Population Health Commons^™

Persistent Gaps In Management And Risk Factor Control Among Patients With Atherosclerotic Cardiovascular Disease: All Of Us Research Program, Yakubu Bene-Alhasan, Soad Al Osta, Yussif Issaka, Isaac Acquah, Ahmad Alkhatib, Leen Othman, Samuel Mensah, Ato Howard, Christie Ballantyne, Salim S. Virani

Population Health, East Africa

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Background

Contemporary guidelines recommend aggressive low-density lipoprotein cholesterol (LDL-C) lowering in patients with atherosclerotic cardiovascular disease (ASCVD), yet significant treatment gaps persist in clinical practice. We evaluated lipid-lowering therapy (LLT) use, LDL-C control, and prevelance of cardiovascular risk factors among patients with coronary artery disease (CAD), peripheral artery disease (PAD), cerebral atherosclerosis (CAS) and those with all three (polyvascular disease) using real-world data from the NIH-run All of Us Research Program.

Methods

We analyzed electronic health records from 26,935 patients with ASCVD (CAD 21,573; PAD 4752; CAS 6864; and polyvascular 902) enrolled between 2018 and 2023. We assessed baseline LLT …

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Ambulatory Blood Pressure Monitoring Phenotypes And Circadian Blood Pressure Patterns Among Adults Referred For Diagnostic Evaluation At Aga Khan University Hospital, Nairobi, Kenya: A Retrospective Cross-Sectional Study, Nadeem Kassam, Mzee Ngunga, James Orwa, Alisa Bhojani, Mohamed Varwani, Swaffiya Salim, Yvonne Oketch, Salim Surani, Anthony Ochola, Barbara Karau, Jeilan Mohamed, Etienne Amendezo

Internal Medicine, East Africa

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Introduction: hypertension represents the primary modifiable risk factor for cardiovascular disease and poses a public health challenge in sub-Saharan regions, with Kenya experiencing particularly low detection and control rates. Traditional office-based blood pressure measurements often fail to detect key phenotypes, such as white-coat and masked hypertension. Ambulatory Blood Pressure Monitoring (ABPM) offers a comprehensive 24-hour profile that excludes white-coat hypertension and allows for the evaluation of circadian patterns, including nocturnal hypertension and non-dipping status, both of which are recognized as high-risk phenotypes strongly linked to adverse cardiovascular events. This study evaluated ABPM data from Aga Khan University Hospital, Nairobi …

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Participant Recruitment, Baseline Characteristics And Burden Of Cardiometabolic Risk Markers Among Adults With Prediabetes In Kenya: Insights From The Fermented Foods And Prediabetes Study, Rosebella Iseme, Alex Muia, Jacob Shabani, Samuel Mucheru, Catherine Gathu, Eliphas Gitonga, Redempta Mutisya, Peter Kioko, Jalal Safipour, Cornelia Witthöft

Population Health, East Africa

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Aims

Cardiometabolic abnormalities such as obesity, hypertension, and dyslipidemia are rising globally and straining health systems. This study assessed the burden of cardiometabolic risk factors among prediabetic adults in Kenya.

Methods

We analyzed baseline data from the Fermented Foods and Prediabetes Randomized Controlled Trial, which recruited adults with prediabetes (HbA1c 39–46 mmol/mol; 5.7%–6.4%) from Aga Khan University Hospital outreach clinics in five Kenyan counties. Standardized questionnaires and clinical assessments were conducted, with HbA1c measured via turbidimetric inhibition immunoassay. Data were managed in REDCap and analyzed in Stata v13. Poisson regression identified factors associated with co-occurrence of cardiometabolic risk factors.

Results …

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Association Of Central Obesity And Hypertension In An Urban Area, Chandrayani Simanjorang, Diva Anita Churiana Sudrajat, Ulya Qoulan Karima

Jurnal Keperawatan Indonesia

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Hypertension is one of the non-communicable diseases in Indonesia that is closely related to obesity. Therefore, this study aimed to determine the association between central obesity and hypertension in a cohort study group in Bogor City, West Java from 2011 to 2021. A retrospective cohort study design was employed, with multivariate Cox regression analysis performed using secondary data from the Risk Factors for Non-Communicable Diseases (FRPTM) Cohort Study. Among 3,586 samples, 879 incident cases of hypertension were observed by the end of follow-up, accounting for 24.5% of the at-risk population. The incidence rate of hypertension was 28 cases per 1000 …

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Intergenerational Hypertension Transmission Before And After South Africa's Democratic Transition, Winfred A. Avogo

Faculty Publications – Sociology and Anthropology

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Background: Apartheid's structural violence produced profound cardiovascular inequalities among Black South Africans through processes that accelerate biological aging ("weathering") and transmit health disadvantage across successive generations. Whether South Africa's 1994 political transition interrupted this intergenerational transmission remains unknown. This study tests whether parent-to-offspring hypertension transmission weakened among cohorts born after apartheid's end, using the 1994 transition as a natural experiment. Methods: This study analyzed 30,438 parent-offspring dyads from five waves (2008–2017) of South Africa's National Income Dynamics Study, representing 11,655 unique offspring aged 18 years and older. Hypertension was defined as blood pressure ≥140/90mmHg or use of antihypertensive medication. Logistic …

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Clinical Challenges Associated With Enhancing Hypertension Among The Underserved African American Population, Ashley Richardson

Doctor of Nursing Practice (DNP) Scholarly Projects

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Background 

African Americans face a significantly higher prevalence of hypertension, tend to develop complications at younger ages, and have disproportionately higher mortality rates. Key social determinants of health (SDoH)—including food deserts, unequal access to healthcare, and geographic disparities in healthcare resources—contribute to these ongoing inequities. Addressing both systemic and individual barriers is crucial for effective hypertension management.

Objective

This study aims to assess the effectiveness of a culturally relevant, community-based intervention designed to reduce both systolic and diastolic blood pressure among Black adults with uncontrolled hypertension.

Methods 

Quality improvement (QI) initiatives typically employ multicomponent, equity-focused models. The primary components of …

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Risk Factors For Hypertension Among Adults Living In A Rural Area, Minahasa, Cindy Debora, Cindy Tolimba, Shekina Palunggi, Deborah Siregar, Lenny Harefa

Jurnal Keperawatan Indonesia

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Hypertension is a major public health issue in Indonesia due to its high prevalence and the fact that it is a risk factor for heart disease, kidney failure, and stroke. Age, gender, family history, alcohol consumption, smoking, iodine consumption, physical activity, and obesity are all risk factors for hypertension. Adults with undiagnosed hypertension can face an increased risk of morbidity and mortality if it is left untreated. Early detection and knowledge about the risk factors for hypertension in adults are important. This cross-sectional study aimed to investigate the risk factors for hypertension in adults in Mapanget Village, North Minahasa. The …

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Hypertension Self-Care Management During Covid-19 Pandemic Crisis In The Meranao Tribe: A Phenomenological Inquiry, Jonaid M. Sadang, Sittie Inshirah P. Macaronsing, Narima M. Alawi, Normala M. Taib, Hamdoni K. Pangandaman

Jurnal Keperawatan Indonesia

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The COVID-19 crisis has been a challenging and stressful event for individuals with known underlying health problems, not to mention their higher risk of contracting the disease. This phenomenological inquiry was conducted to explore the common self-care practices of the Meranao tribe in the Province of Lanao del Sur, Philippines, concerning their management of hypertension amidst the ongoing pandemic health crisis. This study employed a descriptive-phenomenological approach. Ten known hypertensive adults participated in the study selected using purposive sampling. Data collection employed focus group discussion (FGD) and then analyzed using Colaizzi's approach. Four themes were derived which explained the common …

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Improvement In Patients’ Ability To Care For Anxiety And Impaired Body Image: A Case Report Of Acceptance And Commitment Therapy And Family Psychoeducation, Rasmawati Rasmawati, Budi Anna Keliat, Herni Susanti

Jurnal Keperawatan Indonesia

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Heart failure and hypertension are non-communicable diseases that are responsible for 70% of deaths world wide and cause anxiety and impaired body image. Nursing interventions(therapy in general) and acceptance and commitment therapy increase patients’ acceptance of the disease and commitment to alleviate anxiety and improve impaired body image. Meanwhile, family psychoeducation improves the family’s ability to care for the patient. This case report presents two patients with heart failure and hypertension. The two patients experienced a decrease in symptoms on the cognitive aspects(difficulty concentrating, focusing on self, and decline body changes), affective aspects (worry, shame, and despair), physiological aspects(sleep disorders …

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The Impact Of Vegetarian Diets And Body Mass Index On Hypertension, Tri Mariha, Wiwin Wiarsih

Jurnal Keperawatan Indonesia

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A vegetarian diet is believed to prevent hypertension. This study aims to identify the impact of vegetarian diets, including fat, salt, potassium, and body mass index (BMI), on hypertension. Data was taken by systematic random sampling method from 173 vegetarians and analyzed using chi-square. The result showed that there is no significant association between the intake of fat, sodium, and potassium with hypertension in vegetarians (p> 0.05). However, there is a significant relationship between BMI with the incidence of hypertension (p= 0.025), where overweight res-pondents are 3.837 more likely to have hypertension (OR 3.837; 95% CI= 1,256–11,721). It implies that …

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