BACKGROUND
We aimed to determine the prevalence of antibodies against angiotensin II type 1 receptor (AT1RAb) in hypertensive adults and elucidate the relation of antihypertensive medication type to blood pressure (BP) among persons with and without AT1RAb.
METHODS
Sera from participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study with hypertension were tested for AT1RAb using a commercial Enzyme-linked immunosorbent assay (ELISA) (One Lambda; positive ≥17 units/ml). BP measurements, uncontrolled BP (systolic BP ≥140 and/or diastolic BP ≥90 mm Hg), and effect of BP medication type were compared for AT1RAb positive (+) vs. negative (−) participants using descriptive statistics and multivariable regression.
RESULTS
One hundred and thirty-two (13.1%) participants were AT1RAb+. Compared with AT1RAb−, AT1RAb+ persons were more likely to be white (47% vs. 36.7%; P = 0.03) but had similar comorbid disease burden. In models adjusting for age, sex, and race, AT1RAb+ persons had higher diastolic BP (β = 2.61 mm Hg; SE = 1.03; P = 0.01) compared with AT1RAb− participants. Rates of uncontrolled BP were similar between the groups. AT1RAb+ persons on an angiotensin receptor blocker (ARB; n = 21) had a mean of 10.5 mm Hg higher systolic BP (SE = 4.56; P = 0.02) compared with AT1RAb+ persons using other BP medications. The odds of uncontrolled BP among AT1RAb+ participants on an ARB was 2.05 times that of those on other medications. AT1RAb− persons prescribed an angiotensin-converting enzyme inhibitor (ACEi) had 1.8 mm Hg lower diastolic BP (SE = 0.81; P = 0.03) than AT1RAb− persons not prescribed an ACEi.
CONCLUSIONS
AT1RAb was prevalent among hypertensive adults and was associated with higher BP among persons on an ARB.
We conducted a systematic review to assess outcomes in Hispanic donors and explore how Hispanic ethnicity was characterized. We searched PubMed, EMBASE, and Scopus through October 2021. Two reviewers independently screened study titles, abstracts, and full texts; they also qualitatively synthesized results and independently assessed quality of included studies. Eighteen studies met our inclusion criteria. Study sample sizes ranged from 4007 to 143,750 donors and mean age ranged from 37 to 54 years. Maximum follow-up time of studies varied from a perioperative donor nephrectomy period to 30 years post-donation. Hispanic donors ranged between 6% and 21% of the donor populations across studies. Most studies reported Hispanic ethnicity under race or a combined race and ethnicity category. Compared to non-Hispanic White donors, Hispanic donors were not at increased risk for post-donation mortality, end-stage kidney disease, cardiovascular disease, non-pregnancy-related hospitalizations, or overall perioperative surgical complications. Compared to non-Hispanic White donors, most studies showed Hispanic donors were at higher risk for diabetes mellitus following nephrectomy; however, mixed findings were seen regarding the risk for post-donation chronic kidney disease and hypertension. Future studies should evaluate cultural, socioeconomic, and geographic differences within the heterogeneous Hispanic donor population, which may further explain variation in health outcomes.
Introduction:
Favorable neighborhood-level social determinants of health (SDOH) are associated with less cardiovascular disease risk, but there is limited research evaluating their influence on cardioprotective behaviors. We evaluated the association between neighborhood-level SDOH and cardioprotective behaviors among members of predominantly Black churches in New Orleans, LA.
Hypothesis:
Participants residing in more-resourced neighborhoods will be more likely to engage in cardioprotective behaviors than participants residing in less-resourced neighborhoods.
Methods:
A health needs assessment was conducted during the planning phase of a local church-based health intervention. It included a survey distributed between November 2021-February 2022 to church members on their demographics, engagement in health-related behaviors, aspects of the neighborhood environment, and home address (which was linked to their census tract data and a corresponding social deprivation index [SDI]). We conducted descriptive analyses and multivariable logistic regression models to assess the influence of neighborhood predictor variables on the likelihood of engaging in cardioprotective behaviors.
Results:
Overall, there were 302 respondents, 77% were female, 99% were of Black race, and 50% completed an associate’s/bachelor’s degree or higher. Neighborhood social cohesion, availability of fruits and vegetables, and the neighborhood’s walkability and conduciveness to exercise were positively associated with the composite outcome of beneficial health behaviors after adjusting for age, sex, and education. [Table] Neighborhood predictors were not associated with medication adherence or regular medical care.
Conclusions:
Neighborhood-level SDOH were associated with cardioprotective behaviors in this group of predominantly Black church members in New Orleans.
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