Twenty-four-hour versus clinic blood pressure levels as predictors of long-term cardiovascular and renal disease outcomes among African Americans.

In Caucasian and Asian populations, evidence suggests that 24-h blood pressures (BP) are more predictive of long-term cardiovascular events than clinic BP. However, few long-term studies have evaluated the predictive value of 24-h BP phenotypes (24-h, daytime, nighttime) among African Americans (AA). The purpose of this study is to evaluate the added value of 24-h BP phenotypes compared to clinic BP in predicting the subsequent fatal and non-fatal cardiovascular/renal disease events in AA subjects. AA subjects (n = 270) were initially studied between 1994 and 2006 and standardized clinic BP measurements were obtained during screening procedures for a 3-day inpatient clinical study during which 24-h BP measurements were obtained. To assess the subsequent incidence of cardiovascular and renal disease events, follow-up information was obtained and confirmed by review of paper and electronic medical records between 2015 and 2017. During a mean follow-up of 14 ± 4 years, 50 subjects had one or more fatal or non-fatal cardiovascular/renal disease events. After adjustment for covariates, clinic systolic and diastolic BP were strongly associated with cardiovascular/renal disease events and all-cause mortality (p < 0.0001). Twenty-four-hour BP phenotypes conferred a small incremental advantage over clinic BP in predicting cardiovascular/renal events, which was limited to making a difference of one predicted event in 250-1,000 predictions depending on the 24-h BP phenotype. Nocturnal BP was no more predictive than the other 24-h BP phenotypes. In AA, 24-h BP monitoring provides limited added value as a predictor of cardiovascular/renal disease events. Larger studies are needed in AA to confirm these findings.

Feasibility and Perceptions of Cell Phone-Based, Health-Related Communication With Adolescents in an Economically Depressed Area.

We examined the feasibility and perception of cell-based (texting, voicemail [VM], and email/social media), health-related communication with adolescents in Genesee County, MI, where 22% reside below the poverty level. Results of an anonymous survey found that 86% of respondents owned a cell phone, 87% had data, 96% texted, 90.5% emailed/used social media, and 68% had VM. Most adolescents were interested in cell-based communication via texting (52%), VM (37%), and email/social media (31%). Interest in types of health communication included appointment reminders (99% texting; 94% VM; 95% email/social media), shot reminders (84.5% texting; 74.5% VM; 81% email/social media), call for test results (71.5% texting; 75% VM; 65% email/social media), medication reminders (63% texting; 54% VM; 58% e-mail/social media), and health tips (36% texting; 18.5% VM; 73% email/social media). Cell-based health-related communication with adolescents is feasible even within low socioeconomic status populations, primarily via texting. Health providers should embrace cell-based patient communication.