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1. Virtual Care With Digital Technologies for Rural Canadians Living With Cardiovascular Disease

Author

Ryan Buyting, MSc, Sarah Melville, BSc (Hons), CRA, Hanif Chatur, MD, CCFP(EM), Christopher W. White, MD, PhD, FRCSC, Jean-François Légaré, MD, FRCSC, Sohrab Lutchmedial, MD, FRCPC, and Keith R. Brunt, PhD

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Canada is a wealthy nation with a geographically diverse population, seeking health innovations to better serve patients in accordance with the Canada Health Act. In this country, population and geography converge with social determinants, policy, procurement regulations, and technological advances with the goal to achieve equity in the management and distribution of health care. Rural and remote patients are a vulnerable population; when managing chronic conditions like cardiovascular disease, there is currently inequity to accessing specialist physicians at the recommended frequency—increasing the likelihood of poor health outcomes. Ensuring equitable care for this population is an unrealized priority of several provincial and federal government mandates. Virtual care technology might provide practical, economical, and innovative solutions to remedy this discrepancy. We conducted a scoping review of the literature pertaining to the use of virtual care technologies to monitor patients living in rural areas of Canada with cardiovascular disease. A search strategy was developed to identify the literature specific to this context across 3 bibliographic databases. Two hundred thirty-two unique citations were ultimately assessed for eligibility, of which 37 met the inclusion criteria. In our assessment of these articles, we provide a summary of the interventions studied, their reported effectiveness in reducing adverse events and mortality, the challenges to implementation, and the receptivity of these technologies among patients, providers, and policy-makers. Furthermore, we glean insight into the barriers and opportunities to ensure equitable care for rural patients and conclude that there is an ongoing need for clinical trials on virtual care technologies in this context. Résumé: Le Canada, pays riche dont la population est répartie dans des régions géographiquement diversifiées, reste à l’affût des innovations en matière de santé pour mieux servir les patients conformément à la Loi canadienne sur la santé. Dans ce pays, la population et la géographie ainsi que les déterminants sociaux, les politiques, la réglementation des marchés publics et les progrès technologiques convergent vers un objectif d’équité dans la gestion et la distribution des soins de santé. Les patients des régions rurales et éloignées constituent une population vulnérable; la prise en charge de maladies chroniques comme les maladies cardiovasculaires est marquée par des inégalités en ce qui concerne l’accès aux médecins spécialistes à la fréquence recommandée – ce qui augmente le risque de problèmes de santé. La garantie d’un accès équitable aux soins de santé pour cette population constitue une priorité non concrétisée pour plusieurs gouvernements provinciaux et fédéraux. Les technologies des soins virtuels pourraient offrir des solutions pratiques, économiques et novatrices afin de remédier à la disparité qui persiste. Nous avons effectué une revue exploratoire de la littérature relative à l’utilisation des technologies des soins virtuels pour le suivi des patients atteints de maladies cardiovasculaires vivant dans les régions rurales du Canada. Une stratégie de recherche a été élaborée pour recenser les articles visant spécifiquement ce contexte dans trois bases de données bibliographiques. Au terme de la recherche, 232 références uniques ont été évaluées en fonction des critères d’admissibilité; 37 y répondaient. Dans notre évaluation des articles, nous résumons les interventions étudiées, leur efficacité rapportée quant à la réduction des événements indésirables et de la mortalité, les difficultés de mise en œuvre et la réceptivité des patients, des fournisseurs de soins et des décideurs politiques aux technologies utilisées. En outre, nous offrons un aperçu des obstacles à surmonter et des occasions à saisir pour garantir un accès équitable aux soins de santé dans les régions rurales et nous concluons que des études cliniques sur les technologies des soins virtuels demeurent nécessaires dans ce contexte.

Published
2022
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2. The worldwide impact of telemedicine during COVID-19: current evidence and recommendations for the future

Author

Stefano Omboni, Raj S. Padwal, Tourkiah Alessa, Béla Benczúr, Beverly B. Green, Ilona Hubbard, Kazuomi Kario, Nadia A. Khan, Alexandra Konradi, Alexander G. Logan, Yuan Lu, Maurice Mars, Richard J. McManus, Sarah Melville, Claas L. Neumann, Gianfranco Parati, Nicolas F. Renna, Philippe Ryvlin, Hugo Saner, Aletta E. Schutte, and Jiguang Wang

Subjects
360 Social problems & social services, 610 Medicine & health
Abstract

During the COVID-19 pandemic, telemedicine has emerged worldwide as an indispensable resource to improve the surveillance of patients, curb the spread of disease, facilitate timely identification and management of ill people, but, most importantly, guarantee the continuity of care of frail patients with multiple chronic diseases. Although during COVID-19 telemedicine has thrived, and its adoption has moved forward in many countries, important gaps still remain. Major issues to be addressed to enable large scale implementation of telemedicine include: (1) establishing adequate policies to legislate telemedicine, license healthcare operators, protect patients’ privacy, and implement reimbursement plans; (2) creating and disseminating practical guidelines for the routine clinical use of telemedicine in different contexts; (3) increasing in the level of integration of telemedicine with traditional healthcare services; (4) improving healthcare professionals’ and patients’ awareness of and willingness to use telemedicine; and (5) overcoming inequalities among countries and population subgroups due to technological, infrastructural, and economic barriers. If all these requirements are met in the near future, remote management of patients will become an indispensable resource for the healthcare systems worldwide and will ultimately improve the management of patients and the quality of care.

Published
2022
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3. Virtual care with digital technologies for rural and remote Canadians living with cardiovascular disease

Author

Keith R. Brunt, Ryan Buyting, Hanif Chatur, Jean-Francois Légaré, Christopher W. White, Sarah Melville, and Sohrab Lutchmedial

Subjects
education.field_of_study, Equity (economics), Procurement, business.industry, Population, Health care, Canada Health Act, Psychological intervention, Social determinants of health, Rural area, Public relations, education, business
Abstract

Canada is a wealthy nation with a geographically diverse population, seeking health innovations to better serve patients in accordance with the Canada Health Act. In this country, population and geography converge with social determinants, policy, procurement regulations, and technological advances, in order to achieve equity in the management and distribution of healthcare. Rural and remote patients are a vulnerable population; when managing chronic conditions such as cardiovascular disease, there is inequity when it comes to accessing specialist physicians at the recommended frequency—increasing the likelihood of poor health outcomes. Ensuring equitable care for this population is an unrealized priority of several provincial and federal government mandates. Virtual care technology may provide practical, economical, and innovative solutions to remedy this discrepancy. Here we review the literature pertaining to the use of virtual care technologies to monitor patients with cardiovascular disease living in rural areas of Canada. A search strategy was developed to identify the literature specific to this context across three bibliographic databases. 166 unique citations were ultimately assessed for eligibility, of which 36 met the inclusion criteria. In our assessment of these articles, we provide a summary of the interventions studied, their reported effectiveness in reducing adverse events and mortality, the challenges to implementation, and the receptivity of these technologies amongst patients, providers and policy makers. Further, we glean insight into the barriers and opportunities to ensure equitable care for rural patients and conclude that there is an ongoing need for clinical trials assessing virtual care technologies in this context.SummaryPatients living in rural and remote communities’ experience diverse challenges to receiving equitable healthcare as is mandated by the Canada Health Act. Advances in virtual care technology may provide practical, economical, and innovative solutions to ensure this for patients in remote and rural living situations. Here we provide a state-of-the-art review of virtual care technologies available to patients with cardiovascular disease living in rural areas of Canada.

Published
2020
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4. May Measurement Month 2019: The Global Blood Pressure Screening Campaign of the International Society of Hypertension

Author

Beaney, Thomas, Schutte, Aletta E, Stergiou, George S, Borghi, Claudio, Burger, Dylan, Charchar, Fadi, Cro, Suzie, Diaz, Alejandro, Damasceno, Albertino, Espeche, Walter, Jose, Arun Pulikkottil, Khan, Nadia, Kokubo, Yoshihiro, Maheshwari, Anuj, Marin, Marcos J, More, Arun, Neupane, Dinesh, Nilsson, Peter, Patil, Mansi, Prabhakaran, Dorairaj, Ramirez, Agustin, Rodriguez, Pablo, Schlaich, Markus, Steckelings, Ulrike M, Tomaszewski, Maciej, Unger, Thomas, Wainford, Richard, Wang, Jiguang, Williams, Bryan, Poulter, Neil R, Michael H Olsen, Kristin T West-Gustave, Phillip D Levy, Vivian W. Y. Lee, Kenneth L Connell, Naima N. H. Hammoudi, Pascal Bovet, Bharathi Viswanathan, Sabine Perl, Bernard K Kramer, Adrian J. B. Brady, Olulola O Oladapo, Jephat Chifamba, Dejuma Y Goshu, Desalew M Kassie, Sintayehu A Gebru, Toure A Ibrahim, Soumana Kabirou, Elham Tavassoli, Mahsa Zolfaghari, Vahideh Yavari, Larysa Mishchenko, Olena Matova, Tetiana Kolenyk, Liliiya Zelenenka, Sergiy Fedorov, Maria Dorobantu, Alexandra Paval, Jesse Bittman, Biri Mangat, Sarah Melville, Alexander Leung, Neusa Jessen, Eamon Dolan, Hiroshi N. A. Itoh, Atul Pathak, Tine L. M. De Backer, Arman S Postadzhiyan, Osiris V Valoy-Tiburcio, Angel R Gonzalez-Medina, Laura G Valdez-Valoy, Fernando S Wyss, Erkin Mirrakhimov, Sunil K Nadar, Ana I Barrientos, Chukwuemeka R Nwokocha, Magdalene I Nwokocha, Dean Picone, Jun Yang, Yook C Chia, Siew M Ching, Bertrand F Ellenga Mbolla, Christian M Kouala Landa, Corine Y Houehanou, Kolawole W Wahab, Ayodele B Omotoso, Jose Ortellado, Graciela Gonzales, Luis M Ruilope, Enrique Rodilla, Ana Molinero, Angela J Woodiwiss, Ane Orchard, Ruan Kruger, Jana Brguljan, Nina Bozic, Aleksandra O Konradi, Oxana P Rotar, Irian Chazova, Tiny K Masupe, John T Tlhakanelo, Keneilwe Motlhatlhedi, George Stergiou, Michalis Doumas, Pantelis Zebekakis, Francesco P Cappuccio, Carolina Barciela, Tricia Tay, Naranjargal Dashdorj, Khulan Tuvdendarjaa, Khatantuul Boldbaatar, Fernando T Lanas, Melanie Paccot, Mohammed Ishaq, Saulat Sidique, Feroz Memon, Robert N Najem, Ali K Abu Alfa, Samir M. J. Mallat, Jacek J Jozwiak, Maciej Banach, Piotr Janowski, Betty Twumasi-Ankrah, Gustavus A Myers-Hansen, Elliot K Tannor, Marisa F Neto, Sudhirsen Kowlessur, Bhooshun Ori, Jaysing Heecharan, Hatem A Fageh, Hawa A Derbi, Omara M Msalam, Fastone M Goma, Charity Syatalimi, Penias Jr Tembo, Musawa Mukupa, Henry L Ndhlovu, Maureen L Chirwa, Mary M Mbeba, Parounak H Zelveian, Zoya N Hakobyan, Svetlana Gourgenyan, Myeong-Chan Cho, Hae-Young Lee, Jinho Shin, Gianfranco Parati, Guido Grassi, Claudio Ferri, Bezhan Tsinamdzgvrishvili, Amiran Gamkrelidze, Dali Trapaidze, Eduardo C. D. Barbosa, Weimar S Barroso, Audes M Feitosa, Vanda M Azevedo, Luis A Dias, Glenda N Garcia, Isaulina Delgado, Genc Burazeri, Gentiana Qirjako, Alban Ylli, Rudina Cumashi, Antonieta P Costantini-Olmos, Igor Morr, Elias Chuki, Tzung-Dau Wang, Wen-Jone Chen, Hung-Ju Lin, Fazila-Tun-Nesa Malik, Sohel R Choudhury, Mohammad Abdullah Al Mamun, Mir Ishraquzzaman, Ghadeer S Aljuraiban, Fatima Y Al Slail, Shatha K Aldhwailea, Ann A Badawi, Nguyen L Viet, Hoang A Tien, Nguyen T. A. Dong, Cao T Sinh, Huynh V Minh, Tran K Son, Fortunat K Katamba, Nathan B Buila, Anastase Dzudie, Samuel Kingue, Njume Epie, Armel Njomou, Marie S Ndom, Afzalhussein M Yusufali, Nooshin M Bazargani, Buthaina A. Bin Belaila, Amrish Agrawal, Aisha M Suhail, Elijah N Ogola, Bernard M Gitura, Lilian Mbau, Hellen K Nguchu, Felix A Barasa, Enrique Gomez, Luis A Alcocer, Martin Rosas, Silvia Palomo, Alfredo J Estrada, Patricio Lopez-Jaramillo, Gregorio Sanchez-Vallejo, Maria E Casanova, Edgar Arcos, Gustavo Aroca, Bhagawan Koirala, Harikrishna Bhattarai, Ghanashyam Pandey, Surya Devkota, Sweta Koirala, Kamal Ranabhat, Pratik Khanal, Tara B Adhikari, Dolores D Bonzon, Deborah Ignacia D Ona, Leilani M Asis, Benjamin A Balmores Jr, Rafael C Castillo, Diego J Stisman, Walter G Espeche, Marcos J Marin, Irene L Ennis, Xin Chen, Hongyu Wang, Min Liu, Xinhua Yin, Xiaolong Wang, Sandeep Bhalla, Priyanka Gupta, Narsingh Verma, Bal K Gupta, Shehla Sheikh, Gregoire Wuerzner, Laura Garré, José Boggia, Dédonougbo M Houenassi, José A OctavioSeijas, Jean-René M'buyamba-Kabangu, Trésor M Tshiswaka, Dénes Páll, Zoltán Járai, Rafael Hernández, Fortunato Garcia Vásquez, Jesús A Lopez-Rivera, Monica L Gúzman-Franolic, Savarino Victoria Pereira, Mário J Fernandes, Maria S Garcia, Teresa Gijon, Vitoria V. B. Meira Da Cunha, Beaney T, Schutte AE, Stergiou GS, Borghi C, Burger D, Charchar F, Cro S, Diaz A, Damasceno A, Espeche W, Jose AP, Khan N, Kokubo Y, Maheshwari A, Marin MJ, More A, Neupane D, Nilsson P, Patil M, Prabhakaran D, Ramirez A, Rodriguez P, Schlaich M, Steckelings UM, Tomaszewski M, Unger T, Wainford R, Wang J, Williams B, Poulter NR, Thomas, B, Aletta E, S, George S, S, Claudio, B, Dylan, B, Fadi, C, Suzie, C, Alejandro, D, Albertino, D, Walter, E, Arun Pulikkottil, J, Nadia, K, Yoshihiro, K, Anuj, M, Marcos J, M, Arun, M, Dinesh, N, Peter, N, Mansi, P, Dorairaj, P, Agustin, R, Pablo, R, Markus, S, Ulrike M, S, Maciej, T, Thomas, U, Richard, W, Jiguang, W, Bryan, W, Neil R, P, H Olsen, M, T West-Gustave, K, D Levy, P, Lee, V, L Connell, K, Hammoudi, N, Bovet, P, Viswanathan, B, Perl, S, K Kramer, B, Brady, A, O Oladapo, O, Chifamba, J, Y Goshu, D, M Kassie, D, A Gebru, S, A Ibrahim, T, Kabirou, S, Tavassoli, E, Zolfaghari, M, Yavari, V, Mishchenko, L, Matova, O, Kolenyk, T, Zelenenka, L, Fedorov, S, Dorobantu, M, Paval, A, Bittman, J, Mangat, B, Melville, S, Leung, A, Jessen, N, Dolan, E, Itoh, H, Pathak, A, De Backer, T, S Postadzhiyan, A, V Valoy-Tiburcio, O, R Gonzalez-Medina, A, G Valdez-Valoy, L, S Wyss, F, Mirrakhimov, E, K Nadar, S, I Barrientos, A, R Nwokocha, C, I Nwokocha, M, Picone, D, Yang, J, C Chia, Y, M Ching, S, F Ellenga Mbolla, B, M Kouala Landa, C, Y Houehanou, C, W Wahab, K, B Omotoso, A, Ortellado, J, Gonzales, G, M Ruilope, L, Rodilla, E, Molinero, A, J Woodiwiss, A, Orchard, A, Kruger, R, Brguljan, J, Bozic, N, O Konradi, A, P Rotar, O, Chazova, I, K Masupe, T, T Tlhakanelo, J, Motlhatlhedi, K, Stergiou, G, Doumas, M, Zebekakis, P, P Cappuccio, F, Barciela, C, Tay, T, Dashdorj, N, Tuvdendarjaa, K, Boldbaatar, K, T Lanas, F, Paccot, M, Ishaq, M, Sidique, S, Memon, F, N Najem, R, K Abu Alfa, A, Mallat, S, J Jozwiak, J, Banach, M, Janowski, P, Twumasi-Ankrah, B, A Myers-Hansen, G, K Tannor, E, F Neto, M, Kowlessur, S, Ori, B, Heecharan, J, A Fageh, H, A Derbi, H, M Msalam, O, M Goma, F, Syatalimi, C, Jr Tembo, P, Mukupa, M, L Ndhlovu, H, L Chirwa, M, M Mbeba, M, H Zelveian, P, N Hakobyan, Z, Gourgenyan, S, Cho, M, Lee, H, Shin, J, Parati, G, Grassi, G, Ferri, C, Tsinamdzgvrishvili, B, Gamkrelidze, A, Trapaidze, D, Barbosa, E, S Barroso, W, M Feitosa, A, M Azevedo, V, A Dias, L, N Garcia, G, Delgado, I, Burazeri, G, Qirjako, G, Ylli, A, Cumashi, R, P Costantini-Olmos, A, Morr, I, Chuki, E, Wang, T, Chen, W, Lin, H, Malik, F, R Choudhury, S, Abdullah Al Mamun, M, Ishraquzzaman, M, S Aljuraiban, G, Y Al Slail, F, K Aldhwailea, S, A Badawi, A, L Viet, N, A Tien, H, Dong, N, T Sinh, C, V Minh, H, K Son, T, K Katamba, F, B Buila, N, Dzudie, A, Kingue, S, Epie, N, Njomou, A, S Ndom, M, M Yusufali, A, M Bazargani, N, Bin Belaila, B, Agrawal, A, M Suhail, A, N Ogola, E, M Gitura, B, Mbau, L, K Nguchu, H, A Barasa, F, Gomez, E, A Alcocer, L, Rosas, M, Palomo, S, J Estrada, A, Lopez-Jaramillo, P, Sanchez-Vallejo, G, E Casanova, M, Arcos, E, Aroca, G, Koirala, B, Bhattarai, H, Pandey, G, Devkota, S, Koirala, S, Ranabhat, K, Khanal, P, B Adhikari, T, D Bonzon, D, D Ona, D, M Asis, L, A Balmores Jr, B, C Castillo, R, J Stisman, D, G Espeche, W, J Marin, M, L Ennis, I, Chen, X, Wang, H, Liu, M, Yin, X, Wang, X, Bhalla, S, Gupta, P, Verma, N, K Gupta, B, Sheikh, S, Wuerzner, G, Garré, L, Boggia, J, M Houenassi, D, A OctavioSeijas, J, M'buyamba-Kabangu, J, M Tshiswaka, T, Páll, D, Járai, Z, Hernández, R, Garcia Vásquez, F, A Lopez-Rivera, J, L Gúzman-Franolic, M, Victoria Pereira, S, J Fernandes, M, S Garcia, M, Gijon, T, Meira Da Cunha, V, and RS: CARIM other

Subjects
Male, Population level, Comorbidity, 030204 cardiovascular system & hematology, 0302 clinical medicine, Prevalence, adults, Medicine, Mass Screening, awareness, 030212 general & internal medicine, 1102 Cardiorespiratory Medicine and Haematology, Aged, 80 and over, Aspirin, treatment, adults, awareness, blood pressure, hypertension, risk factor, screening, treatment, blood pressure, Middle Aged, Lifestyle factors, risk factor, Female, Life Sciences & Biomedicine, medicine.drug, Adult, medicine.medical_specialty, hypertension, Adolescent, awarene, Opportunistic Sampling, Elevated blood, 1117 Public Health and Health Services, 03 medical and health sciences, Young Adult, Internal Medicine, Humans, Risk factor, Antihypertensive Agents, Aged, Science & Technology, business.industry, screening, Blood Pressure Determination, 1103 Clinical Sciences, Mean blood pressure, Blood pressure, Peripheral Vascular Disease, Cardiovascular System & Hematology, Emergency medicine, Cardiovascular System & Cardiology, business, MMM Investigators
Abstract

Elevated blood pressure remains the single biggest risk factor contributing to the global burden of disease and mortality. May Measurement Month is an annual global screening campaign aiming to improve awareness of blood pressure at the individual and population level. Adults ({greater than or equal to}18 years) recruited through opportunistic sampling were screened at sites in 92 countries during May 2019. Ideally three blood pressure readings were measured for each participant, and data on lifestyle factors and co-morbidities were collected. Hypertension was defined as a systolic BP {greater than or equal to} 140 mmHg, and/or a diastolic BP {greater than or equal to} 90 mmHg (mean of the second and third readings) or taking antihypertensive medication. When necessary, multiple imputation was used to estimate participants' mean blood pressure. Mixed-effects models were used to evaluate associations between blood pressure and participant characteristics. Of 1,508,130 screenees 482,273 (32.0%) had never had a blood pressure measurement before and 513,337 (34.0%) had hypertension, of whom 58.7% were aware and 54.7% were on antihypertensive medication. Of those on medication, 57.8% were controlled to

Published
2020
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5. May measurement month 2019: The global blood pressure screening campaign of the international society of hypertension

Author

Thomas, B, Aletta E, S, George S, S, Claudio, B, Dylan, B, Fadi, C, Suzie, C, Alejandro, D, Albertino, D, Walter, E, Arun Pulikkottil, J, Nadia, K, Yoshihiro, K, Anuj, M, Marcos J, M, Arun, M, Dinesh, N, Peter, N, Mansi, P, Dorairaj, P, Agustin, R, Pablo, R, Markus, S, Ulrike M, S, Maciej, T, Thomas, U, Richard, W, Jiguang, W, Bryan, W, Neil R, P, H Olsen, M, T West-Gustave, K, D Levy, P, Lee, V, L Connell, K, Hammoudi, N, Bovet, P, Viswanathan, B, Perl, S, K Kramer, B, Brady, A, O Oladapo, O, Chifamba, J, Y Goshu, D, M Kassie, D, A Gebru, S, A Ibrahim, T, Kabirou, S, Tavassoli, E, Zolfaghari, M, Yavari, V, Mishchenko, L, Matova, O, Kolenyk, T, Zelenenka, L, Fedorov, S, Dorobantu, M, Paval, A, Bittman, J, Mangat, B, Melville, S, Leung, A, Jessen, N, Dolan, E, Itoh, H, Pathak, A, De Backer, T, S Postadzhiyan, A, V Valoy-Tiburcio, O, R Gonzalez-Medina, A, G Valdez-Valoy, L, S Wyss, F, Mirrakhimov, E, K Nadar, S, I Barrientos, A, R Nwokocha, C, I Nwokocha, M, Picone, D, Yang, J, C Chia, Y, M Ching, S, F Ellenga Mbolla, B, M Kouala Landa, C, Y Houehanou, C, W Wahab, K, B Omotoso, A, Ortellado, J, Gonzales, G, M Ruilope, L, Rodilla, E, Molinero, A, J Woodiwiss, A, Orchard, A, Kruger, R, Brguljan, J, Bozic, N, O Konradi, A, P Rotar, O, Chazova, I, K Masupe, T, T Tlhakanelo, J, Motlhatlhedi, K, Stergiou, G, Doumas, M, Zebekakis, P, P Cappuccio, F, Barciela, C, Tay, T, Dashdorj, N, Tuvdendarjaa, K, Boldbaatar, K, T Lanas, F, Paccot, M, Ishaq, M, Sidique, S, Memon, F, N Najem, R, K Abu Alfa, A, Mallat, S, J Jozwiak, J, Banach, M, Janowski, P, Twumasi-Ankrah, B, A Myers-Hansen, G, K Tannor, E, F Neto, M, Kowlessur, S, Ori, B, Heecharan, J, A Fageh, H, A Derbi, H, M Msalam, O, M Goma, F, Syatalimi, C, Jr Tembo, P, Mukupa, M, L Ndhlovu, H, L Chirwa, M, M Mbeba, M, H Zelveian, P, N Hakobyan, Z, Gourgenyan, S, Cho, M, Lee, H, Shin, J, Parati, G, Grassi, G, Ferri, C, Tsinamdzgvrishvili, B, Gamkrelidze, A, Trapaidze, D, Barbosa, E, S Barroso, W, M Feitosa, A, M Azevedo, V, A Dias, L, N Garcia, G, Delgado, I, Burazeri, G, Qirjako, G, Ylli, A, Cumashi, R, P Costantini-Olmos, A, Morr, I, Chuki, E, Wang, T, Chen, W, Lin, H, Malik, F, R Choudhury, S, Abdullah Al Mamun, M, Ishraquzzaman, M, S Aljuraiban, G, Y Al Slail, F, K Aldhwailea, S, A Badawi, A, L Viet, N, A Tien, H, Dong, N, T Sinh, C, V Minh, H, K Son, T, K Katamba, F, B Buila, N, Dzudie, A, Kingue, S, Epie, N, Njomou, A, S Ndom, M, M Yusufali, A, M Bazargani, N, Bin Belaila, B, Agrawal, A, M Suhail, A, N Ogola, E, M Gitura, B, Mbau, L, K Nguchu, H, A Barasa, F, Gomez, E, A Alcocer, L, Rosas, M, Palomo, S, J Estrada, A, Lopez-Jaramillo, P, Sanchez-Vallejo, G, E Casanova, M, Arcos, E, Aroca, G, Koirala, B, Bhattarai, H, Pandey, G, Devkota, S, Koirala, S, Ranabhat, K, Khanal, P, B Adhikari, T, D Bonzon, D, D Ona, D, M Asis, L, A Balmores Jr, B, C Castillo, R, J Stisman, D, G Espeche, W, J Marin, M, L Ennis, I, Chen, X, Wang, H, Liu, M, Yin, X, Wang, X, Bhalla, S, Gupta, P, Verma, N, K Gupta, B, Sheikh, S, Wuerzner, G, Garré, L, Boggia, J, M Houenassi, D, A OctavioSeijas, J, M'buyamba-Kabangu, J, M Tshiswaka, T, Páll, D, Járai, Z, Hernández, R, Garcia Vásquez, F, A Lopez-Rivera, J, L Gúzman-Franolic, M, Victoria Pereira, S, J Fernandes, M, S Garcia, M, Gijon, T, Meira Da Cunha, V, Beaney, Thomas, Schutte, Aletta E, Stergiou, George S, Borghi, Claudio, Burger, Dylan, Charchar, Fadi, Cro, Suzie, Diaz, Alejandro, Damasceno, Albertino, Espeche, Walter, Jose, Arun Pulikkottil, Khan, Nadia, Kokubo, Yoshihiro, Maheshwari, Anuj, Marin, Marcos J, More, Arun, Neupane, Dinesh, Nilsson, Peter, Patil, Mansi, Prabhakaran, Dorairaj, Ramirez, Agustin, Rodriguez, Pablo, Schlaich, Markus, Steckelings, Ulrike M, Tomaszewski, Maciej, Unger, Thomas, Wainford, Richard, Wang, Jiguang, Williams, Bryan, Poulter, Neil R, Michael H Olsen, Kristin T West-Gustave, Phillip D Levy, Vivian W. Y. Lee, Kenneth L Connell, Naima N. H. Hammoudi, Pascal Bovet, Bharathi Viswanathan, Sabine Perl, Bernard K Kramer, Adrian J. B. Brady, Olulola O Oladapo, Jephat Chifamba, Dejuma Y Goshu, Desalew M Kassie, Sintayehu A Gebru, Toure A Ibrahim, Soumana Kabirou, Elham Tavassoli, Mahsa Zolfaghari, Vahideh Yavari, Larysa Mishchenko, Olena Matova, Tetiana Kolenyk, Liliiya Zelenenka, Sergiy Fedorov, Maria Dorobantu, Alexandra Paval, Jesse Bittman, Biri Mangat, Sarah Melville, Alexander Leung, Neusa Jessen, Eamon Dolan, Hiroshi N. A. Itoh, Atul Pathak, Tine L. M. De Backer, Arman S Postadzhiyan, Osiris V Valoy-Tiburcio, Angel R Gonzalez-Medina, Laura G Valdez-Valoy, Fernando S Wyss, Erkin Mirrakhimov, Sunil K Nadar, Ana I Barrientos, Chukwuemeka R Nwokocha, Magdalene I Nwokocha, Dean Picone, Jun Yang, Yook C Chia, Siew M Ching, Bertrand F Ellenga Mbolla, Christian M Kouala Landa, Corine Y Houehanou, Kolawole W Wahab, Ayodele B Omotoso, Jose Ortellado, Graciela Gonzales, Luis M Ruilope, Enrique Rodilla, Ana Molinero, Angela J Woodiwiss, Ane Orchard, Ruan Kruger, Jana Brguljan, Nina Bozic, Aleksandra O Konradi, Oxana P Rotar, Irian Chazova, Tiny K Masupe, John T Tlhakanelo, Keneilwe Motlhatlhedi, George Stergiou, Michalis Doumas, Pantelis Zebekakis, Francesco P Cappuccio, Carolina Barciela, Tricia Tay, Naranjargal Dashdorj, Khulan Tuvdendarjaa, Khatantuul Boldbaatar, Fernando T Lanas, Melanie Paccot, Mohammed Ishaq, Saulat Sidique, Feroz Memon, Robert N Najem, Ali K Abu Alfa, Samir M. J. Mallat, Jacek J Jozwiak, Maciej Banach, Piotr Janowski, Betty Twumasi-Ankrah, Gustavus A Myers-Hansen, Elliot K Tannor, Marisa F Neto, Sudhirsen Kowlessur, Bhooshun Ori, Jaysing Heecharan, Hatem A Fageh, Hawa A Derbi, Omara M Msalam, Fastone M Goma, Charity Syatalimi, Penias Jr Tembo, Musawa Mukupa, Henry L Ndhlovu, Maureen L Chirwa, Mary M Mbeba, Parounak H Zelveian, Zoya N Hakobyan, Svetlana Gourgenyan, Myeong-Chan Cho, Hae-Young Lee, Jinho Shin, Gianfranco Parati, Guido Grassi, Claudio Ferri, Bezhan Tsinamdzgvrishvili, Amiran Gamkrelidze, Dali Trapaidze, Eduardo C. D. Barbosa, Weimar S Barroso, Audes M Feitosa, Vanda M Azevedo, Luis A Dias, Glenda N Garcia, Isaulina Delgado, Genc Burazeri, Gentiana Qirjako, Alban Ylli, Rudina Cumashi, Antonieta P Costantini-Olmos, Igor Morr, Elias Chuki, Tzung-Dau Wang, Wen-Jone Chen, Hung-Ju Lin, Fazila-Tun-Nesa Malik, Sohel R Choudhury, Mohammad Abdullah Al Mamun, Mir Ishraquzzaman, Ghadeer S Aljuraiban, Fatima Y Al Slail, Shatha K Aldhwailea, Ann A Badawi, Nguyen L Viet, Hoang A Tien, Nguyen T. A. Dong, Cao T Sinh, Huynh V Minh, Tran K Son, Fortunat K Katamba, Nathan B Buila, Anastase Dzudie, Samuel Kingue, Njume Epie, Armel Njomou, Marie S Ndom, Afzalhussein M Yusufali, Nooshin M Bazargani, Buthaina A. Bin Belaila, Amrish Agrawal, Aisha M Suhail, Elijah N Ogola, Bernard M Gitura, Lilian Mbau, Hellen K Nguchu, Felix A Barasa, Enrique Gomez, Luis A Alcocer, Martin Rosas, Silvia Palomo, Alfredo J Estrada, Patricio Lopez-Jaramillo, Gregorio Sanchez-Vallejo, Maria E Casanova, Edgar Arcos, Gustavo Aroca, Bhagawan Koirala, Harikrishna Bhattarai, Ghanashyam Pandey, Surya Devkota, Sweta Koirala, Kamal Ranabhat, Pratik Khanal, Tara B Adhikari, Dolores D Bonzon, Deborah Ignacia D Ona, Leilani M Asis, Benjamin A Balmores Jr, Rafael C Castillo, Diego J Stisman, Walter G Espeche, Marcos J Marin, Irene L Ennis, Xin Chen, Hongyu Wang, Min Liu, Xinhua Yin, Xiaolong Wang, Sandeep Bhalla, Priyanka Gupta, Narsingh Verma, Bal K Gupta, Shehla Sheikh, Gregoire Wuerzner, Laura Garré, José Boggia, Dédonougbo M Houenassi, José A OctavioSeijas, Jean-René M'buyamba-Kabangu, Trésor M Tshiswaka, Dénes Páll, Zoltán Járai, Rafael Hernández, Fortunato Garcia Vásquez, Jesús A Lopez-Rivera, Monica L Gúzman-Franolic, Savarino Victoria Pereira, Mário J Fernandes, Maria S Garcia, Teresa Gijon, Vitoria V. B. Meira Da Cunha, Thomas, B, Aletta E, S, George S, S, Claudio, B, Dylan, B, Fadi, C, Suzie, C, Alejandro, D, Albertino, D, Walter, E, Arun Pulikkottil, J, Nadia, K, Yoshihiro, K, Anuj, M, Marcos J, M, Arun, M, Dinesh, N, Peter, N, Mansi, P, Dorairaj, P, Agustin, R, Pablo, R, Markus, S, Ulrike M, S, Maciej, T, Thomas, U, Richard, W, Jiguang, W, Bryan, W, Neil R, P, H Olsen, M, T West-Gustave, K, D Levy, P, Lee, V, L Connell, K, Hammoudi, N, Bovet, P, Viswanathan, B, Perl, S, K Kramer, B, Brady, A, O Oladapo, O, Chifamba, J, Y Goshu, D, M Kassie, D, A Gebru, S, A Ibrahim, T, Kabirou, S, Tavassoli, E, Zolfaghari, M, Yavari, V, Mishchenko, L, Matova, O, Kolenyk, T, Zelenenka, L, Fedorov, S, Dorobantu, M, Paval, A, Bittman, J, Mangat, B, Melville, S, Leung, A, Jessen, N, Dolan, E, Itoh, H, Pathak, A, De Backer, T, S Postadzhiyan, A, V Valoy-Tiburcio, O, R Gonzalez-Medina, A, G Valdez-Valoy, L, S Wyss, F, Mirrakhimov, E, K Nadar, S, I Barrientos, A, R Nwokocha, C, I Nwokocha, M, Picone, D, Yang, J, C Chia, Y, M Ching, S, F Ellenga Mbolla, B, M Kouala Landa, C, Y Houehanou, C, W Wahab, K, B Omotoso, A, Ortellado, J, Gonzales, G, M Ruilope, L, Rodilla, E, Molinero, A, J Woodiwiss, A, Orchard, A, Kruger, R, Brguljan, J, Bozic, N, O Konradi, A, P Rotar, O, Chazova, I, K Masupe, T, T Tlhakanelo, J, Motlhatlhedi, K, Stergiou, G, Doumas, M, Zebekakis, P, P Cappuccio, F, Barciela, C, Tay, T, Dashdorj, N, Tuvdendarjaa, K, Boldbaatar, K, T Lanas, F, Paccot, M, Ishaq, M, Sidique, S, Memon, F, N Najem, R, K Abu Alfa, A, Mallat, S, J Jozwiak, J, Banach, M, Janowski, P, Twumasi-Ankrah, B, A Myers-Hansen, G, K Tannor, E, F Neto, M, Kowlessur, S, Ori, B, Heecharan, J, A Fageh, H, A Derbi, H, M Msalam, O, M Goma, F, Syatalimi, C, Jr Tembo, P, Mukupa, M, L Ndhlovu, H, L Chirwa, M, M Mbeba, M, H Zelveian, P, N Hakobyan, Z, Gourgenyan, S, Cho, M, Lee, H, Shin, J, Parati, G, Grassi, G, Ferri, C, Tsinamdzgvrishvili, B, Gamkrelidze, A, Trapaidze, D, Barbosa, E, S Barroso, W, M Feitosa, A, M Azevedo, V, A Dias, L, N Garcia, G, Delgado, I, Burazeri, G, Qirjako, G, Ylli, A, Cumashi, R, P Costantini-Olmos, A, Morr, I, Chuki, E, Wang, T, Chen, W, Lin, H, Malik, F, R Choudhury, S, Abdullah Al Mamun, M, Ishraquzzaman, M, S Aljuraiban, G, Y Al Slail, F, K Aldhwailea, S, A Badawi, A, L Viet, N, A Tien, H, Dong, N, T Sinh, C, V Minh, H, K Son, T, K Katamba, F, B Buila, N, Dzudie, A, Kingue, S, Epie, N, Njomou, A, S Ndom, M, M Yusufali, A, M Bazargani, N, Bin Belaila, B, Agrawal, A, M Suhail, A, N Ogola, E, M Gitura, B, Mbau, L, K Nguchu, H, A Barasa, F, Gomez, E, A Alcocer, L, Rosas, M, Palomo, S, J Estrada, A, Lopez-Jaramillo, P, Sanchez-Vallejo, G, E Casanova, M, Arcos, E, Aroca, G, Koirala, B, Bhattarai, H, Pandey, G, Devkota, S, Koirala, S, Ranabhat, K, Khanal, P, B Adhikari, T, D Bonzon, D, D Ona, D, M Asis, L, A Balmores Jr, B, C Castillo, R, J Stisman, D, G Espeche, W, J Marin, M, L Ennis, I, Chen, X, Wang, H, Liu, M, Yin, X, Wang, X, Bhalla, S, Gupta, P, Verma, N, K Gupta, B, Sheikh, S, Wuerzner, G, Garré, L, Boggia, J, M Houenassi, D, A OctavioSeijas, J, M'buyamba-Kabangu, J, M Tshiswaka, T, Páll, D, Járai, Z, Hernández, R, Garcia Vásquez, F, A Lopez-Rivera, J, L Gúzman-Franolic, M, Victoria Pereira, S, J Fernandes, M, S Garcia, M, Gijon, T, Meira Da Cunha, V, Beaney, Thomas, Schutte, Aletta E, Stergiou, George S, Borghi, Claudio, Burger, Dylan, Charchar, Fadi, Cro, Suzie, Diaz, Alejandro, Damasceno, Albertino, Espeche, Walter, Jose, Arun Pulikkottil, Khan, Nadia, Kokubo, Yoshihiro, Maheshwari, Anuj, Marin, Marcos J, More, Arun, Neupane, Dinesh, Nilsson, Peter, Patil, Mansi, Prabhakaran, Dorairaj, Ramirez, Agustin, Rodriguez, Pablo, Schlaich, Markus, Steckelings, Ulrike M, Tomaszewski, Maciej, Unger, Thomas, Wainford, Richard, Wang, Jiguang, Williams, Bryan, Poulter, Neil R, Michael H Olsen, Kristin T West-Gustave, Phillip D Levy, Vivian W. Y. Lee, Kenneth L Connell, Naima N. H. Hammoudi, Pascal Bovet, Bharathi Viswanathan, Sabine Perl, Bernard K Kramer, Adrian J. B. Brady, Olulola O Oladapo, Jephat Chifamba, Dejuma Y Goshu, Desalew M Kassie, Sintayehu A Gebru, Toure A Ibrahim, Soumana Kabirou, Elham Tavassoli, Mahsa Zolfaghari, Vahideh Yavari, Larysa Mishchenko, Olena Matova, Tetiana Kolenyk, Liliiya Zelenenka, Sergiy Fedorov, Maria Dorobantu, Alexandra Paval, Jesse Bittman, Biri Mangat, Sarah Melville, Alexander Leung, Neusa Jessen, Eamon Dolan, Hiroshi N. A. Itoh, Atul Pathak, Tine L. M. De Backer, Arman S Postadzhiyan, Osiris V Valoy-Tiburcio, Angel R Gonzalez-Medina, Laura G Valdez-Valoy, Fernando S Wyss, Erkin Mirrakhimov, Sunil K Nadar, Ana I Barrientos, Chukwuemeka R Nwokocha, Magdalene I Nwokocha, Dean Picone, Jun Yang, Yook C Chia, Siew M Ching, Bertrand F Ellenga Mbolla, Christian M Kouala Landa, Corine Y Houehanou, Kolawole W Wahab, Ayodele B Omotoso, Jose Ortellado, Graciela Gonzales, Luis M Ruilope, Enrique Rodilla, Ana Molinero, Angela J Woodiwiss, Ane Orchard, Ruan Kruger, Jana Brguljan, Nina Bozic, Aleksandra O Konradi, Oxana P Rotar, Irian Chazova, Tiny K Masupe, John T Tlhakanelo, Keneilwe Motlhatlhedi, George Stergiou, Michalis Doumas, Pantelis Zebekakis, Francesco P Cappuccio, Carolina Barciela, Tricia Tay, Naranjargal Dashdorj, Khulan Tuvdendarjaa, Khatantuul Boldbaatar, Fernando T Lanas, Melanie Paccot, Mohammed Ishaq, Saulat Sidique, Feroz Memon, Robert N Najem, Ali K Abu Alfa, Samir M. J. Mallat, Jacek J Jozwiak, Maciej Banach, Piotr Janowski, Betty Twumasi-Ankrah, Gustavus A Myers-Hansen, Elliot K Tannor, Marisa F Neto, Sudhirsen Kowlessur, Bhooshun Ori, Jaysing Heecharan, Hatem A Fageh, Hawa A Derbi, Omara M Msalam, Fastone M Goma, Charity Syatalimi, Penias Jr Tembo, Musawa Mukupa, Henry L Ndhlovu, Maureen L Chirwa, Mary M Mbeba, Parounak H Zelveian, Zoya N Hakobyan, Svetlana Gourgenyan, Myeong-Chan Cho, Hae-Young Lee, Jinho Shin, Gianfranco Parati, Guido Grassi, Claudio Ferri, Bezhan Tsinamdzgvrishvili, Amiran Gamkrelidze, Dali Trapaidze, Eduardo C. D. Barbosa, Weimar S Barroso, Audes M Feitosa, Vanda M Azevedo, Luis A Dias, Glenda N Garcia, Isaulina Delgado, Genc Burazeri, Gentiana Qirjako, Alban Ylli, Rudina Cumashi, Antonieta P Costantini-Olmos, Igor Morr, Elias Chuki, Tzung-Dau Wang, Wen-Jone Chen, Hung-Ju Lin, Fazila-Tun-Nesa Malik, Sohel R Choudhury, Mohammad Abdullah Al Mamun, Mir Ishraquzzaman, Ghadeer S Aljuraiban, Fatima Y Al Slail, Shatha K Aldhwailea, Ann A Badawi, Nguyen L Viet, Hoang A Tien, Nguyen T. A. Dong, Cao T Sinh, Huynh V Minh, Tran K Son, Fortunat K Katamba, Nathan B Buila, Anastase Dzudie, Samuel Kingue, Njume Epie, Armel Njomou, Marie S Ndom, Afzalhussein M Yusufali, Nooshin M Bazargani, Buthaina A. Bin Belaila, Amrish Agrawal, Aisha M Suhail, Elijah N Ogola, Bernard M Gitura, Lilian Mbau, Hellen K Nguchu, Felix A Barasa, Enrique Gomez, Luis A Alcocer, Martin Rosas, Silvia Palomo, Alfredo J Estrada, Patricio Lopez-Jaramillo, Gregorio Sanchez-Vallejo, Maria E Casanova, Edgar Arcos, Gustavo Aroca, Bhagawan Koirala, Harikrishna Bhattarai, Ghanashyam Pandey, Surya Devkota, Sweta Koirala, Kamal Ranabhat, Pratik Khanal, Tara B Adhikari, Dolores D Bonzon, Deborah Ignacia D Ona, Leilani M Asis, Benjamin A Balmores Jr, Rafael C Castillo, Diego J Stisman, Walter G Espeche, Marcos J Marin, Irene L Ennis, Xin Chen, Hongyu Wang, Min Liu, Xinhua Yin, Xiaolong Wang, Sandeep Bhalla, Priyanka Gupta, Narsingh Verma, Bal K Gupta, Shehla Sheikh, Gregoire Wuerzner, Laura Garré, José Boggia, Dédonougbo M Houenassi, José A OctavioSeijas, Jean-René M'buyamba-Kabangu, Trésor M Tshiswaka, Dénes Páll, Zoltán Járai, Rafael Hernández, Fortunato Garcia Vásquez, Jesús A Lopez-Rivera, Monica L Gúzman-Franolic, Savarino Victoria Pereira, Mário J Fernandes, Maria S Garcia, Teresa Gijon, and Vitoria V. B. Meira Da Cunha

Abstract

Elevated blood pressure remains the single biggest risk factor contributing to the global burden of disease and mortality. May Measurement Month is an annual global screening campaign aiming to improve awareness of blood pressure at the individual and population level. Adults (≥18 years) recruited through opportunistic sampling were screened at sites in 92 countries during May 2019. Ideally, 3 blood pressure readings were measured for each participant, and data on lifestyle factors and comorbidities were collected. Hypertension was defined as a systolic blood pressure ≥140 mm Hg, or a diastolic blood pressure ≥90 mm Hg (mean of the second and third readings) or taking antihypertensive medication. When necessary, multiple imputation was used to estimate participants' mean blood pressure. Mixed-effects models were used to evaluate associations between blood pressure and participant characteristics. Of 1 508 130 screenees 482 273 (32.0%) had never had a blood pressure measurement before and 513 337 (34.0%) had hypertension, of whom 58.7% were aware, and 54.7% were on antihypertensive medication. Of those on medication, 57.8% were controlled to <140/90 mm Hg, and 28.9% to <130/80 mm Hg. Of all those with hypertension, 31.7% were controlled to <140/90 mm Hg, and 350 825 (23.3%) participants had untreated or inadequately treated hypertension. Of those taking antihypertensive medication, half were taking only a single drug, and 25% reported using aspirin inappropriately. This survey is the largest ever synchronized and standardized contemporary compilation of global blood pressure data. This campaign is needed as a temporary substitute for systematic blood pressure screening in many countries worldwide.

Published
2020

6. Personalized Medicine and the Treatment of Hypertension

Author

Sarah Melville and James Brian Byrd

Subjects
Nephrology, medicine.medical_specialty, Personalized treatment, Resistant hypertension, Blood Pressure, Population health, 030204 cardiovascular system & hematology, Article, Personalization, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Internal Medicine, medicine, Humans, In patient, 030212 general & internal medicine, Precision Medicine, Intensive care medicine, Antihypertensive Agents, business.industry, Blood pressure, Phenotype, Hypertension, Personalized medicine, business
Abstract

PURPOSE OF REVIEW: The purpose of this review is to discuss the implications of personalized medicine for the treatment of hypertension, including resistant hypertension. RECENT FINDINGS: We suggest a framework for the personalized treatment of hypertension based on the concept of a trade-off between simplicity and personalization. This framework is based on treatment strategies classified as low, medium, or high information burden personalization approaches. The extent to which a higher information burden is justified depends on the clinical scenario, particularly the ease with which the blood pressure can be controlled. SUMMARY: A one-size-fits-many treatment strategy for hypertension is efficacious for most people; however, a more personalized approach could be useful in patients with subtypes of hypertension that do not respond as expected to treatment. Clinicians seeing patients with unusual hypertension phenotypes should be familiar with emerging trends in personalized treatment of hypertension.

Published
2019

7. Out-of-Office Blood Pressure Monitoring in 2018

Author

Sarah Melville and James Brian Byrd

Subjects
medicine.medical_specialty, business.industry, MEDLINE, General Medicine, Equipment Design, 030204 cardiovascular system & hematology, Blood Pressure Monitoring, Ambulatory, 03 medical and health sciences, 0302 clinical medicine, Patient Education as Topic, Emergency medicine, Hypertension, Practice Guidelines as Topic, Medicine, Humans, Blood pressure monitoring, 030212 general & internal medicine, Hypertension diagnosis, business
Published
2018

8. The Heart Has No Horizon

Author

Hodder, Sarah Melville, Hodder, Sarah Melville, Hodder, Sarah Melville, and Hodder, Sarah Melville

Subjects
Fiction
Published
2016

9. A Comparison and Calibration of a Wrist-Worn Blood Pressure Monitor for Patient Management: Assessing the Reliability of Innovative Blood Pressure Devices

Author

Keith R. Brunt, Sarah Melville, Shona Philip, Sohrab Lutchmedial, Jeremy A. Simpson, and Robert Teskey

Subjects
Adult, Male, medicine.medical_specialty, smartphone applications, Diastole, Vital signs, Diastolic Hypertension, Blood Pressure, Health Informatics, Wrist, 030204 cardiovascular system & hematology, diastolic hypertension, vital signs, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Calibration, Humans, Medicine, 030212 general & internal medicine, Aged, Original Paper, business.industry, telemonitoring, Reproducibility of Results, Blood Pressure Determination, Gold standard (test), Middle Aged, Blood Pressure Monitors, 3. Good health, Blood pressure, medicine.anatomical_structure, Hypertension, Cuff, Cardiology, Female, patient self-management, business
Abstract

Background: Clinical guidelines recommend monitoring of blood pressure at home using an automatic blood pressure device for the management of hypertension. Devices are not often calibrated against direct blood pressure measures, leaving health care providers and patients with less reliable information than is possible with current technology. Rigorous assessments of medical devices are necessary for establishing clinical utility. Objective: The purpose of our study was 2-fold: (1) to assess the validity and perform iterative calibration of indirect blood pressure measurements by a noninvasive wrist cuff blood pressure device in direct comparison with simultaneously recorded peripheral and central intra-arterial blood pressure measurements and (2) to assess the validity of the measurements thereafter of the noninvasive wrist cuff blood pressure device in comparison with measurements by a noninvasive upper arm blood pressure device to the Canadian hypertension guidelines. Methods: The cloud-based blood pressure algorithms for an oscillometric wrist cuff device were iteratively calibrated to direct pressure measures in 20 consented patient participants. We then assessed measurement validity of the device, using Bland-Altman analysis during routine cardiovascular catheterization. Results: The precalibrated absolute mean difference between direct intra-arterial to wrist cuff pressure measurements were 10.8 (SD 9.7) for systolic and 16.1 (SD 6.3) for diastolic. The postcalibrated absolute mean difference was 7.2 (SD 5.1) for systolic and 4.3 (SD 3.3) for diastolic pressures. This is an improvement in accuracy of 33% systolic and 73% diastolic with a 48% reduction in the variability for both measures. Furthermore, the wrist cuff device demonstrated similar sensitivity in measuring high blood pressure compared with the direct intra-arterial method. The device, when calibrated to direct aortic pressures, demonstrated the potential to reduce a treatment gap in high blood pressure measurements. Conclusions: The systolic pressure measurements of the wrist cuff have been iteratively calibrated using gold standard central (ascending aortic) pressure. This improves the accuracy of the indirect measures and potentially reduces the treatment gap. Devices that undergo auscultatory (indirect) calibration for licensing can be greatly improved by additional iterative calibration via intra-arterial (direct) measures of blood pressure. Further clinical trials with repeated use of the device over time are needed to assess the reliability of the device in accordance with current and evolving guidelines for informed decision making in the management of hypertension. Trial Registration: ClinicalTrials.gov NCT03015363; https://clinicaltrials.gov/ct2/show/NCT03015363 (Archived by WebCite at http://www.webcitation.org/6xPZgseYS)

Published
2017
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10. Impact of Obesity on Postoperative Outcomes following cardiac Surgery (The OPOS study): rationale and design of an investigator-initiated prospective study

Author

Alexandra M. Yip, Petra C. Kienesberger, Keith R. Brunt, Christie Aguiar, Ansar Hassan, Thomas Pulinilkunnil, Sarah Melville, J.B. MacLeod, and Jean-Francois Légaré

Subjects
medicine.medical_specialty, coronary artery bypass grafting, morbidity, Cardiovascular Medicine, Overweight, Body Mass Index, globesity, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Quality of life, Risk Factors, Diabetes mellitus, Protocol, Humans, Medicine, Obesity, Postoperative Period, Prospective Studies, 030212 general & internal medicine, Cardiac Surgical Procedures, Intensive care medicine, Prospective cohort study, Exercise, business.industry, atrial appendage, General Medicine, medicine.disease, Institutional review board, adipose tissue, Cardiac surgery, Treatment Outcome, inflammation, Research Design, Quality of Life, Observational study, medicine.symptom, business, Body mass index, 030217 neurology & neurosurgery
Abstract

IntroductionIncreasing levels of obesity worldwide have led to a rise in the prevalence of obesity-related complications including cardiovascular risk factors such as diabetes, hypertension and dyslipidaemia. Healthcare providers believe that overweight and obese cardiac surgery patients are more likely to experience adverse postoperative outcomes. The body mass index (BMI) is the primary measure of obesity in clinical practice, without accounting for a patient’s level of cardiopulmonary fitness or muscle mass. The objective of this study is to determine whether fitness capacity of obese cardiac surgical patients and biomarkers, alone or in combination, will help identify patients at risk for adverse outcomes when undergoing cardiac surgery.Methods and analysisPatients between the ages of 18 and 75 years undergoing elective cardiac surgery are consented to participate in this prospective observational study. Patients will be invited to participate in measures of obesity, functional capacity and exercise capacity assessments, quality of life questionnaires, and blood and tissue sampling for biomarker analysis. The endpoints evaluated are measures other than BMI that could be predictive of short-term and long-term postoperative outcomes. Clinical outcomes of interest are prolonged ventilation, hospital length of stay, renal failure and all-cause mortality. Biomarkers of interest will largely focus on metabolism (lipids, amino acids) and inflammation (adipokines, cytokines and chemokines).Ethics and disseminationThis study has been approved by the institutional review board at the Horizon Health Network. On completion of the study, the results shall be disseminated through conference presentations and publications in peer-reviewed journals. Additionally, the report shall also be diffused more broadly to the general public and the cardiovascular community.Trial registration numberNCT03248921.

Published
2019
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11. Monitoring Blood Pressure Outside of the Doctor’s Office

Author

James Brian Byrd and Sarah Melville

Subjects
0301 basic medicine, business.industry, 030209 endocrinology & metabolism, General Medicine, medicine.disease, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Blood pressure, Medicine, Blood pressure monitoring, Doctor's office, Medical emergency, business, Monitoring blood pressure
Published
2018
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12. Systems thinking applied to slavery

Author

Sarah Melville, Christy A. R. Licklider, and Garrett Kastl

Subjects
Government, Work (electrical), Process (engineering), Order (exchange), Supply chain, Political economy, media_common.quotation_subject, South kivu, Development economics, Systems thinking, Sociology, Democracy, media_common
Abstract

This study utilizes soft system dynamics methodology to analyze modern-day slavery in order to increase understanding and communicate the complexities of slavery. The authors collaborated with Free The Slaves (FTS), a Washington D.C.-based nongovernmental organization, in order to gain feedback throughout the modeling process. FTS activists conduct frontline work and have an expertise in understanding how people become susceptible to slavery, victims of slavery, how they are freed, and how they can become slave-proof or highly unlikely to be susceptible to slavery. The authors are currently creating a base macro model of the variables that affect how a community first becomes susceptible to slavery, which will theoretically represent any community in the world. This model will then be tested using assessment data collected by FTS on the North and South Kivu Regions of the Democratic Republic of the Congo (DRC). This analysis of the DRC may include slavery's roots, geography, growth, magnitude, supply chain of the mining and movement of conflict minerals, the role of law and local organizations, and an overlay of how FTS affects the system. While the ultimate goal for this research is to create proposals for desirable and culturally feasible changes that can reduce the extent of slavery in the North and South Kivu Regions of the DRC, this paper focuses on the first stages of analysis and the base model of the factors that make a community vulnerable to slavery. This paper recommends areas for future research and discussion on how to build further upon the base model.

Published
2014

13. Diving into the ice bucket challenge

Author

Sarah Melville, Keith R. Brunt, Thomas Pulinilkunnil, Sohrab Lutchmedial, and Anil Adisesh

Subjects
Holiday Reading, medicine.medical_specialty, Head (watercraft), business.industry, Diving, media_common.quotation_subject, Ice, Hemodynamics, Fund Raising, General Medicine, medicine.disease, Surgery, Physical medicine and rehabilitation, Reading (process), medicine, Humans, Fund raising, Amyotrophic lateral sclerosis, business, media_common
Abstract

Over the past year, amyotrophic lateral sclerosis (ALS) associations have benefitted from people embracing the “ice bucket challenge,” in which cold water is tipped over the participant’s head. To date, about 150 million dollars has been donated worldwide as a result of the challenge. However

Published
2014
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14. Opening the Tablet Box : Near Eastern Studies in Honor of Benjamin R. Foster

Author

Sarah Melville, Alice Slotsky, Sarah Melville, and Alice Slotsky

Subjects
Akkadian language, Egyptian language, Assyro-Babylonian literature--History and criticism, Sumerian literature--History and criticism
Abstract

This volume is a scholarly tribute to Benjamin R. Foster, Laffan Professor of Assyriology and Babylonian Literature and Curator of the Babylonian Collection at Yale University, from some of his students, colleagues, and companions, in appreciation of his outstanding achievements and in thanks for his friendship. Reflecting on the remarkable breadth of the honoree's research interests, the twenty-six original papers in this Festschrift cover a wide range of topics in ancient Near Eastern and Egyptian literature, economic and social history, as well as art and archaeology.

Published
2010

15. Erythropoietin increases eNOS protein in the mouse heart

Author

Tao Rui, Sarah Melville, and Peter R. Kvietys

Subjects
medicine.medical_specialty, biology, business.industry, biology.organism_classification, Biochemistry, Endocrinology, Erythropoietin, Enos, Internal medicine, Genetics, medicine, business, Molecular Biology, Mouse Heart, Biotechnology, medicine.drug
Published
2006
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16. Estimating actual foot size from a static bare foot print in a White British Population

Author

Mike Curran, Laura Gillespie, Sarah Melville, Bryan Kagan, and Jacqueline Ann Campbell

Subjects
Adult, Male, common, media_common.quotation_subject, Population, White People, Pathology and Forensic Medicine, Footprint, Young Adult, Reference Values, Linear regression, Statistics, Humans, Body Weights and Measures, education, Mathematics, media_common, Aged, education.field_of_study, Student population, Variables, Foot, Data Collection, common.demographic_type, Forensic Sciences, Regression analysis, Middle Aged, United Kingdom, Dimensional Measurement Accuracy, Standing Position, Regression Analysis, Female, Foot (unit), White British
Abstract

In forensic intelligence-gathering it would be useful to be able to estimate the size of a perpetrator's foot from a standing bare footprint found at the scene of crime. Currently, the advice is to add a fixed amount to the length of the footprint (typically 1.5 or 2.0 cm), but there is little evidence for this approach. This study used measured footprint and actual foot lengths from 146 participants from the white British student population of a University in the UK. Data were analysed using multiple regression with foot length as the dependent (outcome) variable and footprint length and sex as the independent variable/factor respectively. Sex was not a significant predictor. The regression equation for the best estimate of the foot length is 19.89 + 0.95 × print length ± 8 mm.

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