American journal of preventive medicine
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As part of the Edgecombe County High Blood Pressure Control Program, a medical record review was conducted within a multispecialty private group practice in the county. The purposes of the review were to assess the relationship between the process of medical care and blood pressure control and to explore the variation in level and impact of medical care by race and sex. At the end of a three-year period, 41 percent of 628 hypertensive patients from the practice had uncontrolled diastolic blood pressure (DBP), as defined by Hypertension Detection and Follow-up Program criteria. ⋯ Hypertensive patients whose physicians were more aggressive in their use of antihypertensive drug therapy were more likely to be controlled. The effect of the level of physician drug aggressiveness tended to be more pronounced for blacks than for whites. Differences by race in exposure to and efficacy of aggressive drug treatment may influence racial variation in blood pressure control.
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Clinical research has suggested that isolated systolic hypertension differs from essential hypertension in terms of pathophysiological change. Yet little is known of the descriptive epidemiology of isolated systolic hypertension. This paper examines the prevalence of isolated systolic hypertension in biracial Alameda County, California. ⋯ Comparison with the prevalence estimates of isolated systolic hypertension from biracial, rural Evans County, Georgia, indicated that the Alameda County prevalence was significantly lower for white women (p less than .01), black women (p less than .03), and total population (p less than .01). We posit that the larger number of people under care for essential hypertension is responsible for the lower occurrence of pure, isolated systolic hypertension in Alameda County. The results suggest the importance of female family members in the acceptance and promulgation of health promotion efforts for both essential and isolated systolic hypertension at the population level.
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According to the findings of a health survey conducted among 906 young, middle-aged, and elderly residents of an economically depressed area of Alameda County, California, health status is more strongly associated with income than with race, particularly among middle-aged residents. Although income is also significantly associated with health among both young and elderly residents, it is of little substantive importance. These findings support previous research showing that a measure of income difference (less than $6,500 a year), even among residents of a depressed area, can be sufficiently sensitive to identify a group in poor health. More important, the relationship between low income and poor health is most pronounced among middle-aged residents, indicating that the public health needs of these people deserve special attention.
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Results of adult telephone interview data from aggregated state surveys show significant chronic alcohol use (two or more drinks per day) by 8.7 percent of the U. S. population. Rates are higher in men than in women (13.8 percent versus 4.0 percent, and higher in whites than in blacks (9.1 percent versus 4.5 percent). ⋯ Overweight women (2.7 percent) and those who eat in response to stress (3.1 percent) have lower rates of chronic heavy alcohol use than those without these risk factors. Alcohol-related morbidity contributes substantially to the loss of productive life. We conclude that examining alcohol consumption in the light of other lifestyle behaviors would help in the design of effective prevention programs based on multiple risk factor interventions.
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The prevalence of most behavioral risk factors varies substantially among states. The prevalence of current cigarette smoking ranges from 22 percent to 38 percent. ⋯ The prevalence of sedentary lifestyle, uncontrolled hypertension, overweight, and seatbelt use differs markedly among states. These findings represent an initial step toward the analysis of state-specific baseline risk-factor data for use in developing state programs aimed at reducing the leading causes of death in the United States.