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hypertension in blacks guidelines

Matthew L Maciejewski, Xiaojuan Mi, Lesley H Curtis, Judy Ng, Samuel C Haffer, Bradley G Hammill
BACKGROUND: Despite the persistence of significant disparities, few evaluations examine disparities in laboratory testing by race/ethnicity, age, sex, Medicaid eligibility, and number of chronic conditions for Medicare fee-for-service beneficiaries' newly prescribed medications. In Medicare beneficiaries initiating diuretics or digoxin, this study examined disparities in guideline-appropriate baseline laboratory testing and abnormal laboratory values. METHODS AND RESULTS: To evaluate guideline-concordant testing for serum creatinine and serum potassium within 180 days before or 14 days after the index prescription fill date, we constructed retrospective cohorts from 10 states of 99 711 beneficiaries who had heart failure or hypertension initiating diuretic in 2011 and 8683 beneficiaries who had heart failure or atrial fibrillation initiating digoxin...
October 18, 2016: Circulation. Cardiovascular Quality and Outcomes
Agustin Ramirez
The presentation will focus on the different guidelines we have actually in hands (JNCHT 8, ESH / ESC, ISH) and compare them to the last Latin-American Society of Hypertension Guidelines to be published in this year.In this way, we will focus our attention in the socio-economic problem of the different countries in LA and the differences we have included in our Guidelines due to the actual needs in LA.Additionally we will specially mention the special populations from LA like andineans, people living over 500m from sea level, and the different black populations that are different from those described in North America...
September 2016: Journal of Hypertension
Stephen K Williams, Joseph Ravenell, Sara Seyedali, Sam Nayef, Gbenga Ogedegbe
Blacks are especially susceptible to hypertension( HTN) and its associated organ damage leading to adverse cardiovascular, cerebrovascular and renal outcomes. Accordingly, HTN is particularly significant in contributing to the black-white racial differences in health outcomes in the US. As such, in order to address these health disparities, practical clinical practice guidelines (CPGs) on how to treat HTN, specifically in blacks, are needed. This review article is a timely addition to the literature because the most recent U...
September 29, 2016: Progress in Cardiovascular Diseases
Agustin Ramirez
The presentation will focus on the different guidelines we have actually in hands (JNCHT 8, ESH / ESC, ISH) and compare them to the last Latin-American Society of Hypertension Guidelines to be published in this year.In this way, we will focus our attention in the socio-economic problem of the different countries in LA and the differences we have included in our Guidelines due to the actual needs in LA.Additionally we will specially mention the special populations from LA like andineans, people living over 500m from sea level, and the different black populations that are different from those described in North America...
September 2016: Journal of Hypertension
Alexandra Perez, Andrea Levin, Nowrin Alam
PURPOSE: The purpose of this study was to determine the use of clinical-guideline-recommended antihypertensive regimens among Mexican Americans (MAs) and non-Hispanic blacks and whites with type 2 diabetes and hypertension. METHODS: A secondary data analysis based on National Health and Nutrition Examination Survey 2003-2012 cohort data included 1857 noninstitutionalized civilian MA, black, and white adults with type 2 diabetes and hypertension. Unadjusted and adjusted 2-way analysis of variance models evaluated whether there was a difference in the use of recommended antihypertensive regimens across race/ethnic group...
September 12, 2016: Diabetes Educator
Joseph L Izzo, Yan Jia, Dion H Zappe
The effects of race and age on 24-hour mean ambulatory systolic blood pressure (maSBP) responses to sequential 4-week periods of angiotensin receptor blocker therapy (valsartan [VAL] 160 mg/d then 320 mg/d and combination VAL/hydrochlorothiazide [HCTZ] 320/12.5 mg/d) were compared in 304 patients with stage 1 or 2 hypertension. There were lesser blood pressure (BP) responses from baseline with VAL monotherapy in black than Caucasian patients (-2.9 and -4.0 mm Hg vs -8.2 and -9.3 mm Hg, respectively; P<.001 each) but VAL/HCTZ BP responses were similar in both groups (-12 vs -15 mm Hg)...
September 1, 2016: Journal of Clinical Hypertension
Eshan Vasudeva, Nathalie Moise, Chen Huang, Antoinette Mason, Joanne Penko, Lee Goldman, Pamela G Coxson, Kirsten Bibbins-Domingo, Andrew E Moran
BACKGROUND: We compared the cost-effectiveness of hypertension treatment in non-Hispanic blacks and non-Hispanic whites according to 2014 US hypertension treatment guidelines. METHODS: The cardiovascular disease (CVD) policy model simulated CVD events, quality-adjusted life years (QALYs), and treatment costs in 35- to 74-year-old adults with untreated hypertension. CVD incidence, mortality, and risk factor levels were obtained from cohort studies, hospital registries, vital statistics, and national surveys...
October 2016: American Journal of Hypertension
Amanda Bennett, Parham Parto, Selim R Krim
PURPOSE OF REVIEW: Despite its continued increase in prevalence in minorities, data regarding hypertension (HTN) control among such ethnic groups remains limited. This review highlights the most recent literature on the epidemiology, prevalence, and treatment strategies of HTN among four racial groups (non-Hispanic Whites (NHW), Blacks, Hispanics, and Asians). RECENT FINDINGS: Overall awareness and treatment of HTN were found to be higher in blacks when compared with NHWs...
July 2016: Current Opinion in Cardiology
Joel C Marrs, Angela M Thompson
Hypertension affects one-third of all females in the United States, with the prevalence increasing over a female's lifespan. The approach to treating females with hypertension varies depending on a female's age, race, comorbidities, and whether she is of child-bearing age or pregnant. It is important to factor in the safety and effectiveness of antihypertensive medications across these populations of females. Blood pressure target goals are the same in females as in males regardless of comorbidities or stage of life, with the exception of those females who are pregnant...
June 2016: Pharmacotherapy
Karen C Albright, Amelia K Boehme, Rikki M Tanner, Justin Blackburn, George Howard, Virginia J Howard, Monika Safford, T Mark Beasley, Nita Limdi
OBJECTIVE: Recurrent stroke affects 5%-15% of stroke survivors, is higher among Blacks, and preventable with secondary stroke prevention medications. Our study aimed to examine racial differences in risk factors being addressed (defined as either on active treatment or within guideline levels) among stroke survivors and those at risk for stroke. METHODS: A cross-sectional study using NHANES 2009-2010 standardized interviews of Whites and Blacks aged ≥18 years...
2016: Ethnicity & Disease
Rowena E Bartolome, Agnes Chen, Joel Handler, Sharon Takeda Platt, Bernice Gould
OBJECTIVES: At Kaiser Permanente, national Equitable Care Health Outcomes (ECHO) Reports with a baseline measurement of 16 Healthcare Effectiveness Data and Information Set measures stratified by race and ethnicity showed a disparity of 8.1 percentage points in blood pressure (BP) control rates between African- American/black (black) and white members. The aims of this study were to describe a population care management team-based approach to improve BP control for large populations and to explain how a culturally tailored, patient-centered approach can address this racial disparity...
2016: Permanente Journal
Ali Razmara, Bruce Ovbiagele, Daniela Markovic, Amytis Towfighi
BACKGROUND: Expert consensus guidelines recommend antihypertensive treatment to lower secondary stroke risk, but patterns and predictors of blood pressure (BP) treatment and control among stroke survivors in the United States remain unknown. Understanding predictors of poor control can facilitate development of targeted strategies. METHODS: We reviewed the prevalence and control of hypertension among adults 40 years or older with self-reported stroke who participated in the National Health and Nutrition Examination Surveys 1999-2004 with mortality follow-up through 2006...
April 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Natasha J Williams, Girardin Jean-Louis, Joeseph Ravenell, Azizi Seixas, Nadia Islam, Chau Trinh-Shevrin, Gbenga Ogedegbe
OBJECTIVE: Obstructive sleep apnea (OSA) is a leading sleep disorder that is disproportionately more prevalent in minority populations and is a major risk factor for cardiovascular disease (CVD) morbidity and mortality. OSA is associated with many chronic conditions including hypertension, diabetes, and obesity, all of which are disproportionately more prevalent among blacks (ie, peoples of African American, Caribbean, or African descent). METHODS: This article reviews studies conducted in the United States (US) that investigated sleep screenings and adherence to treatment for OSA among blacks...
February 2016: Sleep Medicine
Ashish C Sinha, Preet Mohinder Singh, Suneel Bhat
BACKGROUND: Present guidelines recommend bariatric surgery at BMI ≥ 40 kg/m2 or BMI ≥ 35 kg/m2 with obesity-related morbidity. METHODS: Evidence for cost and mortality/morbidity risk of bariatric surgery and obesity-related diseases was evaluated determining equivalency point of absolute incremental mortality risk by BMI and risks associated with bariatric surgery. A stochastic model was developed evaluating costs related to surgical procedure at a given BMI...
January 2016: Obesity Surgery
Lipika Samal, Adam Wright, Sushrut S Waikar, Jeffrey A Linder
BACKGROUND: Primary care physicians (PCPs) typically manage early chronic kidney disease (CKD), but recent guidelines recommend nephrology co-management for some patients with stage 3 CKD and all patients with stage 4 CKD. We sought to compare quality of care for co-managed patients to solo managed patients. METHODS: We conducted a retrospective cross-sectional analysis. Patients included in the study were adults who visited a PCP during 2009 with laboratory evidence of CKD in the preceding two years, defined as two estimated glomerular filtration rates (eGFR) between 15-59 mL/min/1...
October 12, 2015: BMC Nephrology
Pelbreton C Balfour, Carlos J Rodriguez, Keith C Ferdinand
Race-ethnic disparities in cardiovascular disease (CVD) have persisted in the USA over the past few decades. Hypertension (HTN) is a significant contributor to CVD, including coronary heart disease, stroke, end-stage kidney disease and overall mortality and race-ethnic disparities in longevity. Additionally, both non-Hispanic blacks (NHBs) and Hispanic adults have been known to have higher prevalence of poorly controlled blood pressure compared to non-Hispanic whites (NHWs). Addressing these disparities has been a focus of programs such as the Million Hearts initiative...
April 2015: Current Cardiovascular Risk Reports
Cathleen M Rivera, Laurel A Copeland, Catherine J McNeal, Eric M Mortensen, Mary J Pugh, Daniel J MacCarthy
Evidence-based guidelines for the use of aspirin in secondary prevention of cardiovascular disease events are well established. Despite this, the prevalence of aspirin use for secondary prevention is suboptimal. The study aimed to determine the prevalence of aspirin use for secondary prevention of cardiovascular disease events when it is dispensed as a prescription, as is performed in the Veterans Affairs (VA) managed care system. VA patients who had undergone major surgery and experienced a postoperative myocardial infarction (MI) or unstable angina between the years 2005 and 2009 were identified from administrative databases...
October 2015: American Journal of the Medical Sciences
Leigh A Peterson, Lawrence J Cheskin, Margaret Furtado, Konstantinos Papas, Michael A Schweitzer, Thomas H Magnuson, Kimberley E Steele
BACKGROUND: Over 78 million American adults have obesity. Bariatric surgery is the leading means of durable weight loss. Nutritional deficiencies are commonly treated post-operatively but are often undiagnosed pre-operatively. Malnutrition is correlated with adverse surgical outcomes. OBJECTIVES: The aim of this study is to assess pre-operative nutritional status in our bariatric surgery candidates in a cross-sectional study. METHODS: We recruited 58 bariatric candidates approved to undergo the Roux-en Y gastric bypass...
April 2016: Obesity Surgery
Michael D Miedema, Faye L Lopez, Michael J Blaha, Salim S Virani, Josef Coresh, Christie M Ballantyne, Aaron R Folsom
The recent 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults from the Eight Joint National Committee Panel may significantly affect the aging US population. We performed a cross-sectional analysis of black and white participants in Atherosclerosis Risk in Communities who participated in the fifth study visit (2011-2013). Sitting blood pressure was calculated from the average of 3 successive readings taken after a 5-minute rest. Currently, prescribed antihypertensive medications were recorded by reviewing medication containers brought to the visit...
September 2015: Hypertension
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