DASH lowers blood pressure in obese hypertensives beyond potassium, magnesium and fibre.

The mechanism underlying blood pressure (BP) reduction in the high fruits and vegetables arm of the Dietary Approaches to Stop Hypertension (DASH) study is unknown but may include potassium, magnesium and fibre. This study was designed to separate minerals and fibre from other components of DASH on BP in abdominally obese individuals with metabolic syndrome with pre-hypertension to stage 1 hypertension (obese hypertensives). A total of 15 obese hypertensives and 15 lean normotensives were studied on a standardized usual diet, randomized to DASH or usual diet supplemented with potassium, magnesium and fibre to match DASH, then crossed over to the complementary diet.

Perceived discrimination and blood pressure in older African American and white adults.

Background: The current study was designed to examine the cross-sectional association between perceived discrimination and blood pressure (BP) in a sample of older African American and white adults. We hypothesized that perceived discrimination would be associated with higher levels of BP and that this association would be stronger for older African Americans compared with whites.

Methods: Participants were 4,694 (60% African American, 60% women) community-dwelling older adults.

Plasma Renin test-guided drug treatment algorithm for correcting patients with treated but uncontrolled hypertension: a randomized controlled trial.

Background: Undefined pathophysiologic mechanisms likely contribute to unsuccessful antihypertensive drug therapy. The renin test-guided therapeutic (RTGT) algorithm is based on the concept that, irrespective of current drug treatments, subnormal plasma renin activity (PRA) (<0.65 ng/ml/h) indicates sodium-volume excess "V" hypertension, whereas values >or=0.

The risk of dying from lung cancer by race: a prospective cohort study in a biracial cohort in Charleston, South Carolina.

Purpose: Compared to European Americans (EAs), African Americans (AAs) suffer a disproportionate share of the lung cancer mortality burden. To investigate whether this disparity in lung cancer mortality is due to differential racial risks related to socioeconomic status (education, occupation), body mass index (BMI), hypertension, or cigarette smoking, we compared associations between these factors and lung cancer mortality by race in a biracial prospective cohort study.

Methods: The Charleston (South Carolina) Heart Study (N = 2,054) was established in 1960; 40% of the study participants are AAs.

Thirty-year Survival for Black and White Hypertensive Individuals in the Evans County Heart Study and the Hypertension Detection and Follow-up Program.

The Evans County Heart Study (ECHS), initiated in 1960, was one of the first major studies to document cardiovascular disease (CVD) risks for African Americans and Caucasians with elevated blood pressures. In the early 1970's, the Hypertension Detection and Follow-up Program (HDFP), with a site in Georgia (HDFP-GA) was one of the first major studies to demonstrate that treating hypertension with stepped care (SC), versus referred care (RC), has better short-term outcomes. With this background, study objectives were to evaluate 30-year survival and cardiovascular outcomes of the HDFP-GA and to compare outcomes of these patients with 1619 hypertensive individuals (30-69 years of age) from the ECHS.

Traumatic spinal cord injury mortality, 1981-1998.

Background: We aim to assess the long-term trend of and identify risk factors for traumatic spinal cord injury (TSCI) mortality from 1981 through 1998 in the state of South Carolina (SC).

Methods: We analyzed data from the TSCI surveillance system in SC. Poisson regression analyses were used to examine trends in TSCI mortality rates across subpopulations of interest.

The role of noninvasive hemodynamic monitoring in the evaluation and treatment of hypertension.

Advances in the understanding of the mechanisms accounting for the elevation of arterial pressure in essential hypertension suggest that there is value in assessing the relative contribution of hemodynamic factors in tailoring specific therapies to control arterial pressure. The non-invasive method of impedance cardiography (ICG) to measure hemodynamic abnormalities in hypertensive patients has emerged as a valuable adjuvant in the decision-making process of selecting antihypertensive agents. The technique is both accurate and reproducible in delineating the hemodynamic mechanisms of hypertension, comparing age-and gender-related changes in hemodynamics, detecting the presence of left ventricular dysfunction, and demonstrating clinically significant improvement in blood pressure control using ICG-guided therapy.

Comparison of cardiovascular risk factors for high brachial pulse pressure in blacks versus whites (Charleston Heart Study, Evans County Study, NHANES I and II Studies).

We examined whether the risk factors for increased brachial pulse pressure (PP) are similar for blacks and whites. Many studies have reported the strong association of increased brachial PP and the prevalence of cardiovascular disease. Participants were from 4 major epidemiologic studies in the United States (26,083 subjects): Charleston Heart Study, Evans County Heart Study, the National Health and Nutrition Examination Survey (NHANES) I study, and the NHANES II study.

The treatment of lupus pernio: results of 116 treatment courses in 54 patients.

Background: Lupus pernio is a disfiguring sarcoidosis skin lesion that is difficult to treat and often causes a major psychosocial impact that may adversely affect the patient's quality of life. We reviewed the treatment outcome of 54 patients with lupus pernio who received 116 individual courses of treatment in our sarcoidosis clinic.

Methods: Lupus pernio patients were identified from an institution-approved database.

Racial disparities in trends for cardiovascular disease and procedures among hospitalized diabetic patients.

Methods: To determine if racial differences exist for trends in diabetes-related cardiovascular disease (CVD) hospitalization rates, we analyzed data from an inpatient hospital discharge database maintained by the South Carolina Office of Research and Statistics. All hospitalizations involving a diagnosis of diabetes were collected from 1996 through 2003. International Classification of Diseases codes were used to determine diagnosis for diabetes, acute myocardial infraction (AMI), stroke, and other CVD outcomes.

Cross-sectional associations of C-reactive protein with vascular risk factors and vascular complications in the DCCT/EDIC cohort.

Objective: To determine the relationships between C-reactive protein (CRP) levels and features of Type 1 diabetes.

Research Design And Methods: Serum CRP was measured by nephelometry in a cross-sectional study of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) cohort (n=983) and nondiabetic subjects (n=71).

Results: CRP levels [geometric mean (95% CI)] were higher in diabetic than in control subjects, 1.

Care seeking after stroke symptoms.

Objective: To assess risk factors associated with care for stroke symptoms.

Methods: Using data from the population-based national cohort study (REasons for Geographic And Racial Differences in Stroke) conducted January 25, 2003-February 28, 2007 (N = 23,664), we assessed care-seeking behavior among 3,668 participants who reported a physician diagnosis of stroke/transient ischemic attack (n = 647) or stroke symptoms (n = 3,021) during follow-up. Care seeking was defined as seeking medical attention after stroke symptoms or a physician diagnosis.

Connective tissue growth factor and susceptibility to renal and vascular disease risk in type 1 diabetes.

Objective: We explored the relevance and significance of connective tissue growth factor (CTGF) as a determinant of renal and vascular complications among type 1 diabetic patients.

Methods And Results: We measured the circulating and urinary levels of CTGF and CTGF N fragment in 1050 subjects with type 1 diabetes from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study cohort. We found that hypertensive diabetic subjects have significantly higher levels of plasma log CTGF N fragment relative to normotensive subjects (P = 0.

Concordance between self-reported heights and weights and current and ideal body images in young adult African American men and women.

Satisfaction with overweight and obesity purportedly contribute to greater weight gain in African American women than men, yet relatively little data on perceived (PBI) and ideal body image (IBI) are available for young adult African Americans. In this survey, 509 self-identified African American freshmen in 2003 and 669 in 2006 at a historically Black university completed a survey that included self-reported height, weight and IBI. In 2003 and 2006, 42.

Oral cancer prevention and early detection: using the PRECEDE-PROCEED framework to guide the training of health professional students.

Background: Teaching cancer prevention and detection is important in health professional education. It is desirable to select a comprehensive framework for teaching oral cancer (OC) prevention and detection skills.

Methods: The PRECEDE-PROCEED model was used to design a randomized pretest and posttest study of the OC prevention and detection skills of dental students (n = 104).

Differences in cardiovascular disease mortality associated with body mass between Black and White persons.

We analyzed cardiovascular disease mortality risks associated with obesity using participant-level meta-analysis of data from the Black Pooling Project for Black and White individuals. The adjusted relative risks (ARRs) were stronger among White participants than among Black participants for coronary heart disease AAR=1.21 (95% confidence interval [CI]=1.

Association between concurrent and remote blood pressure and disability in older adults.

The objective of this study was to investigate the association between blood pressure and disability in older adults. Stroke-free participants in the Charleston Heart Study (n=999, mean age=68.5+/- 0.

Use of the OSCE to evaluate brief communication skills training for dental students.

Although communications competency is recommended by the American Dental Education Association, only a few (n=5) dental schools report evaluating students' skills using a competency examination for communication. This study used an objective structured clinical examination (OSCE) to evaluate dental students' competency in interpersonal and tobacco cessation communication skills. All students were evaluated on their interpersonal communication skills at baseline and at six months post-OSCE by standardized patients and on their tobacco cessation communication skills by two independent raters.

Diabetes-related lower extremity amputation rates fall significantly in South Carolina.

Background: The aims of this study are to compare the diabetes-related lower extremity amputation (LEA) rate trend in South Carolina (SC) to that of the United States (US) and to determine changes in LEA rates in SC according to age, race, gender, and amputation

Methods: National Hospital Discharge Survey (NHDS) and SC hospital discharge data for 1996 to 2002 were analyzed. ICD-9-CM codes identified all diabetic patients and occurrences of LEA. Linear regression was used to compare the LEA rate trends between SC and the US.