Spectrum of prevalent cardiovascular diseases in urban Port-au-Prince, Haiti: a population-based cross-sectional study

Yan, Lily D.; Sufra, Rodney; St Sauveur, Reichling; Jean-Pierre, Marie Christine; Apollon, Alexandra; Malebranche, Rodolphe; Théard, Michel; Pierre, Gerard; Dévieux, Jessy; Lau, Jennifer; Mourra, Nour; Roberts, Nicholas L.S.; Rasul, Rehana; Nash, Denis; Pirmohamed, Altaf M.; Devereux, Richard B.; Lee, Myung Hee; Kwan, Gene F.; Safford, Monika M.; Adrien, Lauré; Alfred, Jean Patrick; Deschamps, Marie; Severe, Patrice; Fitzgerald, Daniel W.; Pape, Jean W.; Rouzier, Vanessa; McNairy, Margaret L.; Yan, Lily D.; Sufra, Rodney; St Sauveur, Reichling; Jean-Pierre, Marie Christine; Pierre, Jean Lookens; Apollon, Alexandra; Malebranche, Rodolphe; Théard, Michel; Pierre, Gerard; Dévieux, Jessy; Lau, Jennifer; Mourra, Nour; Metz, Miranda; Smith, Caleigh; Sabwa, Shalom; Clermont, Adrienne; Roberts, Nicholas L.S.; Rasul, Rehana; Nash, Denis; Pirmohamed, Altaf M.; Devereux, Richard B.; Lee, Myung Hee; Kwan, Gene F.; Safford, Monika; Adrien, Lauré; Alfred, Jean Patrick; Deschamps, Marie; Severe, Patrice; Fitzgerald, Daniel W.; Pape, Jean W.; Rouzier, Vanessa; McNairy, Margaret L.

doi:10.1016/j.lana.2024.100729

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…In 2019, cardiovascular diseases were responsible for 19.7 million deaths globally and occur mainly in low-and middle-income countries [91]. In Haiti, cardiovascular diseases account for 36% of all deaths among adults over the age of 20 in the country, far exceeding the mortality rate from infectious diseases such as HIV [92]. Kudzu root has a protective effect on blood vessels, preventing the occurrence of cardiovascular diseases such as infarction, angina pectoris, cerebral ischemia, and hypertension.…”

Section: Regulates Vasodilationmentioning

confidence: 99%

Puerariae lobatae Radix: Progress in Extraction, Separation Methods and Pharmacological Activities Research

Gao,

Wang,

Huang

et al. 2024

Separations

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Kudzu root (Puerariae lobatae Radix) is the tuberous root of Pueraria lobata, family Leguminosae. Kudzu root contains a variety of beneficial active ingredients such as puerarin, daidzin, daidzein, genistenin, 3′-hydroxy puerarin, β-sitosterol, stigmasterol, arachidic acid, and so on. Modern medical research shows that active ingredients in kudzu root are widely used clinically as raw materials for the treatment of hyperglycemia, non-alcoholic fatty liver disease, myocardial infarction, alcohol addiction, oxidative stress, inflammatory response, and retinal blockage due to their various pharmacological effects such as improving cardiovascular circulation, lowering blood lipids, lowering blood pressure, lowering blood sugar, being antipyretic, being estrogen-like, and relieving alcohol. China has rich resources of kudzu root, and active ingredients are usually extracted before it is made into a preparation, so whether the extraction and separation process is reasonable will directly affect the ease of preparation and the efficacy of the treatment. This paper reviews the process methods for the extraction and separation of active ingredients in kudzu root and its common pharmacological activities. The aim is to provide some references for readers to compare the advantages and disadvantages of various extraction and separation methods as well as understand the active ingredients and pharmacological activities of kudzu root.

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Section: Regulates Vasodilationmentioning

confidence: 99%

Puerariae lobatae Radix: Progress in Extraction, Separation Methods and Pharmacological Activities Research

Gao,

Wang,

Huang

et al. 2024

Separations

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Effectiveness of community‐based hypertension management on hypertension in the urban slums of Haiti: A mixed methods study

St Sauveur,

Sufra,

Jean Pierre

et al. 2024

J of Clinical Hypertension

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Hypertension is a leading contributor to mortality in low‐middle income countries including Haiti, yet only 13% achieve blood pressure (BP) control. We evaluated the effectiveness of a community‐based hypertension management program delivered by community health workers (CHWs) and physicians among 100 adults with uncontrolled hypertension from the Haiti Cardiovascular Disease Cohort. The 12‐month intervention included: community follow‐up visits with CHWs (1 month if BP uncontrolled ≥140/90, 3 months otherwise) for BP measurement, lifestyle counseling, medication delivery, and dose adjustments. Primary outcome was mean change in systolic BP from enrollment to 12 months. Secondary outcomes were mean change in diastolic BP, BP control, acceptability, feasibility, and adverse events. We compared outcomes to 100 age, sex, and baseline BP matched controls with standard of care: clinic follow‐up visits with physicians every 3 months. We also conducted qualitative interviews with participants and providers. Among 200 adults, median age was 59 years, 59% were female. Baseline mean BP was 154/89 mmHg intervention versus 153/88 mmHg control. At 12 months, the difference in SBP change between groups was −12.8 mmHg (95%CI −6.9, −18.7) and for DBP −7.1 mmHg (95%CI −3.3, −11.0). BP control increased from 0% to 58.1% in intervention, and 28.4% in control group. Four participants reported mild adverse events. In mixed methods analysis, we found community‐based delivery addressed multiple participant barriers to care, and task‐shifting with strong teamwork enhanced medication adherence. Community‐based hypertension management using task‐shifting with CHWs and community‐based care was acceptable, and effective in reducing SBP, DBP, and increasing BP control.

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Heart Failure Care Facilitators and Barriers in Rural Haiti: A Qualitative Study

Kwan,

Basow,

Isaac

et al. 2024

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Background: Heart failure (HF) is a leading cause of hospitalizations in Haiti. However, few patients return for outpatient care. The factors contributing to chronic HF care access are poorly understood. Objective: The purpose of this study is to investigate the facilitators and barriers to accessing care for chronic HF from the patients’ perspectives. Methods: We conducted a qualitative descriptive study of 13 patients with HF participating in three group interviews and one individual interview. We recruited patients after discharge from a nongovernmental organization-supported academic hospital in rural Haiti. We employed thematic analysis using emergent coding and categorized themes using the socioecological model. Findings: Facilitators of chronic care included participants’ knowledge about the importance of treatment for HF and engagement with health systems to manage symptoms. Social support networks helped participants access clinics. Participants reported low cost of care at this subsidized hospital, good medication accessibility, and trust in the healthcare system. Participants expressedstrong spiritual beliefs, with the view that the healthcare system is an extension of God’s influence. Barriers to chronic care included misconceptions about the importance of adherence to medications when symptoms improve and remembering follow-up appointments. Unexpectedly, participants believed they should take their HF medications with food and that food insecurity resulted in missed doses. Lack of social support networks limited clinic access. The nonhealthcare costs associated with clinic visits were prohibitive for many participants. Participants expressed low satisfaction regarding the clinic experience. A barrier to healthcare was the belief that heart disease caused by mystical and supernatural spirits is incurable. Conclusions: We identified several facilitators and barriers to chronic HF care with meaningful implications for HF management in rural Haiti. Future interventions to improve chronic HF care should emphasize addressing misconceptions about HF management and fostering patient support systems for visit and medication adherence. Leveraging local spiritual beliefs may also promote care engagement.

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Spectrum of prevalent cardiovascular diseases in urban Port-au-Prince, Haiti: a population-based cross-sectional study

Cited by 3 publications

References 33 publications

Puerariae lobatae Radix: Progress in Extraction, Separation Methods and Pharmacological Activities Research

Puerariae lobatae Radix: Progress in Extraction, Separation Methods and Pharmacological Activities Research

Effectiveness of community‐based hypertension management on hypertension in the urban slums of Haiti: A mixed methods study

Heart Failure Care Facilitators and Barriers in Rural Haiti: A Qualitative Study

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