Medicine and Health Sciences Commons^™

Managing Hypertension With Lifestyle Modifications, Ladonna D. Willis

MSN Capstone Projects

Cardiovascular disease has taken the lives of millions of Americans, specifically, African Americans who do not have access to health care, which leads to morbidity and increased mortality. This benchmark project proposes to provide cardiovascular educational packets to patients who are admitted to the hospital and have been diagnosed with hypertension.

Home Blood Pressure Monitoring, Bethany N. Hughes

MSN Capstone Projects

Hypertension is prevalent worldwide and is responsible for nine million deaths annually. Despite its prevalence, a majority of patients go unmanaged or undiagnosed (Kitt et al., 2019). Health complications of hypertension can be life-altering and life-threatening; therefore, if changes are not made to improve community hypertension control rates, worsened population health and financial burden on health systems may persist. Would you believe that an effective tool exists and has been endorsed worldwide to combat hypertension, yet it is not used consistently in practice? Furthermore, can you imagine this specific tool is easy to operate, cheap, and recruits patient involvement in …

Quantifying Hypertension Indicators Through Informatics, Diana Sanchez

Doctor of Nursing Practice

The purpose of this quality improvement project was to create optimal quality indicators for hypertension measures using evidence-based practice to improve metric percentages, improving hypertension management for the practice. Implementing associated interventions for the quality measures and providing the interprofessional team with fundamental knowledge of inclusion and exclusion criteria and will empower the team with knowledge, improving patient care.

An expert panel was chosen to conduct a series of three PDSA cycles for systematic measurement until desired quality indicators were achieved, within a three-month duration. The expert panel consisted of the head physician, a physician assistant, the facility administrator and …

Automated Office Blood Pressure Measurement For The Diagnosis Of Hypertension, Guido Filler, Maria E Díaz-González De Ferris

Paediatrics Publications

Editorial

An Analysis Of Patient-Generated Health Data In Assisting Nurses And Physicians To Better Treat Patients With Hypertension, Diana Chaparadza

Applied Research Projects

Patient Generated Health Data (PGHD is not new but it has gained more attention these past years due to the advent of smart devices, remote monitoring devices and many applications on various smart devices. PGHD reflects medications and treatment, lifestyle choices, and health history. Unlike traditional medical visits, where clinicians collect and manage data within their offices, PGHD is collected by patients throughout the course of their day and provides an insight of how they are responding to treatments or lifestyle choices. Examples include blood glucose monitoring or blood pressure readings using home health equipment, exercise and diet tracking using …

Multi-Ancestry Genome-Wide Association Study Accounting For Gene-Psychosocial Factor Interactions Identifies Novel Loci For Blood Pressure Traits, Daokun Sun, Melissa A. Richard, Soloman K. Musani, Yun Ju Sung, Thomas W. Winkler, Karen Schwander, Jin Fang Chai, Xiuqing Guo, Tuomas O. Kilpeläinen, Dina Vojinovic, Hugues Aschard, Traci M. Bartz, Lawrence F. Bielak, Michael R. Brown, Kumaraswamy Chitrala, Fernando P. Hartwig, Andrea R. V. R. Horimoto, Yongmei Liu, Alisa K. Manning, Raymond Noordam, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Psychological and social factors are known to influence blood pressure (BP) and risk of hypertension and associated cardiovascular diseases. To identify novel BP loci, we carried out genome-wide association meta-analyses of systolic, diastolic, pulse, and mean arterial BP, taking into account the interaction effects of genetic variants with three psychosocial factors: depressive symptoms, anxiety symptoms, and social support. Analyses were performed using a two-stage design in a sample of up to 128,894 adults from five ancestry groups. In the combined meta-analyses of stages 1 and 2, we identified 59 loci (p value < 5e−8), including nine novel BP loci. The novel associations were observed mostly with pulse pressure, with fewer observed with mean arterial pressure. Five novel loci were identified in African ancestry, and all but one showed patterns of interaction with at least one psychosocial factor. Functional annotation of the novel loci supports a major role for genes implicated in the immune response (PLCL2), synaptic function and neurotransmission (LIN7A …

Genetic-Based Hypertension Subtype Identification Using Informative Snps, Yuanjing Ma, Hongmei Jiang, Sanjiv J. Shah, Donna K. Arnett, Marguerite R. Irvin, Yuan Luo

Epidemiology and Environmental Health Faculty Publications

In this work, we proposed a process to select informative genetic variants for identifying clinically meaningful subtypes of hypertensive patients. We studied 575 African American (AA) and 612 Caucasian hypertensive participants enrolled in the Hypertension Genetic Epidemiology Network (HyperGEN) study and analyzed each race-based group separately. All study participants underwent GWAS (Genome-Wide Association Studies) and echocardiography. We applied a variety of statistical methods and filtering criteria, including generalized linear models, F statistics, burden tests, deleterious variant filtering, and others to select the most informative hypertension-related genetic variants. We performed an unsupervised learning algorithm non-negative matrix factorization (NMF) to identify hypertension …

From The Democratic Republic Of The Congo To North Carolina: An Examination Of Chronic Disease Risk, Lauren R. Sastre Dr.

Journal of Refugee & Global Health

Refugees from the Democratic Republic of the Congo are one of the largest refugee groups globally and in the US, however, there is limited research with this group. Therefore, objectives of this study were to examine: 1) obesity and hypertension rates, 2) diet and lifestyle behavior changes, and 3) diet, lifestyle and social factors of obesity and hypertension risk of Congolese refugees in the US. This cross-sectional data collection utilized a survey developed specifically for this project. Clinical and anthropometric measures including height, weight and blood pressure were also obtained. Data analysis included descriptive and regression analysis. Participants (n=48, >18 …

Assessment Of Growth And Blood Pressure Measurements In Gharbia Urban And Rural Primary School Children, Aml Y. Mahmoud, Soheir S. Abou El.Ella, Wafaa M. Abo Elfotoh

Menoufia Medical Journal

Objective To assess the growth using anthropometric measurements and determine the prevalence of obesity, short stature, and hypertension among primary school children. Background Healthy growth for children is of great importance in the development of their physical and mental growth. Growth is influenced by many factors that act to modify a child's genetic growth. Patients and methods A cross-sectional study was conducted on 1050 children aged 6 to less than 12 years, including 515 (49%) boys and 535 (51%) girls, who were recruited from primary schools in Zefta city, Gharbeya Governorate. All children were assessed for anthropometric measurements such as …

Use Of Advanced Statistical Techniques To Predict All-Cause Mortality In The Systolic Blood Pressure Intervention Trial, William Kostis, Javier Cabrera, Chun Pang Lin, John Kostis, Jennifer Wellings, Stavros Zinonos, Jeanne Dobrzynski, Daniel Blickstein

Department of Medicine Faculty Papers

Background: The Systolic Blood Pressure Intervention Trial (SPRINT) was conducted in patients with hypertension and additional risk for cardiovascular disease who were randomized to the intensive blood pressure group targeting systolic blood pressure (SBP) less than 120 mm Hg and to the standard group where the target was less than 140 mm Hg. Analyses were done in the matched group of participants with the same gender, same age (±2 years) and same SBP (±3 mm Hg) at three months of treatment regardless of initial randomization to intensive or standard group (shaded area in Figure 1). Methods and results: During 3.26 …

Increased Epicardial Adipose Tissue Is Associated With The Extent Of Aortic Dissection, Ahmet S. Yõlmaz

Journal of the Saudi Heart Association

Background: Epicardial adipose tissue (EAT) is a biologically active organ that has endocrine and paracrine functions. Endothelial dysfunction, systemic, and local inflammatory response, due to bio-active molecules produced by EAT, may affect aortic dissection propagation and extent. We investigated the association between EAT thickness and the extent of aortic dissection.

Methods: We retrospectively enrolled 78 patients with aortic dissection diagnosed by thoracoabdominal Computerized Tomography (CT). EAT was measured from the thickest part of the perpendicular plane between the pericardium and free wall of the right ventricle using CT. Aortic dissection length was measured from the beginning to the end of …

Two-Year Responses Of Office And Ambulatory Blood Pressure To First Occupational Lead Exposure, Yu-Ling Yu, Wen-Yi Yang, Lutgarde Thijs, Jesus D. Melgarejo, Cai-Guo Yu, Dong-Mei Wei, Fang-Fei Wei, Tim S. Nawrot, Zhen-Yu Zhang, Jan A. Staessen

School of Medicine Publications and Presentations

Lead exposure causing hypertension is the mechanism commonly assumed to set off premature death and cardiovascular complications. However, at current exposure levels in the developed world, the link between hypertension and lead remains unproven. In the Study for Promotion of Health in Recycling Lead (URL: https://www.clinicaltrials.gov; Unique identifier: NCT02243904), we recorded the 2-year responses of office blood pressure (average of 5 consecutive readings) and 24-hour ambulatory blood pressure to first occupational lead exposure in workers newly employed at lead recycling plants. Blood lead (BL) was measured by inductively coupled plasma mass spectrometry (detection limit 0.5 µg/dL). Hypertension was defined …

Hypertension Among Refugees: A Disease Of Risingpublic Health Concern, Issam Shaarani Senior Lecturer Of Family Medicine, Department Of Clinical Sciences, Faculty Of Medicine,, Rami Warrak

BAU Journal - Health and Wellbeing

After the war in Syria, Lebanon became among the top countries hosting for refugees. Many public health issues started to be raised with non-communicable diseases (NCDs) being high on the list. Providing health care for refugees is not easy since it requires huge resources, continuous follow-up encounters, and an extensive financial support. Reports show that NCDs are a health priority in Syrian refugees, and hypertension is the most prevalent one affecting more than half of the older Syrian refugees in Lebanon. This creates an enormous burden on the host community health system that needs effective interventions. While Lebanese citizens favor …

Frequency Of Intraoperative Hypotension After The Induction Of Anesthesia In Hypertensive Patients With Preoperative Angiotensin-Converting Enzyme Inhibitors, Fahad Salim, Fazal Hameed Khan, Muhammad Nasir, Rashid Ali, Ayesha Iqbal, Amir Raza

Department of Anaesthesia

Introduction: The renin-angiotensin-aldosterone system (RAAS) is an important target in the treatment of hypertension. Angiotensin-converting enzyme (ACE) inhibitors block the conversion of angiotensin I to angiotensin II. ACE inhibitors not only treat hypertension but also decrease morbidity and mortality in heart failure patients and in patients with acute myocardial infarction. The discontinuation of ACE inhibitors before the surgery is still controversial. To assess the current magnitude of the problem in our population, we aimed to conduct this study, which evaluated the frequency of intraoperative hypotension after the induction of anesthesia in controlled hypertensive patients with preoperative ACE inhibitors.
Material and …

Nsaids For Analgesia In The Era Of Covid-19, Daniel L Herzberg, Harry P Sukumaran, Eugene R. Viscusi

Department of Anesthesiology Faculty Papers

Globally, non-steroidal anti-inflammatory drugs (NSAIDs) are highly used to treat pain. With the rise of the COVID-19 pandemic, the safety of NSAIDs use has been called into question. These concerns are worthy of review. At present, there is no compelling data showing that NSAIDs worsen the severity of COVID-19 symptoms or increase one's likelihood of contracting the illness. For patients in pain and without symptoms that could potentially be attributed to COVID-19 (cough, fevers/chills, lethargy, myalgias, anosmia and so on), NSAIDs should continue to remain a viable option to provide analgesia to patients in need.

The Community-Level Interventions For Pre-Eclampsia (Clip) Cluster Randomised Trials In Mozambique, Pakistan, And India: An Individual Participant-Level Meta-Analysis, Peter Von Dadelszen, Zulfiqar Ahmed Bhutta, Sumedha Sharma, Jeffrey Bone, Joel Singer, Hubert Wong, Mrutyunjaya B. Bellad, Shivaprasad S. Goudar, Tang Lee, Rahat Qureshi, Clip Trials Working Group

Woman and Child Health

Background: To overcome the three delays in triage, transport and treatment that underlie adverse pregnancy outcomes, we aimed to reduce all-cause adverse outcomes with community-level interventions targeting women with pregnancy hypertension in three low-income countries.
Methods: In this individual participant-level meta-analysis, we de-identified and pooled data from the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised controlled trials in Mozambique, Pakistan, and India, which were run in 2014-17. Consenting pregnant women, aged 12-49 years, were recruited in their homes. Clusters, defined by local administrative units, were randomly assigned (1:1) to intervention or control groups. The control groups continued local standard of …

Health Insurance Plan Design And Chronic Disease Management, Daniel E. Feldman

Electronic Theses and Dissertations

Each year, Americans spend more money on health care than any other industrialized nation, despite comparable mortality rates for people with risk factors for heart disease. The reasons for this lack of health care value in the US are numerous and complex – including market distortions like supplier-inflated pricing and regulatory structures that enable consumers to utilize ubiquitous, high-cost medical technologies that yield uncertain benefits. Health insurance, once thought to be an insignificant contributor to rising health spending, has changed considerably in the past few decades in ways that make it more accessible and more generous in coverage. Health insurance …

What Factors Shape Doctors’ Trustworthiness? Patients’ Perspectives In The Context Of Hypertension Care In Rural Tanzania, Kahabi Isangula, Holly Seale, Rohan Jayasuriya, Tumaini M. Nyamhanga, Niamh Stephenson

School of Nursing & Midwifery, East Africa

Introduction: There is increasing evidence that improving patient trust in doctors can improve patients’ use of healthcare services, compliance and continuing engagement with care –particularly for chronic diseases. Consequently, much of the current literature on trust in therapeutic relationships focuses on factors shaping doctors’ trustworthiness. However, few studies on this issue have been conducted among rural populations in low-income Africa, where health service delivery, cultural norms and patient expectations differ from those in high-income countries. This study examined patients’ perspectives of factors that shape doctors’ trustworthiness in rural Tanzania in the context of hypertension care.

Methods: A qualitative inquiry using …

Non-Physician Led Hypertension Management, Poupak Moshayedi

MSN Capstone Projects

The importance of controlling and better management of hypertension cannot be overemphasized, and the need for task sharing and multidisciplinary approach has never been more significant than in chronic conditions like hypertension. With many complications that it causes and with the many classes of drugs that we have in controlling blood pressure, having only 24 percent of people being controlled shows a break in knowledge and patient care. The gap can be filled with nurse involvement and taking more ownership and responsibility in tackling high numbers with interventions that are proven to work. Getting patients involved and following up with …

Cardiovascular Disease, Samantha Kohler

Nursing Student Class Projects (Formerly MSN)

The purpose of the presentation is to expand on cardiovascular disease and the pathophysiology contributing to the disease process. The presentation allows for further education on modifiable risk factors, and the most common causes of cardiovascular disease. Cardiovascular disease is one of the main causes of death in the world (Najafipour, Afshari & Rostamzadeh, 2018). When diagnosing patients with cardiovascular disease they often have more than one modifiable risk factor. The modifiable risk factors are hypertension, diabetes, high cholesterol, obesity, smoking, and low physical activity (Najafipour et al., 2018). The purpose of the arteries of the heart is to provide …

A Case Of Systemic Sclerosis Sine Scleroderma, Adrian Lugo, Andrew Cappiello, Nemer Dabage, Guruswamy Ramamurthy

West Florida Division GME Research Day 2020

• Scleroderma and systemic sclerosis are autoimmune phenomena that can cause progressive and permanent damage to the organs of the human body.
• They can cause fibrosis of various internal organs, including the kidneys, lungs, GI tract, and heart
• Rarely, the only manifestation of systemic sclerosis is severe hypertension with renal failure, a subset known as systemic sclerosis sine scleroderma.

Role Of Neuronal Nitric Oxide Synthase On Cardiovascular Functions In Physiological And Pathophysiological States, Ahmmed Ally, Isabella Powell, Minora M. Ally, Kevin Chaitoff, Surya M. Nauli

Pharmacy Faculty Articles and Research

This review describes and summarizes the role of neuronal nitric oxide synthase (nNOS) on the central nervous system, particularly on brain regions such as the ventrolateral medulla (VLM) and the periaqueductal gray matter (PAG), and on blood vessels and the heart that are involved in the regulation and control of the cardiovascular system (CVS). Furthermore, we shall also review the functional aspects of nNOS during several physiological, pathophysiological, and clinical conditions such as exercise, pain, cerebral vascular accidents or stroke and hypertension. For example, during stroke, a cascade of molecular, neurochemical, and cellular changes occur that affect the nervous system …

Empowering Newly Diagnosed Patients With Hypertension In Reducing Complications Through Self-Managed Care, Ana Pacis

Doctor of Nursing Practice Final Manuscripts

Background: High blood pressure affects millions of people, including children and adults. According to the Centers for Disease Control and Prevention (CDC), about 1 in every 3 adults or approximately 75 million American adults are affected with high blood pressure. High blood pressure often does not cause any signs and symptoms, which is why it is also known as the “silent killer,” and many people are not aware that they have elevated blood pressure (AHA, 2017). If high blood pressure is not controlled, it can lead to other heart diseases such as stroke. It can also cause other health problems, …

Examining The Factors That Influence African Americans In The Midwest To Reduce Salt Intake, Ni Zhang, Emily Leary, Michelle Teti, Jon Stemmle, Natalie Hampton

Faculty Research, Scholarly, and Creative Activity

Purpose: Salt intake is associated with cardiovascular diseases that are the leading cause of death especially among African American communities in the Midwest. Interventions need to be developed to address the culture of this population to decrease the health disparities of cardiovascular disease. This study applying the Health Belief Model aims to explore the factors that are associated with the behavior of reducing salt intake among this population.
Methods: Three hundred ninety-nine African American adults participated in the telephone surveys. Logistic regression analysis was performed.
Results: We found that affective risk perception in the form of concern of salt intake …

The Role Of Central Ace2 And Nrf2 In Sympatho-Excitation: Responses To Central Angiotensin Ii, Anyun Ma

Theses & Dissertations

Sympatho-excitation is a key characteristic in cardiovascular diseases such as chronic heart failure (CHF) and primary Hypertension (HTN). Evidence suggests that increased sympathetic tone is closely related to activation of the Renin-Angiotensin-Aldosterone system (RAAS) in the central nervous system. An underlying mechanism for sympatho-excitation is thought to be oxidative stress resulting from Angiotensin II (AngII) type 1 receptor (AT1R) activation. Over the past several decades, pharmacological targeting of components of the RAAS have been used as standard therapy in CHF and HTN. However, additional therapeutic strategies are necessary to control these diseases. Oxidative stress is regulated, in part, by the …

Baseline Health Assessment Of A Rural Delta Community, Sydney Mitchell

Honors Theses

The Lower Mississippi Delta is characterized by poverty, chronic health issues, health disparities, and food insecurity. The rural Delta communities are primarily African American, experiencing disproportionately higher rates of poverty, job loss, and chronic health problems. Historically, chronic health issues have persisted in these areas over time, including obesity, hypertension, and diabetes, which have only seemed to increase in this region. The food environment in this rural region tends to assist in the creation of the largely obesogenic population which, in turn, contributes to the increased prevalence of diabetes and hypertension and a lower quality of life. Many residents in …

Addressing Hypertension Health Literacy In Black Individuals Who English Is Their Second Language, Uche Olateru

Doctor of Nursing Practice Projects

Hypertension is a primary preventable risk factor for cardiovascular disease. Despite advances in preventive and treatment measures, related to blood pressure control, the prevalence of hypertension in the United States remains high among Black People of immigrant and non immigrant communities. Healthcare is increasingly complex, and health literacy problems have increased due to demands by healthcare stakeholders for patients to assume a more independent role in taking charge of their health. A quality improvement project was conducted in a Faith based community to improve the knowledge of participants about hypertension. The objective of this project was to enhance lifestyle management …

Prevalence Of Hypertension And Its Risk Factors Among Cotton Textile Workers In Low- And Middle-Income Countries: A Protocol For A Systematic Review, Naureen Akber Ali, Anam Shahil Feroz

School of Nursing & Midwifery

Background: Cotton workers are exposed to various hazards in the textile industry that might result in different ailments including hypertension (HTN). However, few attempts have been made to systematically review the prevalence of hypertension and its risk factor among cotton textile workers in low-and middle-income countries (LMICs). The objective of this study will be to evaluate the prevalence of hypertension and its risk factors among adult cotton textile workers in low- and middle-income countries.
Methods: We designed and registered a study protocol for a systematic review of descriptive epidemiology data. We will include observational studies (e.g., cross-sectional, cohort, surveys) on …

Late Referrals Of Pediatric Patients With Elevated Blood Pressure, Guido Filler, Laura Torres-Canchala

Paediatrics Publications

Editorial Commentary

Factors Affecting Blood Pressure Target Outcomes For Veterans Using Home Telehealth, Vincent Boom

Theses and Dissertations

Hypertension is the most common diagnosis among Veterans, contributing to approximately 15,000 veterans hospitalized for stroke every year. The high prevalence of hypertension found in the Veteran population suggests a need to better define the risks and benefits associated with the diagnosis and treatment of hypertension. The U. S. Department of Veteran Affairs (VA) home telehealth program provides chronic care management for hypertension to facilitate Veteran access to care. Existing evidence suggests Veterans’ monitoring of blood pressure at home may selectively assist in managing hypertension. This secondary analysis of data used a self-management lens to assign meaning to traditionally demographic …