Adverse social determinants of health elevate uncontrolled hypertension risk: a cardio-oncology prospective cohort study.

Autor:	Nain P; Department of Medicine, Division of Cardiology, and Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, GA, USA.; Cardio-Oncology Program, Department of Medicine, Cardiology Division, Medical College of Georgia at Augusta University, Augusta, GA, USA., Stabellini N; Cardio-Oncology Program, Department of Medicine, Cardiology Division, Medical College of Georgia at Augusta University, Augusta, GA, USA.; Division of Hematology and Oncology, Department of Medicine, University Hospitals/Seidman Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.; Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Makram OM; Department of Medicine, Division of Cardiology, and Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, GA, USA.; Cardio-Oncology Program, Department of Medicine, Cardiology Division, Medical College of Georgia at Augusta University, Augusta, GA, USA., Rast J; Department of Internal Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA., Yerraguntla S; Medical College of Georgia at Augusta University, Augusta, GA, USA., Gopu G; Medical College of Georgia at Augusta University, Augusta, GA, USA., Bhave A; Medical College of Georgia at Augusta University, Augusta, GA, USA., Seth L; Medical College of Georgia at Augusta University, Augusta, GA, USA., Patel V; Medical College of Georgia at Augusta University, Augusta, GA, USA., Jiang S; Medical College of Georgia at Augusta University, Augusta, GA, USA., Malik S; Medical College of Georgia at Augusta University, Augusta, GA, USA., Shetewi A; Medical College of Georgia at Augusta University, Augusta, GA, USA., Montero AJ; Division of Hematology and Oncology, Department of Medicine, University Hospitals/Seidman Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA., Cullen J; Cancer Population Sciences, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA., Agarwal N; Division of Medical Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., Wang X; Georgia Prevention Institute, Medical College of Georgia at Augusta University, Augusta, GA, USA., Ky B; Department of Biostatistics, Epidemiology, & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.; Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Baldassarre LA; Section of Cardiovascular Medicine, Department of Medicine and Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA., Weintraub NL; Department of Medicine, Division of Cardiology, and Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, GA, USA.; Cardio-Oncology Program, Department of Medicine, Cardiology Division, Medical College of Georgia at Augusta University, Augusta, GA, USA., Harris RA; Georgia Prevention Institute, Medical College of Georgia at Augusta University, Augusta, GA, USA., Guha A; Department of Medicine, Division of Cardiology, and Vascular Biology Center, Medical College of Georgia at Augusta University, Augusta, GA, USA.; Cardio-Oncology Program, Department of Medicine, Cardiology Division, Medical College of Georgia at Augusta University, Augusta, GA, USA.
Jazyk:	angličtina
Zdroj:	JNCI cancer spectrum [JNCI Cancer Spectr] 2024 Sep 02; Vol. 8 (5).
DOI:	10.1093/jncics/pkae064
Abstrakt:	The role of social determinants of health (SDOH) in controlling hypertension (HTN) in cancer patients is unknown. We hypothesize that high SDOH scores correlate with uncontrolled HTN in hypertensive cancer patients. In our prospective study, patients completed the Protocol for Responding to & Assessing Patients' Assets, Risks & Experiences questionnaire. After integrating home and clinic blood pressure readings, uncontrolled HTN was defined as systolic blood pressure greater than or equal to 140 mm Hg and/or diastolic blood pressure greater than or equal to 90 mm Hg. Using Cox regression, we analyzed the impact of SDOH on HTN control, adjusting for relevant factors. The study involved 318 participants (median age 66.4, median follow-up 166 days, SDOH score 6.5 ± 3.2), with stress, educational insecurity, and social isolation as prevalent adverse SDOH. High SDOH scores led to 77% increased risk of uncontrolled HTN (adjusted hazards ratio = 1.77; 95% confidence interval = 1.10 to 2.83, P = .018). Urban residents with high SDOH scores were at an even greater risk. Identifying SDOH and mitigating underlying factors may help control HTN, the most typical disease process treated in all cardio-oncology clinics. (© The Author(s) 2024. Published by Oxford University Press.)
Databáze:	MEDLINE
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