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Hypertension: HELP
Articles by Andrea Cassells
Based on 6 articles published since 2010
(Why 6 articles?)

Between 2010 and 2020, Andrea Cassells wrote the following 6 articles about Hypertension.
+ Citations + Abstracts
1 Clinical Trial Theoretical and Pragmatic Adaptation of the 5As Model to Patient-Centered Hypertension Counselling. 2018

Carroll, Jennifer K / Fiscella, Kevin / Cassells, Andrea / Sanders, Mechelle R / Williams, Stephen K / D'Orazio, Brianna / Holder, Tameir / Farah, Subrina / Khalida, Chamanara / Tobin, Jonathan N. · ·J Health Care Poor Underserved · Pubmed #30122677.

ABSTRACT: Patient-centered communication is a means for engaging patients in partnership. However, patient centered communication has not always been grounded in theory or in clinicians' pragmatic needs. The objective of this report is to present a practical approach to hypertension counselling that uses the 5As framework and is grounded in theory and best communication practices.

2 Article Lifetime racial/ethnic discrimination and ambulatory blood pressure: The moderating effect of age. 2016

Beatty Moody, Danielle L / Waldstein, Shari R / Tobin, Jonathan N / Cassells, Andrea / Schwartz, Joseph C / Brondolo, Elizabeth. ·Department of Psychology, University of Maryland, Baltimore County. · Clinical Directors Network. · Department of Psychiatry and Behavioral Science, Stony Brook University. · Department of Psychology, St. John's University. ·Health Psychol · Pubmed #27018724.

ABSTRACT: OBJECTIVE: To determine whether the relationships of lifetime discrimination to ambulatory blood pressure (ABP) varied as a function of age in a sample of Black and Latino(a) adults ages 19 - 65. METHOD: Participants were 607 Black (n = 318) and Latino(a) (n = 289) adults (49% female) who completed the Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV), which assesses lifetime exposure to racism/ethnic discrimination. They were outfitted with an ABP monitor to assess systolic and diastolic blood pressure (SBP, DBP) across a 24-hr period. Mixed-level modeling was conducted to examine potential interactive effects of lifetime discrimination and age to 24-hr, daytime, and nighttime ABP after adjustment for demographic, socioeconomic, personality and life stress characteristics, and substance consumption covariates (e.g., smoking, alcohol). RESULTS: There were significant interactions of Age × Lifetime Discrimination on 24-hr and daytime DBP (ps ≤ .04), and in particular significant interactions for the Social Exclusion component of Lifetime Discrimination. Post hoc probing of the interactions revealed the effects of Lifetime Discrimination on DBP were seen for older, but not younger participants. Lifetime discrimination was significantly positively associated with nocturnal SBP, and these effects were not moderated by age. All associations of Lifetime Discrimination to ABP remained significant controlling for recent exposure to discrimination as well as all other covariates. CONCLUSIONS: Exposure to racial/ethnic discrimination across the life course is associated with elevated ABP in middle to older aged Black and Latino(a) adults. Further research is needed to understand the mechanisms linking discrimination to ABP over the life course. (PsycINFO Database Record

3 Article Blood Pressure Visit Intensification Study in Treatment: Trial design. 2015

Fiscella, Kevin / Ogedegbe, Gbenga / He, Hua / Carroll, Jennifer / Cassells, Andrea / Sanders, Mechelle / Khalida, Chamanara / D'Orazio, Brianna / Tobin, Jonathan N. ·Department of Family Medicine, University of Rochester Medical Center, Rochester, NY. Electronic address: kevin_fiscella@urmc.rochester.edu. · Department of Population Health, Langone Medical Center, New York University, New York, NY. · Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. · Department of Family Medicine, University of Rochester Medical Center, Rochester, NY. · Clinical Directors Network (CDN), New York, NY. · Clinical Directors Network (CDN), New York, NY; Albert Einstein College of Medicine of Yeshiva University/Montefiore Medical Center, Bronx, NY; The Rockefeller University Center for Clinical and Translational Science, New York, NY. ·Am Heart J · Pubmed #26678642.

ABSTRACT: BACKGROUND: There is a presumption that, for patients with uncontrolled blood pressure (BP), early follow-up, that is, within 4 weeks of an elevated reading, improves BP control. However, data are lacking regarding effective interventions for increasing clinician frequency of follow-up visits and whether such interventions improve BP control. METHODS/DESIGN: Blood Pressure Visit Intensification Study in Treatment involves a multimodal approach to improving intensity of follow-up in 12 community health centers using a stepped wedge study design. DISCUSSION: The study will inform effective interventions for increasing frequency of follow-up visits among patients with uncontrolled BP and determine whether increasing follow-up frequency is associated with better BP control.

4 Article Counseling African Americans to Control Hypertension: cluster-randomized clinical trial main effects. 2014

Ogedegbe, Gbenga / Tobin, Jonathan N / Fernandez, Senaida / Cassells, Andrea / Diaz-Gloster, Marleny / Khalida, Chamanara / Pickering, Thomas / Schwartz, Joseph E. ·From the Division of Health and Behavior and Center for Healthful Behavior Change, Department of Population Health, New York University Langone Medical Center, New York, NY (G.O., S.F.) · Clinical Directors Network, New York, NY (J.N.T., A.C., M.D.-G., C.K.) · Department of Epidemiology and Population Health, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY (J.N.T.) · Center for Clinical and Translational Science, Rockefeller University, New York, NY (J.N.T.) · Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY (T.P., J.E.S.) · Department of Psychiatry and Behavioral Science, Stony Brook University, Stony Brook, NY (J.E.S.). ·Circulation · Pubmed #24657991.

ABSTRACT: BACKGROUND: Data are limited on the implementation of evidence-based multilevel interventions targeted at blood pressure (BP) control in hypertensive blacks who receive care in low-resource primary care practices. METHODS AND RESULTS: Counseling African Americans to Control Hypertension is a cluster-randomized clinical trial in which 30 community health centers were randomly assigned to the intervention condition (IC) or usual care (UC). Patients at the IC sites received patient education, home BP monitoring, and monthly lifestyle counseling, whereas physicians attended monthly hypertension case rounds and received feedback on their patients' home BP readings and chart audits. Patients and physicians at the UC sites received printed patient education material and hypertension treatment guidelines, respectively. The primary outcome was BP control, and secondary outcomes were mean changes in systolic and diastolic BPs at 12 months, assessed with an automated BP device. A total of 1059 patients (mean age, 56 years; 28% men, 59% obese, and 36% with diabetes mellitus) were enrolled. The BP control rate was similar in both groups (IC=49.3% versus UC=44.5%; odds ratio, 1.21 [95% confidence interval, 0.90-1.63]; P=0.21). In prespecified subgroup analyses, the intervention was associated with greater BP control in patients without diabetes mellitus (IC=54.0% versus UC=44.7%; odds ratio, 1.45 [confidence interval, 1.02-2.06]); and small-sized community health centers (IC=51.1% versus UC=39.6%; odds ratio, 1.45 [confidence interval, 1.04-2.45]). CONCLUSIONS: A practice-based, multicomponent intervention was no better than UC in improving BP control among hypertensive blacks. Future research on the implementation of behavioral modification strategies for hypertension control in low-resource settings should focus on the development of more efficient and tailored interventions in this high-risk population. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00233220.

5 Article The counseling African Americans to Control Hypertension (CAATCH) Trial: baseline demographic, clinical, psychosocial, and behavioral characteristics. 2011

Fernandez, Senaida / Tobin, Jonathan N / Cassells, Andrea / Diaz-Gloster, Marleny / Kalida, Chamanara / Ogedegbe, Gbenga. ·Center for Healthful Behavior Change, Division of General Internal Medicine, Department of Medicine, New York University School of Medicine, 550 First Avenue, New York, NY, USA. ·Implement Sci · Pubmed #21884616.

ABSTRACT: BACKGROUND: Effectiveness of combined physician and patient-level interventions for blood pressure (BP) control in low-income, hypertensive African Americans with multiple co-morbid conditions remains largely untested in community-based primary care practices. Demographic, clinical, psychosocial, and behavioral characteristics of participants in the Counseling African American to Control Hypertension (CAATCH) Trial are described. CAATCH evaluates the effectiveness of a multi-level, multi-component, evidence-based intervention compared with usual care (UC) in improving BP control among poorly controlled hypertensive African Americans who receive primary care in Community Health Centers (CHCs). METHODS: Participants included 1,039 hypertensive African Americans receiving care in 30 CHCs in the New York Metropolitan area. Baseline data on participant demographic, clinical (e.g., BP, anti-hypertensive medications), psychosocial (e.g., depression, medication adherence, self-efficacy), and behavioral (e.g., exercise, diet) characteristics were gathered through direct observation, chart review, and interview. RESULTS: The sample was primarily female (71.6%), middle-aged (mean age = 56.9 ± 12.1 years), high school educated (62.4%), low-income (72.4% reporting less than $20,000/year income), and received Medicaid (35.9%) or Medicare (12.6%). Mean systolic and diastolic BP were 150.7 ± 16.7 mm Hg and 91.0 ± 10.6 mm Hg, respectively. Participants were prescribed an average of 2.5 ± 1.9 antihypertensive medications; 54.8% were on a diuretic; 33.8% were on a beta blocker; 41.9% were on calcium channel blockers; 64.8% were on angiotensin converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs). One-quarter (25.6%) of the sample had resistant hypertension; one-half (55.7%) reported medication non-adherence. Most (79.7%) reported one or more co-morbid medical conditions. The majority of the patients had a Charlson Co-morbidity score ≥ 2. Diabetes mellitus was common (35.8%), and moderate/severe depression was present in 16% of participants. Participants were sedentary (835.3 ± 1,644.2 Kcal burned per week), obese (59.7%), and had poor global physical health, poor eating habits, high health literacy, and good overall mental health. CONCLUSIONS: A majority of patients in the CAATCH trial exhibited adverse lifestyle behaviors, and had significant medical and psychosocial barriers to adequate BP control. Trial outcomes will shed light on the effectiveness of evidence-based interventions for BP control when implemented in real-world medical settings that serve high numbers of low-income hypertensive African-Americans with multiple co-morbidity and significant barriers to behavior change.

6 Article Daily interpersonal conflict predicts masked hypertension in an urban sample. 2010

Schoenthaler, Antoinette M / Schwartz, Joseph / Cassells, Andrea / Tobin, Jonathan N / Brondolo, Elizabeth. ·Department of Medicine, Center for Healthful Behavior Change, New York University School of Medicine, New York, USA. ·Am J Hypertens · Pubmed #20616788.

ABSTRACT: BACKGROUND: Masked hypertension (MH) is a risk factor for cardiovascular and cerebrovascular diseases. However, little is known about the effect of psychosocial stressors on MH. METHODS: Daily interpersonal conflict was examined as a predictor of elevated ambulatory blood pressure (ABP) in a community sample of 240 unmedicated black and Latino(a) adults (63% women; mean age 36 years) who had optimal office blood pressure (BP) readings (≤120/80 mm Hg). Electronic diaries were used to assess daily interpersonal conflict (i.e., perceptions of being treated unfairly/harassed during social interactions). Participants rated the degree to which they experienced each interaction as unfair or harassing on a scale of 1-100. Systolic and diastolic ABP (SysABP and DiaABP, respectively) were collected using a validated 24-h ABP monitor. Participants were classified as having marked MH (MMH) if the average of all readings obtained yielded SysABP: ≥135 mm Hg or DiaABP: ≥85 mm Hg. Logistic regression was used to examine whether daily interpersonal conflict is an independent predictor of MMH. RESULTS: This form of MMH (i.e., optimal office BP plus elevated ABP) was present in 21% of participants (n = 50). Those with MMH (vs. without) were significantly more likely to be men (P < 0.001). Daily harassment and unfair treatment scores were significant predictors of MMH group status (P < 0.05). Participants with harassment scores >30 were significantly more likely to be in the MMH group. CONCLUSION: MH may be a concern, even for patients with optimal office BP. Evaluating exposure to psychosocial stressors, including routine levels of interpersonal conflict may help to identify those patients who might benefit from further clinical follow-up.