Medicine and Health Sciences Commons^™

Simultaneous Bilateral Intracerebral Hemorrhage In A Case Of Wegener's Granulomatosis: A Casereport And Literature Reviewarticle, Yu-Jen Chen, Ho-Fai Wong, Chih-Chi Chen, Chia-Ling Chen, Chia-Ying Chung

Rehabilitation Practice and Science

Background: Simultaneous multiple intracerebral hemorrhages (ICHs) are rare and their underlying mechanisms are unknown. Reported etiologies include hypertension, vasculitis, cerebral amyloid angiopathy, venous sinus thrombosis, coagulopathy, and intracranial vascular anomalies. Granulomatosis with polyangiitis (GPA; Wegener's granulomatosis) is a necrotizing granulomatous vasculitis affecting small- and medium-sized vessels of the respiratory tract and kidneys. The reported frequency of central nervous system (CNS) involvement in GPA is 0%-16.4%. Case presentation: A 34-year-old man with hypertension presented with a sudden loss of consciousness and weakness in the right limbs. Brain computed tomography (CT) showed a left basal ganglion hemorrhage and right basal ganglion infarction …

Interaction Between Angiotensin Ii And Bdnf In Modulating Sympathetic Nerve Activity, Bryan K. Becker

Theses & Dissertations

Over activation of the sympathetic nervous system is prevalent in many forms of cardiovascular disease such as chronic heart failure (CHF) and hypertension. Although increased neuronal renin-angiotensin system activity in presympathetic neurons has been well implicated in mediating this sympatho-excitation, many of the neuronal effects of angiotensin II (Ang II) signaling remain poorly understood. One particular mechanism of Ang II-mediated increases in presympathetic neuronal activity is through reductions in voltage-gated K⁺ currents. Another pathway that has profound effects on neuronal K⁺ currents and that has been previously implicated in Ang II-signaling is brain-derived neurotrophic factor (BDNF) activity through …

Hypertension Patient Compliance, Taylor Myers

University Honors Program

Hypertension is a prevalent condition in the United States that often has many comorbidities. It is usually asymptomatic, so patients are less likely to comply with treatment if they feel healthy. This is a growing concern due to the complications that can arise from hypertension. Hypertension can be associated with a lower quality of life in patients that have symptoms. However, in patients that do not show symptoms they may feel that they have a higher quality of life by not changing their preexisting habits. The reasons for patient noncompliance will be studied as well as interventions to increase compliance, …

Prevalence Of Hypertension In Low- And Middle-Income Countries: A Systematic Review And Meta-Analysis., Ahmed Sarki, Chidozie U. Nduka, Saverio Stranges, Ngianga-Bakwin Kandala, Olalekan A. Uthman

School of Nursing & Midwifery, East Africa

We aimed to obtain overall and regional estimates of hypertension prevalence, and to examine the pattern of this disease condition across different socio-demographic characteristics in low-and middle-income countries. We searched electronic databases from inception to August 2015. We included population-based studies that reported hypertension prevalence using the current definition of blood pressure ≥140/90 mm Hg or self-reported use of antihypertensive medication. We used random-effects meta-analyses to pool prevalence estimates of hypertension, overall, by World Bank region and country income group. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. A total of 242 studies, comprising data …

Dashing Away Hypertension: Evaluating The Efficacy Of The Dietary Approaches To Stop Hypertension Diet In Controlling High Blood Pressure, Preeya Shah Phd, Kyle D. Maxwell, Joseph I. Shapiro Md

Biochemistry and Microbiology

The dietary approaches to stop hypertension (DASH) diet has been developed and popularized as a non-pharmaceutical intervention for high blood pressure reduction since 1995. However, to date, a comprehensive description of the biochemical rationale behind the diet’s principal guidelines has yet to be compiled. With rising interest for healthy and reliable life-style modifications to combat cardiovascular disease, this review aims to compile the most recent and relevant studies on this topic and make an informed assessment as to the efficacy of and underlying mechanisms operant in the DASH diet. Specifically, the merits of lowering dietary intake of sodium and saturated …

Disease-Management In Family Medicine Clinics Through The Addition Of A Health Coach: A Pilot Study, Crystal Y. Cichon, Jessica J.F. Kram, Tiffany A. Mullen, Pamela Voelkers, Kristin J. Magliocco, Kiley A. Bernhard, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Background: In the United States, more than 80% of health care spending is focused on the management of chronic illnesses such as hypertension, diabetes and hyperlipidemia. Controlling these chronic diseases can lead to better health outcomes and decrease the number of preventable deaths. Patient self-management has shown to improve clinical outcomes. In a primary care setting, a multidisciplinary approach can more effectively educate patients on improving their health.

Purpose: To assess the impact of a health coach in a primary care setting as it relates to clinical outcomes.

Methods: Patients from two Aurora family medicine clinics were referred to a …

Impact Of The Georgia Charitable Care Network On Cost Savings From Lowering Blood Pressure And Decreasing Emergency Department Use, Phaedra Corso, Rebecca Walcott, Justin Ingels

Journal of the Georgia Public Health Association

Background: The Georgia Charitable Care Network (GCCN) is a non-profit organization whose primary mission is to foster collaborative partnerships to deliver compassionate health care to low-income, uninsured individuals. Hypertension screening and management is a service provide by 90+ clinics in the GCCN statewide.

Methods: With data from N=1661 patients who were screened and treated for hypertension at n=12 clinics in 2013, the impact of hypertension management on blood pressure levels, the incidence of coronary heart disease (CHD) and stroke, and utilization of emergency departments (EDs) were examined. The resulting changes in healthcare utilization were converted to changes in healthcare costs …

Hypertension Management Through Patient Education, Shaleena Kumar

Master's Projects and Capstones

Hypertension serves as a common diagnosis among Americans, and its management to prevent further cardiovascular complications remains as an organizational goal. To prevent complications, the goal of a Primary Care Provider’s patient panel maintaining a blood pressure less than 140/90 has been established on the organization’s national office. In the Primary Care Clinic, an interdisciplinary team consisting of a Registered Nurse, Clinical Psychologist, and Cardiologist implemented a group education class aimed at a Hypertensive Veteran cohort. The purpose of this project is to improve self-management behaviors in the Veteran population, and to help increase the hypertension performance metric by 2% …

Role Of Redox-Sensitive Calcium/Calmodulin-Dependent Protein Kinase Lla In Angiotensin Ii Intra-Neuronal Signaling And Angiotensin Ll-Mediated Hypertension, Urmi Basu

Theses & Dissertations

Activation of renin-angiotensin system and elevated levels of circulating and brain angiotensin II (AngII) has been implicated in the pathogenesis of neuro-cardiovascular diseases, such as hypertension and heart failure. In central neurons AngII increases generation of reactive oxygen species (ROS), which in turn regulates neuronal ion channels. Previous studies have demonstrated that ion channels can also be regulated by protein kinases, such as calcium /calmodulin-dependent protein kinase II (CaMKII) as a downstream mediator of AngII signaling. In the heart, CaMKIIδ undergoes oxidation upon AngII stimulation and increased pro-oxidant conditions. However, the exact mechanism by which AngII and ROS regulate CaMKIIα, …

Using Simplified Blood Pressure Tables To Avoid Underdiagnosing Childhood Hypertension, Ajay P. Sharma, Javed Mohammed, Benson Thomas, Ram N. Singh, Guido Filler

Paediatrics Publications

Background: Recent studies have revealed that hypertension remains underdiagnosed in a significant number of children despite their recorded office blood pressure (OBP) exceeding the recommended fourth report OBP thresholds. Simplified OBP thresholds have been proposed to reduce this underdiagnosis of hypertension in children. In clinical practice, OBP screened as elevated according to the fourth report OBP thresholds are referred for ambulatory blood pressure (ABP) monitoring to rule out 'white coat' hypertension. Objectives: The present study tested the usefulness of simplified OBP thresholds to screen abnormal OBP for ABP monitoring referral. Methods: A total of 155 subjects were retrospectively analyzed with …

The Search For High-Impact Diagnostic And Management Tools For Low-And Middle-Income Countries: A Self-Powered Low-Cost Blood Pressure Measurement Device Powered By A Solid-State Vibration Energy Harvester, Onur Bilgen, John G. Kenerson, Muge Akpinar-Elci, Rebecca Hattery, Lisbet M. Hanson

Mechanical & Aerospace Engineering Faculty Publications

The World Health Organization has established recommendations for blood pressure measurement devices for use in low-resource venues, setting the triple A expectations of Accuracy, Affordability, and Availability. Because of issues related to training and assessment of proficiency, the pendulum has swung away from manual blood pressure devices and auscultatory techniques towards automatic oscillometric devices. As a result of power challenges in the developing world, there has also been a push towards semiautomatic devices that are not dependent on external power sources or batteries. Beyond solar solutions, disruptive technology related to solid-state vibrational energy harvesting may be the next iterative solution …

Involvement Of Reactive Oxygen Species In A Feed-Forward Mechanism Of Na/K-Atpase Mediated Signaling, Yanling Yan, Anna P. Shapiro, Steven Haller, Vinal Katragadda, Lijun Liu, Jiang Tian, Venkatesha Basrur, Deepak Malhotra, Zi-Jian Xie, Nader G. Abraham, Joseph I. Shapiro Md, Jiang Liu

Nader G. Abraham

Cardiotonic steroids (such as ouabain) signaling through Na/K-ATPase regulate sodium reabsorption in the renal proximal tubule. We report here that reactive oxygen species are required to initiate ouabain-stimulated Na/K-ATPase·c-Src signaling. Pretreatment with the antioxidant N-acetyl-L-cysteine prevented ouabain-stimulated Na/K-ATPase·c-Src signaling, protein carbonylation, redistribution of Na/K-ATPase and sodium/proton exchanger isoform 3, and inhibition of active transepithelial 22Na+ transport. Disruption of the Na/K-ATPase·c-Src signaling complex attenuated ouabain-stimulated protein carbonylation. Ouabain-stimulated protein carbonylation is reversed after removal of ouabain, and this reversibility is largely independent of de novo protein synthesis and degradation by either the lysosome or the proteasome pathways. Furthermore, ouabain stimulated direct …

Involvement Of Reactive Oxygen Species In A Feed-Forward Mechanism Of Na/K-Atpase Mediated Signaling, Yanling Yan, Anna P. Shapiro, Steven Haller, Vinal Katragadda, Lijun Liu, Jiang Tian, Venkatesha Basrur, Deepak Malhotra, Zi-Jian Xie, Nader G. Abraham, Joseph I. Shapiro Md, Jiang Liu

Joseph I Shapiro MD

Cardiotonic steroids (such as ouabain) signaling through Na/K-ATPase regulate sodium reabsorption in the renal proximal tubule. We report here that reactive oxygen species are required to initiate ouabain-stimulated Na/K-ATPase·c-Src signaling. Pretreatment with the antioxidant N-acetyl-L-cysteine prevented ouabain-stimulated Na/K-ATPase·c-Src signaling, protein carbonylation, redistribution of Na/K-ATPase and sodium/proton exchanger isoform 3, and inhibition of active transepithelial 22Na+ transport. Disruption of the Na/K-ATPase·c-Src signaling complex attenuated ouabain-stimulated protein carbonylation. Ouabain-stimulated protein carbonylation is reversed after removal of ouabain, and this reversibility is largely independent of de novo protein synthesis and degradation by either the lysosome or the proteasome pathways. Furthermore, ouabain stimulated direct …

Involvement Of Reactive Oxygen Species In A Feed-Forward Mechanism Of Na/K-Atpase Mediated Signaling, Yanling Yan, Anna P. Shapiro, Steven Haller, Vinal Katragadda, Lijun Liu, Jiang Tian, Venkatesha Basrur, Deepak Malhotra, Zi-Jian Xie, Nader G. Abraham, Joseph I. Shapiro Md, Jiang Liu

Jiang Liu

Cardiotonic steroids (such as ouabain) signaling through Na/K-ATPase regulate sodium reabsorption in the renal proximal tubule. We report here that reactive oxygen species are required to initiate ouabain-stimulated Na/K-ATPase·c-Src signaling. Pretreatment with the antioxidant N-acetyl-L-cysteine prevented ouabain-stimulated Na/K-ATPase·c-Src signaling, protein carbonylation, redistribution of Na/K-ATPase and sodium/proton exchanger isoform 3, and inhibition of active transepithelial 22Na+ transport. Disruption of the Na/K-ATPase·c-Src signaling complex attenuated ouabain-stimulated protein carbonylation. Ouabain-stimulated protein carbonylation is reversed after removal of ouabain, and this reversibility is largely independent of de novo protein synthesis and degradation by either the lysosome or the proteasome pathways. Furthermore, ouabain stimulated direct …

Telemonitoring Can Assist In Managing Cardiovascular Disease In Primary Care: A Systematic Review Of Systematic Reviews, Renee Purcell, Susan Mcinnes, Elizabeth J. Halcomb

Susan McInnes

Background There has been growing interest regarding the impact of telemonitoring and its ability to reduce the increasing burden of chronic diseases, including chronic cardiovascular disease (CVD), on healthcare systems. A number of randomised trials have been undertaken internationally and synthesised into various systematic reviews to establish an evidence base for this model of care. This study sought to synthesise and critically evaluate this large body of evidence to inform clinicians, researchers and policy makers. Methods A systematic review of systematic reviews investigating the impact of telemonitoring interventions in the primary care management of CVD was conducted. Reviews were included …

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 …

Dysregulated Arginine Metabolism And Cardiopulmonary Dysfunction In Patients With Thalassaemia, Claudia Morris, Hae-Young Kim, Elizabeth Klings, John Wood, John B. Porter, Felicia Trachtenberg, Frans Kuypers, Elliott P Vichinsky, Frans A Kuypers

NYMC Faculty Publications

Pulmonary hypertension (PH) commonly develops in thalassaemia syndromes, but is poorly characterized. The goal of this study was to provide a comprehensive description of the cardiopulmonary and biological profile of patients with thalassaemia at risk for PH. A case-control study of thalassaemia patients at high versus low PH-risk was performed. A single cross-sectional measurement for variables reflecting cardiopulmonary status and biological pathophysiology were obtained, including Doppler-echocardiography, 6-min-walk-test, Borg Dyspnoea Score, New York Heart Association functional class, cardiac magnetic resonance imaging (MRI), chest-computerized tomography, pulmonary function testing and laboratory analyses targeting mechanisms of coagulation, inflammation, haemolysis, adhesion and the arginine-nitric oxide …

The Role Of G Protein-Coupled Estrogen Receptor In Vascular Function And Hypertension, Natalie C. Fredette

Biomedical Sciences ETDs

Regulation of arterial tone relies heavily on molecular crosstalk between endothelial and smooth muscle cells. Although it has been demonstrated that estrogen (E2) exerts protective effects against cardiovascular disease (CVD), the exact mechanisms and balance of E2 signaling in endothelial and smooth muscle cells remain unresolved. Here we characterize the G protein-coupled estrogen receptor (GPER) in the vasculature by elucidating its pathway in endothelial nitric oxide (NO) production and vascular smooth muscle maintenance of reactive oxygen species (ROS) by NADPH oxidases (NOX). NO is thought of as a vasoprotective entity, while the overproduction of ROS by NOX can lead to …

Sleep Duration Associated With Cardiovascular Conditions Among Adult Nevadans, Brianna Pergola

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cardiovascular disease (CVD) is the leading cause of mortality in the United States accounting for 1 out of every 3 deaths. Additionally, 43.9% of the population is expected to have some form of cardiovascular disease by the year 2030, with direct and indirect costs expected to rise upwards of 58 percent. To successfully prevent cardiovascular disease conditions such as myocardial infarction, coronary heart disease, and stroke, research must be done to identify risk factors, both modifiable and non-modifiable. In the existing literature, sleep duration as a risk factor for cardiovascular disease conditions has shown inconsistent associations. According to the National …

Practice Matters: Screening And Caring For Those With Hypertension, Dawn M. Garrett Wright, Maria E. Main, Mary L. Branstetter

International Journal of Faith Community Nursing

The purpose of this article is to review best practices for screening and monitoring hypertension for Faith Community Nurses (FCNs). Epidemiological data regarding hypertension will be presented, along with current guidelines for blood pressure monitoring. Information on lifestyle modification and patient education resources is included to assist the FCN to improve service to patients at risk for and with current hypertension.

Religious Spiritual Coping In African American Women With Hypertension, Danice B. Greer

Faculty Posters

This poster was presented at the 28th Annual Southern Nursing Research Society-Enhancing Value-based Care: Generating New Knowledge, The Southern Nursing Research Society, San Antonio, TX, 2014.

Are Bp Readings Taken After A Patient-Physician Encounter In A Real-World Clinic Scenario The Lowest Of All The Readings In A Clinic Visit., Hunaina Shahab, Hamza Sohail Kan2 Khan, Aysha Almas, Sohail Abrar Khan, Aamir Hameed Khan

Department of Medicine

Objective: To determine the difference in Blood Pressure (BP) readings taken before, during and after the clinic encounter.

Study Design: Descriptive study.

Place and Duration of Study: Cardiology Clinic, The Aga Khan University Hospital, Karachi, from January to August 2013.

Methodology: Hypertensive and normotensive participants aged ≥ 18 years were recruited. Pre-clinic BP was measured by a nurse and in-clinic BP by a physician. After 15 minutes, two post-clinic BP readings were taken at 1 minute interval. All readings were taken using Omron HEM7221-E.

Results: Out of 180 participants, males were 57% and 130 (71%) were hypertensive. Mean SBP (Systolic …

Is 2015 The Primetime Year For Prehypertension? Prehypertension: A Cardiovascular Risk Factor Or Simply A Risk Marker?, Gabriel B. Habib, Salim S. Virani, Hani Jneid

Office of the Provost

No abstract provided.

Comparison Of Oral And Printed Health Literacy Tools In Hypertension Education For Low-Income Patients, Andrew D. Forsgren, Annie Heggestad, Charles Ruegemer

All Electronic Theses and Dissertations

Hypertension is a prevalent health concern in today’s society, especially among individuals of low-income economic status. An increased risk for heart disease has long been correlated to hypertension, and this risk increases further as the population ages. Patient education is crucial for prevention and management of diseases such as hypertension; therefore it is necessary to develop effective education tools. This is particularly true among high-risk groups such as low-income populations. This study compared the efficacy of printed educational materials versus orally presented educational materials in terms of improving patient knowledge regarding hypertension. Subjects were randomly assigned to either the printed …

Measuring Adherence To Evidence-Based Practice Guidelines For The Management Of Hypertension In Women, Cristina M. Jorgensen

DNP Projects

Approximately 1 in 3 adults In the United States (U. S.) with approximately half being women have hypertension, a significant risk factor for cardiovascular disease (CVD) and stroke (Nwankwo, Yoon, Burt, & Gu, 2013). Nearly 70% of people who had a first heart attack, 80% of those who had a first stroke, and 75% of those who had congestive heart failure (CHF) have hypertension (Mozaffarian et al., 2013). Hypertension was the underlying or contributing cause of more than 375,000 deaths in 2011. Despite multiple publications of national hypertension guidelines, only 50% of adults with hypertension have their blood pressure under …

Program For Healthcare Personnel To Improve Anti-Hypertensive Medication Adherence In Black Adults, Verena D. Johnson

Walden Dissertations and Doctoral Studies

Medication nonadherence is a healthcare problem that costs the United States billions of dollars annually. The purpose of this project was to propose an evidence-based program for healthcare personnel to increase the rate of medication adherence in hypertensive Black adults who require daily, oral medication. The transtheoretical model of change was used to explain the process of change and to identify approaches to changing non-adherent behaviors related to medications. Motivational interviewing was used to explain the process that nurse-educators would use to guide patients through the stages of change. In the initial step of this quality improvement program, a convenience …

Risk Factors For Coronary Heart Disease Among Asian Indians Living In Australia, Ritin Fernandez, John X. Rolley, Rohan Rajaratnam, Subbaram Sundar, Navin C. Patel, Patricia M. Davidson

Faculty of Science, Medicine and Health - Papers: part A

The aim of this study was to assess the coronary heart disease risk factors in the Asian Indian community living in a large city in Australia. A cross-sectional survey was conducted at the Australia India Friendship Fair in 2010. All people of Asian Indian descent who attended the Fair and visited the health promotion stall were eligible to participate in the study if they self-identified as of Asian Indian origin, were aged between 18 and 80 years, and were able to speak English. Blood pressure, blood glucose, waist circumference, height, and weight were measured by a health professional. Smoking, cholesterol …

Association Between Psychological Trauma From Assault In Childhood And Metabolic Syndrome, W Sumner Davis

Walden Dissertations and Doctoral Studies

Metabolic syndrome and its component conditions of hypertension, obesity, and insulin resistance are on the increase in United States. Metabolic syndrome substantially increases the risk of cardiovascular disease and type 2 diabetes (T2D). To date, no published study has examined the relationship between psychological traumas from physical and/or sexual assault in childhood and metabolic syndrome or its components. This study, using the psychoneuroimmunology (PNI) model, investigated associations between psychological trauma (physical/sexual abuse) in childhood and metabolic syndrome in adulthood using data from the Midlife in the United States II (MIDUS-II) study. This research was undertaken to investigate whether a history …

Health Literacy And The Level Of Hypertension In Urban Latinos, Marlene Rosetta Glashen

Walden Dissertations and Doctoral Studies

Health literacy (HL) plays a significant role in health care communication and patient compliance. Low health literacy leads to noncompliance with health instructions, poor health choices, failure to participate in recommended health screenings, frequent hospitalizations, and higher health care costs. Using the health belief model (HBM) as the conceptual framework, this quantitative, cross-sectional study addresses a gap in the literature related to the research questions of this study. The research questions are: (a) Is there a relationship between HL and the level of hypertension (HTN) in hypertensive urban Latinos?, and (b) Will HL predict the level of control of HTN …

Hypertension Management: Making Sense Of Guidelines And Therapy Options For The Elderly, Miranda Arthur, Lindsay Saum, Jessica E. Wilhoite

Scholarship and Professional Work – COPHS

Goal: The goal of this activity is to increase the awareness of the pharmacist on the complications surrounding hypertension management in the elderly individual, clarify the differences in current guideline recommendations, and aid in making the most appropriate drug therapy decisions regarding the management of hypertension.