Hypertension is a serious public health challenge in the United States, affecting approximately 30% of adults and increasing the risk for heart disease and stroke, the first and third leading causes of death in the United States. Racial/ethnic and socioeconomic disparities in hypertension prevalence in the United States have been documented for decades. Non-Hispanic blacks have a higher risk for hypertension and hypertension-related complications (e.g., stroke, diabetes, and chronic kidney disease) than non-Hispanic whites and Mexican Americans. Between 1999--2000 and 2007--2008, the prevalence of hypertension did not change, but control of hypertension increased among those with hypertension. Despite considerable improvements in increasing awareness, treatment and control of hypertension, in 2007--2008, approximately half of adults with hypertension did not have their blood pressure under control. Because of the fundamental role of hypertension in cardiovascular health, Healthy People 2010 includes national objectives to reduce the proportion of adults aged ≥20 years with hypertension to 14% from a baseline of 26% (objective 12-9) and to increase the proportion of adults aged ≥18 years with hypertension whose blood pressure is under control to 68% from a baseline of 25% (objective 12-10).
"While the burden of HTN among older adults is increasing , the ability to control HTN has remained well below the Healthy People 2020 goal of 50%. Based on analysis of 2005– 2008 NHANES data, the control rate for all adults is 43.7% . The challenge of improving HTN control is significant particularly given the relationship between uncontrolled HTN and cardiovascular disease (CVD), heart failure, stroke, kidney disease, and retinal diseases. "
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to develop a prediction model of demographic and sociobehavioral characteristics common among older adults with hypertension (HTN) who engage in self-management behavior. A descriptive, correlational predictive design was used to collect data at 14 faith-based and senior citizen organizations in a major urban northeastern city. Participants ranged in age from 63 to 96 with a mean age of 77 (SD 6.9). A 33-item questionnaire was used to gather data on 15 explanatory and 5 outcome variables. Instruments were the Perceived Stress Scale, the Duke Social Support Index, the stage of change for physical activity scale, and the DASH Food Frequency Questionnaire. Correlation and regression analyses were used to test the hypothesis. Results indicate there is a common set of characteristics such as higher stage of change, reading food labels, and higher self-rated health that can predict the older adult's likelihood to engage in hypertension self-management behavior. The significant correlations found in this preliminary study warrant further study and validation. Findings are clinically relevant as knowledge of demographic and sociobehavioral characteristics associated with engagement in self-management behavior enables health care clinicians to support and encourage older adults to improve management of this common, chronic condition.
"Estimates of these chronic conditions among veterans vary, but in one study of veterans using VA health-care data, 16% had diabetes and 37% had hypertension , the prevalence of dyslipidemia was estimated to be between 25% and 36% (Table 1)  . A comparison of veterans with nonveterans from the National Health and Nutrition Examination Survey indicates that the prevalence of hypertension was not significantly different between the two groups . "
[Show abstract][Hide abstract] ABSTRACT: Lifestyle and health-related factors are critical components of the risk for cognitive aging among veterans. Because dementia has a prolonged prodromal phase, understanding effects across the life course could help focus the timing and duration of prevention targets. This perspective may be especially relevant for veterans and health behaviors. Military service may promote development and maintenance of healthy lifestyle behaviors, but the period directly after active duty has ended could be an important transition stage and opportunity to address some important risk factors. Targeting multiple pathways in one intervention may maximize efficiency and benefits for veterans. A recent review of modifiable risk factors for Alzheimer's disease estimated that a 25% reduction of a combination of seven modifiable risk factors including diabetes, hypertension, obesity, depression, physical inactivity, smoking, and education/cognitive inactivity could prevent up to 3 million cases worldwide and 492,000 cases in the United States. Lifestyle interventions to address cardiovascular health in veterans may serve as useful models with both physical and cognitive activity components, dietary intervention, and vascular risk factor management. Although the evidence is accumulating for lifestyle and health-related risk factors as well as military risk factors, more studies are needed to characterize these factors in veterans and to examine the potential interactions between them.
Alzheimer's and Dementia 06/2014; 10(3):S111–S121. DOI:10.1016/j.jalz.2014.04.010 · 12.41 Impact Factor
"In our study people who were married or co-habiting were protected from pre-hypertension compared to never married, widowed separated or divorced and this may be related to lower levels of stress associated with married life. Marital differences in psychological status (prolonged stress and low social support), dietary intake (mainly sodium and potassium intake) and economic aspects of living alone are suggested as factors, which might explain at least partly the marital diversity in blood pressure and the risk of hypertension in men [25-27]. "
[Show abstract][Hide abstract] ABSTRACT: Persons with a systolic blood pressure (BP) of 120 to < 140 or diastolic BP of 80 to < 90 mm hg are classified as having pre-hypertension. Pre-hypertension is associated with cardiovascular disease (CVD) risk factors, incident CVD and CVD mortality. Understanding determinants of pre-hypertension especially in low income countries is a pre-requisite for improved prevention and control.
Data were analyzed for 4142 persons aged 18 years and older with BP measured in a community cross sectional survey in Uganda. The prevalence of pre-hypertension was estimated and a number of risk factors e.g. smoking, use of alcohol, overweight, obesity, physical activity, sex, age, marital status, place of residence, and consumption of vegetables and fruits were compared among different groups (normotension, pre-hypertension, and hypertension) using bivariate and multivariable logistic regression.
The age standardized prevalence of normal blood pressure was 37.6%, pre-hypertension 33.9%, hypertension 28.5% and raised blood pressure 62%. There was no difference between the prevalence of hypertension among women compared to men (28.9% versus 27.9%). However, the prevalence of pre-hypertension was higher among men (41.6%) compared to women (29.4%). Compared to people with normal blood pressure, the risk of pre-hypertension was increased by being 40 years and above, smoking, consumption of alcohol, not being married, being male and being overweight or obese. Compared to pre-hypertension, hypertension was more likely if one was more than 40 years, had infrequent or no physical activity, resided in an urban area, and was obese or overweight.
More than one in three of adults in this population had pre-hypertension. Preventive and public health interventions that reduce the prevalence of raised blood pressure need to be implemented.
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