Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Ogunniyi MO[original query] |
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Geographic variations in heart failure hospitalizations among Medicare beneficiaries in the Tennessee catchment area
Ogunniyi MO , Holt JB , Croft JB , Nwaise IA , Okafor HE , Sawyer DB , Giles WH , Mensah GA . Am J Med Sci 2011 343 (1) 71-7 INTRODUCTION: Although differences in heart failure (HF) hospitalization rates by race and sex are well documented, little is known about geographic variations in hospitalizations for HF, the most common discharge diagnosis for Medicare beneficiaries. METHODS: Using exploratory spatial data analysis techniques, the authors examined hospitalization rates for HF as the first-listed discharge diagnosis among Medicare beneficiaries in a 10-state Tennessee catchment area, based on the resident states reported by Tennessee hospitals from 2000 to 2004. RESULTS: The age-adjusted HF hospitalization rate (per 1000) among Medicare beneficiaries was 23.3 [95% confidence interval (CI), 23.3-23.4] for the Tennessee catchment area, 21.4 (95% CI, 21.4-21.5) outside the catchment area and 21.9 (95% CI, 21.9-22.0) for the overall United States. The age-adjusted HF hospitalization rates were also significantly higher in the catchment area than outside the catchment area and overall, among men, women and whites, whereas rates among the blacks were higher outside the catchment area. Beneficiaries in the catchment area also had higher age-specific HF hospitalization rates. Among states in the catchment area, the highest mean county-level rates were in Mississippi (30.6 +/- 7.6) and Kentucky (29.2 +/- 11.5), and the lowest were in North Carolina (21.7 +/- 5.7) and Virginia (21.8 +/- 6.6). CONCLUSIONS: Knowledge of these geographic differences in HF hospitalization rates can be useful in identifying needs of healthcare providers, allocating resources, developing comprehensive HF outreach programs and formulating policies to reduce these differences. |
Racial/ethnic differences in microalbuminuria among adults with prehypertension and hypertension: National Health and Nutrition Examination Survey (NHANES), 1999-2006
Ogunniyi MO , Croft JB , Greenlund KJ , Giles WH , Mensah GA . Am J Hypertens 2010 23 (8) 859-64 BACKGROUND: Microalbuminuria, a biomarker of endothelial dysfunction, is associated with increased cardiovascular, renal, and cerebrovascular morbidity and mortality, especially among ethnic minorities. METHODS: A total of 16,567 adults in the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2006 were categorized according to JNC 7 blood pressure (BP) definitions. Microalbuminuria was defined as spot urinary albumin/creatinine ratio (ACR) of 30-299 mg/g. Logistic regression estimated the odds of having microalbuminuria among BP categories compared with normal BP after adjusting for age, race/ethnicity, sex, education level, smoking status, body mass index (BMI), systolic BP, and diabetes. RESULTS: Prevalence of microalbuminuria was 4.5% for normal BP, 6.3% for prehypertension, 12.4% for stage 1 hypertension, 25.3% for stage 2 hypertension, and 11.3% among those with treated, controlled hypertension. Compared with participants with normal BP, the adjusted odds ratios and 95% confidence intervals (CIs) for microalbuminuria were 1.3 (1.0-1.7, P = 0.03) for those with prehypertension, 2.3 (1.8-3.0, P < 0.01) with stage 1 hypertension, 4.8 (3.7-6.3 P < 0.01) with stage 2 hypertension, and 1.6 (1.3-2.1, P < 0.01) with treated, controlled hypertension. The treated controlled hypertension group exhibited the strongest race-ethnicity gradient. CONCLUSIONS: Participants with hypertension and prehypertension had a higher likelihood of microalbuminuria than those with normal BP, especially ethnic minorities, suggesting greater target organ damage. Our observations suggest that further research is necessary to determine whether microalbuminuria can be used as a screening tool in adults with prehypertension, to identify adults at highest risk for cardiovascular disease or decline in renal function.American Journal of Hypertension 2010; doi:10.1038/ajh.2010.77. |
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