scholarly journals Association Between Self-Reported Hypertension and Antihypertensive Medication Use and Cardiovascular Disease–Related Events and Expenditures Among Patients Diagnosed With Hypertension

2019 ◽  
Vol 134 (5) ◽  
pp. 493-501
Author(s):  
Madeleine M. Baker-Goering ◽  
David H. Howard ◽  
Julie C. Will ◽  
Garrett R. Beeler Asay ◽  
Kakoli Roy
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
High Blood Pressure ◽  
Antihypertensive Medication ◽  
Medication Use ◽  
Medical Expenditures ◽  
Self Report ◽  
Related Event ◽  
Predicted Probability

Objectives: Research suggests that persons who are aware of the risk factors for cardiovascular disease (CVD) are more likely to engage in healthy behaviors than persons who are not aware of the risk factors. We examined whether patients whose insurance claims included an International Classification of Diseases, Ninth Revision (ICD-9) code associated with hypertension who self-reported high blood pressure were more likely to fill antihypertensive medication prescriptions and less likely to have CVD-related emergency department visits and hospitalizations (hereinafter, CVD-related events) and related medical expenditures than patients with these codes who did not self-report high blood pressure. Methods: We used a large convenience sample from the MarketScan Commercial Database linked with the MarketScan Health Risk Assessment (HRA) Database to identify patients aged 18-64 in the United States whose insurance claims included an ICD-9 code associated with hypertension and who completed an HRA from 2008 through 2012 (n = 111 655). We used multivariate logistic regression analysis to examine the association between self-reported high blood pressure and (1) filling prescriptions for antihypertensive medications and (2) CVD-related events. Because most patients with hypertension will not have a CVD-related event, we used a 2-part model to analyze medical expenditures. The first part estimated the likelihood of a CVD-related event, and the second part estimated expenditures. Results: Patients with an ICD-9 code of hypertension who self-reported high blood pressure had a significantly higher predicted probability of filling antihypertensive medication prescriptions (26.5%; 95% confidence interval, 25.7-27.3; P < .001), had a significantly lower predicted probability of a CVD-related event (0.6%, P < .001), and on average spent significantly less on CVD-related events ($251, P = .01) than patients who did not self-report high blood pressure. Conclusion: This study affirms that self-knowledge of high blood pressure, even among patients who are diagnosed and treated for hypertension, can be improved. Interventions that improve patients’ awareness of their hypertension may improve antihypertensive medication use and reduce adverse CVD-related events.

scholarly journals Novel Dietary Approaches for Controlling High Blood Pressure

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3902
Author(s):  
George Moschonis ◽  
Kalliopi Karatzi
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
High Blood Pressure ◽  
Health Problem

Hypertension is a common health problem, and one of the most important risk factors for cardiovascular disease [...]

Abstract P151: Primary ASCVD Risk Associated With Undiagnosed Conditions Decreased Over NHANES 1999-2014

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
David R Nelson ◽  
Jessica A Davis
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
High Blood Pressure ◽  
The United States ◽  
High Cholesterol ◽  
Diabetes Status ◽  
Ascvd Risk ◽  
Over Time

Introduction: Atherosclerotic cardiovascular disease (ASCVD) is a general term for a group of diseases characterized by atherosclerosis that affect the heart and blood vessels. ASCVD is the leading cause of death in the United States contributing to at least 200,000 preventable deaths from heart disease and stroke each year. Cardiovascular disease, heart disease, and stroke mortality has declined since the year 2000, due to broader use of evidence-based therapies and changes to risk factors and lifestyle modifications, but the decline began to slow after 2011. Two main risk factors contributing to ASCVD are high blood pressure and high cholesterol. Efforts have been made to increase control of these factors at the population-level, however, only those who are diagnosed can be treated. While awareness has increased over time, there is still a significant contribution to ASCVD events from those who were undiagnosed but have high blood pressure, high cholesterol, and/or diabetes. Hypothesis: To assess how much of the total U.S. population ASCVD risk is undiagnosed from 1999-2014. Methods: The Pooled Cohort Equations assessed 10-year ASCVD risk, based on age, sex, race, total cholesterol, HDL level, systolic blood pressure, use of blood pressure medication, smoking status, and diabetes status. The undiagnosed risk of the primary risk population (age 40-79 years, without missing values for necessary cholesterol, blood pressure, and glucose measures) from 1999-2014 Continuous National Health and Nutrition Examination Survey (NHANES) was calculated based on self-report questions and clinical measures, after age, sex, race, smoking, and diagnosed risks were accounted for. Linear regression for complex survey data tested whether undiagnosed risk was changing over time. Results: Applying the ASCVD risk equation to the NHANES subset (n=8,763; weighted n=104,421,757), undiagnosed conditions were associated with 10% of the projected ASCVD events. That is, per 100,000 Americans in this subset, 7,747 ASCVD events were estimated over 10-years, and 800 were based on risk from undiagnosed diabetes, hypercholesterolemia, or hypertension. However, ASCVD risk associated with undiagnosed conditions over time decreased (p<0.001), from 1,169 per 100,000 in 1999-2000, to 642 per 100,000 in 2013-2014. Conclusions: NHANES creates a unique opportunity to quantify undiagnosed ASCVD risk in a nationally representative sample. Since 1999, a sizeable portion of the US primary ASCVD risk was based on undiagnosed conditions, however, this proportion of undiagnosed risk decreased over time.

scholarly journals May Measurement Month 2019: an analysis of blood pressure screening results from Tunisia

2021 ◽  
Vol 23 (Supplement_B) ◽  
pp. B144-B146
Author(s):  
Sina Haj Amor ◽  
Thomas Beaney ◽  
Olfa Saidi ◽  
Jonathan Clarke ◽  
Neil R Poulter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Antihypertensive Medication ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Population Based ◽  
Intervention Programme ◽  
And Control ◽  
Adult Volunteers

Abstract We performed a May Measurement Month (MMM) screening campaign among adult volunteers aged 18 years old and over in Tunisia. The objective was to raise awareness, and to estimate the prevalence, awareness, treatment, and control of hypertension, one of the main cardiovascular risk factors. Following the MMM protocol, three blood pressure (BP) measurements were taken by physicians and standard interviewing procedures were used to record medical history, socio-demographic, and cardiovascular disease risk factors. Hypertension was defined as a systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or treatment with antihypertensive medication. From 11 271 adults screened, the prevalence of hypertension was 38.1%. Among those with hypertension, 72.5% were aware of their diagnosis, and 67.5% were treated. BP control was achieved in only 38.2% of all those with hypertension. The study highlights the magnitude of hypertension in Tunisia. There is an urgent need for implementing a comprehensive integrated population-based intervention programme to ameliorate the growing problem of hypertension.

Abstract 17345: Particulate Matter and Risk of Incident Cardiovascular Disease in a Nationwide Cohort of Men

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jaime E Hart ◽  
Jarvis T Chen ◽  
Robin C Puett ◽  
Jeff D Yanosky ◽  
Eric B Rimm ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Particulate Matter ◽  
High Blood Pressure ◽  
Smoking Status ◽  
Sensitivity Analyses ◽  
Cvd Risk ◽  
Ambient Exposure ◽  
The Impact

Introduction: Chronic exposures to particulate matter (PM) have been associated with cardiovascular disease (CVD) morbidity and mortality. We examined the impact of long-term exposures to PM on the risk of incident coronary heart disease (CHD) and stroke among members of the nationwide all-male Health Professionals Follow-Up Study (HPFS) prospective cohort. Methods: HPFS members were followed biennially between 1986-2006 to obtain information on incident disease and to update information on CVD risk factors. Time-varying ambient PM 10 , PM 2.5-10 , and PM 2.5 for the previous 12 months were calculated from monthly predictions at the address level. Multivariate adjusted Cox proportional hazards models were used to estimate [HR (95%CI)] for the association between each fraction of PM and each outcome among 43,371 CVD-free members of the HPFS, adjusting for risk factors and other potential confounders. We also assessed effect modification by region of the country, BMI, smoking status, and comorbidities (hypercholesterolemia, high blood pressure, and diabetes). Sensitivity analyses were conducted restricting the population to men who provided residential (N=15,395), as opposed to work, addresses. Results: The mean (SD) levels of 12-month average PM 10 , PM 2.5-10 , and PM 2.5 were 20.7 (6.2), 8.4 (4.7) and 12.3 (3.4) μg/m 3 . In the full population, there was only modest evidence of increased risks of incident CHD or stroke with increasing PM exposures. Associations with stroke were modified by region, hypercholesterolemia, high blood pressure, and diabetes, with larger effects among those with comorbid conditions and in the Northeast and South. CHD, but not stroke, dose-responses were stronger among those who provided residential as opposed to work addresses; each 10 μg/m 3 increase, was associated with increases in overall CHD [1.10 (95%CI: 1.01-1.20), 1.09 (0.97-1.23), and 1.14 (0.98-1.32) for PM 10 , PM 2.5-10 , and PM 2.5 , respectively]. Conclusions: In this cohort of US men, PM exposures were only modestly associated with elevated risks of CHD and stroke. Comorbidities and region modified the associations with stroke, and residential ambient exposures were more associated with CHD than work ambient exposure.

The Effects of a Digital Mental Health Intervention in Adults with Cardiovascular Disease Risk Factors: An Analysis of Real-World User Data (Preprint)

2021 ◽  
Author(s):  
Robert M Montgomery ◽  
Eliane M Boucher ◽  
Ryan D Honomichl ◽  
Tyler A Powell ◽  
Sharelle L Guyton ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
High Blood Pressure ◽  
Real World ◽  
Well Being ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Over Time

BACKGROUND The American Heart Association has identified poor mental health in particular as a key barrier to healthy behavior change for those with cardiovascular disease (CVD) risk factors such as high blood pressure, high cholesterol, and diabetes. Digital mental health interventions, like those delivered via the internet to computers or smartphones, may provide a scalable solution to improving the mental and physical health of this population. Happify is one such intervention, and has demonstrated evidence of efficacy for improving aspects of mental health in both the general population and amidst users with chronic conditions. OBJECTIVE The objective of this analysis of real-world user data was to examine changes in both subjective well-being and anxiety over time in Happify users with self-reported cardiovascular disease risk factors, including high blood pressure and cholesterol, diabetes, and heart disease. METHODS Data were obtained from existing Happify users who reported the aforementioned CVD risk factors. The sample included 1803 users receiving at least 6 weeks’ exposure to Happify (ranging from 42 to 182 days) who completed at least one activity and two assessments within the app during that time. Subjective well-being was assessed with the Happify Scale, a 9-item measure of positive emotionality and life satisfaction, and anxiety was assessed with the Generalized Anxiety Disorder 2 (GAD-2). To evaluate our first hypothesis, changes over time in both outcomes were assessed using mixed effects linear regression models, controlling for demographics and usage. For the second hypothesis, an interaction term was added to the models to assess whether usage as recommended was associated with greater improvement over time. RESULTS Users completed an average of 2.9 activities per week, and 35% (636/1803) met criteria for the recommended use. For both the Happify scale and the GAD-2, the initial multivariable model without an interaction demonstrated an effect for time from baseline, supporting the first hypothesis. The addition of the interaction term between time and recommended use, was significant as well for both outcomes, supporting the second hypothesis. CONCLUSIONS This analysis of real-world data provides preliminary evidence that Happify users with self-reported CVD risk factors including high blood pressure or cholesterol, diabetes, and heart disease experienced improved well-being and anxiety over time, and that those who used Happify as recommended experienced greater improvements in these aspects of mental health than those who used less. These findings extend previous research, which demonstrated that engagement with Happify as recommended was associated with improved well-being among physically healthy users and in those with chronic conditions, to a new population for whom mental health is especially critical: those at risk of developing cardiovascular disease. 

scholarly journals Food Insecurity and Cardiovascular Disease Risk Factors among Mississippi Adults

2018 ◽  
Vol 15 (9) ◽  
pp. 2016 ◽  
Author(s):  
Vincent Mendy ◽  
Rodolfo Vargas ◽  
Gerri Cannon-Smith ◽  
Marinelle Payton ◽  
Byambaa Enkhmaa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Food Insecurity ◽  
High Blood Pressure ◽  
Disease Risk ◽  
Vegetable Consumption ◽  
Cardiovascular Disease Risk ◽  
Public Health Problem ◽  
Cardiovascular Disease Risk Factors

Background: Food insecurity is a public health problem. There is limited data on food insecurity in Mississippi. Methods: We analyzed data from the 2015 Mississippi Behavioral Risk Factor Surveillance System, which included the Social Context Module for 5870 respondents. Respondents who indicated that in the past 12 months they were “always”, “usually”, or “sometimes” “worried or stressed about having enough money to buy nutritious meals” were considered food insecure. Food insecurity was compared across sociodemographic and health characteristics using chi-square tests, and the association between food insecurity and select cardiovascular disease risk factors was assessed using logistic regression. Results: The prevalence of food insecurity was 42.9%. Compared to the referent group, Mississippi adults with high blood pressure had 51% higher odds, those with diabetes had 30% higher odds, those who were not physically active had 36% higher odds, and those who consumed fewer than five fruits and vegetables daily had 50% higher odds of being food insecure. Conclusion: Among Mississippi adults, food insecurity is associated with high blood pressure, diabetes, obesity, fruit and vegetable consumption, physical inactivity, and smoking.

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