by gestational hypertension were at greater risk of cardiovascular disease (RR, 1.81; 95% CI, 1.42–2.31), coronary heart disease (RR, 1.83; 95% CI, 1.33–2.51), and heart failure (RR, 1.77; 95% CI, 1.47–2.13), but not stroke (RR, 1.50; 95% CI, 0.75–2.99). Conclusions Gestational hypertension is associated with a greater risk of overall cardiovascular disease, coronary heart disease, and heart failure. More research is needed to assess the presence of a dose–response relationship between gestational hypertension and subsequent cardiovascular disease. Registration URL: https://www.crd.york.ac.uk/prosp​ero/ ; Unique identifier: CRD 42018119031.

scholarly journals Community-Driven Citizen Science Approach to Explore Cardiovascular Disease Risk Perception, and Develop Prevention Advocacy Strategies in Sub-Saharan Africa: A Programme Protocol

2020 ◽  
Author(s):  
Kufre Okop ◽  
Kathy Murphy ◽  
Estelle Victoria Lambert ◽  
Kiya Kedir ◽  
Hailemichael Getachew ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Citizen Science ◽  
Risk Perceptions ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Data Gathering ◽  
Lessons Learned ◽  
Sub Saharan Africa ◽  
Rural And Urban ◽  
Sub Saharan

Abstract Background: In sub-Saharan Africa (SSA), which experiences a disproportionately high cardiovascular disease (CVD) burden, population-based screening and prevention measures are hampered by low levels of knowledge about CVD and associated risk factors, and inaccurate perceptions of severity of risk. Methods: This protocol describes the planned processes for implementing community-driven participatory research, using a citizen science method to explore CVD risk perceptions and to develop community-specific advocacy and prevention strategies in rural and urban SSA settings. Research teams in four selected African countries will engage with and train community members living in rural and urban communities as citizen scientists to facilitate conceptualization, co-designing of research, data gathering, and co-creation of knowledge that can lead to a shared agenda to support collaborative participation in community-engaged science. The emphasis is on robust community engagement, using mobile technology to support data gathering, participatory learning, and co-creation of knowledge and disease prevention advocacy. Discussion: Contextual processes applied and lessons learned in specific settings will support redefining or disassembling boundaries in participatory science to foster effective implementation of sustainable prevention intervention programmes in Low- and Middle-income countries.

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