scholarly journals My Hypertension Education and Reaching Target (MyHEART): Development and Dissemination of a Patient-Centered Website for Young Adults with Hypertension (Preprint)

2017 ◽  
Author(s):  
Heather M Johnson ◽  
Jamie N LaMantia ◽  
Colleen M Brown ◽  
Ryan C Warner ◽  
Laura M Zeller ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Young Adults ◽  
Healthcare Providers ◽  
Age Groups ◽  
Clinical Information ◽  
Pressure Control ◽  
Healthcare Research ◽  
Evidence Based ◽  
Patient Centered ◽  
Adult Age

BACKGROUND Young adults (18 to 39 years old) with hypertension have the lowest rates of blood pressure control (defined as blood pressure less than 140/90 mmHg) compared to other adult age groups. Approximately 1 in 15 young adults have high blood pressure, increasing their risk of future heart attack, stroke, congestive heart failure, and/or chronic kidney disease. Many young adults reported having few resources to address their needs for health education on managing cardiovascular risk. OBJECTIVE The goal of our study was to develop and disseminate a website with evidence-based, clinical information and health behavior resources tailored to young adults with hypertension. METHODS In collaboration with young adults, health systems, and community stakeholders, the My Hypertension Education and Reaching Target (MyHEART) website was created. A toolkit was also developed for clinicians and healthcare systems to disseminate the website within their organizations. The dissemination plan was guided by the Dissemination Planning Tool of the Agency for Healthcare Research and Quality (AHRQ). RESULTS Google Analytics data were acquired for January 1, 2017 to June 29, 2017. The MyHEART website received 1090 visits with 2130 page views; 18.99% (207/1090) were returning visitors. The majority (55.96%, 610/1090) approached the website through organic searches, 34.95% (381/1090) accessed the MyHEART website directly, and 5.96% (65/1090) approached through referrals from other sites. There was a spike in site visits around times of increased efforts to disseminate the website. CONCLUSIONS The successfully implemented MyHEART website and toolkit reflect collaborative input from community and healthcare stakeholders to provide evidence-based, portable hypertension education to a hard-to-reach population. The MyHEART website and toolkit can support healthcare providers’ education and counseling with young adults and organizations’ hypertension population health goals.

scholarly journals A study on prevalence of hypertension and its relationship with overweight and obesity in adolescents and young adults, Nizamabad city

2019 ◽  
Vol 6 (9) ◽  
pp. 3861
Author(s):  
G. Chethan Raj ◽  
Syam Sundar Junapudi
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Young Adults ◽  
Age Groups ◽  
Overweight And Obesity ◽  
Adolescents And Young Adults ◽  
Age Group ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Study Population

Background: The overall imbalance between unhealthy diet intake and physical activity leads to obesity which contributes to high blood pressure and high cholesterol. It is multi factorial disease and changes in the levels of blood pressure and blood lipids differ by age sex and race and are influenced by body fat and dietary patterns. These risk factors need to be monitored and evaluated in childhood and adolescents. So identifying and modifying the risk factors in early age reduces the incidence in adolescents and adult. Prevalence of hypertension varies across countries and states. The prevalence of hypertension in India is reported as ranging from 10 to 30.9%. The objective of the present study is to observe the prevalence hypertension among study population and to study contributing factors for hypertension among study population.Methods: A cross sectional study done on 100 adolescents and young adults of both sexes in the age group 17 to 25 years from 2 degree colleges randomly selected in Nizamabad city, Telangana, India.Results: In the present study population 52 were males and 48 were females, 22 students belongs to rural area and 78 belongs to urban area, pre-hypertension and hypertension was found 8% in both age groups. Overweight and obesity (>25) was found 7% in 17-19 age group and 9% in 20-25 age group. Pre-hypertension and hypertension was found among 10% of alcoholics.Conclusions: The result of our study concluded that there is increasing prevalence of hypertension with increase in age and is associated with overweight and obesity. 

Evidence based medical ethics: A critical evaluation

2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Dr R K Gorea
Keyword(s):  
Medical Ethics ◽  
Health Care Providers ◽  
Ethical Dilemmas ◽  
Medical Profession ◽  
Critical Evaluation ◽  
Healthcare Providers ◽  
Evidence Based ◽  
Care Providers ◽  
Patient Centered ◽  
Evidence Based Practices

<p>Education in the medical colleges in some parts of the world and treatment of the patients in most parts of the<br />world is leaning towards evidence based practices and medical ethics are no exception to this trend. The ethical<br />values of the society are changing since the days of Hippocrates when the moral values were controlling the<br />profession and earning of money by medical professionals. Following these values sometimes lead to lot of<br />dilemmas in the medical profession. Due to increasing investments in the medical establishments and emergence<br />of corporate hospitals aims and visions of healthcare providers are changing and ethical dilemmas are cropping up<br />while treating the patients. Evidence based ethics are definitely a patient centered approach where individual<br />cases can be treated depending upon the available evidence and it will be easy to solve the ethical dilemmas in a<br />way where the interest of patients as well as health care providers are not laid up. It is better to know the good<br />points of any emerging field but simultaneously it is our duty to know the limitations of the same.</p>

scholarly journals Willingness to pay and willingness to accept in a patient-centered blood pressure control study

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Julie Gleason-Comstock ◽  
Alicia Streater ◽  
Allen Goodman ◽  
James Janisse ◽  
Aaron Brody ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Willingness To Pay ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Willingness To Accept ◽  
Patient Centered ◽  
Control Study

scholarly journals Trends in body mass index and blood pressure associations from 1989 to 2018: co-ordinated analysis of 145,399 participants

2020 ◽  
Author(s):  
David Bann ◽  
Shaun Scholes ◽  
Rebecca Hardy ◽  
Dara O’Neill
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Quantile Regression ◽  
Body Mass ◽  
Age Groups ◽  
High Body Mass Index ◽  
Obesity Prevalence ◽  
Birth Cohorts ◽  
Cross Sectional ◽  
Adult Age

BackgroundHigh body mass index (BMI) is an important contributor to higher blood pressure (BP) levels and its deleterious consequences. However, the strength of this association may be context-specific and differ across time due to increases in medication use or secular changes in body composition. Thus, we utilised two independent data sources to investigate if associations between BMI and systolic BP (SBP) in Britain changed from 1989-2018.MethodsWe used 23 repeated cross-sectional datasets—the Health Survey for England (HSE) at ≥25 years (1994–2018; N=126,742); and three British birth cohorts (born 1946, 1958, and 1970) with outcomes available at 43-46 years (N=18,657). Anthropometry and BP were measured using standard protocols. We used linear and quantile regression to investigate cross-sectional associations between BMI and SBP.ResultsIn HSE, associations were weaker in subsequent years, and this trend was most pronounced amongst older adults—after accounting for sex, treatment and education, the mean difference in SBP per 1 kg/m2 increase in BMI amongst adults ≥55 years was 0.75mmHg (95% CI: 0.60, 0.90) in 1994, 0.66mmHg (0.46, 0.85) in 2003, and 0.53mmHg (0.35, 0.71) in 2018. In cohorts, BMI and SBP associations were of similar magnitude in 1958 and 1970 cohorts and weaker in the 1946 cohort. Quantile regression analyses suggested that associations between BMI and SBP were present both below and above the hypertension threshold.ConclusionThe consequences of BMI may differ across time and by age —associations between BMI and SBP appear to have weakened in recent decades, particularly in older ages. Thus, at older ages, this weakening strength of association may partly offset the public health impacts of increases in obesity prevalence. However, BMI remains positively associated with SBP in all adult age groups, highlighting the potential adverse consequences of the ongoing obesity epidemic.

scholarly journals Tracking Blood Pressure Control Performance and Process Metrics in 25 US Health Systems: The PCORnet Blood Pressure Control Laboratory

2021 ◽  
Author(s):  
Rhonda M. Cooper‐DeHoff ◽  
Valy Fontil ◽  
Thomas Carton ◽  
Alanna M. Chamberlain ◽  
Jonathan Todd ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Research ◽  
Health Systems ◽  
Blood Pressure Control ◽  
Race And Ethnicity ◽  
Pressure Control ◽  
Research Network ◽  
Control Laboratory ◽  
Patient Centered ◽  
National Patient

Background The National Patient‐Centered Clinical Research Network Blood Pressure Control Laboratory Surveillance System was established to identify opportunities for blood pressure (BP) control improvement and to provide a mechanism for tracking improvement longitudinally. Methods and Results We conducted a serial cross‐sectional study with queries against standardized electronic health record data in the National Patient‐Centered Clinical Research Network (PCORnet) common data model returned by 25 participating US health systems. Queries produced BP control metrics for adults with well‐documented hypertension and a recent encounter at the health system for a series of 1‐year measurement periods for each quarter of available data from January 2017 to March 2020. Aggregate weighted results are presented overall and by race and ethnicity. The most recent measurement period includes data from 1 737 995 patients, and 11 956 509 patient‐years were included in the trend analysis. Overall, 15% were Black, 52% women, and 28% had diabetes. BP control (<140/90 mm Hg) was observed in 62% (range, 44%–74%) but varied by race and ethnicity, with the lowest BP control among Black patients at 57% (odds ratio, 0.79; 95% CI, 0.66–0.94). A new class of antihypertensive medication (medication intensification) was prescribed in just 12% (range, 0.6%–25%) of patient visits where BP was uncontrolled. However, when medication intensification occurred, there was a large decrease in systolic BP (≈15 mm Hg; range, 5–18 mm Hg). Conclusions Major opportunities exist for improving BP control and reducing disparities, especially through consistent medication intensification when BP is uncontrolled. These data demonstrate substantial room for improvement and opportunities to close health equity gaps.

Abstract 004: The Cost-Effectiveness of Blood Pressure Control in Young Adulthood to Prevent Later Life Coronary Heart Disease: A Computer Simulation Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Sonia Singh ◽  
Ciaran Kohli-Lynch ◽  
YiYi Zhang ◽  
Anusorn Thanataveerat ◽  
Eric Vittinghoff ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Young Adults ◽  
Heart Disease ◽  
Cost Effectiveness ◽  
Young Adulthood ◽  
Blood Pressure Control ◽  
Lifestyle Modification ◽  
Later Life ◽  
Pressure Control

Introduction: Prehypertension defined as blood pressure (BP) 120-139/80-89 mmHg, has a prevalence of 23% in U.S. young adults (age 20-39 years). Young adult high diastolic blood pressure (DBP) has been associated with later life coronary heart disease (CHD), but it is unclear if lifelong benefits of early blood pressure control outweigh costs and side-effect risks. Objective: We estimated CHD events and life-long cost-effectiveness of U.S. Preventive Service Task Force recommended lifestyle modification (LM) or pharmacotherapy in young adults with DBP ≥80mmHg, incremental to later life hypertension treatment. Methods: A microsimulation model simulated CHD events from age 20 until death for 20-year olds selected from 1999-2014 NHANES. Individual risk factor trajectories were assigned, and risk functions predicted CHD based on Framingham Offspring Study data, accounting for both age 20-39 time-weighted average DBP and later life systolic blood pressure (SBP). Simulated interventions lowered DBP ≥80mmHg for age 20-39 years, and SBP ≥140mmHg for age ≥40 years. Cost-effectiveness was measured as incremental cost-effectiveness ratios (ICERs) and net health benefit (NHB) at willingness to pay (WTP) threshold $50,000/quality adjusted life year (QALY). Results: In 40,000 young adults with DBP ≥80 mmHg (50% women), pharmacologic BP control in young adulthood and later life prevented the most CHD events (Table). The strategy that yielded highest NHB in women was pharmacologic control after age 40 (ICER $26,536/QALY). In men, lifestyle modification to control DBP in young adulthood plus pharmacotherapy for later life hypertension (ICER $42,481/QALY) yielded highest NHB. Conclusion: Early DBP control in young adults could achieve substantial health benefits over the life course but standard interventions to achieve this goal are costly. Innovative strategies to reduce pharmacotherapy costs and improve sustainability of lifestyle modification could make early BP control a higher-value prevention strategy in young adults.

Abstract 54: Gender Differences In Blood Pressure Control Is Mediated By Age In United States Adults

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Aayush Visaria ◽  
Fariha Hameed ◽  
Brinda Raval ◽  
Sumaiya Islam
Keyword(s):  
Blood Pressure ◽  
Gender Differences ◽  
Older Women ◽  
Survey Design ◽  
Age Groups ◽  
Medication Use ◽  
Pressure Control ◽  
Antihypertensive Medications ◽  
Health And Nutrition ◽  
Public Health Challenge

Introduction: Blood pressure (BP) control remains a major public health challenge. Little is known about the gender differences in BP control across the age spectrum. We determined the age-stratified associations between gender and uncontrolled HTN. Methods: We included adults ≥20 years who reported HTN diagnosis and antihypertensive medication use from the 1999-2018 National Health and Nutrition Examination Surveys. Mean BP was calculated as the average of 3 consecutive BP readings 30 seconds apart. Uncontrolled HTN was considered as BP ≥140/90. We used survey design-adjusted multivariable logistic regression to determine the odds of uncontrolled HTN in women vs. men, adjusting for demographic, sociobehavioral, metabolic, and comorbid factors. Results: Among 13,253 participants taking antihypertensive medications (mean age 57, 52% female, 71% White), 34% had HTN (35% women, 33% men). Upon stratifying by 10-year age groups, men had higher odds of uncontrolled HTN from age 20 to 49 years, followed by a period of insignificantly different odds of uncontrolled HTN from age 50-69 years (Table). Among participants ≥70 years, females had significantly higher adjusted odds of uncontrolled HTN. These associations persisted when using the 2017 ACC/AHA guidelines. Conclusion: Women have significantly higher odds (>20%) of uncontrolled HTN compared to men starting age 70. This may suggest that interventions to improve BP control in older women are warranted. The changes in the gender differences across the age spectrum warrant further evaluation.

scholarly journals Association between self-reported snoring and hypertension among Chinese Han population aged 30–79 in Chongqing, China

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Meng Xiao ◽  
Xiaojun Tang ◽  
Fan Zhang ◽  
Li Zhou ◽  
Xiaoqing Bu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Age Groups ◽  
Pressure Control ◽  
Chinese Han ◽  
Face To Face ◽  
Final Sample ◽  
Increased Risk ◽  
Physical Examinations ◽  
And Gender ◽  
Prevention Of Hypertension

Abstract Background We aim to explore the association between self-reported snoring and hypertension among adults aged 30–79 in Chongqing, China. Methods A total of 23,342 individuals aged 30–79 were included at baseline from August 2018 to January 2019, and the final sample size for the analysis was 22,423. Face-to-face interviews and physical examinations were conducted by trained investigators. Logistic regression was performed to study age-specific and gender-specific associations between snoring and hypertension. Results Frequent snoring was associated with the risk of hypertension for each age and gender group, and the frequency of snoring was positively correlated with the risk for hypertension. For the three age groups (< 45, 45–59, ≥ 60), compared with the non-snoring group, those who snore often had a 64.5%, 53.3%, and 24.5% increased risk of hypertension (< 45: OR = 1.65, 95%CI 1.34–2.02; 45–59: OR = 1.53, 95%CI 1.37–1.72; ≥ 60: OR = 1.25, 95%CI 1.09–1.42), respectively. For men and women, those who snore often had a 46.8% and 97.2% increased risk of hypertension, respectively, than the non-snoring group (men: OR = 1.47, 95%CI 1.33–1.63; women: OR = 1.97, 95%CI 1.75–2.23). Conclusions People who snore frequently should pay close attention to their blood pressure levels in order to achieve early prevention of hypertension, particularly for snorers who are female and aged under 45; importance should be attached to their blood pressure control.

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