Association between depression and hypertension using classic and revised blood pressure thresholds.

BACKGROUND: In a primary care population, the relationship between treatment of depression and hypertension (HTN) under the recently revised American College of Cardiology and American Heart Association HTN thresholds for diagnosing HTN is unknown. OBJECTIVE: To compare the association between changes in severity of co-occurring depression and HTN over time using the newly revised versus previous HTN guidelines. METHODS: In this retrospective cohort study, outpatients ≥18 years (n = 3018) with clinically significant depressive symptoms and elevated blood pressure at baseline were divided into a 'revised' guideline group (baseline blood pressure ≥130/80 mmHg), a 'classic' guideline group (≥140/90 mmHg) and a 'revised-minus-classic' group (≥130/80 and <140/90 mmHg). Depressive symptom change was assessed using the Patient Health Questionnaire-9 (PHQ-9). Correlations between changes in PHQ-9 scores and HTN levels by group over a 6- to 18-month observation period were assessed using robust regression analysis. RESULTS: There were demographic and clinical differences between groups. A total of 41% of study subjects (1252/3018) had a visit during the follow-up period where additional PHQ-9 and HTN results were available. Depressive symptom change was unrelated to change in blood pressure in the revised and revised-minus-classic groups. The classic HTN group demonstrated a clinically insignificant change in systolic blood pressure for each unit change in PHQ-9 score (ß = 0.23, P-value =0.02). CONCLUSIONS: Although a statistically significant association between reduced HTN levels and improvement in depressive symptoms was demonstrated under classic HTN guidelines, there was no clinically meaningful association between treatment of depression and improved HTN levels under either guideline.

Diffuse alveolar damage and e-cigarettes: Case report and review of literature.

The prevalence of e-cigarette usage has increased in non-smokers and those who are planning to quit smoking since introduced in 2003. Although the potential long term adverse effects have not been studied in humans, there have been studies showing that e-cigarette vapor causes release of proinflammatory cytokines leading to cytotoxic damage to alveolar epithelial cells, increase in the release of fibroblast growth factor (FGF) in the alveolar epithelial cells which leads to fibroblastic proliferation, and increased risk of staphylococcus aureus and viral infections which are implicated in the pathogenesis of diffuse alveolar damage. We describe a case of a 47-year-old woman who was diagnosed with histologically confirmed diffuse alveolar damage (DAD). She had no significant medical history and she had been smoking e-cigarettes for 3 years prior to presentation. This case report describes the potential association between e-cigarettes and diffuse alveolar damage while making reference to relevant associated studies.

Age- and body weight-dependent association between sleep duration and hypertension in US adults: findings from the 2014-2017 National Health Interview Survey.

OBJECTIVES: Previous studies have confirmed the relationship between sleep duration and hypertension. However, there are unanswered questions on how this relationship is affected by age and body mass index (BMI). This study examined the association between sleep duration and hypertension in US adults and evaluated interaction by age and BMI. DESIGN: Nationwide, population-based, cross-sectional survey. SETTING: National Health Interview Survey (NHIS), 2014 to 2017. PARTICIPANTS: Adult participants aged 18 years or older (n = 130,139). MEASUREMENTS: Sleep duration, hypertension, age, and BMI status were assessed based on self-reported survey responses. Odds ratios (ORs) and 95% confidence intervals (CIs) for sleep duration-hypertension associations were estimated by logistic regression, adjusting for potential confounders. RESULTS: The proportion of participants who reported sleeping less than 7 hours (short sleepers) and more than 9 hours (long sleepers) per night was 32% and 4%, respectively. In adjusted analysis, short sleepers had higher odds of hypertension (OR: 1.54, 95% CI: 1.10-2.17). Although not statistically significant, long sleepers also had higher odds of hypertension (OR: 1.28, 95% CI: 0.80-2.05). In stratified analyses by age and BMI, the association between short sleep and hypertension was especially notable in adults aged 18-44 years (OR: 1.25, 95% CI: 1.16-1.35) and adults with normal weight (OR: 1.21, 95% CI: 1.11-1.33). CONCLUSIONS: Short sleep is associated with increased odds of hypertension among American adults and this relationship is dependent on age and BMI.

Evidence-based approaches to reduce cancer health disparities: Discover, develop, deliver, and disseminate.

The Texas Center for Health Disparities (TCHD) at the University of North Texas Health Science Center is a National Institute on Minority Health and Health Disparities-funded, specialized center of excellence for health disparities. TCHD organized its 12th annual conference focusing on "Evidence-Based Approaches to Reduce Cancer Health Disparities: Discover, Develop, Deliver, and Disseminate." At this conference, experts in health care, biomedical sciences, and public health gathered to discuss the current status and strategies for reducing cancer health disparities. The meeting was conducted in three sessions on breast cancer, prostate cancer, and colorectal cancer disparities, in addition to roundtable discussions and a poster session. Each session highlighted differences in the effects of cancer, based on factors such as race/ethnicity, gender, socioeconomic status, and geographical location. In each session, expert speakers presented their findings, and this was followed by a discussion panel made up of experts in that field and cancer survivors, who responded to questions from the audience. This article summarizes the approaches to fundamental, translational, clinical, and public health issues in cancer health disparities discussed at the conference.