Perspectives on Hypertension in the New England Cape Verdean Community

Exploring the dietary practices and perceptions of African immigrants in Illinois- a qualitative study of immigrants from Nigeria and Congo

OBJECTIVE

Previous studies suggest an increased prevalence of diet-related chronic diseases among African immigrants with increased length of stay in the U.S. The objective of the current study is to understand the dietary practices and perceptions of recent African immigrant families.

DESIGN

Focus group sessions were conducted with Nigerian and Congolese immigrant parents residing in Illinois. Participants were recruited using convenience sampling methods and focus group sessions were conducted via videoconference. Participants discussed dietary practices, meal preparation, and family mealtimes for their families. They also discussed experiences with eating different kinds of foods since arrival in the U.S. Verbatim transcription of focus group sessions were completed and deductive thematic analysis of transcribed data was conducted using NVivo (QSR International Pty Ltd. [2020] NVivo [version 12]).

RESULTS

Twenty African immigrant parents (Mean age: 42 years, Female: 95%) residing in Northern and Central Illinois participated in a total of five focus group sessions. Seven themes were derived from the analysis. Participants had a positive attitude toward healthy diet and had a high level of interest in receiving educational resources to make healthier food choices. Participants preferred and mostly consumed foods they were familiar with before migration. A majority of the participants perceived 'American foods' as unhealthy, characterizing them as containing a high amount of sugar and salt. Parents reported that their school-aged children often preferred a western diet over traditional African meals.

CONCLUSION

This study helps to understand unique diet-related practices and perceptions of recent Nigerian and Congolese African immigrants in Illinois. Findings could help to inform cultural adaptation of evidence-based nutrition education programs for these groups of African immigrants.

Symptom experiences in hypertension: a mixed methods systematic review

AIM

Understanding patients' hypertension (HTN) symptoms can assist healthcare professionals' awareness of individual, cultural, and behavioral responses and improve diagnostic accuracy to optimize treatment. The purpose of this review was to evaluate and synthesize current literature exploring HTN symptoms.

METHODS

Databases searched included MEDLINE (PubMed), CINAHL (EBSCO), Scopus, and Web of Science from January 2010 to January 2022. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The McMaster critical review forms were used to determine the quality of both qualitative and quantitative articles. Synthesis of the data was guided by the Joanna Briggs Institute Convergent Integrated Approach to Mixed Study Systematic Reviews.

RESULTS

In total, 41 articles were included, nine qualitative studies and 32 quantitative. The quality of the articles varied. Symptoms included commonly reported symptoms and some less prevalent, including some reporting absence of symptoms. Factors that affected symptoms included culture, beliefs, psychosocial factors, and knowledge. We also found that there may be a bidirectional relationship between symptoms and behaviors that may lead to self-management.

CONCLUSION

HTN is common and symptoms are frequently reported. HTN management is related to multiple factors. Symptoms continue in a number of individuals after initial diagnosis. Evaluating symptoms after initial diagnosis may help to optimally manage and meet blood pressure guidelines.

Influence of "Hospital-Community-Family" Integrated Management on Blood Pressure, Quality of Life, Anxiety and Depression in Hypertensive Patients

Objective

To explore the Influence of "hospital-community-family" integrated management on blood pressure, quality of life, anxiety and depression in hypertensive patients.

Methods

A total of 60 patients with hypertension were treated in our hospital from July 2019 to July 2021. The patients were randomly divided into control group (n =30) and study group (n =30). The former accepts routine management, while the latter accepts "hospital-community-family" integrated management. Nursing satisfaction, blood pressure, disease awareness rate, anxiety and depression scores, disease control ability and quality of life scores were compared.

Results

First of all, we compared the nursing satisfaction: the study group was very satisfied in 25 cases, satisfactory in 4 cases, general in 1 case, the satisfaction rate was 100.00%, while in the control group, 10 cases were very satisfied, 8 cases were satisfied, 7 cases were general, and 5 cases were dissatisfied, the satisfaction rate was 83.33%; The nursing satisfaction of the study group was higher than that of the control group (P <0.05). Secondly, we compared the level of blood pressure. There was no significant difference before management (P >0.05) but the blood pressure decreased after treatment. In the control group, the level of blood pressure in the study group was lower than that in the control group (P <0.05). In terms of disease awareness rate the scores of hypertension related knowledge hypertension harmfulness community management methods regular reexamination and blood pressure monitoring in the study group were significantly higher than those in the control group (P <0.05). There was no significant difference in anxiety and depression scores before treatment (P >0.05), but decreased after treatment. Compared with the control group, the anxiety and depression scores of the study group were lower (P <0.05). In terms of disease control ability, the total scores of diet management, medication management, behavior management and information management in the study group were higher compared to the control group (P <0.05). Finally, we compared the scores of qualities of life. Before management, there exhibited no significant difference (P >0.05). After management, the scores of quality of life decreased. Compared to the control group, the scores of physiological function, psychological function, social function and health self-cognition in the study group were lower than those in control group (P <0.05).

Conclusion

The application of integrated "hospital, community and family" management can vertically integrate medical resources and establish a truly effective hierarchical treatment model. Integrated "hospital-community-family" management can improve patient compliance with treatment, enhance patients' self-management ability and confidence, and improve the management efficiency of medical staff.

Late eating, blood pressure control, and cardiometabolic risk factors among adults with hypertension: results from the Korea National Health and Nutrition Examination Survey 2010-2018

OBJECTIVES

Despite growing concerns regarding the timing of eating, little is known about the association between late eating and health. This study aimed to investigate whether late eating is associated with blood pressure (BP) control and cardiometabolic risk factors among Korean adults with hypertension.

METHODS

Data from the Korea National Health and Nutrition Examination Survey 2010-2018 were used. Adults with hypertension aged 30-79 years (n=13,361) were included in this study. Dietary intake and information on meal timing were assessed using 1-day 24-hour recall. Late eating was defined as after the median midpoint between the times of the first and the last eating episode during the recall day. Logistic and linear regression models were used to estimate the associations of late eating with BP control and cardiometabolic risk factors.

RESULTS

Among late eaters, there were more men than women. Compared to early eaters, late eaters were younger, had a higher body mass index (BMI) and unhealthier habits, and their overall dietary quality score was lower. A negative association between late eating and BP control was found in a univariate model (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.94 to 1.12), but this association disappeared after adjustment for confounders (OR, 1.03; 95% CI, 0.94 to 1.12). Late eating was independently associated with higher BMI (p=0.03) and blood triglyceride concentration (p<0.01).

CONCLUSIONS

Our results do not support a link between late eating and BP control among adults with hypertension, but suggest that late eating is associated with cardiometabolic risk factors.

Factors associated with dietary adherence to the guidelines for prevention and treatment of hypertension among Korean adults with and without hypertension

Background

Although dietary modification is strongly recommended for prevention and treatment of hypertension, little is known about which factors are associated with adherence to dietary guidelines. We investigated knowledge and attitude, perceived benefits of, barriers to, and self-efficacy of dietary therapy, and identified the factors associated with dietary adherence among adults with and without hypertension.

Methods

We collected information on the knowledge/attitudes and perceived benefits of dietary therapy, as well as barriers to and self-efficacy regarding dietary adherence from 497 middle-aged (34–69 years) adults who participated in the follow-up examination of the Cardiovascular and Metabolic Diseases Etiology Center (CMERC) cohort study during December 2018 and February 2019.

Results

Among people without hypertension, 95.5% (343/359) and 95.8% (344/359) answered that they would limit sodium intake and consume health diet, respectively, if diagnosed hypertension. However, among people with hypertension, only 79.7% (110/138) and 77.5% (107/138) reported they were limiting dietary sodium intake and having healthy diet, respectively. Frequency of diet management was not different between normotensive (34.0%) and hypertensive (35.5%) groups. Compared to normotensives, hypertensive people were more likely to have lower dietary adherence score, think they need to change their diet, think dietary change impossible, and report lower self-efficacy for following diet guidelines. Dietary management was significantly associated with cardiometabolic risk factors (OR: 1.63) and dietary education (OR: 2.19) among normotensives, while it was associated only with awareness that lifestyle modification is necessary regardless of antihypertensive medication (OR: 6.29) among hypertensive people. Good dietary adherence had significant associations with perceived barriers (OR: 0.71), self-efficacy (OR: 3.71), and dietary education (OR: 1.98) among normotensives; and with perceived barriers (OR: 0.54), self-efficacy (OR: 4.06), and dietary management (OR: 4.16) among hypertensive people.

Conclusions

Many Koreans have relatively low adherence to dietary guidelines for hypertension prevention and treatment. Knowledge, dietary practices, and factors affecting dietary adherence were different between adults with and without hypertension. A targeted approach will be needed to improve blood pressure control of the Korean population.