Hypertension in diverse populations: a New York State Medicaid clinical guidance document

Wrobel, Mark J.; Figge, James; Izzo, Joseph L.

doi:10.1016/j.jash.2011.05.003

Cited by 21 publications

(14 citation statements)

References 190 publications

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“…ese �ndings support previous literature with respect to race/ethnicity and hypertension in the United States [1][2][3][4]. In this sample, Hispanics presented with a higher family income level compared with non-Hispanic blacks.…”

Section: Discussionsupporting

confidence: 89%

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Racial/Ethnic Variability in Hypertension Prevalence and Risk Factors in National Health Interview Survey

et al. 2013

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Objective. Hypertension is one of the leading causes of death attributed to cardiovascular diseases, and the prevalence varies across racial/ethnic groups, with African Americans being disproportionately affected. e underlying causes of these disparities are not fully understood despite volume of literature in this perspective. We aimed in this current study to examine ethnic/racial disparities in hypertension utilizing Hispanics as the base racial/ethnic group for comparison. Research Design and Methods. We utilized the National Health Interview Survey (NHIS), which is a large cross-sectional survey of the United States non-institutionalized residents to investigate the racial/ethnic disparities in hypertension aer the adjustment of other socio-economic, demographic, and prognostic risk factors. e study participants were adults (n = 30,852). Data were analyzed using Chi square statistic, and logistic regression model. Results. ere were statistically signi�cant differences by race/ethnicity with respect to income, education, marital status, smoking, alcohol, physical activities, body mass index, and age, P < 0.01, but not insurance coverage, P > 0.01. Hispanic ethnicity (18.9%) compared to either non-Hispanic White (27.7%) or non-Hispanic Black (35.5%) was associated with the lowest prevalence of hypertension. Race/ethnicity was a single independent predictor of hypertension, with non-Hispanic Black more likely to be hypertensive compare with Hispanic, prevalence odds ratio (POR), 2.38, 99% Con�dence Interval (CI), 2.17-2.61 and non-Hispanic White, POR, 1.64, 99% CI, 1.52-1.77. Aer controlling for the confounding variables, the racial/ethnic differences in hypertension persisted. Conclusions. Racial/ethnic disparities in hypertension persisted aer controlling for potential predictors of hypertension in NHIS, implying the inability of known hypertension risk factors to account for racial/ethnic variability in hypertension in US.

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Section: Discussionsupporting

confidence: 89%

“…Hypertension remains one of the leading causes of cardiovascular mortality in the United States population, affecting disproportionately non-Hispanic blacks [1][2][3][4]. e etiology of hypertension is multifactorial and incidence, prevalence and mortality vary by race/ethnicity [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Racial/Ethnic Variability in Hypertension Prevalence and Risk Factors in National Health Interview Survey

et al. 2013

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“…Translation of relevant clinical study findings into provider practice has been, and remains, an important function of public health. Federal agencies, such as the National Heart Lung and Blood Institute and Centers for Disease Control and Prevention, as well as state and local health departments, promote guidelines for screening and treatment and provide technical assistance in the prevention and control of various diseases 14–17 . Collaborations between local health departments and primary care clinics have great potential to promote effective treatment approaches that have yet to be widely adapted and disseminated.…”

Section: Study Strengthsmentioning

confidence: 99%

Integrating Self Blood Pressure Monitoring Into the Routine Management of Uncontrolled Hypertension: Translating Evidence to Practice

Angell

Guthartz

Dalal

et al. 2013

J of Clinical Hypertension

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Improving hypertension control is a public health priority and could reduce health disparities. Self blood pressure monitoring (SBPM) is effective but not widely integrated into clinical care. A pragmatic study distributing blood pressure (BP) monitors was conducted to assess its effectiveness in the management of uncontrolled hypertension under conditions consistent with clinic resources. Patients, predominantly black and Hispanic adults from clinics in low‐income, medically underserved communities with uncontrolled BP were enrolled. Follow‐up assessments were conducted 9 months after enrollment. Approximately half (53%) of the patients had controlled hypertension at follow‐up. Systolic and diastolic BP decreased by 18.7 mm Hg and 8.5 mm Hg, respectively, at follow‐up. Although attenuated, decreases persisted after adjustment for regression to the mean. Clinicians were supportive of the program, although collecting follow‐up data from enrolled patients was a common challenge. The integration of SBPM into routine management of uncontrolled hypertension demonstrated substantial improvements in control. Systems to identify and track patients who are self‐monitoring may increase impact. J Clin Hypertens (Greenwich). 2013;00:00–00. ©2013 Wiley Periodicals, Inc.

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“…There are several factors that contribute to the development of hypertension, such as old age, obesity, sedentary lifestyle, salt intake, lack of physical activity, imbalanced diet, some socioeconomic factors and psychological factors, among which, salt intake is an relatively major one [5]. A number of studies have demonstrated that a reduction in salt intake can lower blood pressure significantly [6], [7], and help to enhance the curative effect of antihypertensive drugs and non-pharmacological treatments for high blood pressure [8], [9].…”

Section: Introductionmentioning

confidence: 99%

Determinants of Salt-Restriction-Spoon Using Behavior in China: Application of the Health Belief Model

Chen

Liao

et al. 2013

PLoS ONE

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BackgroundThe two-gram salt-restriction-spoons, which can be used to reduce the salt intake of people, had been handed out for free by the Chinese government to the citizens several years ago, but only a small fraction of residents use such a spoon currently. Since no studies have been conducted to investigate relevant influencing factors, this study was designed to explore the determinants of salt-restriction-spoon using behavior (SRB) in China.MethodsThis cross-sectional study was conducted in Beijing, China. Altogether 269 rural residents and 244 urban residents aged over 18 were selected by convenience sampling method in 2012. Variables measured in a questionnaire designed according to the Health Belief Model (HBM) included socio-demographics, perceived susceptibility, perceived severity, perceived benefits, perceived objective barriers, perceived subjective barriers, self-efficacy, knowledge of hypertension, cues to action, and SRB. Answers to the questionnaire were obtained from all the participants, and 24-hour urine samples were collected to determine the 24-hour urinary sodium excretion (24HUNa). Path analyses were used to explore the determinants of SRB.ResultsApproximately 22.7% and 45.3% of residents used a salt-restriction-spoon everyday in the rural and urban areas, respectively. The average 24HUNa was 211.19±98.39 mmol for rural residents and 109.22±58.18 mmol for urban residents. Path analyses shown that perceived objective barriers, perceived benefits, perceived severity, knowledge and age were related to SRB and 24HUNa for both rural and urban participants, among which perceived objective barrier (β = − 0.442 and β = − 0.543, respectively) was the most important determinant.ConclusionImprovement of the current salt-restriction-spoon and education on the right usage of the salt-restriction-spoon, the severity of hypertension, and the benefit of salt reduction are necessary, especially among those who are relatively young but at risk of hypertension, those who have lower education levels, and those who live in the rural areas.

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Hypertension in diverse populations: a New York State Medicaid clinical guidance document

Cited by 21 publications

References 190 publications

Racial/Ethnic Variability in Hypertension Prevalence and Risk Factors in National Health Interview Survey

Racial/Ethnic Variability in Hypertension Prevalence and Risk Factors in National Health Interview Survey

Integrating Self Blood Pressure Monitoring Into the Routine Management of Uncontrolled Hypertension: Translating Evidence to Practice

Determinants of Salt-Restriction-Spoon Using Behavior in China: Application of the Health Belief Model

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