This study aims to evaluate the relationship between mean outdoor temperature and mean daily blood pressure (BP) and heart rate (HR) among six, large, geographically and climatically diverse US cities. We collected BP and HR data from Higi stations, located in a wide range of neighborhood grocery stores and retail pharmacies, from six US cities (Houston, Los Angeles, Miami, Boise, Chicago, and New York City). Outdoor daily temperature data were collected from the National Centers for Environmental Information’s database. Pearson’s correlation was used to assess the linear relationship between mean daily outdoor temperature and mean daily BP and HR for each city from May 2016 through April 2017. A total of 2 140 626 BP and HR readings were recorded in the six study cities. Mean outdoor temperature was inversely correlated with both mean daily average systolic (r=−0.69, P<0.0001) and diastolic (r=−0.71; P<0.0001) BPs, but not HR (r<0.0001, P=0.48). We also found that temperature change had a larger impact on BP in equatorial climates such as Miami compared with colder and more temperature variable cities like Chicago and Boise. Previous studies have found that BP varies seasonally, but few have looked at the impact of daily temperature on both BP and HR changes. Our study is one of the largest and most climatically diverse populations ever looking at this relationship. Our results suggest that temperature, and perhaps geography, should play a role in tailoring individualized evaluation and treatment for hypertensive diseases.
Background: Ambulatory blood pressure (ABP) is known to provide prognostic information about cardiovascular disease better than office BP. Not much is known about the correlation of ABP control and patient engagement with gamification. Objective: To examine the relationship between ambulatory blood pressure and patient engagement with a nationwide ABP kiosk network. Methods: De-identified historic data from a nation wide ABP kiosk network (higi SH, llc www.higi.com) was analyzed from September 2012 to May 2015. At time of this abstract submission 9,926 ABP kiosks were deployed within the network. Only patients with initial BP readings in the hypertensive range and those who opted-in to share data for research purposes were included in the study. Level of engagement was defined as the total number of achievements, or badges, earned on the gamification platform. BP changes were defined as the difference between patients first and last reading on the kiosk network. Patient demographics, level of engagement with gamification platform and their ABP trends were analyzed and correlation measured. Results: A total of 153,092 patients qualified the inclusion criteria for the study. Mean age was 52 years with 56% (85,361) male and 44% (67,731) female. Almost half the patients were obese (49%, 74,587). The patients on the gamification platform earned a total of 898,130 achievements. There was a statistically significant difference in drop in systolic and diastolic blood pressure with number of achievements earned by patients (systolic BP: p-value < 0.0001, diastolic BP: p-value = 0.0033). Patients achieving greater than 20 achievements showed an average drop of systolic BP of 16.2 mmHg (p<0.01) and a drop of diastolic BP of 10.6 mmHg (p<0.01). Of the patients earning greater than 20 achievements 84.8% moved from hypertensive classification to normotensive classification. Conclusion: The results showed a statistically significant relationship between level of achievements earned on the gamification platform and lowering of blood pressure.
According to data from retail blood pressure kiosks, almost one-third of Americans just moved into the hypertensive category, roughly doubling its size. National costs of hypertension treatment were already estimated at $40-50B, so understanding the detailed impact of this development is important for healthcare providers, payors, and policymakers alike. We leverage the 42,614,330 blood pressure readings that took place across the national network of 11K+ higi health kiosks in 2017 to study the effect of the new guidelines on both macro and micro (i.e. zip code) levels, and within sub-populations of interest. We find that new blood pressure guidelines do not impact all states, or all communities within a given metro area, equally. (It’s also not the case that size of impact positively correlates with rate of high blood pressure under the old guidelines - i.e. healthy populations often see greater impact.) Furthermore, the guidelines affect certain cohorts of patients differently than others. This study identifies the communities and cohorts that pose the blood pressure greatest risk post-2017.
Background: Socially influencing systems (SIS) have shown to impact behavior change and outcomes in various clinical scenarios. Two aspects of SIS, i.e., Social Competition and Social Recognition are also known to increase engagement in a program. Objective: To evaluate the impact of social influence on hypertension control. Methods: All hypertensive patients that had initial hypertensive reading between July 1, 2015 and September 30, 2015 using an ambulatory BP kiosk (higi Station, higi SH llc) were identified. A random sample of 1,352 patients were identified as controls and 38,885 patients were invited to participate in a challenge to check their BP on a weekly basis. Weekly drawing for $25 gift card was conducted for those that checked their BP that week and a grand prize of $100 was awarded to the user with the most BP readings. Challenge duration was from October 1, 2015 to January 20, 2016. Patients who joined also received weekly email reminders to check their BP as well as coaching tips on how to maintain or improve their BP. Patients invited to join challenge but did not participate were referred to as Invitees, those who participated were referred to as Joiners and those not invited as Control. Results: A total of 1,655 patients participated in the challenge. Analysis of variance indicated a statistically significant difference between Control and Joiners (p=.016) as well as between Invitees and Joiners (p=0.009). Controls’ mean arterial pressure change increased 38.5% during the course of the study, while Invitees’ mean arterial pressure change increased 12.2%, and Joiners’ mean arterial pressure change dropped by almost 45%. Conclusion: Social competition and social recognition as implemented in the form of a BP check challenge showed significant reduction in mean arterial pressure. Incorporating socially influencing systems in treatment protocols for hypertension can assure adherence to the program and improve outcomes.
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