Public Health Commons^™

Global Blood Pressure Screening During The Covid-19 Pandemic: Results From The May Measurement Month 2021 Campaign, Thomas Beaney, Wei Wang, Markus P Schlaich, Aletta E Schutte, George S Stergiou, Luis Alcocer, Jafar Alsaid, Alejandro Bimbo Diaz, Rafael Hernandez-Hernandez, Mohammad Ishaq, Jacek Jozwiak, Nadia Khan, Gaia Kiru, Harsha Mccardle, Augustine Nonso Odili, Wook Bum Pyun, Cesar A Romero, Jiguang Wang, Neil R Poulter, Mmm Investigators

Journal Articles

BACKGROUND: Raised blood pressure (BP) remains the biggest risk factor contributing to the global burden of disease and mortality, despite the COVID-19 pandemic. May Measurement Month (MMM), an annual global screening campaign aims to highlight the importance of BP measurement by evaluating global awareness, treatment and control rates among adults with hypertension. In 2021, we assessed the global burden of these rates during the COVID-19 pandemic.

METHODS: Screening sites were set up in 54 countries between May and November 2021 and screenees were recruited by convenience sampling. Three sitting BPs were measured, and a questionnaire completed including demographic, lifestyle and …

Association Of Birth Weight And Preterm Birth With Subsequent Risk For Hypertension In Women From The Women’S Health Initiative, Christian P. Daniele

Masters Theses

Hypertension is a chronic disease with an estimated prevalence of nearly 50% in US adults. In addition to sociodemographic and lifestyle factors, evidence suggests that in utero and early life exposures may contribute to life-long risk of hypertension. This study aimed to investigate the potential associations between an individual’s birthweight and preterm birth status with their risk for hypertension in the Women’s Health Initiative (WHI) cohort. WHI is a large, multi-racial cohort of postmenopausal women. At study entry, birthweight and preterm birth status were self-reported by category (< 6 lbs., 6-7 lbs. 15 oz., 8-9 lbs. 15 oz., or ≥ 10 lbs.; ≥ 4 weeks premature or full term). Baseline and incident hypertension status were self-reported; mean systolic blood pressure, diastolic blood pressure, and 30-second pulse were also recorded at baseline by trained study staff. Linear, logistic, and Cox-proportional hazards regression models were used to generate crude and adjusted beta estimates, odds ratios, and hazards ratios, respectively. After adjusting for demographic and lifestyle factors, we found that participants born at a low birthweight had a higher mean systolic blood pressure than participants born at a normal birthweight and were at increased risk for both baseline and incident hypertension. Women born at a higher birthweight had a lower mean systolic blood pressure and were at lower risk for baseline and incident hypertension. When compared to participants born full term, participants born preterm were at increased risk for baseline and incident hypertension. These results support current research on early life exposures and health risks later in life. Long term follow-up or targeted counseling may be required for individuals born prematurely or at low birthweights to prevent and treat hypertension and associated cardiovascular outcomes.

Blood Pressure Surge With Alarm Is Reduced After Exercise And Diet Intervention In Firefighters, Deborah L Feairheller, Macie Smith, Megan Carty, Emily H Reeve

College of Population Health Faculty Papers

BACKGROUND: Cardiac-related incidents are a public health concern for tactical occupations, and cardiovascular disease rates are higher in these populations compared with civilians. Research is needed to examine blood pressure (BP) responses in firefighters. The pager alert is one occupational hazard, and it is unknown if lifestyle change can reduce the systolic surge response.

PURPOSE: To measure BP surge with alarm in firefighters to determine whether the magnitude is lower after a 6-week tactical exercise and Mediterranean-diet intervention.

METHODS: SBP and DBP and BP surge levels, circulating markers, vascular health, and fitness were analyzed. BP surge with alarm was captured …

A Rollout Of A Blood Pressure Remote Patient Monitoring Program To Improve High-Risk Maternal Outcomes At A Pilot Clinic For Systemwide Expansion, Laura Geron

Seton Hall University Dissertations and Theses (ETDs)

An existing virtual care platform provides an innovative means of early recognition, identification, and intervention for women with elevated blood pressures during pregnancy, known as preeclampsia. A pilot program took place at a Northeastern prenatal care clinic where patients were identified as high-risk for preeclampsia, enrolled, educated by their providers, and equipped with Bluetooth-enabled blood pressure cuffs.

Through remote patient monitoring (RPM) technology, blood pressure readings could transmit from a patient’s residence to a portal accessible by their clinic provider at any time. This doctoral-level quality improvement project focuses on the identification of patients at high-risk for preeclampsia, their enrollment …

Associations Of Cereal Grains Intake With Cardiovascular Disease And Mortality Across 21 Countries In Prospective Urban And Rural Epidemiology Study: Prospective Cohort Study, Sumathi Swaminathan, Mahshid Dehghan, John Michael Raj, Tinku Thomas, Sumathy Rangarajan, David Jenkins, Prem Mony, Viswanathan Mohan, Scott A. Lear, Romaina Iqbal

Community Health Sciences

Objective: To evaluate the association between intakes of refined grains, whole grains, and white rice with cardiovascular disease, total mortality, blood lipids, and blood pressure in the Prospective Urban and Rural Epidemiology (PURE) study.
Design: Prospective cohort study.
Setting: PURE study in 21 countries.
Participants: 148 858 participants with median follow-up of 9.5 years.
Exposures: Country specific validated food frequency questionnaires were used to assess intakes of refined grains, whole grains, and white rice.
Main outcome measure: Composite of mortality or major cardiovascular events (defined as death from cardiovascular causes, non-fatal myocardial infarction, stroke, or heart failure). Hazard ratios were …

Vegetable Nitrate Intake, Blood Pressure And Incident Cardiovascular Disease: Danish Diet, Cancer, And Health Study, Catherine P. Bondonno, Frederik Dalgaard, Lauren C. Blekkenhorst, Kevin Murray, Joshua R. Lewis, Kevin D. Croft, Cecilie Kyrø, Christian Torp-Pedersen, Gunnar Gislason, Anne Tjønneland, Kim Overvad, Nicola P. Bondonno, Jonathan M. Hodgson

Research outputs 2014 to 2021

Whether the vascular effects of inorganic nitrate, observed in clinical trials, translate to a reduction in cardiovascular disease (CVD) with habitual dietary nitrate intake in prospective studies warrants investigation. We aimed to determine if vegetable nitrate, the major dietary nitrate source, is associated with lower blood pressure (BP) and lower risk of incident CVD. Among 53,150 participants of the Danish Diet, Cancer, and Health Study, without CVD at baseline, vegetable nitrate intake was assessed using a comprehensive vegetable nitrate database. Hazard ratios (HRs) were calculated using restricted cubic splines based on multivariable-adjusted Cox proportional hazards models. During 23 years of …

Blood Pressure Management Education, Lauren G. Gernon, Cara Rathmell

Family Medicine Clerkship Student Projects

The expansion of telehealth with COVID-19 and recent recommendations to use at-home blood pressure monitoring to diagnose and monitor hypertension have increased the need for materials and education for clinicians and patients. A pilot project in Primary Care Internal Medicine UVM in Essex, VT, produced an electronic medical record dot phrase and compiled educational materials to initiate nurse visits for at-home BP measurements. Materials and experience with this pilot was researched for initiation of a similar program at UVM Family Medicine Hinesburg.

Determinants Of Uncontrolled Hypertension In Rural Communities In South Asia-Bangladesh, Pakistan, And Sri Lanka, Tazeen Jafar, Mihir Gandhi, Imtiaz Jehan, Aliya Naheed, H Asita De Silva, Hunaina Shahab, Dewan Alam, Nathasha Luke, Ching Wee Lim Wee Lim, Cobra-Bps Study Group

Community Health Sciences

Background: Uncontrolled blood pressure (BP) is a leading risk factor for death and disability in South Asia. We aimed to determine the cross-country variation, and the factors associated with uncontrolled BP among adults treated for hypertension in rural South Asia.
Methods: We enrolled 1718 individuals aged ≥40 years treated for hypertension in a cross-sectional study from rural communities in Bangladesh, Pakistan, and Sri Lanka. Multivariable logistic regression model was used to determine the factors associated with uncontrolledBP (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg).
Results: Among hypertensive individuals, 58.0% (95% confidence interval 55.7, 60.4) had uncontrolled BP: 52.8% …

Contributions Of Mean And Shape Of Blood Pressure Distribution To Worldwide Trends And Variations In Raised Blood Pressure: A Pooled Analysis Of 1018 Population-Based Measurement Studies With 88.6 Million Participants, Majid Ezzati, Bin Zhou, James Bentham, Mariachiara Di Cesare, Honor Bixby, Goodarz Danaei, Kaveh Hajifathalian, Cristina Taddei, Rodrigo M. Carrillo-Larco, Shirin Djalalinia, Shahab Khatibzadeh, Charles Lugero, Niloofar Peykari, Wan Zhu Zhang, James Bennett, Ver Bilano, Gretchen A. Stevens, Melanie J. Cowan, Leanne M. Riley, Zhengming Chen, Ian R. Hambleton, Rod T. Jackson, Andre Pascal Kengne, Young Ho Khang, Avula Laxmaiah, Jing Liu, Reza Malekzadeh, Hannelore K. Neuhauser, Maroje Sorić, Gregor Starc, Johan Sundström, Tara Coppinger, Janette Walton, Con Burns, Mark Woodward

Publications

Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean …

The Association Of Calcium Intake And Other Risk Factors With Cardiovascular Disease Among Obese Adults In Usa, Yang Chen, Sheryl Strasser, Katie Callahan, David Blackley, Yan Cao, Liang Wang, Shimin Zheng

Shimin Zheng

In this study, we used a cross-sectional study design to examine the relationship between the calcium intake and risk factors for CVD among obese adults by using continuous waves of National Health and Nutrition Examination Survey (NHANES) data 1999-2010. The association between calcium intake and risk factors of CVD (hypertension, total cholesterol, HDL, glycohemoglobin), CRP, albuminuria) is assessed among obese adults in USA. The incidence of Cardiovascular Disease (CVD) is high among obese people. The potential effects of inadequate calcium intake on CVD are receiving increased epidemiologic attention. Understanding the association between risk factors for CVD and calcium intake among …

A Comparison Of Measured And Self-Reported Blood Pressure Status Among Low-Income Housing Residents In New York City, James H. Williams Ab, Dustin T. Duncan Scd, Jonathan Cantor Ms, Brian Elbel Phd Mph, Gbenga Ogedegbe Md Ms Mph, Joseph Ravenell Md Ms

Journal of Health Disparities Research and Practice

Self-report is widely used to measure hypertension prevalence in population-based studies, but there is little research comparing self-report with measured blood pressure among low-income populations. The objective of this study was to compare self-reported and measured blood pressure status among a sample of low-income housing residents in New York City (n=118). We completed a cross-sectional analysis comparing self-report with measured blood pressure status. We determined the sensitivity, specificity, and positive predictive value (PPV) of each self-report metric. Of the sample, 68.1% was Black, 71.1% had a household income under $25,000/year, and 28.5% did not complete high school. In our study, …

Worldwide Trends In Blood Pressure From 1975 To 2015: A Pooled Analysis Of 1479 Population-Based Measurement Studies With 19·1 Million Participants, Bin Zhou, James Bentham, Mariachiara Di Cesare, Honor Bixby, Goodarz Danaei, Melanie J. Cowan, Christopher J. Paciorek, Gitanjali Singh, Kaveh Hajifathalian, James E. Bennett, Cristina Taddei, Con Burns, Tara Coppinger, Ver Bilano, Rodrigo M. Carrillo-Larco, Shirin Djalalinia, Shahab Khatibzadeh, Charles Lugero, Niloofar Peykari, Wan Zhu Zhang, Yuan Lu, Gretchen A. Stevens, Leanne M. Riley, Pascal Bovet, Paul Elliott, Dongfeng Gu, Nayu Ikeda, Rod T. Jackson, Michel Joffres, Andre Pascal Kengne, Tiina Laatikainen, Tai Hing Lam, Avula Laxmaiah, Jing Liu

Publications

Background Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. Methods For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean …

Historical Differences In School Term Length And Measured Blood Pressure: Contributions To Persistent Racial Disparities Among Us- Born Adults, Sze Yan Liu, Jennifer J. Manly, Benjamin D. Capistrant, M. Maria Glymour

Department of Public Health Scholarship and Creative Works

Introduction
Legally mandated segregation policies dictated significant differences in the educational experiences of black and white Americans through the first half of the 20th century, with markedly lower quality in schools attended by black children. We determined whether school term length, a common marker of school quality, was associated with blood pressure and hypertension among a cohort of older Americans who attended school during the de jure segregation era.
Methods
National Health and Nutrition Examination Survey I and II data were linked to state-level historical information on school term length. We used race and gender-stratified linear regression models adjusted for …

Assessment Of Obesity As A Cardiovascular Disease Risk Factor In A Geriatric Rural Texas Community - A Six Month Follow-Up, Alberto Coustasse Md, Mba

Alberto Coustasse, DrPH, MD, MBA, MPH

Coustasse, Alberto, Assessment of Obesity as a Cardiovascular Disease Risk Factor in a Geriatric Rural Texas Community – A Six Month Follow-up. Master of Public Health Track, Public Health Administration, December 1999, 22 pp., 9 tables, 9 illustrations, bibliography, 7 titles. The health fair approach was used as a method to establish individual and population health status baselines and to provide a mechanism to follow-up with an elderly population in a rural Texas community. A controlled trial sample of forty-four seniors was initially screened in a primary care clinic in August 1998. Patients were reevaluated at six months and results …

The Association Of Calcium Intake And Other Risk Factors With Cardiovascular Disease Among Obese Adults In Usa, Yang Chen, Sheryl Strasser, Katie Callahan, David Blackley, Yan Cao, Liang Wang, Shimin Zheng

ETSU Faculty Works

In this study, we used a cross-sectional study design to examine the relationship between the calcium intake and risk factors for CVD among obese adults by using continuous waves of National Health and Nutrition Examination Survey (NHANES) data 1999-2010. The association between calcium intake and risk factors of CVD (hypertension, total cholesterol, HDL, glycohemoglobin), CRP, albuminuria) is assessed among obese adults in USA. The incidence of Cardiovascular Disease (CVD) is high among obese people. The potential effects of inadequate calcium intake on CVD are receiving increased epidemiologic attention. Understanding the association between risk factors for CVD and calcium intake among …

Lifetime Racism And Blood Pressure Changes During Pregnancy: Implications For Fetal Growth, Clayton J. Hilmert, Tyan Parker Dominguez, Christine Dunkel Schetter, Sindhu K. Srinivas, Laura M. Glynn, Calvin J. Hobel, Curt A. Sandman

Psychology Faculty Articles and Research

Objective: Research suggests that exposure to racism partially explains why African American women are 2 to 3 times more likely to deliver low birth weight and preterm infants. However, the physiological pathways by which racism exerts these effects are unclear. This study examined how lifetime exposure to racism, in combination with maternal blood pressure changes during pregnancy, was associated with fetal growth. Methods: African American pregnant women (n = 39) reported exposure to childhood and adulthood racism in several life domains (e.g., at school, at work), which were experienced directly or indirectly, meaning vicariously experienced when someone …

The Prevalence Of Essential Hypertension In Kasigau, Kenya, Lindsay Williams

Mahurin Honors College Capstone Experience/Thesis Projects

Hypertension is the leading cause of cardiovascular disease worldwide. Cardiovascular disease (CVD) is a widespread chronic non-communicable disease (NCD) which is on the rise in developing countries. Evidence based on extensive research studies on risk factors for NCDs suggests that they could be easily significantly decreased by simply controlling their risk factors. Although high blood pressure has been recognized as a leading risk factor for CVD, little research has been done to document the prevalence and incidence of essential hypertension (EH) in lower socioeconomic developing countries. One such country is Kenya. It was found in our research study that Kasigau …