State and Regional Variation in Prescription- and Payment-Related Promoters of Adherence to Blood Pressure Medication

Background: Tight control of blood pressure can have long term positive effects, non-pharmacological interventions to achieve it are documented in this study. Hypothesis: Vegan diets together with other lifestyle changes can safely decrease blood pressure. Methods: Twelve years of data was used, 1196 patients participated in a lifestyle program in Weimar California. The intervention consisted in whole food plant based diet (WFPD), exercise, sleep hygiene, medical, psychological and spiritual therapies. Treatments of massage and hydrotherapy were also given. A physician monitored the progress of each patient during the 18 days. Blood pressure was measured at baseline, at the end of the first week (time 1) and at the end of the second week (time 2) and at the end of 18 days. Some patients need it to decrease their blood pressure medication during the 18 days. Data was process with SPSS statistics package. Results: From 1196 patients, 764 of them were females. Mean age at baseline was 60.7 SD 15. Both systolic and diastolic blood pressure were reduced throughout treatment. For systolic on average (in mm HG) at baseline: 132.21, at time 1: 125.3, at rime 2: 121.96, at the end : 121.4. For diastolic on average (in mm HG) at baseline: 76.1, time 1: 72.2, time 2: 70.86, at the end : 69.9. A repeated measures ANOVA determined that mean systolic blood pressure differed significantly between time points (F(3,3585) = 69.008, P < .001). Post hoc polynomial contrasts revealed a significant linear trend in the data from start to end (F(1,1195 = 206.474. p<.001, partial η 2 = .14)). A similar pattern was found for diastolic blood pressure. The overall ANOVA found a significant difference in time points (F(3,3585) = 34.738, P < .001). Post hoc polynomial contrasts also showed a significant linear trend (F(1,1195 = 109.031. p<.001, partial η 2 = .08). Participants lost 4.8 pounds on average by the end of the program. Conclusion: WFPD together with lifestyle interventions are associated with a significant reduction of systolic and diastolic blood pressures. Many patients reduced their blood pressure medication. Lifestyle interventions options should be offered to patients with hypertension.

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Association Between Cardiometabolic Factors and Dizziness in African Americans: The Jackson Heart Study

Journal of the American Academy of Audiology ◽

10.1055/s-0041-1722949 ◽

2021 ◽

Author(s):

Amrita Ray ◽

Christopher Spankovich ◽

Charles E. Bishop ◽

Dan Su ◽

Yuan-I Min ◽

...

Keyword(s):

Blood Pressure ◽

African American ◽

African Americans ◽

Noise Exposure ◽

Medication Use ◽

Blood Pressure Medication ◽

Jackson Heart Study ◽

Screening Questionnaire ◽

Heart Study ◽

Cardiometabolic Factors

Abstract Background Balance dysfunction is a complex, disabling health condition that can present with multiple phenotypes and etiologies. Data regarding prevalence, characterization of dizziness, or associated factors is limited, especially in an African American population. Purpose The aim of the study is to characterize balance dysfunction presentation and prevalence in an African American cohort, and balance dysfunction relationship to cardiometabolic factors. Research Design The study design is descriptive, cross sectional analysis. Study Sample The study sample consist of N = 1,314, participants in the Jackson Heart Study (JHS). Data Collection and Analysis JHS participants were presented an initial Hearing health screening questionnaire (N = 1,314). Of these, 317 participants reported dizziness and completed a follow-up Dizziness History Questionnaire. Descriptive analysis was used to compare differences in the cohorts' social-demographic characteristics and cardiometabolic variables to the 997 participants who did not report dizziness on the initial screening questionnaire. Based on questionnaire responses, participants were grouped into dizziness profiles (orthostatic, migraine, and vestibular) to further examine differences in cardiometabolic markers as related to different profiles of dizziness. Logistical regression models were adjusted for age, sex, education, reported noise exposure, and hearing sensitivity. Results Participants that reported any dizziness were slightly older and predominantly women. Other significant complaints in the dizzy versus nondizzy cohort included hearing loss, tinnitus, and a history of noise exposure (p < 0.001). Participants that reported any dizziness had significantly higher prevalence of hypertension, blood pressure medication use, and higher body mass index (BMI). Individuals with symptoms alluding to an orthostatic or migraine etiology had significant differences in prevalence of hypertension, blood pressure medication use, and BMI (p < 0.001). Alternatively, cardiometabolic variables were not significantly related to the report of dizziness symptoms consistent with vestibular profiles. Conclusion Dizziness among African Americans is comparable to the general population with regards to age and sex distribution, accordingly to previously published estimates. Participants with dizziness symptoms appear to have significant differences in BMI and blood pressure regulation, especially with associated orthostatic or migraine type profiles; this relationship does not appear to be conserved in participants who present with vestibular etiology symptoms.

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