CDC Grand Rounds: A Public Health Approach to Detect and Control Hypertension

Merai, Rikita

doi:10.15585/mmwr.mm6545a3

Cited by 186 publications

(140 citation statements)

References 7 publications

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“…In addition, they were seeking various dental treatments and comprehensive dental examinations, and their selection was not limited to patients seeking periodontal treatment. In addition, the prevalence of systemic medical conditions and tobacco use are in accordance with the estimates of the Centers for Disease Control and Prevention (CDC) among adults in the United States . Thus, the sample of the present study may be considered representative of the United States population.…”

Section: Discussionsupporting

confidence: 69%

Validity of self‐reported periodontal measures, demographic characteristics, and systemic medical conditions

Chatzopoulos

Cisneros

Sanchez

et al. 2018

Journal of Periodontology

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Section: Discussionsupporting

confidence: 69%

Validity of self‐reported periodontal measures, demographic characteristics, and systemic medical conditions

Chatzopoulos

Cisneros

Sanchez

et al. 2018

Journal of Periodontology

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“…When race and ethnicity are taken into account, there are higher rates of hypertension in blacks, followed by US non-Hispanic whites and Mexican Americans. 20 In addition, diabetes mellitus and obesity are increasing in frequency across the United States. In 2014, there were an estimated 22 million Americans living with diabetes mellitus, a 4-fold increase from the 5.5 million with diabetes mellitus in 1980 and nearly double the 12.1 million in 2000.…”

Section: Public Health Impact Of Cognitive Impairment Dementia Stromentioning

confidence: 99%

Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association

Gorelick

Furie

Iadecola

et al. 2017

Stroke

316

271

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Cognitive function is an important component of aging and predicts quality of life, functional independence, and risk of institutionalization. Advances in our understanding of the role of cardiovascular risks have shown them to be closely associated with cognitive impairment and dementia. Because many cardiovascular risks are modifiable, it may be possible to maintain brain health and to prevent dementia in later life. The purpose of this American Heart Association (AHA)/American Stroke Association presidential advisory is to provide an initial definition of optimal brain health in adults and guidance on how to maintain brain health. We identify metrics to define optimal brain health in adults based on inclusion of factors that could be measured, monitored, and modified. From these practical considerations, we identified 7 metrics to define optimal brain health in adults that originated from AHA’s Life’s Simple 7: 4 ideal health behaviors (nonsmoking, physical activity at goal levels, healthy diet consistent with current guideline levels, and body mass index <25 kg/m2) and 3 ideal health factors (untreated blood pressure <120/<80 mm Hg, untreated total cholesterol <200 mg/dL, and fasting blood glucose <100 mg/dL). In addition, in relation to maintenance of cognitive health, we recommend following previously published guidance from the AHA/American Stroke Association, Institute of Medicine, and Alzheimer’s Association that incorporates control of cardiovascular risks and suggest social engagement and other related strategies. We define optimal brain health but recognize that the truly ideal circumstance may be uncommon because there is a continuum of brain health as demonstrated by AHA’s Life’s Simple 7. Therefore, there is opportunity to improve brain health through primordial prevention and other interventions. Furthermore, although cardiovascular risks align well with brain health, we acknowledge that other factors differing from those related to cardiovascular health may drive cognitive health. Defining optimal brain health in adults and its maintenance is consistent with the AHA’s Strategic Impact Goal to improve cardiovascular health of all Americans by 20% and to reduce deaths resulting from cardiovascular disease and stroke by 20% by the year 2020. This work in defining optimal brain health in adults serves to provide the AHA/American Stroke Association with a foundation for a new strategic direction going forward in cardiovascular health promotion and disease prevention.

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“…The clinical potential for the use of this drug is further exemplified by consideration of the number of hypertensive patients in the United States. According to Centers for Disease Control and Prevention, approximately 75 million people in the US have HTN [18]. Within this population 312,550–721,153 patients that may benefit from starting on an ACE-I for their HTN with regards to reduction in pulmonary outcomes.…”

Section: Resultsmentioning

confidence: 99%

Renin Angiotensin system-modifying therapies are associated with improved pulmonary health

Soto

Bang

McCombs

et al. 2017

Clin Diabetes Endocrinol

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BackgroundPulmonary diseases are often complicated and have diverse etiologies. One common factor is the lack of therapeutics available for these diseases. The goal of this study was to investigate the impact of Renin-Angiotensin System (RAS)-modifying medications on incidence and time to pulmonary complications.MethodsA retrospective analysis was conducted using claims data from a US commercial insurance company (2007–2013). The study consisted of patients with an emerging hypertension (HTN) diagnosis. Cox analysis was used to look at the effect of angiotensin converting enzyme inhibitors (ACE-Is) and angiotensin receptor blockers (ARBs) in this population. The events included pneumonia and influenza (infectious), Chronic obstructive pulmonary disease (COPD) and allied conditions (inflammatory), and other diseases (structural).ResultsA total of 215,225 patients were followed in the study. These fell into three groups depending on the first prescribed anti-hypertension medication; ACE-Is (47.21%), ARBs (11.40%) and calcium channel blockers (CCBs)/Diuretics-Control (41.39%). The use of ACE-I as first treatment significantly reduced the incidence of infectious (Hazard Ratio (HR) 0.886, 95% Confidence Interval (95% CI) 0.859–0.886), inflammatory (HR 0.924, 95% CI 0.906–0.942) and structural outcomes (HR 0.865, 95% CI 0.847–0.885); it also increased the time (delayed) to diagnosis with prolonged treatment. Primary ARB use only significantly lowered the incidence of structural outcomes (HR 0.900, 95% CI 0.868–0.933); prolonged treatment did reduce incidence of all three diagnosis groups and significantly delayed disease onset.ConclusionsThere is an association between the use of ACE-Is and ARBs and a delay in the progression of pulmonary complications in vulnerable populations. Research into the RAS may identify future therapies for patients with potential chronic pulmonary conditions.

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CDC Grand Rounds: A Public Health Approach to Detect and Control Hypertension

Cited by 186 publications

References 7 publications

Validity of self‐reported periodontal measures, demographic characteristics, and systemic medical conditions

Validity of self‐reported periodontal measures, demographic characteristics, and systemic medical conditions

Defining Optimal Brain Health in Adults: A Presidential Advisory From the American Heart Association/American Stroke Association

Renin Angiotensin system-modifying therapies are associated with improved pulmonary health

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